Department of Neurology, University of Washington, 325 Ninth Ave, Seattle, WA, 98104, USA.
Department of Anesthesiology and Neurocritical Care, University of Washington, Seattle, WA, USA.
Neurocrit Care. 2017 Oct;27(2):163-172. doi: 10.1007/s12028-017-0426-3.
Examine the association of a daily palliative care needs checklist on outcomes for family members of patients discharged from the neurosciences intensive care unit (neuro-ICU).
We conducted a prospective, longitudinal cohort study in a single, thirty-bed neuro-ICU in a regional comprehensive stroke and level 1 trauma center. One of two neuro-ICU services that admit patients to the same ICU on alternating days used a palliative care needs checklist during morning work rounds. Between March and October, 2015, surveys were mailed to family members of patients discharged from the neuro-ICU.
Nearly half of surveys (n = 91, 48.1%) were returned at a median of 4.7 months. At the time of survey completion, mean Modified rankin scale score (mRS) of neuro-ICU patients was 3.1 (SD 2). Overall ratings of quality of care were relatively high (82.2 on a 0-100 scale) with 32% of family members meeting screening criteria for depressive syndrome. The primary outcome measuring family satisfaction, consisting of eight items from the Family Satisfaction in the ICU questionnaire, did not differ significantly between families of patients from either ICU service nor did family ratings of depression (PHQ-8) and post-traumatic stress (PCL-17).
Among families of patients discharged from the neuro-ICU, the daily use of a palliative care needs checklist had no measurable effect on family satisfaction scores or long-term psychological outcomes. Further research is needed to identify optimal interventions to meet the palliative care needs specific to family members of patients treated in the neuro-ICU.
研究神经重症监护病房（Neuro-ICU）出院患者家属每日姑息治疗需求清单对其结局的影响。
我们在一家地区性综合卒中与 1 级创伤中心的 30 床神经重症监护病房中进行了一项前瞻性、纵向队列研究。Neuro-ICU 有两个服务组，每天轮流收治患者。其中一组在晨间查房时使用姑息治疗需求清单。2015 年 3 月至 10 月，向从 Neuro-ICU 出院的患者家属邮寄了调查问卷。
近一半的调查问卷（n=91，48.1%）在中位数为 4.7 个月时被寄回。在调查完成时，Neuro-ICU 患者的改良 Rankin 量表评分（mRS）平均为 3.1（标准差 2）。总体护理质量评分较高（0-100 分制下评分为 82.2），32%的家属符合抑郁综合征筛查标准。主要结局指标是家庭满意度，由 ICU 家庭满意度问卷中的 8 个条目组成，来自两个 ICU 服务的患者家属的家庭满意度没有显著差异，家属的抑郁评分（PHQ-8）和创伤后应激评分（PCL-17）也没有显著差异。
在 Neuro-ICU 出院患者的家属中，每日使用姑息治疗需求清单对家庭满意度评分或长期心理结局没有可衡量的影响。需要进一步研究以确定满足 Neuro-ICU 患者家属特定姑息治疗需求的最佳干预措施。
