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护理干预对减少成年危重症患者谵妄的有效性——一项随机试验方案

Effectiveness of nursing intervention to reduce delirium in adult critically ill - A protocol for a randomized trial.

作者信息

Gómez Tovar Luz Omaira, Henao-Castaño Ángela María

机构信息

Universidad Surcolombiana, Neiva, Colombia.

Universidad Nacional de Colombia, Bogotá, Colombia.

出版信息

Contemp Clin Trials Commun. 2022 Dec 15;31:101042. doi: 10.1016/j.conctc.2022.101042. eCollection 2023 Feb.

Abstract

The incidence of delirium in intensive care patients remains high, and its consequences have a high negative impact on patients, their families, health care teams, and society in general. Because delirium can lead to increased hospital stay, increased days on mechanical ventilation, increased risk of adverse events, increased memory loss and even increased mortality. However, some factors that precipitate delirium can be modified to reduce its presence and duration through non-pharmacological measures. Thus, the present protocol seeks to establish the theoretical and methodological background to develop and test nursing interventions to reduce delirium in adult patients hospitalized in the intensive care unit. For this reason, it is based on the theoretical elements of delirium and a nursing theory, called the Dynamic Symptoms Model (DSM), to understand the phenomenon and how nursing knowledge can be used to intervene. Thus, a nursing intervention proposal is proposed based on the DSM and scientific evidence, and a methodological design of a randomized controlled clinical trial type with parallel groups, which allows measuring the effectiveness of the designed interventions, following methodological and ethical rigor and with adequate control of biases.

摘要

重症监护患者中谵妄的发生率仍然很高,其后果对患者、其家属、医疗团队以及整个社会都有很大的负面影响。因为谵妄会导致住院时间延长、机械通气天数增加、不良事件风险增加、记忆力丧失加剧甚至死亡率上升。然而,一些引发谵妄的因素可以通过非药物措施加以改变,以减少其发生和持续时间。因此,本方案旨在建立理论和方法学背景,以开发和测试护理干预措施,减少入住重症监护病房的成年患者的谵妄。出于这个原因,它基于谵妄的理论要素和一种护理理论,即动态症状模型(DSM),来理解这一现象以及如何运用护理知识进行干预。因此,基于DSM和科学证据提出了一项护理干预建议,并设计了一种平行组随机对照临床试验类型的方法学设计,该设计能够在遵循方法学和伦理严谨性并充分控制偏差的情况下,衡量所设计干预措施的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efd8/9791593/d05a6de48e8c/gr1.jpg

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