Chien Wai-Tong, Chiu Y L, Lam Lai-Wah, Ip Wan-Yim
Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China.
Int J Nurs Stud. 2006 Jan;43(1):39-50. doi: 10.1016/j.ijnurstu.2005.01.006. Epub 2005 Sep 22.
Critical illness and subsequent hospitalisation of a relative to an intensive care unit (ICU) can result in many physiological and psychosocial problems for patients and their family members. Caring for the anxiety and frustration of these families is an integral part of critical care nursing. The purpose of this study was to examine the effect of a needs-based education programme provided within the first 3 days of patients' hospitalisation, on the anxiety levels and satisfaction of psychosocial needs of their families. This was a quasi-experimental study with pre- and post-test design. A convenience sample was recruited over a period of three months, consisting of one primary family carer of each critically ill patient who had been admitted to an ICU in Hong Kong. Conducted by an ICU nurse specially assigned for the purpose, family carers in the experimental group (n=34) received an individual education programme based on the results of a literature review and an individual family needs assessment carried out at the time of patient admission, using the Critical Care Family Needs Inventory. The subjects in the control group (n=32) received the usual orientation and explanation given by the ICU nurses. Anxiety and need satisfaction were measured in the two groups at pre- and post-test and their mean scores were compared. Of the ten most important statements identified by the family carers in the two groups, the statements regarding the needs for information and assurance were found to predominate. After the needs-based intervention, the experimental group reported significantly lower levels of anxiety and higher levels of satisfaction of family needs than the control group at the post-test. The findings support the effectiveness of providing families of newly admitted critically ill patients, with a needs-based educational intervention to allay anxiety and satisfy immediate psychosocial needs. The formulation of a family education programme should be based on the results of a needs assessment, in order to meet family carers' individual needs.
危重病以及亲属随后入住重症监护病房(ICU)会给患者及其家庭成员带来许多生理和心理社会问题。关注这些家庭的焦虑和沮丧情绪是重症护理的一个重要组成部分。本研究的目的是检验在患者住院的头3天内提供的基于需求的教育项目对其家庭焦虑水平和心理社会需求满意度的影响。这是一项采用前后测试设计的准实验研究。在三个月的时间里招募了一个便利样本,由香港各ICU收治的每位危重病患者的一名主要家庭照顾者组成。由专门为此目的指定的一名ICU护士实施,实验组(n = 34)的家庭照顾者根据文献综述结果以及患者入院时使用《重症监护家庭需求量表》进行的个体家庭需求评估,接受了个性化教育项目。对照组(n = 32)的受试者接受了ICU护士通常提供的指导和解释。在前后测试中对两组的焦虑和需求满意度进行了测量,并比较了它们的平均得分。在两组家庭照顾者确定的十条最重要陈述中,发现关于信息需求和保证需求的数据占主导地位。经过基于需求的干预后,实验组在测试后报告的焦虑水平显著低于对照组,家庭需求满意度高于对照组。研究结果支持为新入院的危重病患者家庭提供基于需求的教育干预以减轻焦虑和满足即时心理社会需求的有效性。家庭教育项目的制定应基于需求评估结果,以满足家庭照顾者的个体需求。