Padilla-Fortunatti Cristobal, Munro Cindy L, Gattamorta Karina
School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile.
School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA.
J Nurs Scholarsh. 2023 Jan;55(1):33-44. doi: 10.1111/jnu.12812. Epub 2022 Sep 29.
This study aims to explore the associations among psychological distress, perceived social support, and family satisfaction among family members of non-COVID-19 intensive care unit (ICU) patients during the COVID-19 pandemic.
A cross-sectional study.
Family members of patients with at least 48 h in the ICU and without a COVID-19 diagnosis were screened between January and March 2021. For enrolled ICU family members, five questionnaires for perceived stress (Perceived Stress Scale), anxiety symptoms (General Anxiety Disorder-7), depressive symptoms (Patient Health Questionnaire-9), perceived social support (Medical Outcomes Study Social Support Survey), and family satisfaction (Family Satisfaction with Care in the Intensive Care Unit-24) were administered by phone either in English or Spanish language. Sociodemographic and patient clinical data were also collected. Data were analyzed using descriptive statistics, Pearson's correlations, Mann-Whitney U, and Fisher's exact tests.
Of 87 eligible ICU family members, 63 were enrolled (72.4%); 27% of the sample presented with clinically significant symptoms of anxiety, 25.4% with depression, and 76.2% had a high perception of social support. ICU family members with low/fair perceived social support reported statistically significantly higher perceived stress and lower family satisfaction. Perceived stress was negatively correlated with family satisfaction. Clinically significant symptoms of anxiety and depression were not statistically associated with family satisfaction or perceived social support.
While ICU admission-related stress may undermine family satisfaction, perceived social support may be positively associated with the way that ICU family members of non-COVID-19 patients evaluate the quality of care in the ICU. Knowing the factors that influence family satisfaction in the ICU may assist stakeholders and policy developers to improve family-centered care in the hospital setting.
Early screening for psychological distress and social support levels during admission should be included in updates of visiting and communication policies in the ICU. Prompt identification of family members at risk of a poor ICU experience may enhance efforts to support them, particularly in acute care settings where differentiated approaches to COVID-19 and non-COVID-19 ICU family members are established.
本研究旨在探讨2019冠状病毒病(COVID-19)大流行期间,非COVID-19重症监护病房(ICU)患者家属的心理困扰、感知社会支持与家庭满意度之间的关联。
一项横断面研究。
在2021年1月至3月期间,对入住ICU至少48小时且未确诊COVID-19的患者家属进行筛查。对于入选的ICU患者家属,通过电话以英语或西班牙语发放了五份问卷,分别用于评估感知压力(感知压力量表)、焦虑症状(广泛性焦虑障碍量表-7)、抑郁症状(患者健康问卷-9)、感知社会支持(医学结局研究社会支持调查)和家庭满意度(重症监护病房护理家庭满意度量表-24)。同时收集了社会人口学和患者临床数据。采用描述性统计、Pearson相关性分析、Mann-Whitney U检验和Fisher精确检验对数据进行分析。
在87名符合条件的ICU患者家属中,63名被纳入研究(72.4%);样本中27%有临床显著焦虑症状,25.4%有抑郁症状,76.2%有较高的社会支持感知。社会支持感知较低/一般的ICU患者家属报告的感知压力在统计学上显著更高,家庭满意度更低。感知压力与家庭满意度呈负相关。焦虑和抑郁的临床显著症状与家庭满意度或感知社会支持在统计学上无关联。
虽然入住ICU相关的压力可能会降低家庭满意度,但感知社会支持可能与非COVID-19患者的ICU家属评估ICU护理质量的方式呈正相关。了解影响ICU家庭满意度的因素可能有助于利益相关者和政策制定者改善医院环境中以家庭为中心的护理。
在ICU探视和沟通政策的更新中,应纳入入院时心理困扰和社会支持水平的早期筛查。及时识别有不良ICU体验风险的家属可能会加强对他们的支持力度,特别是在针对COVID-19和非COVID-19 ICU家属制定了差异化方法的急性护理环境中。