Department of Critical Care Medicine, Peking University First Hospital, Beijing, China.
Department of Critical Care Medicine, Peking University First Hospital, Beijing, China.
Intensive Crit Care Nurs. 2023 Jun;76:103394. doi: 10.1016/j.iccn.2023.103394. Epub 2023 Jan 20.
To investigate the effect of video visitation on intensive care patients' and family members' outcomes during the COVID-19 pandemic.
This is a randomised controlled trial.
An adult intensive care unit in a tertiary hospital in Beijing, China.
A total of 121 adults, who were >18 years of age, conscious, able to communicate verbally, and admitted to the intensive care unit for over 24 hours were randomised into the intervention (video visitation) (n = 65) and control (n = 56) Groups. A total of 98 family members participated. Patient primary outcomes included anxiety and depression, measured using the Hospital Anxiety and Depression Scale. Secondary outcomes included patient delirium and family anxiety assessed using the Confusion Assessment Method scale and Self-Rating Anxiety Scale, respectively; and patient and family satisfaction, measured using a questionnaire routinely used in the hospital.
There were no statistically significant differences between the groups in patients' anxiety (t = 1.328, p = 0.187) and depression scores (t = 1.569, p = 0.119); and no statistically significant differences in delirium incidence between the groups (7.7 % vs 7.1 %, p > 0.05). There were no significant differences in changes in family members' anxiety scores (t = 0.496, p = 0.621). A statistically significant difference in satisfaction was found between the two group patients (86.1 % vs 57.2 % of patients were satisfied with using video visitation, p < 0.05), and the result of family members' satisfaction was also statistically significant (88 % vs 62.5 % of family members were satisfied with using video visitation, p < 0.05).
Video visitation did not seem to influence anxiety, but the use of video visitation can improve the patient and their family members' satisfaction. Future research is needed to determine the feasibility of embedding video visitation into routine practice, and the optimal frequency and length of video visitation in relation to patients' and family members' outcomes.
Video visitation improved patient and family members' satisfaction. Therefore, clinicians should consider using video visitation when face to face visit is restricted. Video visVitation did not reduce patient anxiety significantly in this study maybe because the average length of intensive care stay was too short. Future research is needed on its effect on long term intensive care patients.
研究在 COVID-19 大流行期间视频探视对重症监护患者及其家属结局的影响。
这是一项随机对照试验。
中国北京一家三级医院的成人重症监护病房。
共有 121 名年龄>18 岁、意识清醒、能够进行口头交流且入住重症监护病房超过 24 小时的成年人被随机分为干预(视频探视)(n=65)和对照组(n=56)。共有 98 名家属参与。患者主要结局指标包括使用医院焦虑抑郁量表(HADS)评估的焦虑和抑郁。次要结局指标包括使用意识模糊评估法(CAM)和自评焦虑量表(SAS)评估的患者谵妄和家庭焦虑,以及使用医院常规使用的问卷评估的患者和家庭满意度。
两组患者的焦虑评分(t=1.328,p=0.187)和抑郁评分(t=1.569,p=0.119)无统计学差异;两组谵妄发生率无统计学差异(7.7%比 7.1%,p>0.05)。家庭成员焦虑评分变化无统计学差异(t=0.496,p=0.621)。两组患者满意度存在统计学差异(86.1%的患者对使用视频探视满意,57.2%的患者对使用视频探视满意,p<0.05),家属满意度的结果也具有统计学意义(88%的家属对使用视频探视满意,62.5%的家属对使用视频探视满意,p<0.05)。
视频探视似乎不会影响焦虑,但使用视频探视可以提高患者及其家属的满意度。需要进一步研究将视频探视纳入常规实践的可行性,以及视频探视的最佳频率和时长与患者和家属结局的关系。
视频探视提高了患者及其家属的满意度。因此,当面对面探视受到限制时,临床医生应考虑使用视频探视。在这项研究中,视频探视并没有显著降低患者的焦虑,这可能是因为重症监护的平均住院时间太短。需要进一步研究其对长期重症监护患者的影响。