ICU病人亲属支持干预及支持源的调查研究

目的 :了解ICU病人亲属支持获得情况及支持源 ,帮助ICU护士充分认识支持干预 ,积极为ICU病人亲属提供社会支持。方法 :采用开放式问卷及“ICU病人家庭支持干预量表” ,对60例ICU病人亲属进行支持干预重要性、获得情况及支持源的调查。结果 :ICU病人亲属认为信息支持最为重要 ,且多数亲属认为可以获得此方面的支持 ,医生被认为是提供信息支持的主要源泉。情感支持及物质支持次之 ,约半数病人亲属认为可以获得情感及物质支持 ,但提供此方面支持的主要源泉是亲友 ;信息支持的获得在病人配偶及子女间存在统计学意义 (P <0 .0 5 ) ,病人配偶及子女在 4方面支持重要性得分方面不存在统计学意义 (P >0 .0 5 )。结论 :ICU护士应正确认识病人亲属支持干预的重要性 ,积极提供有效的社会支持 ,以帮助病人家庭应对病人危重时的危机状态 ,维持家庭功能 ,促进病人康复     

重症监护室危重患者家属需求的调查与分析

目的了解重症监护室患者家属的需求，为临床护理工作提供依据。方法采用Molter的“急危重患者家庭需要量表”中文版，对47例ICU患者的家属进行调查。结果患者家属认为最需要的项目是了解患者的治疗与预后、知晓患者病情变化等，认为最不需要的项目是与自身有关的需求；人口学分析结果显示，部分需要与患者家属的年龄、性别、文化水平和人均月收入有关。结论ICU护士必须正确认识患者家属的需要，根据其性别、年龄、文化水平和家庭收入等因素满足患者家庭需要，以帮助其应对家庭危机状态。     

新生儿患儿父母焦虑及需求的调查研究

目的：了解新生儿父母在患儿住院期间的焦虑及需要情况，以更好地提供心理及行为方面的护理。方法：采用状态——特质焦虑量表及Molter病人家庭需要量表对50例新生儿科患儿父母进行调查。结果：新生儿科患儿父母状态焦虑(SAI)均分明显高于正常人群，不同文化程度父母SAI均分不同。家庭需要量表显示，患儿亲属认为能够保证患儿的安全，了解患儿的治疗与预后，了解患儿护理的需要最重要。部分需要与患儿亲属的文化程度和家庭收入有显著相关。结论：新生儿科护士必须正确认识患者家属的需要，根据文化程度及收入水平等因素满足患儿家属的需要，有针对性的提供心理及行为方面的护理，以帮助患儿家属应对在患儿住院治疗期间的焦虑状态。     

评价与治疗睡眠问题

当病人住进ICU时，其家人难免会面临许多压力。在病人住院以及出院后，其家人会感到焦虑、恐惧以及不知所措，出现失眠、疲惫感等不适。研究显示，从ICU出院病人的家庭护理者经常会面临焦虑与抑郁。这与病人出院后，许多与之相关的健康问题需要家人照顾有关。因此，病人家属必须休息好，在身体上、心理上做好在家中护理病人的准备。病人家属所面临的失眠问题是众多导致其心理压力的因素之一，病人在ICU中对家庭护理人员产生压力的多数因素在病人出院后都无法控制。然而，睡眠却是家庭护理人员可以控制的因素。     

ICU病人家属对限制陪护的心理反应及护理对策

目的 探讨病人在ICU接受监护期间，其家属对ICU限制陪护的心理反应及相关原因。方法 参考国外危急重病人家属需要量表，对本市两家三级甲等医院100名ICU病人家属进行调查。结果 病人家属对探视制度的看法与健康教育，病情转归，医护质量有关。结论 ICU护士必须重视健康教育，充分认识病人家属的需要，及时提供各种反馈信息，帮助家属应对其危机状态，同时，要求医院设定相关配套服务措施，维护病人家属的身心健康。     

全子宫切除病人配偶焦虑相关因素分析

目的探讨全子宫切除病人配偶的焦虑状况及其相关因素，旨在通过干预配偶心理，达到提高病人心身健康水平目的。方法采用焦虑自评量表（SAS）和自编影响因素调查问卷，对60名全子宫切除病人配偶进行调查。结果焦虑得分（32．46±5．78）分，与焦虑呈正相关的因素有：担心妻子的疾病是恶性，担心自己不能照顾好妻子的身体，担心妻子会提早衰老，担心妻子手术效果，担心妻子的体力不能恢复到术前水平（P〈0．05或P〈0．01）。呈负相关因素有：配偶的年龄、家庭收入（P〈0．05）。结论全子宫切除病人配偶存在不同程度焦虑心理，主要与其担心妻子的病情、手术效果、术后体力恢复及家庭生活相关。提示应对全子宫切除病人配偶开展有关知识的健康教育，以减轻其焦虑感，更好地照顾病人。     

ICU护士掌握危重病人肠内营养支持相关知识的调查

目的了解ICU护士对危重病人肠内营养支持相关知识的掌握程度。方法采用自行设计的危重病人肠内营养支持相关知识调查问卷,对82名ICU护士进行调查。结果问卷总平均分为（10．26±3．31）分,67．1％的护士掌握程度在中等水平,肠内营养支持相关知识3个维度掌握程度均不足60％;护士对危重病人肠内营养支持相关知识的知晓主要来源于临床经验积累,与ICU工作年限呈正相关。结论ICU护士对危重病人肠内营养支持相关知识的认知水平较低,应实施切实有效的培训,提升危重病人肠内营养支持的护理质量。     

ICU转出病人重返原因分析及护理对策

[目的]了解近3年来综合重症监护室(ICU)转出病人重返ICU的原因,并提出相应对策,降低ICU病人重返率.[方法]收集2007年1月-2009年12月我院综合ICU收治的679例转出病人中重新返回ICU的52例病人的临床资料,分析重返原因,找出危险因素.[结果]3年ICU病人重返率为7.66％;ICU转出病人重返原因主要与呼吸系统问题有关,突出表现为病人人工气道护理不到位、病人排痰措施不能落实、合并医院内肺部感染、家庭照顾无力等.[结论]影响ICU病人重返率的原因是多方面的,主要与呼吸道的护理与管理不能满足病人需要有关.     

ICU转出病人重返原因分析及护理对策

[目的]了解近3年来综合重症监护室（ICU）转出病人重返ICU的原因,并提出相应对策,降低ICU病人重返率。[方法]收集2007年1月-2009年12月我院综合ICU收治的679例转出病人中重新返回ICU的52例病人的临床资料,分析重返原因,找出危险因素。[结果]3年ICU病人重返率为7．66％;ICU转出病人重返原因主要与呼吸系统问题有关,突出表现为病人人工气道护理不到位、病人排痰措施不能落实、合并医院内肺部感染、家庭照顾无力等。[结论]影响ICU病人重返率的原因是多方面的,主要与呼吸道的护理与管理不能满足病人需要有关。     

ICU病人家属心理健康状况的调查研究

[目的]了解ICU病人家属的心理健康状况.[方法]采用症状自评量表(SCL-90)对47名ICU病人家属进行测量,并与普通病房病人家属进行比较.[结果]ICU病人家属心理健康水平低.[结论]对ICU病人家属进行心理护理是很有必要的.     

Necesidades y estrategias de participación propuestas por la familia en los cuidados diarios del paciente crítico

IntroductionThe continuous and technical assistance that the critical patient requires sometimes produces a barrier with the family, generating the alteration of their needs. Family involvement is beneficial to both the family and the patient.Objective1) Knowing the feelings and needs of the patients’ relative admitted to an ICU of a third level hospital in Catalonia and 2) To study the participation strategies proposed by the relatives.MethodsPhenomenological qualitative study. The sample population selected was the patients’ relatives admitted to an UCI of a 3rd level Catalan hospital from May 2017 to February 2018. The sampling was intentional, considering different typologies to guarantee the diversity of the discourse. Semi-structured interviews were conducted, analyzed thematically. The rigor criteria of Guba and Lincoln were applied.Results15 relatives were interviewed. The participants express negative, positive and transformative feelings. Psychological assistance, having more information and collaborating in the care of your family member are some of the expressed needs. Among the strategies proposed in the absence of care participation is the increase in family hours in the ICU and the support of a nurse educator care.ConclusionsIt is necessary to reorient the personnel practice incorporating strategies that further integrate the family in the daily care of the critically ill patient. Helping the family, prioritizing their needs and guiding them in learning is basic and part of the professional care.     

ICU患者家属需求及满足程度的调查

目的调查ICU患者家属需求的重要程度及满足程度,并探讨两者之间的关系及单个家属需求满足程度的量化判断方法。方法80名神经内科ICU患者家属于患者进入ICU 24~36 h后接受危重患者家属需求量表(critical care family needs inventory,CCFNI)及需求满足程度量表(NMI)的调查。结果ICU患者家属需求的重要程度和满足程度由高到低依次为病情保证(92.3%和84.8%)、获取信息(91.3%和70.5%)、接近患者(86.1%和63.8%)、获得支持(65.3%和43.9%)和自身舒适(44.8%和41.3%)。80名家属中,有10%其需求满足程度较低,56%满足程度中等,34%满足程度较高。结论ICU患者家属需求的重要程度及其满足程度基本一致,均为病情保证最高,获取信息和接近患者次之,获得支持和自身舒适最低;单个ICU患者家属需求满足程度的量化判断仍需进一步探讨和临床验证。家属的需求不同所采用的护理措施不同,应对每位家属施行个体化护理。     

The needs of the relatives in the adult intensive care unit: Cultural adaptation and psychometric properties of the Chilean-Spanish version of the Critical Care Family Needs Inventory

IntroductionThe admission of a patient to an intensive care unit is an extraordinary event for their family. Although the Critical Care Family Needs Inventory is the most commonly used questionnaire for understanding the needs of relatives of critically ill patients, no Spanish-language version is available. The aim of this study was to culturally adapt and validate theCritical Care Family Needs Inventory in a sample of Chilean relatives of intensive care patients.MethodsThe back-translated version of the inventory was culturally adapted following input from 12 intensive care and family experts. Then, it was evaluated by 10 relatives of recently transferred ICU patients and pre-tested in 10 relatives of patients that were in the intensive care unit. Psychometric properties were assessed through exploratory factor analysis and Cronbach’s α in a sample of 251 relatives of critically ill patients.ResultsThe Chilean-Spanish version of the Critical Care Family Needs Inventoryhad minimal semantic modifications and no items were deleted. A two factor solution explained the 31% of the total instrument variance. Reliability of the scale was good (α = 0.93), as were both factors (α = 0.87; α = 0.93).ConclusionThe Chilean-Spanish version of theCritical Care Family Needs Inventory was found valid and reliable for understanding the needs of relatives of patients in acute care settings.     

The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives: A randomised controlled trial (DRIP-study)

BackgroundCritical illness and mechanical ventilation may cause patients and their relatives to experience symptoms of posttraumatic stress, anxiety, and depression due to fragmentation of memories of their intensive care unit (ICU) stay. Intensive care diaries authored by nurses may help patients and relatives process the experience and reduce psychological problems after hospital discharge; however, as patients particularly appreciate diary entries made by their relatives, involving relatives in authoring the diary could prove beneficial.ObjectivesThe objective of this study was to explore the effect of a diary authored by a close relative for a critically ill patient.MethodsThe study was a multicenter, block-randomised, single-blinded, controlled trial conducted at four medical-surgical ICUs at two university hospitals and two regional hospitals. Eligible for the study were patients ≥18 years of age, undergoing mechanical ventilation for ≥24 h, staying in the ICU ≥48 h, with a close relative ≥18 years of age. A total of 116 relatives and 75 patients consented to participate. Outcome measures were scores of posttraumatic stress symptoms, anxiety, depression, and health-related quality of life three months after ICU discharge.ResultsRelatives had 26.3% lower scores of posttraumatic stress in the diary group than in the control group (95% confidence interval: 4.8–% to 52.2%). Patients had 11.2% lower scores of posttraumatic stress symptoms in the diary group (95% confidence interval: −15.7% to 46.8%). There were no differences between groups in depression, anxiety, or health-related quality of life.ConclusionA diary written by relatives for the ICU patient reduced the risk of posttraumatic stress symptoms in relatives. The diary had no effect on depression, anxiety, or health-related life quality. However, as the diary was well received by relatives and proved safe, the diary may be offered to relatives of critically ill patients during their stay in the ICU.     

结核病监护室患者家属需求的差异性分析

目的 了解结核病监护室（tubercular ICU，TICU）患者家属需求状况的差异性。方法采用问卷调查的方法，随机调查60例TICU患者家属和60例综合ICU患者家属。结果TICU患者家属认为有关结核病防治、情感支持的需要明显高于综合ICU患者家属。其中有关结核病防治的需要与TICU患者家属的年龄、收入水平和文化程度分别显著相关。结论TICU护士应理解和重视患者家属的心理需求，及时与家属沟通有关信息，并根据家属的年龄、收入水平、文化程度的不同做好其自身的结核病防治，消除和减轻其不良心理，维持患者和家属的身心健康，以更好地发挥TICU患者家属对患者的正性支持作用。     

The impact on new-onset stress and PTSD in relatives of critically ill patients explored by diaries study (The “INSPIRED” study)

Background

There is rising prevalence of post-traumatic-stress-disorder (PTSD) in patients and their relatives after ICU discharge. The impact of ICU diaries on PTSD in relatives of critically ill patients in Australia has not been fully evaluated.

Participación de la familia en el cuidado del paciente crítico: un estudio exploratorio

ObjectivesTo determine the level of readiness of the healthcare team regarding family participation in the care of the critically ill adult and their relationship with the individual characteristics of the participants in a medical-surgical intensive care unit (ICU) in Santiago de Chile.MethodA cross-sectional correlational study using a quantitative method and including a focus group to explore the perception of healthcare staff of family participation in the care of the critically ill patient.ResultsThe level of readiness of the healthcare team for family participation in the care of the critically ill patient is medium, at 13.81 out of a total 20. The greater the readiness, the lower the age (r=?.215; P=.019), the higher the rating of previous experience working with families (r=.304; P=.006), and the higher the perception of being comfortable with different activities in the care of the critical patient (r=.495: P<.001). The participants also state that the work environment of the unit, the patient's condition, the relatives’ characteristics, personal judgement, and the preparedness of relatives affect their readiness.ConclusionsThe results contribute towards determining the healthcare team's level of readiness in a setting where the subject of the study has not been implemented. The readiness of the healthcare team is medium, and is related to individual characteristics of the healthcare staff, and to organizational and family aspects. Therefore, strategies are required to address these aspects that might increase readiness.     

The relationship between person-centred care and the intensive care unit experience of critically ill patients: A multicentre cross-sectional survey

BackgroundPerson-centred care has the potential to improve the patient experience in the intensive care unit (ICU). However, the relationship between person-centred care perceived by critically ill patients and their ICU experience has yet to be determined.ObjectivesThe aim of this study was to investigate the relationship between person-centred care and the ICU experience of critically ill patients.MethodsThis study was a multicentre, cross-sectional survey involving 19 ICUs of four university hospitals in Busan, Korea. The survey was conducted from June 2019 to July 2020, and 787 patients who had been admitted to the ICU for more than 24 hours participated. We measured person-centred care using the Person-Centered Critical Care Nursing perceived by Patient Questionnaire. Participants' ICU experience was measured by the Korean version of the Intensive Care Experience Questionnaire that consists of four subscales. We analysed the relationship between person-centred care and each area of the ICU experience using multivariate linear regression.ResultsPerson-centred care was associated with ‘awareness of surroundings’ (β = 0.29, p < .001), ‘frightening experiences’ (β = ?0.31, p < .001), and ‘satisfaction with care’ (β = 0.54, p < .001). However, there was no significant association between person-centred care and ‘recall of experience’.ConclusionsWe observed that person-centred care was positively related to most of the ICU experiences of critically ill patients except for recall of experience. Further studies on developing person-centred nursing interventions are needed.