Leske Jane S, McAndrew Natalie S, Brasel Karen J
College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 523201, USA.
J Trauma Nurs. 2013 Apr-Jun;20(2):77-85. doi: 10.1097/JTN.0b013e31829600a8.
Several organizations have published national guidelines on providing the option of family presence during resuscitation (FPDR). Although FPDR is being offered in clinical practice, there is limited description of family experiences after FPDR. The aim of this study was to describe family experiences of the FPDR option after trauma from motor vehicle crashes and gunshot wounds. A descriptive, qualitative design based on content analysis was used to describe family experiences of the FPDR option. Family members (N = 28) were recruited from a major level 1 adult trauma center in the Midwest. Participants in this study were 1 family member per patient who were 18 years or older, visited the patient in the surgical intensive care unit, spoke and understood English, and had only one critically injured patient in the family. Family interview data on experiences during FPDR after trauma were used to identify themes. Two main categories were found. Families view the role of health care professionals (HCPs) to "fix" the patient, whereas they as family members have an important role to protect and support the patient. Subcategories related to the role of the HCP include the following: multiple people treating the patient, completion of many tasks with "assessment of the damages," and professionalism/teamwork. Important subcategories related to the family member role include the following: providing information to the HCP, ensuring that the medical team is doing its job, and remaining close to provide physical and emotional comfort to the patient. Health care professionals are viewed positively by the family, and the role of the family is viewed as important. Families wanted to be present and would recommend the choice to other family members. The findings of this study support that the FPDR option is an intervention that helps family members build trust in HCPs, fulfills informational needs, allows family members to gain close proximity to the patient, and support their family member emotionally.
几个组织已经发布了关于在复苏过程中提供家属在场选项（FPDR）的国家指南。尽管FPDR在临床实践中已被采用，但关于FPDR后家属经历的描述却很有限。本研究的目的是描述机动车碰撞和枪伤创伤后家属对FPDR选项的经历。采用基于内容分析的描述性定性设计来描述家属对FPDR选项的经历。从美国中西部一家大型一级成人创伤中心招募了家庭成员（N = 28）。本研究的参与者为每位患者一名18岁及以上的家庭成员，他们在外科重症监护病房探望患者，会说并理解英语，且家中只有一名重伤患者。利用关于创伤后FPDR期间经历的家属访谈数据来确定主题。发现了两个主要类别。家属认为医护人员（HCP）的角色是“治好”患者，而他们作为家庭成员则有保护和支持患者的重要角色。与医护人员角色相关的子类别包括：多人治疗患者、通过“损伤评估”完成许多任务以及专业精神/团队合作。与家庭成员角色相关的重要子类别包括：向医护人员提供信息、确保医疗团队履行职责以及待在患者身边给予身体和情感上的安慰。家属对医护人员评价积极，并且认为家庭成员的角色很重要。家属希望在场，并会向其他家庭成员推荐这一选择。本研究结果支持FPDR选项是一种有助于家庭成员建立对医护人员信任、满足信息需求、使家庭成员能够近距离陪伴患者并在情感上支持其家庭成员的干预措施。
