Humanizing intensive nursing care for people with COVID-19

Objective: to understand the impact of music on the intensive care for COVID-19 as an instrument to humanize assistance from the perspective of nurses who work on assistance. Methods: qualitative study carried out with seven intensive care nurses working in the COVID-19 Intensive Care Unit of a public state hospital. Sample reached through theoretical saturation. Data were collected using interviews through the on-line application WhatsApp, guided by a semi-structured guide. Results: the following discursive categories emerged: Feelings of health professionals and humanized actions in intensive care; Music therapy to provide integral care for people with COVID-19 in the score of intensive care; Living in the moment; Music therapy as an instrument for spirituality in the intensive care environment. Conclusion: the nursing intensive care did not only carry out a biological treatment, but considered all aspects of the human being, using to do so humanization by music. Descriptors: Coronavirus Infections; Pandemics; Critical Care; Humanization of Assistance; Nursing. RESUMO Objetivo: compreender o impacto da música na terapia intensiva para COVID-19 como instrumento de humanização da assistência na perspectiva de enfermeiros assistenciais. Métodos: estudo qualitativo realizado com sete enfermeiros intensivistas atuantes em uma Unidade de Terapia Intensiva para COVID-19 de um hospital público estadual. Amostra alcançada por saturação teórica. Para a coleta de dados, utilizou-se entrevista online pelo aplicativo WhatsApp, norteada por um roteiro semiestruturado. Resultados: emergiram as categorias discursivas: Sentimentos dos profissionais de saúde e ações humanizadas no ambiente da terapia intensiva; A musicoterapia proporcionando integralidade da assistência a pessoas com COVID-19 no âmbito da terapia intensiva; Vivenciando o momento; Musicoterapia como instrumento de espiritualidade no ambiente da terapia intensiva. Conclusão: o cuidado intensivo em enfermagem não se deteve apenas ao âmbito biológico, mas incluiu aspectos integrais do ser humano por meio da humanização pela música. Descritores: Infecções por Coronavírus; Pandemias; Cuidados Críticos; Humanização da Assistência; Enfermagem. 1Universidade Federal da Paraíba. João Pessoa, PB, Brazil. 2Hospital Metropolitano Dom José Maria Pires. Santa Rita, PB, Brazil. Corresponding author: Sergio Vital da Silva Junior Programa de Pós-graduação em Enfermagem da Universidade Federal da Paraíba, Campus I Lot. Cidade Universitária, CEP: 58051-900. João Pessoa, PB, Brazil. E-mail: sergioenfe1@gmail.com EDITOR IN CHIEF: Ana Fatima Carvalho Fernandes ASSOCIATE EDITOR: Francisca Diana da Silva Negreiros Sergio Vital da Silva Junior1 Aline Gomes Machado2 Anny Michelle Rodrigues da Silva Alves2 Katia Jaqueline da Silva Cordeiro2 Maíra Bonfim Barbosa2 Gilberto Costa Teodozio2 Maria Eliane Moreira Freire1 How to cite this article: Silva Junior SV, Machado AG, Alves AMRS, Cordeiro KJS, Barbosa MB, Teodozio GC, et al. Humanizing intensive nursing care for people with COVID-19. Rev Rene. 2021;22:e62584. DOI: https://doi.org/10.15253/2175-6783.20212262584 Silva Junior SV, Machado AG, Alves AMRS, Cordeiro KJS, Barbosa MB, Teodozio GC, et al Rev Rene. 2021;22:e62584. 2 Introduction Nursing is both a science and a profession with an important role in the care of individuals and the community. It seeks to promote the wellbeing of human beings and improve their quality of life(1). In the scope of health care, technological procedures and hospital routines contribute for a mechanical assistance, with risks to the autonomy of the patient and their families(2). Intensive care, for critical patients, is one of the main settings where nursing attention is needed. There, the work process is marked by complex and invasive procedures, which expose the nursing team to stress. This can lead to repercussions regarding the safety of the patient, and diminish the quality of the care provided(3). At the beginning of 2020, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), responsible for the Coronavirus Disease 2019 (COVID-19), quickly spread throughout the world(4). The World Health Organization (WHO), in January 30, 2020, declared that the COVID-19 outbreak was a public health emergency, characterizing it as a pandemic(5). Up to March 2021, there were 124,378,693 confirmed COVID-19 cases throughout the world, with 2,736,980 deaths. Brazil, up to the same month, confirmed 12,130,019 cases and 300,000 deaths caused by the disease(6). It has been observed that music in the intensive care environment generates, in general, satisfactory effects, such as relaxation and feelings of wellbeing, which can promote feelings of love and gratitude that are extremely needed in such an environment(7). Considering this subject, the following question emerges: what is the impact of music therapy in the humanization of nursing care in Intensive Care Units, directed to people with COVID-19? To answer this question, this researched aimed to understand the impact of music on the intensive care for COVID-19 as an instrument to humanize assistance from the perspective of nurses who work on assistance. Methods Qualitative study developed with seven intensive care nurses who work in the Intensive Care Unit of a hospital in the metropolitan region of João Pessoa, in Paraíba, Brazil. This hospital is a cardiology and neurology complex associated with the State Health Secretariat from Paraíba, and only attends the Single Health System. It was restructured in 2020 to be a reference hospital for those affected by SARS-CoV-2, in moderate-to-severe conditions. The sample was selected by convenience, and the following inclusion criteria were adopted: being an intensive care nurse in the aforementioned service, providing care in the field of COVID-19, and having participated in the music therapy intervention carried out in the sector mentioned. The exclusion criteria were: nurses who only work in administrative tasks in the sector. In the day of intervention, there were ten nurses, two of whom preferred not to participate because they felt uncomfortable participating in the interview. One other nurse, who only worked in administrative functions, was excluded. At first, a music therapy activity was proposed to mitigate the feelings of affliction, stress, and loss being experienced by professionals working in the Intensive Care Units for COVID-19. The professionals in the frontlines of this assistance had stated how difficult it has been to deal, daily, with these losses, also mentioning the difficulties treating people with COVID-19, this new disease with severe and systemic impact, in addition to uncertain clinical evolutions and treatment. The intervention was carried out in a single moment, in the morning, by three nurses from another ward of the hospital who made themselves available and contributed to this investigation. These nurses have knowledge about music and singing techniques and were aided by a guitar. The members of the music team dressed in the appropriate personal protection equipment, followed the health recommendations about proper distance and those indicated to avoid