title: Traditional/restrictive vs patient-centered intensive care unit visitation: perceptions of patients' family members, physicians, and nurses.
abstract: BACKGROUND
  Patient-centered intensive care units (ICUs) are advocated by professional organizations for critical care nursing and medicine. The patient-centered ICU paradigm recognizes the patient-family unit as inseparable and supports visitation designed to meet the needs of patients and patients' families.
  
  
  OBJECTIVE
  To understand perceptions about patient-centered ICUs among patients' family members, physicians, and nurses from 5 ICUs that had restrictive visitation and to guide development of a patient-centered, open visitation paradigm.
  
  
  METHODS
  Patients' family members, nurses, and physicians from 5 ICUs with a traditional/restrictive visitation policy at a southeastern academic, tertiary care hospital were invited to participate in focus group meetings to understand perceptions about patient-centered care. All qualitative work was taped, transcribed, reviewed, and corrected after each session. Corrected transcripts and observer notes were integrated and coded.
  
  
  RESULTS
  Patients' families identified facilitators of patient-centeredness as nurses' and physicians' communication, concern, compassion, closeness, and flexibility. However, competing roles of control over the patient's health care served as barriers to a patient-centered paradigm.
  
  
  CONCLUSIONS
  Patient-centered care is an expectation among patients, patients' families, and health quality advocates. These exploratory methods increased understanding of the powerful perceptions of family members, physicians, and nurses involved with patient care and provided direction to plan interventions to implement patient-centered, family-supportive ICU services.
authors.affiliation: Bettina H. Riley is an assistant professor at University of South Alabama, College of Nursing, Mobile, Alabama. Joseph White is a nurse manager in the heart lung transplant unit at University of Alabama at Birmingham (UAB) Hospital in Birmingham, Alabama. Shannon Graham is Magnet program director and advanced nursing coordinator, Center for Nursing Excellence, UAB Hospital. Anne Alexandrov is assistant dean for program evaluation, professor, and program director, doctor of nursing practice and NET SMART, UAB School of Nursing and UAB Comprehensive Stroke Research Center, Birmingham, Alabama. briley@southalabama.edu.
authors.forename: Bettina H
authors.initials: BH
authors.lastname: Riley
authors.affiliation: Bettina H. Riley is an assistant professor at University of South Alabama, College of Nursing, Mobile, Alabama. Joseph White is a nurse manager in the heart lung transplant unit at University of Alabama at Birmingham (UAB) Hospital in Birmingham, Alabama. Shannon Graham is Magnet program director and advanced nursing coordinator, Center for Nursing Excellence, UAB Hospital. Anne Alexandrov is assistant dean for program evaluation, professor, and program director, doctor of nursing practice and NET SMART, UAB School of Nursing and UAB Comprehensive Stroke Research Center, Birmingham, Alabama.
authors.forename: Joseph
authors.initials: J
authors.lastname: White
authors.affiliation: Bettina H. Riley is an assistant professor at University of South Alabama, College of Nursing, Mobile, Alabama. Joseph White is a nurse manager in the heart lung transplant unit at University of Alabama at Birmingham (UAB) Hospital in Birmingham, Alabama. Shannon Graham is Magnet program director and advanced nursing coordinator, Center for Nursing Excellence, UAB Hospital. Anne Alexandrov is assistant dean for program evaluation, professor, and program director, doctor of nursing practice and NET SMART, UAB School of Nursing and UAB Comprehensive Stroke Research Center, Birmingham, Alabama.
authors.forename: Shannon
authors.initials: S
authors.lastname: Graham
authors.affiliation: Bettina H. Riley is an assistant professor at University of South Alabama, College of Nursing, Mobile, Alabama. Joseph White is a nurse manager in the heart lung transplant unit at University of Alabama at Birmingham (UAB) Hospital in Birmingham, Alabama. Shannon Graham is Magnet program director and advanced nursing coordinator, Center for Nursing Excellence, UAB Hospital. Anne Alexandrov is assistant dean for program evaluation, professor, and program director, doctor of nursing practice and NET SMART, UAB School of Nursing and UAB Comprehensive Stroke Research Center, Birmingham, Alabama.
authors.forename: Anne
authors.initials: A
authors.lastname: Alexandrov
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D004645:Empathy; D005190:Family / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D009741:Nursing Staff, Hospital / Q000523:psychology*; D016134:Organizational Policy; D005791:Patient Care; D018802:Patient-Centered Care; D010465:Perception; D011368:Professional-Family Relations; D036301:Qualitative Research; D012380:Role; D013997:Time Factors; D014789:Visitors to Patients