Twibell Renee Samples, Siela Debra, Neal Alexis, Riwitis Cheryl, Beane Heather
Renee Samples Twibell, PhD, RN, CNE, is an associate professor at Ball State University School of Nursing, and nurse researcher at Indiana University Health Ball Memorial Hospital, Muncie, IN. Debra Siela, PhD, RN, CCNS, ACNS-BC, CCRN-K, CNE, RRT, is an associate professor and critical care clinical nurse specialist at Ball State University School of Nursing, Muncie, IN. Alexis Neal, MA, RN, is a cardiovascular service line leader at Indiana University Health Ball Memorial Hospital, Muncie, IN. Cheryl Riwitis, MSN, RN, FNP-BC, CEN, CFRN, TCRN, EMT-B, is a critical care transport nurse, family nurse practitioner, and nurse educator at Indiana University Health Lifeline, Indianapolis, IN. Heather Beane, MS, RN, is an instructor at Ball State University School of Nursing, and clinical nurse at the Cardiac Intensive Care Unit, Indiana University Health Ball Memorial Hospital, Muncie, IN.
Dimens Crit Care Nurs. 2018 May/Jun;37(3):167-179. doi: 10.1097/DCC.0000000000000297.
Families often desire proximity to loved ones during life-threatening resuscitations and perceive clear benefits to being present. However, critical care nurses and physicians perceive risks and benefits. Whereas research is accumulating on nurses' perceptions of family presence, physicians' perspectives have not been clearly explicated. Psychometrically sound measures of physicians' perceptions are needed to create new knowledge and enhance collaboration among critical care nurses and physicians during resuscitation events.
This study tests 2 new instruments that measure physicians' perceived risks, benefits, and self-confidence related to family presence during resuscitation.
By a correlational design, a convenience sample of physicians (N = 195) from diverse clinical specialties in 1 hospital in the United States completed the Physicians' Family Presence Risk-Benefit Scale and Physicians' Family Presence Self-confidence Scale.
Findings supported the internal consistency reliability and construct validity of both new scales. Mean scale scores indicated that physicians perceived more risk than benefit and were confident in managing resuscitations with families present, although more than two-thirds reported feeling anxious. Higher self-confidence was significantly related to more perceived benefit and less perceived risk (P = .001). Younger physicians, family practice physicians, and physicians who previously had invited family presence expressed more positive perceptions (P = .05-.001).
These 2 new scales offer a means to assess key perceptions of physicians related to family presence. Further testing in diverse physician populations may further validate the scales and yield knowledge that can strengthen collaboration among critical care nurses and physicians and improve patient and family outcomes.
在危及生命的复苏过程中，家属通常希望能与亲人近距离相处，并认为在场有明显益处。然而，重症护理护士和医生则察觉到了其中的风险和益处。尽管关于护士对家属在场的看法的研究不断积累，但医生的观点尚未得到明确阐释。需要采用心理测量学上可靠的方法来衡量医生的看法，以便创造新知识并加强重症护理护士和医生在复苏事件中的协作。
本研究测试了两种新工具，用于测量医生在复苏过程中对家属在场的感知风险、益处和自信心。
采用相关性设计，来自美国一家医院不同临床专科的195名医生组成的便利样本，完成了《医生家属在场风险-益处量表》和《医生家属在场自信心量表》。
研究结果支持了这两种新量表的内部一致性信度和结构效度。量表平均得分表明，医生认为风险大于益处，并且对在有家属在场的情况下进行复苏有信心，尽管超过三分之二的医生表示感到焦虑。更高的自信心与更多的感知益处和更少的感知风险显著相关（P = 0.001）。年轻医生、家庭医生以及之前曾邀请家属在场的医生表达了更积极的看法（P = 0.05 - 0.001）。
这两种新量表提供了一种评估医生对家属在场关键看法的方法。在不同医生群体中进行进一步测试可能会进一步验证这些量表，并产生有助于加强重症护理护士和医生之间协作以及改善患者和家属结局的知识。
