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探讨家庭成员实施感觉刺激计划对重症监护病房住院脑损伤患者谵妄状态的影响:一项随机临床试验。

Investigating the effect of implementing a sensory stimulation program by family members on delirium status of brain injury patients hospitalized in the intensive care unit: A randomized clinical trial.

作者信息

Adineh Mohammad, Elahi Nasrin, Molavynejad Shahram, Jahani Simin, Savaie Mohsen

机构信息

Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Educ Health Promot. 2023 Jun 30;12:187. doi: 10.4103/jehp.jehp_921_22. eCollection 2023.

Abstract

BACKGROUND

Delirium is the most common psychological disorder in brain injury patients hospitalized in the intensive care unit (ICU), one of the leading causes of which can be sensory deprivation or sensory overload. This study aimed to determine the effect of implementing a sensory stimulation program by family members on the delirium status of ICU-hospitalized brain injury patients.

MATERIALS AND METHODS

In this randomized controlled clinical trial, 66 brain injury patients hospitalized in the ICUs were assigned to intervention and control groups using stratified random sampling. For the intervention group, a sensory stimulation program was implemented by family members for 1 h a day during the ICU stay. The control group received routine care. Patients' delirium status was assessed daily using the confusion assessment method for the intensive care unit (CAM-ICU). Data were analyzed by the SPSS software version 22, using Chi-square, independent -test, and Binary logistic regression model tests, at a significance level of 0.05.

RESULTS

Odds of delirium Incidence in the intervention group was 94% lower than in the control group (OR = 0.057, 95% CI 0.017, 0.19, = 0.001). There is a significant difference between the two groups in terms of length of delirium ( = 0.001), stay in ICU ( = 0.001) and mechanical ventilation ( = 0.001). The mean of all three variables in the intervention group was lower than the control group.

CONCLUSIONS

Implementing of sensory stimulation program by the family members, as a non-pharmacological method, can reduce the incidence of delirium in brain injury patients admitted to ICU.

摘要

背景

谵妄是入住重症监护病房(ICU)的脑损伤患者中最常见的心理障碍,其主要原因之一可能是感觉剥夺或感觉超载。本研究旨在确定家庭成员实施感觉刺激方案对入住ICU的脑损伤患者谵妄状态的影响。

材料与方法

在这项随机对照临床试验中,采用分层随机抽样将66名入住ICU的脑损伤患者分为干预组和对照组。对于干预组,家庭成员在患者入住ICU期间每天实施1小时的感觉刺激方案。对照组接受常规护理。每天使用重症监护病房谵妄评估方法(CAM-ICU)评估患者的谵妄状态。使用SPSS 22软件进行数据分析,采用卡方检验、独立样本t检验和二元逻辑回归模型检验,显著性水平为0.05。

结果

干预组谵妄发生率的比值比低于对照组94%(OR = 0.057,95%CI 0.017,0.19,P = 0.001)。两组在谵妄持续时间(P = 0.001)、入住ICU时间(P = 0.001)和机械通气时间(P = 0.001)方面存在显著差异。干预组这三个变量的平均值均低于对照组。

结论

家庭成员实施感觉刺激方案作为一种非药物方法,可以降低入住ICU的脑损伤患者谵妄的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3370/10402778/6c4b15bc2e3a/JEHP-12-187-g001.jpg

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