Moore Crystal Dea, Bernardini Gary L, Hinerman Rachel, Sigond Karen, Dowling Jane, Wang Deborah Baofeng, Shelton Wayne
Department of Social Work Skidmore College, Saratoga Springs, NY 12866, USA.
Crit Care Nurs Q. 2012 Oct-Dec;35(4):378-87. doi: 10.1097/CNQ.0b013e318268fde3.
Many patients in the intensive care unit (ICU) have predictable medical and discharge outcomes, but some trajectories are marked with medical uncertainty. Stressed family-surrogates receive multiple medical updates from a variety of personnel. These circumstances can lead to confusion, which may result in conflicts and dissatisfaction with care. This study examined the effects of adding a family support coordinator to the surgical, neurological, and medical ICUs on family, physician, and nurse satisfaction with communication and care. A quasi-experimental design was conducted in 2 sequential phases (baseline and intervention). The data sources were 2 surveys: (1) Family Satisfaction Survey and (2) Nurse and Physician Perception and Satisfaction Survey. Family Satisfaction Survey data, a combined data set, were collected in the 3 ICUs. Nurse and Physician Perception and Satisfaction Survey data were collected from the attending physicians and critical care nurses in the medical and neurological ICUs. Results show that family ratings of satisfaction with ICU team communication and care generally increased as a result of the intervention. Overall, physician and nurse perceptions of communication and care did not change as a result of the intervention.
重症监护病房（ICU）的许多患者都有可预测的医疗和出院结果，但有些病程却存在医疗不确定性。压力重重的家属代理人会从不同人员那里收到多次医疗情况更新。这些情况可能导致混乱，进而引发冲突以及对护理的不满。本研究考察了在外科、神经科和内科重症监护病房增设一名家属支持协调员，对家属、医生和护士在沟通及护理方面满意度的影响。采用准实验设计，分两个连续阶段（基线期和干预期）进行。数据来源为两项调查：（1）家属满意度调查；（2）护士与医生认知及满意度调查。家属满意度调查数据是一个合并数据集，在三个重症监护病房收集。护士与医生认知及满意度调查数据则从内科和神经科重症监护病房的主治医生和重症护理护士那里收集。结果显示，干预后家属对重症监护病房团队沟通及护理的满意度评分总体有所提高。总体而言，干预后医生和护士对沟通及护理的认知并未改变。
