Paul Fiona, Hendry Charles, Cabrelli Louise
Ninewells Hospital, Dundee, UK.
J Clin Nurs. 2004 Mar;13(3):396-405. doi: 10.1046/j.1365-2702.2003.00876.x.
Transfer from the intensive care unit to a ward is associated with a significant degree of relocation stress for patients and relatives. This can be stressful for ward nurses due to the dependency levels of patients and the ensuing increased workload. Furthermore the patient may require care, not normally undertaken in that clinical area, e.g. tracheostomy care. Patients may forget the verbal information given to them at the time of transfer and often have limited or no memory of the intensive care unit experience. This can cause anxiety and compound the feelings of stress associated with transfer. Many patients suffer psychological and physiological problems after intensive care unit, which can affect their recovery and quality of life.
The aim of the study was to develop an evidence-based information booklet for patients and relatives preparing for transfer from intensive care units.
This collaborative study used an exploratory design with elements of the action research cycle. The study, conducted in three phases, involved identifying patients' and relatives' information needs around the time of transfer; designing and developing an information booklet; and the introduction and evaluation of the booklet into practice.
Semistructured interviews were used to elicit the views of patients and relatives regarding their information needs. Members of the multidisciplinary team were involved in identifying and reviewing booklet content.
Evaluation identified positive outcomes relating to patients' and relatives' satisfaction with the information and enhanced communication with other wards and health care professionals. The study also highlighted the need for more staff education in relation to patients and relatives needs when transferring to a ward.
This study has demonstrated the value of providing patients and relatives with written information regarding transfer from intensive care units. Furthermore the study confirmed the feasibility and importance of including patients and relatives in the process of booklet development to ensure that their needs for information are being met.
Providing written information as part of a structured discharge plan is recommended. It provides patients and relatives with a resource that they can refer to at any time and that enhances verbal communication. The purpose of this information is to inform and empower patients so that they are better prepared for the transfer and recovery period.
从重症监护病房转至普通病房会给患者及其家属带来很大程度的搬迁压力。由于患者的依赖程度以及随之增加的工作量，这对病房护士来说也可能是有压力的。此外，患者可能需要一些在该临床区域通常不会进行的护理，例如气管造口护理。患者可能会忘记转科时被告知的口头信息，并且对重症监护病房的经历通常记忆有限或毫无记忆。这可能会导致焦虑，并加剧与转科相关的压力感。许多患者在离开重症监护病房后会出现心理和生理问题，这可能会影响他们的康复和生活质量。
本研究的目的是为准备从重症监护病房转科的患者及其家属编写一本基于证据的信息手册。
这项合作研究采用了带有行动研究周期元素的探索性设计。该研究分三个阶段进行，包括确定患者及其家属在转科前后的信息需求；设计和编写信息手册；以及将手册引入实践并进行评估。
采用半结构化访谈来了解患者及其家属对信息需求的看法。多学科团队成员参与确定和审核手册内容。
评估确定了与患者及其家属对信息的满意度以及与其他病房和医护人员沟通改善相关的积极成果。该研究还强调，在转至普通病房时，需要针对患者及其家属的需求对更多工作人员进行培训。
本研究证明了向患者及其家属提供有关从重症监护病房转科的书面信息的价值。此外，该研究证实了让患者及其家属参与手册编写过程以确保满足他们的信息需求的可行性和重要性。
建议提供书面信息作为结构化出院计划的一部分。它为患者及其家属提供了一种随时可以参考的资源，并增强了口头沟通。这些信息的目的是告知患者并使其有能力应对，以便他们为转科和康复期做好更好的准备。
