Garrouste-Orgeas Maité, Philippart François, Timsit Jean François, Diaw Frédérique, Willems Vincent, Tabah Alexis, Bretteville Ghylaine, Verdavainne Aude, Misset Benoit, Carlet Jean
Medical Surgical Intensive Care Unit, Saint Joseph Hospital Network, Paris, France.
Crit Care Med. 2008 Jan;36(1):30-5. doi: 10.1097/01.CCM.0000295310.29099.F8.
To examine perceptions by intensive care unit (ICU) workers of unrestricted visitation, to measure visiting times, and to determine prevalence of symptoms of anxiety and depression in family members.
Observational, prospective, single-center cohort.
Medical-surgical ICU in a 460-bed tertiary-care hospital.
Two hundred nine consecutive patients hospitalized >3 days were studied over the first 5 ICU days.
None.
Characteristics of patients (n = 209), families (n = 149), and ICU workers (n = 43) were collected. ICU workers reported their perceptions of unrestricted visitation, and family members completed the Hospital Anxiety and Depression Scale. Daily severity scores (Simplified Acute Physiology Score II and Logistic Organ Failure) and a workload score (Nine Equivalents of Nursing Manpower) were computed. Maximum median visit length was 120 mins per patient per day and occurred on days 4 and 5. No correlations were found among severity of illness, workload, and visit length. For 115 patients, both nurse and physician questionnaires were available; although several differences were noted, neither nurses nor physicians perceived open visitation as disrupting patient care. The median rating for delay in organizing care was "never" for physicians and "occasionally" for nurses. Nurses perceived more disorganization of care than physicians (p = .008). Compared with nurses, the physicians reported greater family trust (p = .0023), more family stress (p = .047), and greater unease when examining the patient (p = .02). The Hospital Anxiety and Depression Scale indicated symptoms of anxiety in 73 (49%) family members and depression in 44 (29.5%).
The 24-hr visitation policy was perceived favorably by families. It induced only moderate discomfort among ICU workers, due to the potential for care interruption, in particular for nurses.
调查重症监护病房（ICU）工作人员对无限制探视的看法，测量探视时间，并确定家庭成员焦虑和抑郁症状的患病率。
观察性、前瞻性、单中心队列研究。
一家拥有460张床位的三级护理医院的内科-外科ICU。
连续209例住院超过3天的患者在ICU的前5天接受研究。
无。
收集了患者（n = 209）、家属（n = 149）和ICU工作人员（n = 43）的特征。ICU工作人员报告了他们对无限制探视的看法，家属完成了医院焦虑抑郁量表。计算每日严重程度评分（简化急性生理学评分II和逻辑器官功能衰竭评分）和工作量评分（九个护理人力当量）。每位患者每天的最大探视时间中位数为120分钟，出现在第4天和第5天。未发现疾病严重程度、工作量和探视时间之间存在相关性。对于115例患者，同时获得了护士和医生的问卷；尽管注意到了一些差异，但护士和医生均未认为开放探视会干扰患者护理。医生对组织护理延迟的中位数评级为“从不”，护士为“偶尔”。护士比医生更认为护理工作混乱（p = 0.008）。与护士相比，医生报告家属的信任度更高（p = 0.0023）、家属压力更大（p = 0.047），并且在检查患者时更不安（p = 0.02）。医院焦虑抑郁量表显示，73名（49%）家属有焦虑症状，44名（29.5%）有抑郁症状。
家属对24小时探视政策评价良好。由于可能会干扰护理，特别是对护士而言，这仅在ICU工作人员中引起了中度不适。
