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重症监护病房联络护士服务在新冠疫情期间重症监护病房出院患者家庭照顾者焦虑情绪方面的作用:一项随机对照试验

The role of the ICU liaison nurse services on anxiety in family caregivers of patients after ICU discharge during COVID-19 pandemic: a randomized controlled trial.

作者信息

Mottaghi Khadijeh, Hasanvand Shirin, Goudarzi Fateme, Heidarizadeh Khadijeh, Ebrahimzadeh Farzad

机构信息

Master of Critical Care Nursing, Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran.

Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.

出版信息

BMC Nurs. 2022 Sep 10;21(1):253. doi: 10.1186/s12912-022-01034-6.

Abstract

BACKGROUND

With the onset of the COVID-19 pandemic and the need to maintain social distancing and changes in wards' structure, families no longer access the routine support they received during the hospitalization of their patients in the ICU. This study aimed to determine the effects of ICU liaison nurse services on the anxiety in patients' family caregivers after ICU discharge during the COVID-19 pandemic.

METHODS

This randomized controlled trial was performed in western Iran from February 2020, to March 2021. Sixty subjects were selected from the family caregivers of the patients transferred from the ICU and were randomly assigned to the control (n = 30) and the intervention groups (n = 30). The control group received routine transfer care. In the intervention group, liaison nurse services were offered in 4 dimensions: patient support, family support, training, support of the ward's staff, and the evaluation of the destination ward. The participants' anxiety was measured using the Spielberger State Anxiety Inventory immediately after the patient transfer and 6 h after admission to the general ward. Data analyzed with SPSS V16, descriptive and inferential statistics, including Chi-square test, Mann-Whitney test, Wilcoxon test, and Generalized Linear Model with cumulative logit link function. Results were reported at a 0.05 significance level.

RESULTS

A statistically significant difference was observed in baseline anxiety levels (P = 0.035) and age group (P < 0.001) between the intervention and control groups. After moderating baseline anxiety levels, the age group, and marital status, the impact of the intervention was significant (X = 10.273, df = 1, P < 0.001), meaning that the intervention could reduce the relative chances of developing higher levels of anxiety by 92.1% (OR: 0.08, 95%CI: 0.017-0.373, P < 0.001).

CONCLUSIONS

This study confirmed the positive impact of nursing services on reducing anxiety in family caregivers during the COVID-19 pandemic. It is recommended to use these services, especially during the COVID-19 condition, to facilitate the patient transfer, support the patient's family, and reduce the health care gap between the ICU and the ward.

摘要

背景

随着新冠疫情的爆发,以及保持社交距离的需要和病房结构的变化,家属无法再获得患者在重症监护病房(ICU)住院期间所得到的常规支持。本研究旨在确定在新冠疫情期间,ICU联络护士服务对ICU出院后患者家庭照顾者焦虑情绪的影响。

方法

本随机对照试验于2020年2月至2021年3月在伊朗西部进行。从转出ICU的患者的家庭照顾者中选取60名受试者,并随机分为对照组(n = 30)和干预组(n = 30)。对照组接受常规的转院护理。干预组在四个方面提供联络护士服务:患者支持、家属支持、培训、病房工作人员支持以及目标病房评估。在患者转院后即刻以及入住普通病房6小时后,使用斯皮尔伯格状态焦虑量表测量参与者的焦虑程度。数据采用SPSS V16进行分析,包括描述性和推断性统计,如卡方检验、曼-惠特尼检验、威尔科克森检验以及具有累积对数链接函数的广义线性模型。结果以0.05的显著性水平报告。

结果

干预组和对照组在基线焦虑水平(P = 0.035)和年龄组(P < 0.001)方面存在统计学显著差异。在对基线焦虑水平、年龄组和婚姻状况进行调整后,干预的影响具有显著性(X = 10.273,df = 1,P < 0.001),这意味着干预可将出现更高焦虑水平的相对几率降低92.1%(OR:0.08,95%CI:0.017 - 0.373,P < 0.001)。

结论

本研究证实了护理服务在新冠疫情期间对于减轻家庭照顾者焦虑情绪的积极影响。建议采用这些服务,尤其是在新冠疫情期间,以便利患者转院、支持患者家属并缩小ICU与病房之间的医疗差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/9464407/02cc931965dc/12912_2022_1034_Fig1_HTML.jpg

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