Mathew Sindu K, Aruna S, Vasudevan Ramesh C, Visweswaran Vivek, Arjunan Porkodi, Panachingal Binuja, Jyothi Mibi
Medical-Surgical Nursing, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Community Health Nursing, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2024 Nov 29;16(11):e74748. doi: 10.7759/cureus.74748. eCollection 2024 Nov.
Introduction Traumatic brain injury (TBI) is a major health concern due to its poor clinical and functional outcome and its impact on family homeostasis. Often, the stressed and anxious family is not involved in the care process until the rehabilitation phase. This study aimed to evaluate the integration of family involvement in the neuro-intensive care of TBI patients on family satisfaction. Materials and methods This pre-test-post-test quasi-experimental study involved 70 families of moderate and severe TBI patients, divided equally into experimental and control groups. A guideline, Family Involvement in the Care of TBI (FIC-TBI), was developed. The key elements of this guideline were structured communication, participation in basic care, and shared decision-making. FIC-TBI was integrated into the critical care management of TBI. The impact of FIC-TBI was evaluated using the Family Satisfaction in the ICU Care Unit 24R (FS-ICU 24R) tool. Results Data analysis was done through paired and unpaired t-tests as well as analysis of covariance (ANCOVA). The results showed statistically significant differences in the post-test family satisfaction scores between the experimental and control groups. The adjusted mean satisfaction scores of components such as satisfaction with care (F(1, N-2)=984.63; p<0.001), satisfaction with decision-making (F(1, N-2)=1489.63; p<0.001), and overall satisfaction (F(1, N-2)=712.87; p<0.001) were higher in the experimental group. The study found a significant correlation between family satisfaction levels and variables such as gender and education. Conclusions This study was done with the objective to evaluate the impact of integration of family involvement into the neuro-intensive care of TBI on family satisfaction. The findings demonstrated that the FIC-TBI guideline improved satisfaction across multiple dimensions, such as care, communication, decision-making, and overall experience. The study also found a significant correlation between family satisfaction and gender and education. This study emphasized the importance of early family involvement in critical care settings as a vital component of holistic TBI management.
引言 创伤性脑损伤（TBI）因其临床和功能预后不佳以及对家庭平衡的影响，成为一个主要的健康问题。通常情况下，压力大且焦虑的家庭直到康复阶段才参与到护理过程中。本研究旨在评估家庭参与TBI患者神经重症护理对家庭满意度的影响。
材料与方法 这项前后测准实验研究纳入了70名中度和重度TBI患者的家庭，平均分为实验组和对照组。制定了一份指南，即《TBI护理中的家庭参与》（FIC-TBI）。该指南的关键要素包括结构化沟通、参与基础护理以及共同决策。FIC-TBI被纳入TBI的重症护理管理中。使用《重症监护病房家庭满意度24R量表》（FS-ICU 24R）工具评估FIC-TBI的影响。
结果 通过配对和非配对t检验以及协方差分析（ANCOVA）进行数据分析。结果显示，实验组和对照组在测试后家庭满意度得分上存在统计学显著差异。实验组在护理满意度（F(1, N - 2)=984.63；p<0.001）、决策满意度（F(1, N - 2)=1489.63；p<0.001）和总体满意度（F(1, N - 2)=712.87；p<0.001）等方面调整后的平均满意度得分更高。研究发现家庭满意度水平与性别和教育等变量之间存在显著相关性。
结论 本研究旨在评估家庭参与纳入TBI神经重症护理对家庭满意度的影响。研究结果表明，FIC-TBI指南在护理、沟通、决策和总体体验等多个维度提高了满意度。研究还发现家庭满意度与性别和教育之间存在显著相关性。本研究强调了家庭在重症监护环境中早期参与作为TBI整体管理重要组成部分的重要性。
