title: Sharing intimacy in "open" intensive care units.
abstract: OBJECTIVE
  Opening intensive care units (ICUs) is particularly relevant because of a new Swiss law granting the relatives of patients without decision-making capability a central role in medical decisions. The main objectives of the study were to assess how the presence of relatives is viewed by patients, health care providers, and relatives themselves and to evaluate the perception of the level of intrusiveness into the personal sphere during admission.
  
  
  METHODS
  In a longitudinal and prospective design, qualitative questionnaires were submitted concomitantly to patients, relatives, and health care providers consecutively over a 6-month period. The study was conducted in the 4 ICUs of the public hospitals of Canton Ticino (Switzerland).
  
  
  RESULTS
  The questionnaires collected from patients, relatives, and health care providers were 176, 173, and 134, respectively. The analysis of the answers of 120 patient-relative pairs showed consistent results (P < .0001), whereas those of health care providers were significantly different (P < .0001), regarding both the usefulness of opening ICUs to patient relatives and what was stressful during admission.
  
  
  CONCLUSIONS
  Relatives in these "open" ICUs share a great deal of intimacy with the patients. Their presence and the deriving benefits were seen as very positive by patients and relatives themselves. Skepticism, instead, prevailed among health care providers.
authors.affiliation: Intensive Care Unit, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland; Sasso Corbaro Medical Humanities Foundation, Bellinzona, Switzerland.
authors.forename: Valentina
authors.initials: V
authors.lastname: Di Bernardo
authors.affiliation: Sasso Corbaro Medical Humanities Foundation, Bellinzona, Switzerland; Psychiatry Consultation Liaison Service, Organizzazione Sociopsichiatrica Cantonale, Mendrisio, Switzerland. Electronic address: nicola.grignoli@eoc.ch.
authors.forename: Nicola
authors.initials: N
authors.lastname: Grignoli
authors.affiliation: Sasso Corbaro Medical Humanities Foundation, Bellinzona, Switzerland; Département d'Histoire des Sciences et de la Vie et de la Santé, University of Strasbourg, Strasbourg, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Marazia
authors.affiliation: Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, Bern, Switzerland.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Andreotti
authors.affiliation: Intensive Care Unit, Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Perren
authors.affiliation: Sasso Corbaro Medical Humanities Foundation, Bellinzona, Switzerland.
authors.forename: Roberto
authors.initials: R
authors.lastname: Malacrida
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D000066491:Clinical Decision-Making; D030881:Disclosure; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000941:ethics / Q000458:organization & administration* / Q000706:statistics & numerical data; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D016134:Organizational Policy; D010465:Perception; D011446:Prospective Studies; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D013557:Switzerland; D020458:Third-Party Consent; D014789:Visitors to Patients / Q000523:psychology*
keywords: Critical care; Ethics; ICU visiting policy; Intensive care; Psychology; Surrogate decision making