Department of Nursing, Fujian medical university, Fuzhou, Fujian, China; Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Heart Center of Fujian Medical University, Fuzhou, Fujian, China.
Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Heart Center of Fujian Medical University, Fuzhou, Fujian, China.
Heart Lung. 2024 Jan-Feb;63:1-8. doi: 10.1016/j.hrtlng.2023.09.002. Epub 2023 Sep 13.
Multiple guidelines recommend that families be involved in the care of ICU patients, which has been widely used in ICU delirium management in recent years. Postoperative delirium (POD) occurs frequently after cardiac surgery and is associated with poor outcomes; however, the effects of family intervention on this group are rarely studied.
This study aimed to investigate the effects of family intervention on the incidence of POD and the ICU prognoses of patients undergoing cardiac valve surgery.
This was a two-group, single-blind, randomized controlled trial involving 80 patients undergoing cardiac valve surgery, with 40 patients in each group. The control group received routine ICU visits, and the experimental group implemented a family intervention that instructed family caregivers to participate in delirium management during ICU visits. The occurrence of POD, ICU stay, mechanical ventilation time of patients; as well as the anxiety, depression, and satisfaction levels of family caregivers were compared between the two groups.
The incidence of POD and ICU stay of patients were significantly lower in the experimental group compared to the control group (P < 0.05). The anxiety and depression incidence of family caregivers in the experimental group was lower than those of the control group (P < 0.05), and satisfaction scores were higher than those of the control group (P < 0.05).
Family intervention has the potential to reduce the incidence of POD in patients undergoing cardiac valve surgery, shorten ICU stays, reduce the incidence of anxiety and depression in family caregivers, and improve their satisfaction. These findings suggest that family intervention could be incorporated into routine nursing practice.
多项指南建议让家庭参与 ICU 患者的护理,近年来这一建议已广泛应用于 ICU 谵妄管理。心脏手术后常发生术后谵妄(POD),且与不良预后相关;然而,家庭干预对该人群的影响鲜少被研究。
本研究旨在探究家庭干预对心脏瓣膜手术患者发生 POD 及 ICU 预后的影响。
这是一项两组成员、单盲、随机对照试验,共纳入 80 例行心脏瓣膜手术的患者,每组 40 例。对照组接受常规 ICU 探视,实验组实施家庭干预,指导家属在 ICU 探视期间参与谵妄管理。比较两组患者发生 POD、ICU 停留时间、机械通气时间,以及家属照护者的焦虑、抑郁和满意度水平。
实验组患者 POD 发生率和 ICU 停留时间明显低于对照组(P<0.05)。实验组家属照护者的焦虑和抑郁发生率低于对照组(P<0.05),满意度评分高于对照组(P<0.05)。
家庭干预有可能降低心脏瓣膜手术患者 POD 的发生率,缩短 ICU 停留时间,降低家属照护者焦虑和抑郁的发生率,并提高其满意度。这些发现表明,家庭干预可以纳入常规护理实践。