Epstein Elizabeth Gingell, Sherman Jessica, Blackman Amy, Sinkin Robert A
Elizabeth Gingell Epstein is an associate professor in the University of Virginia School of Nursing and the University of Virginia Center for Biomedical Ethics and Humanities, Charlottesville. Jessica Sherman is a family nurse practitioner at Village Square Family Medicine, Columbus, Ohio. Amy Blackman is a clinical research coordinator in the neonatal intensive care unit and Robert A. Sinkin is Charles Fuller Professor and division head of neonatology, Department of Pediatrics, and medical director for newborn services, University of Virginia Health System, Charlottesville.
Am J Crit Care. 2015 Jul;24(4):290-6. doi: 10.4037/ajcc2015828.
Effective provider-parent relationships are essential during critical illness when treatment decisions are complex, the environment is crowded and unfamiliar, and outcomes are uncertain.
To evaluate the feasibility of daily Skype or FaceTime updates with parents of patients in the neonatal intensive care unit (NICU) and to assess the intervention's potential for improving parent-provider relationships.
A pre/post mixed-methods approach was used. NICU parent participants received daily Skype or FaceTime updates for 5 days and completed demographic and feasibility surveys. Parents also completed Penticuff's Parents' Understanding survey before and after the intervention. Nurses and physicians completed feasibility surveys after each update.
Twenty-six parents were enrolled and 15 completed the study. More than 90% of providers and parents perceived the intervention to be reliable and easy to use, and about 80% of parents and providers rated video and audio quality as either excellent or good. Frozen screens and missed updates due to scheduling problems were challenges. Two of the 4 subscores on the Parents' Understanding survey improved significantly. Qualitative data favor the intervention as meaningful for parents.
Real-time videoconferencing via Skype or FaceTime is feasible for providing updates for parents when they cannot be present in the NICU and can be used to include parents in bedside rounds. Videoconferencing updates may improve relationships between parents and the health care team.
在危重病期间，当治疗决策复杂、环境拥挤且陌生、结果不确定时，有效的医护人员与家长之间的关系至关重要。
评估在新生儿重症监护病房（NICU）每天通过Skype或FaceTime向患者家长提供病情更新的可行性，并评估该干预措施改善家长与医护人员关系的潜力。
采用前后混合方法。NICU的家长参与者连续5天每天接收Skype或FaceTime病情更新，并完成人口统计学和可行性调查。家长们还在干预前后完成了彭蒂卡夫家长理解度调查。护士和医生在每次更新后完成可行性调查。
26名家长参与研究，15名完成研究。超过90%的医护人员和家长认为该干预措施可靠且易于使用，约80%的家长和医护人员将视频和音频质量评为优秀或良好。因日程安排问题导致的屏幕冻结和错过更新是挑战。家长理解度调查的4个分项得分中有2个显著提高。定性数据表明该干预措施对家长有意义。
当家长无法亲临NICU时，通过Skype或FaceTime进行实时视频会议为家长提供病情更新是可行的，并且可用于让家长参与床边查房。视频会议病情更新可能会改善家长与医疗团队之间的关系。
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