Intensive and Critical Care Nursing最新文献

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Prevalence and risk factors for burnout, missed nursing care, and intention-to-leave the job among intensive care unit and general ward nurses: A cross-sectional study across six European countries in the COVID-19 era 重症监护室和普通病房护士职业倦怠、错过护理和离职意向的发生率和风险因素：COVID-19 时代欧洲六国的横断面研究。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-11-09 DOI: 10.1016/j.iccn.2024.103885

Arnaud Bruyneel , Simon Dello , Jérôme E. Dauvergne , Dorothea Kohnen , Walter Sermeus

Objective

This study aimed to compare the prevalence of burnout, missed nursing care, and intention-to-leave the job among nurses working in general care units and intensive care units (ICUs), and to analyse the risk factors for these outcomes between the two groups.

Design

This was a cross-sectional study involving online surveys of nurses at participating hospitals conducted between November 2020 and July 2021 as part of the Magnet4Europe initiative.

Setting and Participants

A convenience sample was recruited, consisting of 67 acute care hospitals in 6 countries: Belgium, England, Germany, Ireland, Norway, and Sweden. In total, data for 1,150 ICU nurses and 5,145 general ward nurses (1,901 from surgical wards and 3,250 from medical wards) were analysed.

Results

The prevalence of burnout was significantly lower among nurses in ICUs (27.1 % vs. 30.3 %), missed care from care was significantly less frequent (65.5 % vs. 75.4 %), while intention-to-leave was similar (28.1 % vs. 29.2 %) compared with nurses in general wards. Nurses working in a better work environment and with lower workloads had statistically significant lower rates of burnout and intention-to-leave their job compared to those working in a poorer work environment and with higher workloads. Country-specific analysis showed a higher burnout rate and the intention-to-leave the job for nurses working in Germany, Ireland, Scandinavia, and the England compared to Belgium.

Conclusions

ICU nurses did not have a higher risk of burnout and had significantly lower risks of missing care and intention-to-leave, compared to nurses in general wards. A better work environment and lower perceived workload were consistently associated with reduced risks for all outcomes studied.

Implications for clinical practice

National policies should prioritize creating healthy work environments, reducing workloads, and addressing country-specific challenges to lower burnout rates, minimize missed care, and decrease the intention to leave the job among ICU and general ward nurses.

研究目的本研究旨在比较在普通护理病房和重症监护病房（ICU）工作的护士的职业倦怠、错过护理和离职意向的发生率，并分析两组护士出现这些结果的风险因素：这是一项横断面研究，在 2020 年 11 月至 2021 年 7 月期间对参与医院的护士进行在线调查，作为 Magnet4Europe 计划的一部分：调查对象：方便抽样调查，包括 6 个国家的 67 家急症护理医院：比利时、英国、德国、爱尔兰、挪威和瑞典。共分析了 1,150 名重症监护病房护士和 5,145 名普通病房护士（1,901 名来自外科病房，3,250 名来自内科病房）的数据：重症监护室护士的职业倦怠发生率明显较低（27.1% 对 30.3%），护理缺勤率明显较低（65.5% 对 75.4%），而离职意向与普通病房护士相似（28.1% 对 29.2%）。与工作环境较差、工作量较大的护士相比，工作环境较好、工作量较小的护士的职业倦怠率和离职意向在统计学上明显较低。国别分析表明，与比利时相比，在德国、爱尔兰、斯堪的纳维亚半岛和英格兰工作的护士倦怠率和离职意向更高：与普通病房的护士相比，重症监护室护士的职业倦怠风险并不高，缺勤风险和离职意向也明显较低。较好的工作环境和较低的感知工作量始终与所有研究结果的风险降低相关：临床实践的启示：国家政策应优先考虑创造健康的工作环境、减轻工作量和应对特定国家的挑战，以降低重症监护室和普通病房护士的职业倦怠率、最大限度地减少护理缺失和离职意向。

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引用次数: 0

Longitudinal trajectories of health-related quality of life among critical care survivors: A latent class growth approach 重症监护幸存者健康相关生活质量的纵向轨迹：潜类增长法

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-11-09 DOI: 10.1016/j.iccn.2024.103892

Jiyeon Kang, Min Hye Lee

Objectives

This study explored the trajectories of health-related quality of life (HRQOL) and the factors influencing these trajectories.

Research methodology/design

Prospective observational cohort study.

Setting

19 intensive care units (ICUs) in South Korea.

Main outcome measures

We used the Medical Outcomes Study Short Form version 2 (SF-36v2) to assess HRQOL at 3, 6, 12, and 24 months post-discharge. Additionally, we evaluated intensive care experience, post-intensive care syndrome, and demographic and clinical characteristics to identify factors. HRQOL trajectory groups were identified via latent class growth modeling, with determining factors analyzed using multinomial logistic regression.

Results

The analysis identified three distinct groups for the physical component summary (PCS) and mental component summary (MCS) of the SF-36v2. For the PCS, the groups were labeled “Resilient Stable,” “Moderate Recovered,” and “Slow Recovering.” For the MCS, the classifications were “Resilient Stable,” “Low Recovered,” and “Persistent Low.” The determinants of the PCS Moderate Recovered and Slow Recovering Groups included older age, female gender, less educated, increased comorbidities, discharge to extended care facilities, and post-intensive care syndrome. Conversely, the MCS Low Recovered and Persistent Low Groups were determined by the intensive care experience and post-intensive care syndrome.

Conclusion

Our study identified specific vulnerable groups for PCS and MCS and their determinants in terms of HRQOL recovery among ICU survivors.

Implications for clinical practice

There is a need for a preemptive approach for survivors with determinants that place them in vulnerable groups for poorer HRQOL as well as systematic monitoring of post-intensive care syndrome in various healthcare settings.

研究目的研究方法/设计：前瞻性观察性队列研究：前瞻性观察队列研究：主要结果测量：我们使用医学结果研究简表 2 版（SF-36v2）来评估出院后 3、6、12 和 24 个月的 HRQOL。此外，我们还评估了重症监护经历、重症监护后综合征以及人口统计学和临床特征，以确定影响因素。通过潜类增长模型确定了 HRQOL 轨迹组，并使用多项式逻辑回归分析了决定因素：结果：分析结果表明，SF-36v2 的身体成分汇总表（PCS）和精神成分汇总表（MCS）有三个不同的组别。就 PCS 而言，这些组别被标记为 "恢复力稳定"、"中度恢复 "和 "缓慢恢复"。对于 MCS，则分为 "恢复力稳定"、"低度恢复 "和 "持续低度恢复"。PCS 中度康复组和缓慢康复组的决定因素包括年龄较大、性别为女性、受教育程度较低、合并症增加、出院后入住长期护理机构以及重症监护后综合症。相反，MCS 低恢复组和持续低恢复组则由重症监护经历和重症监护后综合症决定：结论：我们的研究发现了 ICU 幸存者中 PCS 和 MCS 的特定弱势群体及其在 HRQOL 恢复方面的决定因素：对临床实践的启示：有必要对那些因其决定因素而成为 HRQOL 较差的弱势群体的幸存者采取先发制人的方法，并在各种医疗环境中对重症监护后综合征进行系统监测。

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引用次数: 0

Sociodemographic representation in ICU recovery research 重症监护室康复研究中的社会人口代表性。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-11-09 DOI: 10.1016/j.iccn.2024.103878

Joanne McPeake , Valerie Danesh , Tammy L. Eaton , Han Su , Leanne M. Boehm

引用次数: 0

Flexible ICU visiting: Improving family outcomes while navigating implementation challenges 灵活的重症监护室探视：在应对实施挑战的同时改善家庭成果。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-11-04 DOI: 10.1016/j.iccn.2024.103894

Dongdong Yang , Meng Zhao , Yu Shi

引用次数: 0

How to prevent ventilator-associated pneumonia (VAP) in trauma patients 如何预防创伤患者的呼吸机相关肺炎 (VAP)。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-11-04 DOI: 10.1016/j.iccn.2024.103876

Georgios Papathanakos, Stijn Blot, Despoina Koulenti

引用次数: 0

“I will get out of this” - The patients’ experiences of early mobilisation in intensive care. A hermeneutic study "我会摆脱困境的"--重症监护中患者对早期康复的体验。诠释学研究。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-11-04 DOI: 10.1016/j.iccn.2024.103884

Annika Söderberg , Anneli Thelandersson , Monika Fagevik Olsén , Veronika Karlsson

Background

The significance of early mobilisation in intensive care has become increasingly apparent along with a growing understanding of patient experiences within this critical setting. However, there is still a need for more knowledge regarding the complex experiences of the patients. Therefore, this study aimed to gain an in-depth understanding of the significance and deeper meaning of early mobilisation in patients recently treated in intensive care.

Methods

A qualitative study with a hermeneutic, interpretive approach. Semi-structured interviews were conducted with 30 participants recently treated in the intensive care units, in two different hospitals.

Findings

The analysis yielded three themes: ‘Struggling to regain independence and normal life’, ‘Interaction with healthcare professionals’ and ’Early mobilisation in a chaotic, confused context without control’. The first theme captures the participants’ experiences, motivations, and the deeper significance of early mobilisation, which was hope, the beginning of recovery and a willingness to fight. The other themes describe the context and circumstances surrounding the participants’ mobilisation including the collaboration with healthcare professionals.

Conclusion

Early mobilisation’s significance and deeper meaning in intensive care were understood as the starting point of recovery. It had the ability to evoke hope and strengthen the fighting spirit, especially when it included leaving bed. The patients’ pre-existing understanding that resilience and persistence were crucial for regaining strength and mobility contributed, as well as positive interactions with healthcare professionals that restored human dignity and facilitated involvement and participation contributed.

Implications for practice

Early mobilisation should be used to inspire hope and a willingness to fight for recovery in patients treated in intensive care. Efforts should be made to engage patients in positive interactions with healthcare professionals that encourage this fighting spirit and active participation in early mobilisation. Mobilisations involving patients getting up and leaving bed should be used as much as possible.

背景：随着人们对重症监护环境中患者体验的了解日益加深，重症监护中早期动员的重要性也变得越来越明显。然而，我们仍然需要更多有关病人复杂经历的知识。因此，本研究旨在深入了解重症监护病房近期接受治疗的患者早期动员的意义和深层含义：方法：采用诠释学、解释学方法进行定性研究。在两家不同的医院对最近在重症监护室接受治疗的 30 名参与者进行了半结构化访谈：分析得出了三个主题："努力恢复独立和正常生活"、"与医护人员的互动 "和 "在混乱无序的环境中进行早期动员"。第一个主题反映了参与者的经历、动机以及早期动员的深层意义，即希望、康复的开始和奋斗的意愿。其他主题描述了参与者动员的背景和环境，包括与医疗专业人员的合作：结论：在重症监护中，早期动员的意义和深层含义被理解为康复的起点。它能够唤起希望，增强斗志，尤其是当它包括离开病床时。患者之前已经认识到韧性和坚持对于恢复体力和行动能力至关重要，而与医护人员的积极互动也有助于恢复人的尊严并促进参与：实践启示：应利用早期动员来激发重症监护患者的希望和争取康复的意愿。应努力让患者与医护人员进行积极的互动，鼓励他们的斗志并积极参与早期动员。应尽可能多地让患者起床和离开病床。

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引用次数: 0

Early changes in skin surface temperature to predict fever – Response to Xie et al. 皮肤表面温度的早期变化可预测发烧 - 对 Xie 等人的回应

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-10-30 DOI: 10.1016/j.iccn.2024.103873

Nai-Ying Ko , Yi-Ting Chung , Chun-Yin Yeh , Yu-Chen Shu , Chao-Han Lai

引用次数: 0

Intensive care nurses’ provision of culturally sensitive care through communication at the end-of-life 重症监护护士通过临终沟通提供文化敏感性护理。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-10-30 DOI: 10.1016/j.iccn.2024.103875

Daniel Joseph E. Berdida, Rizal Angelo N. Grande

引用次数: 0

Thirst relief in ICU patients: The art of flip-thinking 缓解重症监护室病人的口渴：翻转思维的艺术

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-10-30 DOI: 10.1016/j.iccn.2024.103871

Marleen Flim, Peter E. Spronk

引用次数: 0

Should we use artificial intelligence (AI) for writing ICU diaries? Yes! 我们应该使用人工智能（AI）来撰写重症监护室日记吗？是的！

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-10-28 DOI: 10.1016/j.iccn.2024.103867

Ella Peschel , Susanne Krotsetis , Peter Nydahl

引用次数: 0

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