Noguchi Ayako, Nosaka Nobuyuki, Mizoe Akiko, Takeuchi Takashi, Wakabayashi Kenji
Intensive Care Unit, Institute of Science Tokyo Hospital, Tokyo, Japan.
Department of Disaster and Critical Care Nursing, Track of Nursing Innovation Science, Graduate School of Health Care Sciences Institute of Science Tokyo, Tokyo, Japan.
Nurs Crit Care. 2025 Jul;30(4):e70114. doi: 10.1111/nicc.70114.
Preventing post-traumatic stress disorder (PTSD) symptoms in family members of intensive care unit (ICU) patients underscores the importance of patient-family interactions. The COVID-19 pandemic restricted direct visits, prompting video calls as an alternative.
To examine the association between video calls and the development of PTSD symptoms in family members of patients admitted to a COVID-19 ICU.
This mixed-methods study was conducted at a single facility in Tokyo. Video calls were introduced in August 2020 and were used based on family preferences. Using quantitative data obtained from a questionnaire postal survey and the qualitative analysis of free-text responses, family members of severe COVID-19 ICU patients from July 2020 to June 2022 completed self-administered questionnaires, including the Impact of Event Scale-Revised (IES-R) and open-ended questions regarding the patient's ICU stay. Multivariate logistic regression analysis assessed the association between video calls and PTSD symptoms (IES-R > 24). Free-text responses were analysed using text mining techniques.
Out of the 97 eligible families, 68 participated. Video calls were not significantly associated with a reduction in PTSD symptoms. Among those who experienced video calls, text analysis showed that participants with PTSD symptoms more frequently used words related to "doctors," whereas those without symptoms more often mentioned "nurses."
Video calls did not significantly reduce PTSD symptoms in family members of ICU patients with severe COVID-19. However, the presence of bedside nurses during video calls may help foster a sense of connection and support.
When implementing video calls (i.e., virtual visitation), active involvement and compassionate presence of bedside nurses may enhance the emotional quality of communication. Structured approaches that support nurse-family interaction may contribute to better psychological outcomes for families.
预防重症监护病房（ICU）患者家属出现创伤后应激障碍（PTSD）症状凸显了患者与家属互动的重要性。2019冠状病毒病（COVID-19）大流行限制了直接探视，促使视频通话成为一种替代方式。
研究视频通话与COVID-19重症监护病房收治患者家属PTSD症状发生之间的关联。
这项混合方法研究在东京的一家机构进行。2020年8月引入视频通话，并根据家属的偏好使用。利用通过问卷调查获得的定量数据以及对自由文本回复的定性分析，2020年7月至2022年6月期间COVID-19重症监护病房重症患者的家属完成了自填式问卷，包括事件影响量表修订版（IES-R）以及关于患者在重症监护病房住院情况的开放式问题。多变量逻辑回归分析评估了视频通话与PTSD症状（IES-R＞24）之间的关联。使用文本挖掘技术对自由文本回复进行分析。
在97个符合条件的家庭中，68个家庭参与了研究。视频通话与PTSD症状减轻之间无显著关联。在经历过视频通话的人群中，文本分析显示，有PTSD症状的参与者更频繁地使用与“医生”相关的词汇，而无症状者则更多地提及“护士”。
视频通话并未显著减轻重症COVID-19患者家属的PTSD症状。然而，视频通话期间床边护士的在场可能有助于增强联系感和支持感。
在实施视频通话（即虚拟探视）时，床边护士的积极参与和富有同情心的在场可能会提高沟通的情感质量。支持护士与家属互动的结构化方法可能有助于改善家属的心理结局。
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