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家庭探视计划对重症监护病房患者和护理人员的影响:一项混合方法研究。

The impact of family care visitation programme on patients and caregivers in the intensive care unit: A mixed methods study.

机构信息

College of Nursing, Dankook University, Cheonan, South Korea.

College of Nursing, Dongguk University, Gyeongju, South Korea.

出版信息

J Clin Nurs. 2023 Jul;32(13-14):3797-3809. doi: 10.1111/jocn.16650. Epub 2023 Mar 6.

Abstract

AIMS

To track changes in the haemodynamic and respiratory indicators of patients and evaluate families' caring experiences via the visitation programme in the intensive care unit (ICU).

BACKGROUND

Although most people recognise the importance of family care visitation programme in the ICU, objective research results on the effect on patients and caregivers are still insufficient.

DESIGN

Mixed methods.

METHODS

In this a quasi-experimental investigation and qualitative study, after executing the programme with families of ICU patients in a general hospital in South Korea from June to July 2019, changes in haemodynamic and respiratory indicators for control (n = 28) and experimental groups (n = 28) were analysed; the experimental group families' experiences were analysed through in-depth interviews; the qualitative study's reporting rigour was checked against the COREQ guidelines and TREND checklist for a quasi-experimental study. Qualitative and quantitative data were examined using content analysis and repeated-measures analysis of variance, respectively.

RESULTS

There was a significant change in systolic and diastolic blood pressure in the haemodynamic indicator, and the respiratory indicator in both groups increased slightly over time and then gradually stabilised; there were no significant differences or interactions between groups regarding time of systolic blood pressure. The respiratory rate significantly decreased only in the experimental group. There was a significant increase in oxygen saturation over time, as well as interactions between time and group and between groups. Four themes were extracted from families' experiences.

CONCLUSION

The haemodynamic and respiratory indicators of the group using patient- and family-centred care (PFCC) showed a stable effect on critically ill patients, which increased families' satisfaction. In future, interventions should encourage family participation in the ICU for successful PFCC.

RELEVANCE TO CLINICAL PRACTICE

The findings provided evidence for the importance of PFCC through changes in objective haemodynamic and respiratory indicators.

摘要

目的

通过重症监护病房(ICU)探视计划,跟踪患者的血流动力学和呼吸指标变化,并评估家属的护理体验。

背景

尽管大多数人认识到 ICU 家庭护理探视计划的重要性,但关于该计划对患者和护理人员影响的客观研究结果仍然不足。

设计

混合方法。

方法

在韩国一家综合医院对 ICU 患者家属实施该计划后,于 2019 年 6 月至 7 月,对对照组(n=28)和实验组(n=28)的血流动力学和呼吸指标变化进行了分析;通过深入访谈分析实验组家庭的体验;对定性研究的报告严谨性,采用 COREQ 指南和 TREND 清单进行了检查。分别采用内容分析和重复测量方差分析对定性和定量数据进行了检验。

结果

两组的收缩压和舒张压在血流动力学指标上均有显著变化,呼吸指标在两组中均随时间略有增加,然后逐渐稳定;两组之间收缩压的时间无显著差异或交互作用。实验组的呼吸频率仅显著下降。氧饱和度随时间显著增加,且存在时间与组间和组间的交互作用。从家属的体验中提取出四个主题。

结论

以患者和家庭为中心的护理(PFCC)组的血流动力学和呼吸指标对危重症患者表现出稳定的效果,增加了家属的满意度。未来,干预措施应鼓励家庭参与 ICU,以实现成功的 PFCC。

临床意义

通过客观的血流动力学和呼吸指标变化,为 PFCC 的重要性提供了证据。

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