Adineh Mohammad, Elahi Nasrin, Molavynejad Shahram, Jahani Simin, Savaie Mohsen
Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Front Med (Lausanne). 2022 Sep 20;9:931304. doi: 10.3389/fmed.2022.931304. eCollection 2022.
The results of several studies show the different effects of a balanced sensory stimulation program (SSP) on patients with brain injury admitted to the intensive care unit (ICU), but these effects have been less studied based on mixed and comprehensive methods.
This mixed-method study involved 66 patients with brain injury admitted to the ICU who were allocated into intervention ( = 33) and control ( = 33) groups using random stratified sampling. Patients in the intervention group received a sensory stimulation program from family members for 1 h daily during ICU hospitalization, while the control group received only routine care. Patients' level of consciousness and pain intensity were measured immediately before and after the intervention using Glasgow Coma Scale (GCS) and Behavioral Pain Scale (BPS), respectively. In-depth unstructured interviews were conducted with the patients in the intervention group 3 months after discharge from the ICU. These interviews were analyzed following Graneheim and Lundman (2004) conventional content analysis method.
A significant difference was found between the study groups in terms of the mean difference of GCS ( =0.001) and BPS score ( = 0.001) before and after intervention. Patients in the intervention group had a higher mean GCS and a lower mean BPS than did patients in the control group. The main themes extracted from the qualitative analysis confirmed the results obtained from the quantitative phase of the study.
The combination of the quantitative and qualitative findings suggested that amidst the many hardships and sufferings brain injury patients go through in the ICU, a sensory stimulation program offered by family members may have many benefits such as increased level of consciousness and reduced pain for these patients. Therefore, it is necessary to formulate a framework for this program and provide the needed facilities in order to benefit more from the capacity of such programs for ICU patients.
多项研究结果显示，平衡感觉刺激方案（SSP）对入住重症监护病房（ICU）的脑损伤患者有不同影响，但基于混合和综合方法对这些影响的研究较少。
这项混合方法研究纳入了66例入住ICU的脑损伤患者，采用随机分层抽样将其分为干预组（n = 33）和对照组（n = 33）。干预组患者在ICU住院期间每天接受家属提供的1小时感觉刺激方案，而对照组仅接受常规护理。分别使用格拉斯哥昏迷量表（GCS）和行为疼痛量表（BPS）在干预前后立即测量患者的意识水平和疼痛强度。在患者从ICU出院3个月后，对干预组患者进行了深入的非结构化访谈。按照格兰内海姆和伦德曼（2004年）的传统内容分析法对这些访谈进行了分析。
研究组在干预前后的GCS平均差异（P = 0.001）和BPS评分（P = 0.001）方面存在显著差异。干预组患者的平均GCS高于对照组，平均BPS低于对照组。定性分析提取的主要主题证实了研究定量阶段获得的结果。
定量和定性研究结果相结合表明，在脑损伤患者在ICU经历的诸多艰难和痛苦中，家属提供的感觉刺激方案可能对这些患者有诸多益处，如提高意识水平和减轻疼痛。因此，有必要为此类方案制定框架并提供所需设施，以便更多地受益于此类方案对ICU患者的作用。
