Meridian Health System, University of Medicine and Dentistry of New Jersey, Neptune, New Jersey 07101-1709, USA.
Int J Evid Based Healthc. 2011 Dec;9(4):362-87. doi: 10.1111/j.1744-1609.2011.00229.x.
The aim of this review was to appraise and synthesise the best available evidence on visitation models used in adult intensive care units in acute care hospitals and to explicate their congruence with the core concepts of patient- and family-centred care (PFCC).
The review considered both quantitative and qualitative studies on visitation models developed within the PFCC model in adult intensive care units in acute care hospitals. The search strategy sought published and unpublished research papers limited to English for the years 1988 through 2009. An initial search of the Joanna Briggs Institute for Evidence-Based Nursing and Midwifery, the Cochrane Library, and PubMed's Clinical Inquiry/Find Systematic Review database was conducted, followed by an analysis of key words contained in the title, abstract and index terms. Following this, an extensive three-stage search was conducted using PubMed, CINAHL, HealthStar, ScienceDirect, Dissertation Abstracts International, DARE, PsycINFO, BioMedCentral, TRIP, Pre-CINAHL, PsycARTICLES, Psychology and Behavioural Sciences Collection, ISI Current Contents, Science.gov, Web of Science/Web of Knowledge, Scirus.com website. Included was a hand search of reference lists of identified papers to capture all pertinent material as well as a search of relevant worldwide websites and search engines, such as Google Scholar and the Virginia Henderson Library of Sigma Theta Tau International. Each paper was assessed independently by two reviewers for methodological quality prior to inclusion in the review using the appropriate critical appraisal instrument.
Findings from the qualitative studies were extracted and a synthesis conducted using the QARI (Qualitative Assessment and Review Instrument) software developed by the Joanna Briggs Institute. One synthesis revealed that visiting hours were seen as guidelines for the benefit of nurse and patient, rather than rules or policy. Due to the various types of designs in the available studies, it was not possible to pool quantitative research study results into a statistical meta-analysis. Because statistical pooling was not possible, the findings are presented in a narrative form. Following this, results are presented for their congruence with the principles of PFCC.
Flexible visiting policies provide the ability to incorporate the concepts of PFCC into practice. However, nurses believe that while visiting is beneficial to patients, open and/or flexible visiting hours are an impediment to practice and increase their workload. Recommendations for best practice were formulated based on the outcomes and include visiting hours should be used as guidelines, not rules, that allow flexibility dependent upon individual patient/family situation. With regard to congruence with PFCC, patient and family requests for information emerged as an unmet need that needs to be addressed.
本综述旨在评估和综合成人重症监护病房中使用的探视模式的最佳证据，并阐述这些模式与以患者和家庭为中心的护理（PFCC）核心概念的一致性。
本综述考虑了在成人重症监护病房中以 PFCC 模式开发的探视模式的定量和定性研究。搜索策略仅限于 1988 年至 2009 年期间发表和未发表的英语研究论文。首先对 Joanna Briggs 循证护理和助产研究所、Cochrane 图书馆以及 PubMed 的临床查询/查找系统评价数据库进行了初步搜索，然后对标题、摘要和索引术语中包含的关键词进行了分析。在此之后，使用 PubMed、CINAHL、HealthStar、ScienceDirect、 Dissertation Abstracts International、DARE、PsycINFO、BioMedCentral、TRIP、Pre-CINAHL、PsycARTICLES、心理学和行为科学收藏、ISI 目录、Science.gov、Web of Science/Web of Knowledge、Scirus.com 网站进行了广泛的三阶段搜索。还包括对已确定论文的参考文献列表进行了手工搜索，以获取所有相关材料，以及对相关全球网站和搜索引擎（如 Google Scholar 和 Sigma Theta Tau 国际的 Virginia Henderson 图书馆）进行了搜索。每篇论文都由两名评审员独立进行方法学质量评估，然后使用 Joanna Briggs 研究所开发的适当的批判性评估工具将其纳入综述。使用 QARI（定性评估和审查工具）软件提取定性研究的结果，并进行综合。一项综合研究结果表明，探视时间被视为有利于护士和患者的指南，而不是规则或政策。由于现有研究中存在各种类型的设计，因此无法将定量研究结果汇总到统计荟萃分析中。由于不可能进行统计学汇总，因此以叙述形式呈现研究结果。在此之后，根据与 PFCC 原则的一致性呈现结果。
灵活的探视政策使将 PFCC 的概念纳入实践成为可能。然而，护士认为，虽然探视对患者有益，但开放和/或灵活的探视时间对实践是一种障碍，并增加了他们的工作量。根据结果制定了最佳实践建议，包括将探视时间用作指南，而不是规则，根据患者/家庭的具体情况允许灵活性。关于与 PFCC 的一致性，患者和家属对信息的需求被认为是一个未满足的需求，需要加以解决。
