Multiple Symptoms in Family Caregivers of Intensive Care Unit Patients

Context

Intensive care unit (ICU) patients experience physical and psychological challenges related to ICU admission in the acute and recovery phases after a critical illness. Involvement of family caregivers (FCs) is essential in the patients' struggle to survive critical illness. FCs report a high symptom burden related to ICU admission. Previous research has investigated mainly single symptoms. Little is known about multiple symptom burden related to FC experiences in an ICU.

Examining the Needs of Bereaved Parents in the Pediatric Intensive Care Unit: A Qualitative Study

The pediatric intensive care unit (PICU) is a high-tech setting aimed at restoring health to critically ill children. When childhood death occurs in the PICU, it constitutes a special context for parent bereavement. The purpose of this interdisciplinary qualitative research was to gain a deeper understanding of parents' needs around the time of their child's death in the PICU. Through interviews and focus groups with bereaved parents and hospital chaplains, categories of parents' needs emerged. Deeper understanding of parents' needs will allow health professionals to better support parents during bereavement as well as to provide more customized care.     

神经外科患者照顾者对重症监护过渡期护理体验的质性研究

目的 深入了解照顾者对重症监护(intensive care unit, ICU)过渡期护理的体验,为科学实施其护理方案提供参考依据。方法 2021年1-5月,采用目的抽样法,以最大差异化选取武汉市某三级甲等医院神经外科ICU患者照顾者为研究对象,应用现象学研究方法对其进行半结构式深度访谈,并对访谈资料进行转录、编码、类属分析和描述。结果 照顾者对ICU过渡期护理的体验可归纳为4个主题：对患者转出ICU决定的感受、对过渡期护理服务的体验、影响照顾者照护效能的障碍因素以及对过渡期护理的改进需求。结论 照顾者在患者ICU过渡期承受积极希望与多重压力,相关人员应高度重视其在患者ICU过渡期间的体验和需求,构建并实施过渡期护理策略,保障过渡期安全照护。     

Patient Blood Management in the Intensive Care Unit

Patient Blood Management underscores a fundamental shift from a product-centered approach to a patient-centric approach through timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss in an effort to improve patient outcome. In this concept, allogeneic blood transfusion is not viewed as the treatment of default for anemic patients, but one among many treatment modalities that should be weighed based on its merits—potentials risks and benefits—for the individual patient in the context of other alternatives. Patient blood management provides a multidisciplinary framework for patient-centered decision making with strategies focusing on the management of anemia, optimization of coagulation and hemostasis, and utilization of blood conservation modalities. Among the critically ill patients, Patient Blood Management can be particularly effective given the extremely high prevalence of anemia, variable and unjustified transfusion practices, high frequency of coagulation disorders, and avoidable sources of blood loss such as unnecessary diagnostic blood draws. Proper management of anemia—prevention, screening/monitoring, diagnostic workup, and treatment including hematinic agents—is the key to effective implementation of patient blood management. Blood transfusions should be used in accordance of current guidelines, which are supportive of more restrictive transfusion strategies in most critically ill patients. Emerging studies report on the success of Patient Blood Management programs in reducing transfusion utilization, reducing the burden of anemia in patients, and improving patient outcomes including shortened length of hospital stays, less frequency of complications and lower risk of mortality.     

A Clinical Update on Delirium: Focus on the Intensive Care Unit Patient

Acute care nurse practitioners manage a wide range of patient diagnoses and problems encountered in critical care, including management of delirium. As such, they are positioned to be leaders in the prevention, recognition, and management of delirium in the intensive care unit setting. Delirium in the hospitalized patient is linked with a prolonged length of stay, higher risk of death, and cognitive decline. Delirium will occur in up to 87% of intensive care unit patients with severe illness or recovering from major surgery. This overview of current evidence-based practice guidelines and an accompanying case study will assist interdisciplinary teams of health care providers to diagnose, treat, and manage hospitalized patients with delirium, with a focus on the complex care of the critically ill patient population.     

气管切开患儿照顾者居家照护体验的质性研究

目的探讨长期气管切开患儿照顾者的居家照护体验。方法采用半结构式访谈法,访谈13名照顾者,并依据Miles和Hurberman提出的质性研究资料分析法予以分析。结果经不断分析比对,共析出长期气管切开照顾者"照护负荷"、"精神困扰"及"益处发现"3个主题;"从束手无策到熟练掌握"、"亲职角色改变"、"社交隔离"等8个亚主题。结论临床工作者通过了解长期气管切开照顾者的照护体验,了解其身心反应、照护需求等。可在长期气管切开患儿入院时即构建个性化的延续护理方案,合理安排其出院后日常生活;培训照顾者各项专业操作,训练其心理调适技巧,而且可通过挖掘其自身资源促进照顾者体验积极心理变化等,以实现良好心理适应;促进患儿康复,提高其生活质量。