Macnab Andrew J, Northway Tracie, Ryall Karen, Scott Deborah, Straw Geoffrey
Intensive Care Unit, Children's and Women's Health Centre of British Columbia, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia.
Paediatr Child Health. 2003 Jul;8(6):357-62. doi: 10.1093/pch/8.6.357.
To determine which staff behaviours and interventions were helpful to a family who had a child die in the intensive care unit (ICU) and which behaviours could be improved.
Families whose child died six to 18 months earlier were invited to participate. Families whose child's death involved a coroner's inquiry were excluded. Family members were interviewed by a grief counselor, and completed the Grief Experience Inventory Profile and an empirically designed questionnaire.
No family refused to participate. All family members (13 families, 24 individuals) reported that they wanted, were offered and had: time to be alone with their child, time to hold the child, chances to discuss their feelings, and an opportunity to cry and express their emotions openly. Tangible mementos of the child were appreciated. Support provided by nursing staff was rated as excellent. Some physicians appeared to be abrupt, cold and unfeeling. Hospital social workers and chaplains, when available, were appreciated. Parents valued access to private space and holding their child, but these options needed to be suggested, as they did not know to ask for them. Some families wanted more information about funeral arrangements; most wanted more timely information about autopsy results and feedback on organ donations. Follow-up contact from the hospital about four weeks after the death was valued. Families saw the study as an opportunity to provide feedback that may help others.
Many acute bereavement interventions need to be initiated by staff because families do not know to request them. Physicians do not always meet individual family's needs for support. Contact initiated by staff following a death is appreciated.
确定哪些医护人员的行为和干预措施对在重症监护病房（ICU）中失去孩子的家庭有帮助，以及哪些行为可以改进。
邀请孩子在六至18个月前死亡的家庭参与。孩子死亡涉及验尸官调查的家庭被排除在外。由一名悲伤顾问对家庭成员进行访谈，并让他们完成《悲伤经历量表》和一份经实证设计的问卷。
没有家庭拒绝参与。所有家庭成员（13个家庭，24人）报告称，他们希望、得到了并且拥有：与孩子独处的时间、抱孩子的时间、讨论感受的机会，以及公开哭泣和表达情感的机会。孩子的实体纪念品受到珍视。护士提供的支持被评为优秀。一些医生显得唐突、冷漠且无情。医院的社会工作者和牧师（如有）受到赞赏。父母重视有私人空间和抱孩子，但这些选择需要有人提出，因为他们不知道要提出这样的要求。一些家庭希望获得更多关于葬礼安排的信息；大多数家庭希望更及时地了解尸检结果和器官捐赠的反馈。医院在孩子死亡约四周后进行的后续联系受到重视。家庭将这项研究视为提供可能帮助他人的反馈的机会。
许多急性丧亲之痛干预措施需要由医护人员主动发起实施，因为家庭不知道要提出这样的要求。医生并不总是能满足个别家庭对支持的需求。医护人员在患者死亡后主动进行联系受到赞赏。
