School of Medicine and Nursing Sciences, Huzhou University, Huzhou, China.
Guangzhou First People's Hospital, Guangzhou, China.
Worldviews Evid Based Nurs. 2022 Dec;19(6):467-476. doi: 10.1111/wvn.12606. Epub 2022 Oct 8.
Adverse psychological outcomes are prevalent among family members of intensive care unit (ICU) patients. The facilitated sensemaking model (FSM) provides a framework for understanding how intensive care nurses can help these family members overcome situations in which a loved one is critically ill, and reduce adverse psychological outcomes through the facilitated sensemaking process.
This study aimed to implement FSM-based research performed by ICU nurses and patients' family members to investigate the impact of the facilitated sensemaking intervention on the psychological status of ICU families.
The intervention was performed by nurses on 80 family members of mechanically ventilated patients, 40 in the control group and 40 in the experimental group. The control group only received routine medical services, while the experimental group received the nursing intervention based on FSM in addition to routine medical services. Anxiety, depression, and post-traumatic stress disorder (PTSD) were measured with the Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Post-Traumatic Stress Disorder Check-List-Civilian Version (PCL-C), respectively. SPSS version 25.0 was applied to analyze the data; what is more, some statistical methods, including descriptive statistical analysis, chi-square test and t-test were further adopted.
Before the intervention, there were no significant differences in anxiety, depression, and PTSD of family members of ICU mechanical ventilation patients between the two groups (p > .05). After the intervention, the score of anxiety, depression, and PTSD of family members in the control group and the experimental group were 41.50 ± 5.738 versus 36.50 ± 4.385, p < .001; 45.28 ± 8.089 versus 42.13 ± 5.725, p < .05; and 30.55 ± 7.595 versus 27.55 ± 4.696, p < .05, respectively. The nursing intervention based on FSM significantly alleviated anxiety, depression, and PTSD of mechanical ventilation patients' family members.
The nursing intervention based on FSM significantly alleviated anxiety, depression, and PTSD of mechanical ventilation patients' family members. However, there was only a statistically significant difference in the avoidance and numbness symptom cluster of PTSD via the PCL-C. Therefore, the observation time after the implementation of the FSM intervention needs to be extended in the future to clarify the effect of the intervention. Further efforts by advanced practice nurses and the cooperation of patients' families are required to incorporate this intervention into ICU practice.
重症监护病房（ICU）患者家属普遍存在不良心理后果。促成意义建构模型（FSM）为理解重症监护护士如何帮助这些家属克服亲人病危的情况提供了一个框架，并通过促成意义建构过程减轻不良心理后果。
本研究旨在实施 ICU 护士和患者家属进行的基于 FSM 的研究，以调查促成意义建构干预对 ICU 家庭心理状态的影响。
由护士对 80 名机械通气患者的家属进行干预，对照组 40 名，实验组 40 名。对照组仅接受常规医疗服务，实验组除常规医疗服务外，还接受基于 FSM 的护理干预。采用焦虑自评量表、抑郁自评量表和创伤后应激障碍检查表-平民版（PCL-C）分别测量焦虑、抑郁和创伤后应激障碍。采用 SPSS 25.0 版分析数据；此外，还进一步采用描述性统计分析、卡方检验和 t 检验等统计方法。
干预前，两组 ICU 机械通气患者家属的焦虑、抑郁和创伤后应激障碍评分无统计学差异（p>.05）。干预后，对照组和实验组家属的焦虑、抑郁和创伤后应激障碍评分分别为 41.50±5.738 与 36.50±4.385（p<.001）、45.28±8.089 与 42.13±5.725（p<.05）、30.55±7.595 与 27.55±4.696（p<.05）。基于 FSM 的护理干预显著减轻了机械通气患者家属的焦虑、抑郁和创伤后应激障碍。
基于 FSM 的护理干预显著减轻了机械通气患者家属的焦虑、抑郁和创伤后应激障碍。然而，通过 PCL-C，创伤后应激障碍的回避和麻木症状群仅具有统计学意义上的差异。因此，未来需要延长 FSM 干预实施后的观察时间，以明确干预效果。需要高级实践护士进一步努力，并与患者家属合作，将该干预纳入 ICU 实践。
