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在 COVID-19 大流行期间,重症监护病房患者家属的心理社会因素与沟通满意度的关系:一项探索性横断面研究。

Association between psychosocial factors and satisfaction with communication in family members of intensive care unit patients during COVID-19 pandemic: An exploratory cross-sectional study.

机构信息

Pontificia Universidad Católica de Chile, School of Nursing, Avda. Vicuña Mackenna 4860, Macul, 7820436 Santiago, Chile.

Pontificia Universidad Católica de Chile, School of Nursing, Chile.

出版信息

Intensive Crit Care Nurs. 2023 Jun;76:103386. doi: 10.1016/j.iccn.2023.103386. Epub 2023 Jan 9.

Abstract

OBJECTIVE

To investigate the relationship between satisfaction with communication and perceived stress, depressive symptoms and perceived social support among family members of critically ill.

RESEARCH METHODOLOGY/DESIGN: Exploratory, cross-sectional study was conducted.

SETTING

Private teaching hospital in Santiago, Chile.

MAIN OUTCOMES MEASURES

Family members of critically ill patients with 3-7 days of stay and respiratory support were approached. Questionnaires were used to assess satisfaction with communication (Family Satisfaction in the Intensive Care Unit-24), perceived stress (Perceived Stress Scale-10), depressive symptoms (Patient Health Questionnaire-9) and perceived social support (Medical Outcomes Study Social Support Survey). The relationship between satisfaction with communication and relevant variables was investigated using bivariate analyses and a beta regression.

RESULTS

The study included 42 family members, with 71.4% being female and 52.4% having prior critical care experience. There was a positive correlation between perceived stress and depressive symptoms (r = 0.32, p = 0.039). According to the beta regression, perceived social support (B; 95% confidence interval, 0.44 [1.05-2.29]) and the number of calls with unit staff (0.17 [1.06-1.32]) were positively associated with satisfaction with communication but negatively with college education (-1.86 [0.04-0.64]) and perceived stress (-0.07 [0.87-0.99]).

CONCLUSION

Psychosocial factors, such as higher educational level, perceived stress and perceived social support, can influence family members' evaluation of communication with staff. Current communication practices in acute care settings should be adapted to family members' psychosocial context to improve their satisfaction with the communication process.

IMPLICATIONS FOR CLINICAL PRACTICE

Critical care professionals must be aware of the influence of family member-related factors on the quality and effectiveness of the communication process. Psychosocial features of the family members are likely to impact their satisfaction with communication and should be assessed on admission and during their stay to assist clinicians to adjust and improve their communication practices.

摘要

目的

调查危重症患者家属的沟通满意度与感知压力、抑郁症状和感知社会支持之间的关系。

研究方法/设计:本研究为探索性、横断面研究。

地点

智利圣地亚哥的一家私立教学医院。

主要观察指标

纳入入住并接受呼吸支持 3-7 天的危重症患者家属。使用问卷调查评估沟通满意度(重症监护病房家属满意度-24 量表)、感知压力(感知压力量表-10 量表)、抑郁症状(患者健康问卷-9 量表)和感知社会支持(医疗结局研究社会支持量表)。采用双变量分析和β回归分析探讨沟通满意度与相关变量之间的关系。

结果

本研究共纳入 42 名家属,其中 71.4%为女性,52.4%有重症监护经验。感知压力与抑郁症状呈正相关(r = 0.32,p = 0.039)。根据β回归分析,感知社会支持(B;95%置信区间,0.44 [1.05-2.29])和与单位工作人员通话次数(0.17 [1.06-1.32])与沟通满意度呈正相关,但与大学教育程度(-1.86 [0.04-0.64])和感知压力(-0.07 [0.87-0.99])呈负相关。

结论

社会心理因素,如较高的教育程度、感知压力和感知社会支持,可能会影响家属对与工作人员沟通的评价。急性护理环境中的当前沟通实践应适应家属的社会心理背景,以提高他们对沟通过程的满意度。

临床意义

重症护理专业人员必须意识到与家属相关因素对沟通过程质量和效果的影响。家属的社会心理特征可能会影响他们对沟通的满意度,应在入院时和住院期间进行评估,以帮助临床医生调整和改进他们的沟通实践。

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