Beiermann Mary, Kalowes Peggy, Dyo Melissa, Mondor Amanda
Mary Beiermann, BSN, RN, CCRN-CSC, is a clinical nurse at Long Beach Memorial, California. Peggy Kalowes, PhD, RN, CNS, FAHA, is the director for Nursing Research, Innovation and EBP at Long Beach Memorial, California. Melissa Dyo, PhD, RN, NP-C, is an associate professor at the School of Nursing, California State University, Long Beach. Amanda Mondor, BSN, RN, CCRN, is a clinical nurse at Long Beach Memorial, California.
Dimens Crit Care Nurs. 2017 Nov/Dec;36(6):317-326. doi: 10.1097/DCC.0000000000000269.
In the United States, 20% of patients die in the intensive care unit (ICU), yet little is known about bereavement strategies to aid grieving families.
The primary aim was to study the bereavement experience for families in the ICU; secondary aim was to measure nurses' perception of end-of-life care, and a third was to evaluate the impact of the ECG Memento by families and nurses.
A prospective, descriptive study design was used, with a postsurvey methodology. Fifty ICU patient families agreed to participate, although only 28 returned the Satisfaction With Bereavement Experience Questionnaire. In addition, 38 of 100 eligible nurses completed the Quality of Dying and Death in the Intensive Care Unit survey.
The Satisfaction With Bereavement Experience Questionnaire data showed families as highly satisfied with hospital (mean, 1.5), personal (mean, 1.6), ritual (mean, 1.3), and posthospital experiences (mean, 1.9). Quality of Dying and Death in the Intensive Care Unit results indicated that ideal control of patients' symptoms was reported by only 26% of nurses surveyed. Half of the families reported that the death was unexpected. Families (86%) responded positively to the ECG Memento, and according to 98% of the nurses, the ECG Memento was very well received.
Despite most families reporting high satisfaction with the bereavement experience, nurses reported a low level of patient symptom control; also, families often found the death to be unexpected. This suggests that the bereavement experience is a complex process requiring nurses to implement various interventions during this vulnerable period. Most families responded positively to this novel bereavement tool, which may aid families as they transition from anticipatory grieving to bereaved status. Further studies are needed to evaluate the ECG Memento as an innovation on a wider scale and to develop additional interventions to positively impact the grieving process for families.
在美国，20%的患者死于重症监护病房（ICU），但对于帮助悲伤家属的哀伤辅导策略却知之甚少。
主要目的是研究ICU中家属的哀伤经历；次要目的是衡量护士对临终关怀的看法，第三个目的是评估心电图纪念品对家属和护士的影响。
采用前瞻性描述性研究设计，并采用事后调查方法。50个ICU患者家庭同意参与，尽管只有28个家庭返回了哀伤经历满意度调查问卷。此外，100名符合条件的护士中有38名完成了重症监护病房死亡质量调查。
哀伤经历满意度调查问卷数据显示，家属对医院经历（平均分为1.5）、个人经历（平均分为1.6）、仪式（平均分为1.3）和出院后经历（平均分为1.9）高度满意。重症监护病房死亡质量调查结果表明，只有26%的受访护士报告患者症状得到了理想控制。一半的家属报告称死亡是意外发生的。86%的家属对心电图纪念品给予了积极回应，98%的护士表示心电图纪念品很受欢迎。
尽管大多数家属对哀伤经历表示高度满意，但护士报告的患者症状控制水平较低；此外，家属常常觉得死亡是意外发生的。这表明哀伤经历是一个复杂的过程，需要护士在这个脆弱时期实施各种干预措施。大多数家属对这种新颖的哀伤辅导工具给予了积极回应，这可能有助于家属从预期性哀伤过渡到丧亲状态。需要进一步研究以更广泛地评估心电图纪念品作为一项创新，并开发其他干预措施以积极影响家属的哀伤过程。
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