Pasquale Mae Ann, Pasquale Michael D, Baga Leslie, Eid Sherrine, Leske Jane
College of Nursing, Cedar Crest College, Allentown, Pennsylvania 18104, USA.
J Trauma. 2010 Nov;69(5):1092-9; discussion 1099-100. doi: 10.1097/TA.0b013e3181e84222.
The concept of family presence during trauma resuscitation (FPTR) remains controversial. Healthcare providers have expressed concern that resuscitation of severely injured trauma patients is inappropriate for family members as they may have psychologic distress, disrupt resuscitative efforts, or misinterpret provider actions, which can ultimately impact satisfaction with care. The minimal evidence that exists is descriptive or anecdotal.
Using a previously developed FPTR protocol, a prospective, comparative study assessing 50 adult family members, who were present (n = 25) or not present (n = 25) with their severely injured adult family member during resuscitation, was conducted. Family member anxiety was assessed using State-Trait Anxiety Inventory, satisfaction using a Revised-Critical Care Family Needs Inventory, and well-being using Family Member Well-being Index within 48 hours of intensive care unit admission. Mean total scores were compared for both groups with independent t tests. Significance was set at p < 0.05.
Age and Injury Severity Score were statistically equivalent in all patients. Anxiety, satisfaction, and well-being were not statistically different in family members present compared with those not present during resuscitation. There were no untoward events during resuscitation efforts. Family members present felt they benefited the patient and gained a better understanding of the situation. Conversely, family members not present commented that they would have preferred to have been present during resuscitation.
Family members present during trauma resuscitation suffered no ill psychologic effects and scored equivalent to those family members who were not present on anxiety, satisfaction, and well-being measures. Quality of care during trauma resuscitation was maintained. The fact that all the family members would repeat experience again supports the idea that FPTR was not too traumatic for those who chose to be present.
创伤复苏期间家属在场（FPTR）的概念仍存在争议。医疗服务提供者担心，对重伤创伤患者进行复苏对家属不合适，因为他们可能会出现心理困扰、干扰复苏工作或误解医护人员的行为，这最终可能会影响对护理的满意度。现有的少量证据多为描述性或轶事性的。
采用先前制定的FPTR方案，进行了一项前瞻性比较研究，评估50名成年家属，其中25名在其重伤成年家属复苏期间在场，25名不在场。在重症监护病房入院后48小时内，使用状态-特质焦虑量表评估家属焦虑，使用修订的重症监护家庭需求量表评估满意度，使用家庭成员幸福感指数评估幸福感。两组的平均总分采用独立t检验进行比较。显著性设定为p<0.05。
所有患者的年龄和损伤严重程度评分在统计学上相当。与复苏期间不在场的家属相比，在场家属的焦虑、满意度和幸福感在统计学上没有差异。复苏过程中没有发生不良事件。在场的家属认为他们对患者有益，并对情况有了更好的了解。相反，不在场的家属表示他们本希望在复苏期间在场。
创伤复苏期间在场的家属没有受到不良心理影响，在焦虑、满意度和幸福感指标上的得分与不在场的家属相当。创伤复苏期间的护理质量得以维持。所有家属都愿意再次经历这一事实支持了这样一种观点，即对于那些选择在场的人来说，FPTR并没有造成太大的创伤。
