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成年重症监护病房患者亲属希望收到的书面信息——与已发表建议及工作人员意见的比较

Written information that relatives of adult intensive care unit patients would like to receive--a comparison to published recommendations and opinion of staff members.

作者信息

Soltner Christophe, Lassalle Vincent, Galienne-Bouygues Sophie, Pottecher Julien, Floccard Bernard, Delapierre Laurence, Jungfer Francoise, Sargentini Cyril, Alberti Corrine, Beydon Laurent

机构信息

CHU d'Angers, Pôle d'Anesthésie Réanimation, 4933 Angers Cedex 9, France.

出版信息

Crit Care Med. 2009 Jul;37(7):2197-202. doi: 10.1097/CCM.0b013e3181a03063.

Abstract

OBJECTIVE

Information booklets have not been assessed by the families of intensive care unit (ICU) patients. This study explored the information that the relatives of adult ICU patients wanted to find in the information booklets.

DESIGN

Multicenter survey.

SETTING

Twenty-three French ICUs.

SUBJECTS

One close relative of each of 250 consecutive adult patients.

METHODS

Relatives were asked about the desirability of finding information on each of the 24 topics identified by ICU physicians and listed in guidelines as deserving inclusion in information booklets.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The 250 patients (61% men) had a mean age of 60 +/- 18 years and a mean Simplified Acute Physiology Score II of 48 +/- 19; 57% had chronic comorbidities and 41% were surgical patients. At least 72% of the relatives felt that booklets should discuss nosocomial infections, treatment-limitation decisions, access to medical information on the patient, access to medical records, and the meaning of medical terms. Overall, relatives wanted more information than that anticipated by ICU physicians, suggested in guidelines, or found in booklets. However, for at least one of the 24 topics, 38% of relatives indicated that fear or poor comprehension made them unwilling to receive written information. These relatives were younger and had fewer years of formal education than did the other relatives, and they were more likely to be visiting conscious unrestrained patients.

CONCLUSIONS

Opinions of relatives should be taken into account when designing ICU information booklets. Relatives want more information than that anticipated by physicians or suggested in guidelines, but the youngest or the less-educated ones may respond less favorably to written information.

摘要

目的

重症监护病房(ICU)患者家属尚未对信息手册进行评估。本研究探讨了成年ICU患者亲属希望在信息手册中获取的信息。

设计

多中心调查。

地点

23个法国ICU。

对象

250例连续成年患者中的每位患者的一位近亲。

方法

向亲属询问获取ICU医生确定并在指南中列出应纳入信息手册的24个主题中每个主题信息的意愿。

干预措施

无。

测量指标及主要结果

250例患者(61%为男性)的平均年龄为60±18岁,简化急性生理学评分II平均为48±19;57%有慢性合并症,41%为外科手术患者。至少72%的亲属认为手册应讨论医院感染、治疗限制决策、获取患者医疗信息、获取病历以及医学术语的含义。总体而言,亲属希望获得的信息比ICU医生预期的、指南中建议的或手册中提供的更多。然而,对于24个主题中的至少一个,38%的亲属表示恐惧或理解能力差使他们不愿意接受书面信息。这些亲属比其他亲属更年轻,接受正规教育的年限更少,并且他们更有可能探视意识清醒且无约束的患者。

结论

设计ICU信息手册时应考虑亲属的意见。亲属希望获得的信息比医生预期的或指南中建议的更多,但最年轻或受教育程度较低的亲属可能对书面信息的反应较差。

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