Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands; Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia.
Surgery. 2019 Nov;166(5):769-777. doi: 10.1016/j.surg.2019.05.032. Epub 2019 Jul 6.
Active involvement of relatives has the potential to improve postoperative patient outcomes by prevention of complications sensitive to basic care and unplanned readmissions. The aim of this study was to assess the feasibility of a program in which relatives participated in postoperative care.
A pragmatic feasibility trial conducted at the surgical ward of a University hospital in the Netherlands. Patients undergoing esophageal or pancreatic resection with a relative who was willing and able to participate formed the intervention group (n = 20). A control group (n = 20) received usual postoperative care. The program consisted of the following: (1) information; (2) shared goal setting; (3) task-oriented training; (4) participation in basic care, focusing on mobilization, breathing exercises, cognitive activities and oral hygiene; (5) presence of relatives during ward rounds; and (6) rooming-in. Feasibility criteria were adherence to basic care, caregiver burden, and satisfaction of patients, family, and healthcare professionals.
All participants completed the program. Patients in the intervention group mobilized more (estimated difference for walking 170 meters per day, P = .037, and for sitting 109 minutes per day, P < .001), and showed more adherence to breathing exercises (estimated difference per day 1.4, P = .003), oral hygiene (estimated difference 1.52, P = .001), and cognitive activities (estimated difference 2.6, P < .001). Relatives'Care-Related Quality of Life instrument score did not deteriorate over time (P = .64); 96% of relatives would recommend the program and 92% felt better prepared for discharge. Patients in the intervention group were more satisfied with hospital admission. Healthcare professionals valued the program positively.
This program is feasible and is positively appreciated by patients, family, and healthcare professionals. Patients following the program showed more adherence to basic care activities.
亲属的积极参与有可能通过预防对基本护理敏感的并发症和非计划性再入院来改善术后患者的结局。本研究的目的是评估一项使亲属参与术后护理的方案的可行性。
在荷兰一所大学医院的外科病房进行的一项实用可行性试验。接受食管或胰腺切除术且有愿意并能够参与的亲属的患者形成干预组（n=20）。对照组（n=20）接受常规术后护理。该方案包括以下内容：（1）信息；（2）共同设定目标；（3）以任务为导向的培训；（4）参与基本护理，重点是动员、呼吸练习、认知活动和口腔卫生；（5）在查房期间亲属在场；（6）同室居住。可行性标准是遵守基本护理、护理人员负担以及患者、家属和医疗保健专业人员的满意度。
所有参与者均完成了该方案。干预组的患者活动量更大（每天行走 170 米的估计差异，P=0.037，每天坐 109 分钟的估计差异，P<0.001），且更遵守呼吸练习（每天的估计差异为 1.4，P=0.003）、口腔卫生（估计差异 1.52，P=0.001）和认知活动（估计差异 2.6，P<0.001）。亲属的护理相关生活质量量表评分并未随时间恶化（P=0.64）；96%的亲属会推荐该方案，92%的亲属表示对出院准备更充分。干预组的患者对住院治疗更满意。医疗保健专业人员对该方案给予积极评价。
该方案切实可行，得到了患者、家属和医疗保健专业人员的好评。参与该方案的患者更遵守基本护理活动。
