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确立成人重症监护病房以患者和家庭为中心的护理共识:一项德尔菲调查。

Establishing consensus on patient- and family-centered care in adult intensive care units: A Delphi survey.

机构信息

Department of Anesthesiology and Intensive Care Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark.

Department of Anesthesiology and Intensive Care, Gødstrup Hospital, Herning, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

出版信息

J Crit Care. 2024 Dec;84:154859. doi: 10.1016/j.jcrc.2024.154859. Epub 2024 Jul 14.

Abstract

PURPOSE

To establish consensus between intensive care unit (ICU) experts on concrete patient- and family-centered care statements for adult patients and relatives in the ICU.

MATERIALS AND METHODS

We did a three-round Delphi survey with a panel of ICU health care professionals from 23 ICUs in Denmark. In round 1, participants answered 20 open-ended questions, based on existing evidence. Analysis of their responses generated close-ended statements, which participants primary rated on a five-point-Likert-scale, from very important to not important at all. In rounds 2 and 3., consensus was predefined as ≥75% of participants rating a statement important.

RESULTS

Sixty-nine participated: 38 nurses, 24 physicians, and four occupational and physiotherapists. In total 96%, 90% and 72% answered the first, second, and third rounds, respectively. In round 1, participants answers resulted in >3000 statements that were analyzed into 82 condensed statements. After participants rated the statements in round 2 and 3, 47 statements reached consensus as important.

CONCLUSIONS

The 47 statements rated to be important included interdisciplinary approaches to systematic information sharing and consultations with patients and family-members, with the aim being to accommodate patients and family-members´ individual needs throughout the ICU stay.

摘要

目的

在丹麦 23 家重症监护病房(ICU)的 ICU 医护专业人员组成的小组中,就成人患者和家属在 ICU 中具体的以患者和家庭为中心的护理内容达成共识。

材料与方法

我们进行了三轮德尔菲调查,共有来自 23 家 ICU 的 69 名医疗保健专业人员参加。在第 1 轮中,参与者根据现有证据回答了 20 个开放式问题。对他们的回答进行分析后生成了封闭式陈述,参与者对这些陈述进行了 5 分制的初步评分,从非常重要到一点也不重要。在第 2 轮和第 3 轮中,共识定义为≥75%的参与者认为陈述重要。

结果

共有 69 人参与:38 名护士,24 名医生和 4 名职业治疗师和物理治疗师。分别有 96%、90%和 72%的人回答了第 1、2 和 3 轮。在第 1 轮中,参与者的回答产生了>3000 条陈述,这些陈述被分析为 82 条简洁陈述。在第 2 轮和第 3 轮中,参与者对陈述进行评分后,有 47 条陈述被认为是重要的。

结论

被评为重要的 47 条陈述包括跨学科方法以实现系统信息共享和与患者及家属的咨询,目的是在整个 ICU 期间满足患者和家属的个体需求。

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