|本期目录/Table of Contents|

[1]陈娇,贾凌,杨敬辉,等.开放式探视模式在重症监护室中的应用效果分析[J].医学研究与战创伤救治(原医学研究生学报),2019,21(5):521-523.[doi:10.3969/j.issn.1672-271X.2019.05.016]
点击复制

开放式探视模式在重症监护室中的应用效果分析()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
第21卷
期数:
2019年5期
页码:
521-523
栏目:
出版日期:
2019-09-06

文章信息/Info

Title:
-
文章编号:
1672-271X(2019)05-0521-03
作者:
陈娇 贾凌 杨敬辉 薛翔 蔡建芹 徐微笑 赵炜
作者单位:211100 南京,南京医科大学附属逸夫医院重症医学科(陈 娇、贾 凌、杨敬辉、薛 翔、蔡建芹、徐微笑、赵 炜)
Author(s):
-
关键词:
开放式探视 重症监护室 预后 临床应用
Keywords:
-
分类号:
R45
DOI:
10.3969/j.issn.1672-271X.2019.05.016
文献标志码:
B
摘要:
目的 探讨开放式探视模式在重症监护室(ICU)中的应用。 方法 回顾性分析2016年6月至2018年6月入住南京医科大学附属逸夫医院重症医学科432例患者的临床资料,以开放式探视实施时间(2017年7月)为截点,以实施开放式探视模式之前的患者作为对照组(n=211),开放式探视实施后的患者作为开放组(n=221)。统计比较2组患者的入院时和出院时焦虑和抑郁评分量表(HADS)评分、沟通质量评分量表(QOC scale)评分、校正的患者对以患者为中心的评价(校正的PPPC)评分,比较2组患者的住院时间,统计机械通气患者需的机械通气时间、呼吸机相关性肺炎(VAP)发病率,并评估临床各评分指标与患者住院时间的相关性。 结果 出院时开放组较对照组的HADS评分[(11.39±2.14)分 vs (14.62±2.72)分]和校正的PPPC评分[(1.57±0.32)分 vs (1.76±0.28)分]显著降低,QOS评分显著升高[(72.30±6.26)分 vs (61.45±6.47)分],差异均有统计学意义(P<0.05)。开放组患者机械通气时间[(15.36±2.16)d]、ICU住院时间[(12.34±3.28)d]和总住院时间[(20.18±4.45)d]均短于对照组[(18.63±3.27)d、(15.68±3.78)d、(25.37±5.14)d],差异均有统计学意义(P<0.05),但2组VAP发生率比较差异无统计学意义(28.96% vs 27.96%,P>0.05)。相关性分析显示APACHEⅡ评分和校正的PPPC评分与患者住院时间呈正相关(r=0.338,P=0.03;r=0.356,P=0.034)。 结论 开放式探视模式有助于改善医患沟通质量、家属心理应激,对改善患者的病情及预后有利。
Abstract:
-

参考文献/References:

1 KavithaM. Needs of family members of patients admitted in ICU[J]. Nurs J India, 2008, 99(6):128-130.
2 RosaRG, ToniettoTF, DaSD, et al. Effectiveness and Safety of an Extended ICU Visitation Model for Delirium Prevention: A Before and After Study[J]. Crit Care Med, 2017, 45(10):1660-1667.
3 RashidM, KhanN, JonesB. Physical and Visual Accessibilities in Intensive Care Units: A Comparative Study of Open-Plan and Racetrack Units[J]. Crit Care Nurs Q, 2016, 39(4):313-334.
4 de Almeida MacêdoE, AppenzellerS, Lavras CostallatLT. Assessment of the Hospital Anxiety and Depression Scale (HADS) performance for the diagnosis of anxiety in patients with systemic lupus erythematosus[J]. Rheumatol Int,2017,37(12):1999-2004.
5 TorkeAM, CallahanCM, SachsGA, et al. Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study[J]. J Gen Intern Med, 2018,33(3):298-304.
6 IshikawaH, HashimotoH, RoterDL, et al. Patient contribution to the medical dialogue and perceived patient-centeredness. An observational study in Japanese geriatric consultations[J]. J Gen Intern Med, 2010, 20(10):906-910.
7 MonroeM, WoffordL. Open Visitation and Nurse Job Satisfaction: An Integrative Review[J]. J Clin Nurs, 2017, 26(23-24):4868-4876.
8 KirchhoffKT, HansenCB, EvansP, et al. Open visiting in the ICU: a debate[J]. Dimens Crit Care Nurs, 1985, 4(5):296-306.
9 GianniniA. The "open" ICU: not just a question of time[J]. Minerva Anestesiol, 2010, 76(2):89-90.
10 BeesleySJ, HopkinsRO, Holt-LunstadJ, et al. Acute Physiologic Stress and Subsequent Anxiety Among Family Members of ICU Patients[J]. Crit Care Med, 2018, 46(2):229-235.
11 TolentinoA, Tydd-WhitingR, KaanA. Chartering Change: Exploring the Complexity of Implementing a Charter to Support Open Visitation Among Cardiac Surgery Intensive Care Unit (CSICU) Nurses[J]. Can J Cardiol, 2016, 32(10):S328-S329.
12 WhiteDB, AngusDC, ShieldsAM, et al. A Randomized Trial of a Family-Support Intervention in Intensive Care Units[J]. N Engl J Med, 2018, 378(25):2365-2375.
13 蒋琪霞, 刘娟, 刘玉秀. 半卧位不同角度对机械通气患者通气效果和并发症预防效果的临床观察[J]. 医学研究生学报, 2016, 29(10):1083-1088.
14 SchnellD, AbadieS, ToullicP, et al. Open visitation policies in the ICU: experience from relatives and clinicians[J]. Intensive Care Med, 2013, 39(10):1873-1874.
15 薛凡, 周剑锋. 重症监护病房的患者探视方式效果研究[J]. 东南国防医药, 2015, 17(6):650-651.
16 TorkeAM, WocialLD, JohnsSA, et al. The Family Navigator: A pilot intervention to support intensive care unit family surrogates[J]. Am J Crit Care, 2016, 25(6):498-507.

相似文献/References:

备注/Memo

备注/Memo:
收稿日期:2019-02-28
更新日期/Last Update: 2019-09-06