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评估丧亲支持对 ICU 死亡患者家属影响的初步研究。

Pilot Study Assessing the Impact of Bereavement Support on Families of Deceased Intensive Care Unit Patients.

机构信息

Jennifer L. McAdam is an associate professor at Samuel Merritt University, School of Nursing, Oakland, California. Kathleen Puntillo is a professor emeritus at University of California, San Francisco, San Francisco, California.

出版信息

Am J Crit Care. 2018 Sep;27(5):372-380. doi: 10.4037/ajcc2018575.

Abstract

BACKGROUND

Family members of patients who die in an intensive care unit (ICU) may experience negative outcomes. However, few studies have assessed the effectiveness of bereavement care for families.

OBJECTIVE

To evaluate the effectiveness of bereavement follow-up on family members' anxiety, depression, posttraumatic stress, prolonged grief, and satisfaction with care.

METHODS

A cross-sectional, prospective pilot study of 40 family members of patients who died in 2 tertiary care ICUs. Those in the medical-surgical ICU received bereavement follow-up (bereavement group); those in the cardiac ICU received standard care (nonbereavement group). Both groups completed surveys 13 months after the death. Surveys included the Hospital Anxiety and Depression Scale, Impact of Event Scale-Revised, Family Satisfaction With Care in the Intensive Care Unit, Prolonged Grief Disorder, and a bereavement survey.

RESULTS

Of 30 family members in the bereavement group and 10 in the nonbereavement group, most were female and spouses, with a mean (SD) age of 60.1 (13.3) years. Significantly more participants in the nonbereavement group than in the bereavement group had prolonged grief. Posttraumatic stress, anxiety, depression, and satisfaction with care were not significantly different in the 2 groups. However, overall posttraumatic stress scores were higher in the nonbereavement group than the bereavement group, indicating a higher risk of posttraumatic stress disorder.

CONCLUSIONS

Bereavement follow-up after an ICU death reduced family members' prolonged grief and may also reduce their risk of posttraumatic stress disorder. This type of support did not have a measurable effect on depression or satisfaction with ICU care.

摘要

背景

在重症监护病房(ICU)去世的患者的家属可能会经历负面结果。然而,很少有研究评估丧亲关怀对家庭的有效性。

目的

评估丧亲随访对家属焦虑、抑郁、创伤后应激、长期悲伤和对护理满意度的影响。

方法

对 2 家三级护理 ICU 中 40 名死亡患者的家属进行了一项横断面、前瞻性试点研究。接受重症监护病房丧亲随访(丧亲组);接受心脏 ICU 标准护理(非丧亲组)。两组均在死亡后 13 个月完成调查。调查包括医院焦虑和抑郁量表、修订后的事件影响量表、重症监护病房家庭护理满意度量表、长期悲伤障碍和丧亲调查。

结果

在丧亲组的 30 名家属和非丧亲组的 10 名家属中,大多数是女性和配偶,平均(SD)年龄为 60.1(13.3)岁。非丧亲组的长期悲伤者明显多于丧亲组。两组间创伤后应激、焦虑、抑郁和对护理的满意度无显著差异。然而,非丧亲组的总体创伤后应激评分高于丧亲组,表明创伤后应激障碍的风险较高。

结论

ICU 死亡后的丧亲随访减少了家属的长期悲伤,也可能降低他们患创伤后应激障碍的风险。这种支持方式对抑郁或对 ICU 护理的满意度没有明显影响。

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