ICU危重症患者救治早期家属需求状况调查分析

目的:调查分析ICU危重症患者救治早期家属需求状况。方法:应用中文版CCFNI对112名危重症患者家属进行需求调查,对其需求排序并与一般情况进行比较分析。结果:ICU危重症患者救治早期最重要的需求是患者得到最佳救治,家属得到及时的救治信息;家属基本情况与CCFNI各因子间基本不相关。结论:在确保患者得到最佳救治的基础上,医护人员应给予家属及时准确的救治信息;成立照护小组,实现医患双方的有效沟通;建立人性化的探视制度,满足家属不同的探视需求;改善家属等候环境,从而缓解其心理压力,改善医患、护患关系。     

ICU成立多民族地区患者家属沟通小组的实践

目的探讨通过成立多民族地区重症监护室(ICU)患者家属沟通小组,促进医患有效沟通,提升患者社会支持系统对医疗行为的认识及参与。方法成立由5人组成的ICU患者家属沟通小组,成员进行为期1个月的相关沟通技巧、民族习俗、各民族基本生活用语、口语等方面的培训,并制定沟通计划,要求成员掌握回、藏、撒拉族基本生活用语,分布在白班与夜班,使其与家属沟通具有连续性,贯穿在患者住ICU全过程。结果患者家属与医务人员沟通有效,获取医疗信息渠道通畅,对ICU医护人员工作认可,服务满意度较之前提高了7.9%,达93.2%。结论通过成立多民族地区ICU患者家属沟通小组,构建优质护理服务链,提高了护患沟通效果,增进患者家属对医护人员的理解、信任,能达到医患和谐的社会要求。     

神经外科ICU患者家属需求调查分析

目的:探讨神经外科ICU患者家属的需求,以采取针对性的护理。方法:应用调查问卷对80名ICU患者家属进行需求调查。结果:家属最关心的是患者是否得到最佳救治、病情的进展情况、治疗效果,其次是对护理工作不了解、担心护士人力不足、希望每天探视患者,再次是担心医疗费用等;最不关心的是家属等待休息环境。结论:ICU护士必须正确认识患者家属需要,及时与患者家属沟通,给予积极的心理支持和社会支持,帮助患者家属应对患者病重时的危机,以提高护理质量。     

外科ICU患者救治早期家属心理压力的现况调查及对策分析

目的探讨ICU重危患者救治早期家属心理压力的状况。方法方便性抽样选取上海市五所三级甲等医院99例重危患者家属,在患者进入ICU 48～72h内采用症状自评量表(symptom check list-90,SCL-90)对其进行心理压力测定,并分析其影响因素。结果本组患者家属的躯体化、焦虑和偏执因子得分高于常模,人际关系得分低于常模;不同居住环境家属SCL-90强迫因子和精神病性因子得分存在差异(P=0.028);文化程度不同的家属在敌对因子得分上存在差异(P=0.043)。ICU感受压力>7分的患者家属在躯体化、强迫症状、人际关系、抑郁、焦虑、敌对和恐怖7个因子上得分高于感受压力为3～7分的患者家属(P<0.05)。结论在同样遭受应激的情况下,ICU危重患者家属中城市居民比农村居民更容易出现心理问题;医护人员需要重视文化程度低的患者家属,采用他们容易理解的方法进行沟通,以降低其敌对情绪和行为的发生率;同时,ICU患者家属对感受压力的评价与实际测得结果高度一致,医护人员应主动询问并相信患者家属对自身压力的感知,对心理压力超过7分的患者家属须采取积极的心理疏导措施,以降低其心理问题的发生率。     

急性病人家属焦虑、抑郁的分析及对策

目的 调查分析基层医院急性病人家属焦虑、抑郁的情况及影响因素,探讨其应对策略.方法 采用集中问卷方式对50例基层医院急性病人家属的焦虑、抑郁的情况及其影响因素进行调查.结果 基层医院急性病人家属这一特殊而又广大的群体普遍存在不同程度的焦虑、抑郁症状.焦虑、抑郁的主要原因为:住院所致的生活不便;缺乏社会、家庭支持系统;担心病人病情进展与预后;家庭经济困难、担心治疗费高;缺乏相关医学知识、对治疗情况不清楚;对医院有误解;医护人员不关心或语言伤害等.结论 必须高度重视基层急性病人家属的心理状况,采取积极有效的措施,缓解他们的精神和心理压力,使其成为病人的坚强支持者.     

满意度调查在ICU高危孕产妇患者家属中的调查分析

目的调查ICU的高危孕产妇患者家属对重症医学科医疗护理服务质量的满意度,以提高ICU的护理服务质量。方法应用问卷调查的方式,结合危重患者家属满意度量表,对入住本院ICU的60名高危孕产妇患者家属进行调查。结果通过调查发现,家属对患者病情知晓、家属对疾病知识的需求、医护人员与家属的主动沟通及家属探视需求四方面的问题,是影响ICU满意度的主要因素,其中病情保证和获取病情是危重患者家属排在首位的需求。结论对高危孕产妇患者家属的满意度调查,可以从另一个维度来分析影响满意度的焦点问题,并通过采取多渠道的护理干预,如注重与患者家属的沟通,了解家属的需求,学会换位思考,给予有效的帮助等,可以提高ICU的护理服务质量。     

ICU患者家属需求调查分析

目的:探讨ICU患者家属的需求,以采取针对性的护理,减轻患者家属的压力.方法:应用调查问卷对30名ICU患者家属进行需求调查,内容包括患者家属对ICU监护环境,对医务人员业务能力、服务态度、沟通技能,探视陪护,基础护理等各方面的需求及其ICU监护认知获取途径.结果:患者家属对ICU监护相关内容的需求主要包括治疗用药、营养提供、心电监护等;其ICU监护认知获取途径主要包括主管医生、上级医生、护士长等;对医务人员素质的需求主要包括专业技术方面、沟通方面、服务态度方面等;对基础护理方面的需求主要包括保持床单位整洁、及时清理患者分泌物和排泄物、虚弱患者使用床档等.结论:及时与患者家属沟通患者有关信息,理解和重视患者家属的需求,可减轻ICU患者家属的心理负担,提高ICU的工作质量.     

活忆饮对阿尔茨海默病模型大鼠β淀粉样肽1—40表达和学习能力的影响

目的:探讨ICU患者家属的需求,以采取针对性的护理,减轻患者家属的压力.方法:应用调查问卷对30名ICU患者家属进行需求调查,内容包括患者家属对ICU监护环境,对医务人员业务能力、服务态度、沟通技能,探视陪护,基础护理等各方面的需求及其ICU监护认知获取途径.结果:患者家属对ICU监护相关内容的需求主要包括治疗用药、营养提供、心电监护等;其ICU监护认知获取途径主要包括主管医生、上级医生、护士长等;对医务人员素质的需求主要包括专业技术方面、沟通方面、服务态度方面等;对基础护理方面的需求主要包括保持床单位整洁、及时清理患者分泌物和排泄物、虚弱患者使用床档等.结论:及时与患者家属沟通患者有关信息,理解和重视患者家属的需求,可减轻ICU患者家属的心理负担,提高ICU的工作质量.     

健康信念模式下新冠肺炎疫情期间ICU患者家属对暂停入室探视的接受度及影响因素调查分析

目的 调查新冠肺炎疫情下重症加强护理病房（ICU）患者家属对暂停入室探视的接受度及其影响因素。方法 2020年2月至12月应用一般资料调查表、基于健康信念模型的ICU患者家属对暂停入室探视接受度的调查表及焦虑自评量表（GAD 7）对南京市4家三级甲等综合性医院117名ICU患者家属（便利抽样法选出）进行问卷调查。结果 79.5%的家属表示接受暂停入室探视制度,暂停入室探视的接受度与感知疾病严重性、感知疾病易感性、感知益处（条目5除外）、感知障碍各维度存在关联性,差异有统计学意义（P＜0.05）;83.8%的家属认为应该允许探视终末期患者;85.5%的家属认为医护人员主动联系家属沟通病情可增加暂停入室探视的接受度。回归分析显示,患者入住ICU天数＞30天、家属处于重度焦虑状态是影响暂停入室探视接受度的主要因素。结论 新冠肺炎疫情下ICU患者家属对暂停入室探视接受度较高;应制定允许探视终末期患者和加强医护人员主动联系家属沟通病情制度;要特别加强与患者入住ICU>30天、处于严重焦虑状态的家属的沟通。     

心外科监护室患者家属需求及影响因素的调查

目的了解心外监护室患者家属需求的现状,分析影响家属需求的因素,为临床护理工作提供有针对性的措施提供借鉴。方法应用重危患者家属需求量表（CCFNI）中文修订版对100名心外科监护室患者的亲属进行问卷调查。结果心外科监护室患者家属的需求与期望值有较大距离;最需求的项目有：能让我了解患者的预后结果;希望在第1次进ICU时,医护人员能为我介绍ICU内的有关情况;医护人员能如实回答我的问题。最不需求的项目有：希望家属休息室附近设有浴室;希望能允许有时大声哭叫;希望偶尔能允许暂时离开医院片刻。影响需求的因素为患者家属的月收入,两者成负相关。结论护理人员应加强与患者家属的沟通,有针对性地满足其合理需求,维护患者及亲属的身心健康。     

外科监护室病人家属需求和心理状况调查

目的 :了解外科监护室 (SICU )病人家属的需求和心理状况。方法 :对87例病人家属进行问卷调查。结果 :家属对SICU的各项需求值在 3.88分～ 4.72分 (总分 5分 ) ,对SICU各方面满意值在4.5 2分～ 4.72 (总分 5分 ) ,焦虑值比常人高 ,焦虑值与家属认为亲人的病情严重程度呈正相关 ,与家属对访客制度的满意程度呈负相关。结论 :家属对SICU有较高需求 ,他们比常人焦虑 ,医护人员应尽量满足家属合理需求 ,减轻其焦虑心理 ,以更好地发挥家属对SICU病人的正性支持作用。     

外科ICU健康教育面临的形势与应对

对外科ICU(surgicalintensivecareunit,SICU)患者及家属实施健康教育已得到广泛重视,对于预知术后需进入SICU的患者及其家属如何实施健康教育进行简要的归纳和总结,探讨适合SICU的健康教育模式,从而提高临床健康教育的效果。     

重症监护室患者家属需求调查分析

目的研究重症监护室（ICU）患者家属需求。方法采用重危患者家属需求量表（CCFIN）调查80名ICU患者家属需求情况。结果家属需求排名前10的条目中有6条是对患者病情的保证;不同教育程度、ICU经历、医疗费用支付方式对家属需求的侧重有一定影响;有ICU经历的家属对于获取信息和病情保证的需求比无ICU经历家属的需求强烈（P〈0.01）;自费患者家属对自身的舒适需求高于公费和医保患者家属（P〈0.01）。结论 ICU患者家属存在不同程度的需求,ICU护士应加强与患者家属的沟通,建立合作、信任的交流渠道,采取人性化管理,最大程度地满足患者家属的需求,提高护理质量。     

外科监护室食道癌术后患者的睡眠质量与影响因素调查

目的 了解外科重症监护室(SICU)食道癌术后患者的睡眠质量及影响因素.方法 采用匹兹堡睡眠质量指数量表(PSQI)和自编影响睡眠因素调查表,对80例食道癌术后患者进行问卷调查.结果 SICU食道癌术后患者的PSQI总分为12.01±4.88,明显高于正常成人组.影响睡眠的因素依次为疼痛、担心预后、体位不适、邻床患者干扰、口干、病床不适、孤独等.结论 SICU食道癌术后患者的睡眠质量差;影响睡眠的因素是多方面的,且影响因素大部分是可控制的.     

Family perceptions of worry, symptoms, and suffering in the dying

In this exploratory study, family members of 63 decedents were interviewed by telephone, two to five months post-death, about their perceptions of their loved one's worries, symptoms, and suffering at the end of life. The most common worries reported focused on loss of bodily function (44%), being dependent (40%), and being a burden (39%). Distressing physical and psychological symptoms were reported. A majority (94%) of family members reported that their loved one suffered at the end of life, but only worries about loss of quality of life (e.g., being unable to participate in enjoyable activities) were predictive of reports of suffering. Findings suggest that worries, irrespective of the level of current symptoms, play an important role in the suffering of dying patients, and that treatment plans for the terminally ill should routinely explore both symptoms and worries.     

Stressor experienced by family members in the process of organ and tissue donation for transplant

The purpose of the present study is to identify the stressors experienced by family members during the process of organ donation, evince the most distressful moment of the process and verify the association of variable with the family members' experience. The sample consisted of 16 family members that were making the donation through a Organ Search Organization, in S?o Paulo, in 2007. A structured instrument was used, containing question addressing the family members' experience and their evaluation of the donation process. The main stressors reported were: dissatisfaction with the service (31.25%); receiving a harsh notification about the individual's brain death (62.50%); and the wait to release the body (62.50%), which was considered the most distressful moment of the process. Using the phi coefficient, it was found that there was a moderate association between the variables of interest with the family's experience. In conclusion, the donation process is stressful on the family and nursing care is necessary in each stage of the process to offer support and reduce the distress on the family members.     

Distribution and antimicrobial resistance of bloodstream pathogens in surgical and medical ICUs北大核心CSCD

Objective To analyze the distribution and antimicrobial resistance of bloodstream pathogens in surgical intensive care unit (SICU) and medical intensive care unit (MICU) of Fujian Provincial Hospital in the past four and half years for better use of antimicrobial drugs. Methods A retrospective analysis was carried out for the bloodstream pathogens isolated from SICU and MICU patients from January 2012 to June 2016. The clinical data and outcomes of patients were also reviewed. Results A total of 329 strains of isolates were recovered from blood samples in SICU, including gram-negative bacteria (53.5%), gram-positive bacteria (39.2%), and fungi (7.3%); 258 strains were collected from MICU, including gram-negative bacteria (57.8%), gram-positive bacteria (36.0%), and fungi (6.2%). A. baumannii, K. pneumonia and E. coli were the top three gram-negative species in both SICU and MICU. The main gram-positive species were coagulasenegative Staphylococcus and Enterococcus faecium. Overall, 386 cases of bloodstream infections were diagnosed, including 226 cases in SICU (202 cases of single bacterial infection and 24 cases of multiple bacterial infection), and 160 cases in MICU (138 cases of single bacterial infection and 22 cases of multiple bacterial infection). A. baumannii isolates showed significantly higher rate of resistance to antibiotics in SICU than in MICU, while the K. pneumoniae and E. coli isolates in MICU showed higher resistance rates to cephalosporins, quinolones, penicillins and carbapenems than the corresponding isolates in SICU. The coagulase negative Staphylococcus and E. faecium isolates in MICU were associated with significantly higher resistance rates to quinolones and tigecycline than those strain in SICU. The bloodstream infections due to K. pneumoniae, E. coli and E. faecium were associated with higher mortality in MICU than in SICU, while the bloodstream infections due to A. baumannii were associated with higher mortality in SICU than in MICU. The total mortality rate of bloodstream infections was higher in MICU than in SICU. Conclusions SICU and MICU share similar profile of main bloodstream pathogens even though the disease spectrum was different between SICU and MICU. All the bloodstream pathogens isolated from MICU patients except A. baumannii showed significantly higher antimicrobial resistance rates than the isolates from SICU. The mortality rate associated with bloodstream infection was also higher in MICU patients than in SICU. © 2018, Editorial Department of Chinese Journal of Infection. All rights reserved.     

A qualitative analysis of family member needs and concerns in the population of patients with burns

The importance of family support to ameliorate the recovery of a patient with burns has been documented in the literature. However, there is a dearth of research that identifies family members' needs and concerns during the hospitalization of patients with burns. Study aims were as follows: (1) identify support needs and concerns of family members of adult and pediatric patients currently in a burn center and (2) explore the relationship between family needs and the patient's severity of injury. An observational design was used that incorporated semistructured interviews with family members 1 to 3 days after the burn. A convenience sample of family members of burn center patients (n = 97) was recruited over 9 months. Content analysis was used to establish themes from interview data. Interrater reliability on coding of thematic units from 15% of the interviews was 86%; discrepancies were corrected to 100%. The average family member was 42.3 years old, female, white, and at least a high school graduate. Family members' concerns included general patient concerns, physical concerns about the patient, satisfaction of personal needs, and psychologic concerns about the patient. Major sources of support were family and friends, burn center staff, and spirituality. Family members of pediatric patients identified pain and skin graft surgery as priority worries. Satisfaction of personal needs, financial support, and information needs were greater among family members of intensive care unit patients in comparison with step-down patients. These findings underscore the importance of communication and reassurance between the burn team and the family members. Alterations to the support provided to families can be made on the basis of study subjects' responses.     

Patients' fears, worries, and concerns when visiting an out-patient clinic

In an out-patient clinic for specialised medical care, 30 patients were questioned about their worries prior to the visit. The purpose of the study was to obtain basic knowledge about emotional experiences of patients visiting a doctor. The theoretical viewpoint was that of social interaction and social construction of reality. The statements of the patients were categorized as follows: before the encounter, the social interaction, the outcome of the encounter, and unspecific worries. A tool for measuring the degree and profile of the worries will be developed. Some of the worries described will be studied in depth. An education programme for all staff members is planned.