Fumis Renata Rego Lins, Nishimoto Inês Nobuko, Deheinzelin Daniel
Unidade de Terapia Intensiva, Centro de Tratamento e Pesquisa Hospital do Câncer, CEP 01509-900 São Paulo, SP, Brazil.
J Crit Care. 2008 Sep;23(3):281-6. doi: 10.1016/j.jcrc.2007.04.004. Epub 2007 Jul 5.
The objective of this study is to correlate the levels of satisfaction of family members, with their perception of the way information was offered and assistance delivered during the patient's stay in the intensive care unit (ICU).
This is a prospective study conducted in a 13-bed mixed ICU in a tertiary cancer. Family members were enrolled 2 days after admission if the patient remained in the ICU. Questions derived from a previous study assessed the quality of the information and support received (Crit Care Med 1998; 26:1187). To generate the satisfaction criteria, families fulfilled a Portuguese version of the Critical Care Family Needs Inventory.
One hundred sixty-four families were interviewed between May 2002 and May 2003. Insufficient information concerning the consequences of disease was a determinant of dissatisfaction (odds ratio [OR], 3.35; confidence interval [CI], 1.3-8.8), as well as insufficient information given by the ICU doctors (OR, 3.85; CI, 1.2-12.2). Accessibility of doctors was a major determinant of dissatisfaction when considered inadequate (OR, 6.92; CI, 2.3-20.6), and it was associated to a conflict regarding prognosis (P = .017).
Family satisfaction and understanding in the ICU may improve if the doctors are more accessible to provide information and the staff strive to better explain the patient's condition.
本研究的目的是将家庭成员的满意度水平与其对患者在重症监护病房(ICU)期间信息提供方式和援助交付方式的认知相关联。
这是一项在一家三级癌症中心拥有13张床位的混合ICU中进行的前瞻性研究。如果患者仍在ICU,家庭成员在入院2天后被纳入研究。从先前的一项研究中衍生出的问题评估了所获得的信息和支持的质量(《危重病医学》1998年;26:1187)。为了生成满意度标准,家属填写了葡萄牙语版的《重症监护家庭需求问卷》。
在2002年5月至2003年5月期间,对164个家庭进行了访谈。关于疾病后果的信息不足是不满的一个决定因素(优势比[OR],3.35;置信区间[CI],1.3 - 8.8),以及ICU医生提供的信息不足(OR,3.85;CI,1.2 - 12.2)。当认为医生难以接触时,医生的可及性是不满的一个主要决定因素(OR,6.92;CI,2.3 - 20.6),并且它与关于预后的冲突相关(P = 0.017)。
如果医生更容易提供信息且工作人员努力更好地解释患者的病情,ICU中的家庭满意度和理解可能会提高。