title: Asymmetry in the intensive care unit: redressing imbalance and meeting the needs of family.
abstract: OBJECTIVE
  The purpose of this study was to develop a way for nurses to understand how they negotiate and work with families in the intensive care unit (ICU).
  
  
  BACKGROUND
  The importance of family to the critically ill patient is described in previous research; however, research exploring how to work with families in the clinical context of ICU is modest and there is little information and research to understand how the nurse might work to integrate family and understand family needs in the clinical context.
  
  
  METHODS
  The study was designed using action research methodology where an action research group of registered nurses from ICU proposed changes to how the family are defined, assessed and understood.
  
  
  METHODS
  In the action research group and reflective conversations, the group planned new assessment tools to use in ICU to work with the family.
  
  
  RESULTS
  Exploring their pragmatic knowledge of the context, the action research group suggested ways of working with families that did not impede the clinical work of the ICU. Families provided information about themselves and the patient that helped the nurse to plan care that redressed some of the asymmetrical nature of the relationship in the ICU.
  
  
  CONCLUSIONS
  This research created novel ways of viewing family and offers strategies to address asymmetry between families and ICU professionals.
  
  
  CONCLUSIONS
  Positive steps to redress asymmetrical relationships can help ensure that family care is better integrated into ICU practice.
authors.affiliation: School of Health and Social Services, Massey University Wellington, Wellington, New Zealand. d.l.blanchard@massey.ac.nz
authors.forename: Denise
authors.initials: D
authors.lastname: Blanchard
authors.forename: Christine
authors.initials: C
authors.lastname: Alavi
mesh_terms: D016638:Critical Illness / Q000451:nursing*; D022143:Family Nursing; D005260:Female; D006302:Health Services Research; D006801:Humans; D007362:Intensive Care Units; D009520:New Zealand; D009730:Nursing Assessment / Q000379:methods; D016134:Organizational Policy; D011209:Power, Psychological; D011368:Professional-Family Relations; D012944:Social Support