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一项混合方法研究,旨在开发和评估针对重症监护病房中危重症患者照顾者的心理困扰和感知需求的结构化治疗性沟通模块。

A mixed-method study to develop and evaluate a structured therapeutic communication module on psychological distress and perceived needs among caregivers of critically ill patients in Critical Care Units.

机构信息

College of Nursing, CMC Vellore Chittoor Campus, Chittoor, Andhra Pradesh, India.

Department of Neurosurgery ICU, AIIMS Bhubaneswar, India.

出版信息

Arch Psychiatr Nurs. 2024 Oct;52:89-100. doi: 10.1016/j.apnu.2024.07.008. Epub 2024 Jul 9.

Abstract

AIMS AND OBJECTIVES

To develop and evaluate the effectiveness of a structured therapeutic communication module on psychological distress and perceived needs among caregivers of critically ill patients.

BACKGROUND

Caregivers of critically ill patients experience intense psychological distress, and their needs often go unexpressed or unidentified. Structured therapeutic communication enables nurses to explore and fulfill these needs.

METHOD

A mixed-method study was conducted among 30 caregivers of critically ill patients. During phase one, a qualitative interview was conducted, and a structured therapeutic communication module was developed based on Hildegard Peplau's Interpersonal Relations Theory. In the second phase, one group pre-test and post-test design was adopted. The Hospital Anxiety and Depression Scale (HADS) and a Semi-structured interview schedule were used to assess psychological distress and perceived needs, respectively.

RESULTS

Half of (50 %) the caregivers reported a high level of anxiety before intervention, with a mean of 11.30 (SD: 4.0), and 66.7 % of them had a high level of depression, with a mean of 12.03 (SD: 0.08). There was a statistically significant difference in anxiety (CI: 0.451-2.016) and depression (CI: 0.261-1.538) before and after the intervention. The qualitative analysis revealed unmet needs perceived by caregivers.

CONCLUSION

Using a structured therapeutic communication module helps nurses to alleviate the psychological distress experienced by caregivers of CCU patients.

RELEVANCE TO CLINICAL PRACTICE

Nurses need to be sensitive to the unexpressed needs of caregivers of critically ill patients. The structured therapeutic communication modules can be integrated into routine nursing care practice to ensure family-centered care.

摘要

目的和目标

开发和评估结构化治疗性沟通模块对 ICU 患者照顾者心理困扰和感知需求的有效性。

背景

危重症患者的照顾者经历强烈的心理困扰,他们的需求往往未得到表达或未被识别。结构化治疗性沟通使护士能够探索和满足这些需求。

方法

在 30 名危重症患者的照顾者中进行了一项混合方法研究。在第一阶段,进行了定性访谈,并根据 Hildegard Peplau 的人际关系理论开发了结构化治疗性沟通模块。在第二阶段,采用了一组预测试和后测试设计。使用医院焦虑和抑郁量表(HADS)和半结构化访谈时间表分别评估心理困扰和感知需求。

结果

一半(50%)的照顾者在干预前报告有高度焦虑,平均得分为 11.30(SD:4.0),66.7%的照顾者有高度抑郁,平均得分为 12.03(SD:0.08)。干预前后焦虑(CI:0.451-2.016)和抑郁(CI:0.261-1.538)存在统计学差异。定性分析揭示了照顾者感知到的未满足需求。

结论

使用结构化治疗性沟通模块有助于护士减轻 CCU 患者照顾者的心理困扰。

临床实践意义

护士需要对危重症患者照顾者的未表达需求保持敏感。结构化治疗性沟通模块可以整合到常规护理实践中,以确保以家庭为中心的护理。

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