# Comprehensive Care in Critical Services: A Spanish Qualitative Study

## TL;DR

This study explores how healthcare professionals in Spain perceive and implement comprehensive care in intensive care units and emergency services.

## Contribution

The study provides new insights into the barriers and facilitators of implementing holistic care practices in critical healthcare settings in Spain.

## Key findings

- Healthcare professionals recognize the importance of comprehensive care but face barriers like lack of resources and time.
- Key themes identified include knowledge, resources, bioethics, and the multidimensional impact of comprehensive care.
- The study emphasizes the need for infrastructure and human resources to support holistic patient care in critical units.

## Abstract

Background/Objectives: Comprehensive care is crucial in emergency healthcare. In intensive care units, a holistic approach may be difficult to implement due to the conditions of the patients and existing work protocols aimed at maintaining vital functions for the survival of patients. The present study aims to explore and describe the knowledge, attitudes, and perceptions of critical care and emergency health professionals regarding the implementation of integrated care practices within intensive care units, with the goal of identifying barriers and facilitators to adopting a holistic approach in emergency healthcare settings. Methods: This study implemented an exploratory and descriptive qualitative design with a phenomenological approach through semi-structured interviews with health professionals who had worked in intensive care units or emergency services for both public and private health institutions in Spain (n = 25). The study was conducted during the years 2023 and 2024, using a convenience sampling method along with snowball sampling, and a narrative discourse analysis was performed. The MAXQDA 2022 software program was used. This study was granted due permission by the Research Ethics Committee belonging to the Junta de Andalucía, under protocol code 0768-N-20. Results: The total sample consisted of 25 healthcare professionals from critical care and emergency services in Spain. The main themes, as key findings, were knowledge and perception, determining factors, resources and infrastructure, the bioethical dimension, perspectives on comprehensive care, and multidimensional impact. Most of the professionals were familiar with comprehensive care, but lack of resources and time prevented them from carrying it out in their units. Conclusions: For critical care and emergency professionals, comprehensive care is important to their clinical practice, but barriers to its realization still exist. Understanding the importance to these professionals of the application of comprehensive care is fundamental to establishing measures for its implementation in these services. It is also a motivation to continue providing humanized and compassionate care that respects the patient’s dignity. It is a priority to provide the necessary infrastructure and human resources so that patients admitted to these units can be cared for with this tool.