Intensive and Critical Care Nursing最新文献_第4页

Single-use vs. reusable products for six respiratory procedures in an intensive care unit: A retrospective evaluation of plastic waste implications 在重症监护室的六个呼吸程序的一次性使用与可重复使用的产品：塑料废物影响的回顾性评估

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.iccn.2025.104327

Alberto Lucchini , Giancarla Nava , Marta Villa , Matteo Cesana , Stefano Citterio , Davide Ausili , Marco Giani , Emanuele Rezoagli , Stefano Bambi

Objective

Intensive care units (ICUs) are recognised as carbon “hotspots” within hospitals due to their reliance on resource-intensive technologies. This study aimed to compare reusable and disposable products used for six common respiratory procedures in an Italian ICU to determine the potential for reducing plastic waste generation and the carbon footprint associated with plastic waste incineration.

Methods

We performed a retrospective evaluation in a 10-bed ICU over 12 months. The comparison between reusable and single-use devices was based on theoretical calculations: each device was weighed with a precision scale, and annual totals were estimated by multiplying individual device weights by the number of procedures recorded in the clinical information system. CO₂e emissions were calculated using the European Environment Agency emission factor of 2.9 kg CO₂e per kg of plastic waste incinerated.

Results

Reusable or low-waste products generated an estimated 143.50 kg of plastic waste, compared with 501.64 kg from single-use devices. Using reusable strategies could have potentially reduced plastic waste by 358.14 kg and avoided approximately 1038.60 kg CO₂e over one year of respiratory procedures, equivalent to approximately 4258 km driven by an average gasoline-powered passenger vehicle.

Conclusion

Reusable and low-waste alternatives can substantially reduce plastic waste and the carbon footprint associated with incinerating plastic from disposable ICU respiratory care products. Critical care nurses are well positioned to integrate these sustainable strategies into everyday clinical practice.

Implications for clinical practice

Implementing reusable equipment and low-waste alternatives can become part of standard care pathways, aligning clinical excellence with environmental sustainability. These findings support the integration of sustainability into everyday nursing decisions and institutional policies in critical care settings in the future.

重症监护室（icu）由于依赖资源密集型技术，被认为是医院内的碳“热点”。本研究旨在比较意大利ICU六种常见呼吸手术中使用的可重复使用和一次性产品，以确定减少塑料废物产生和塑料废物焚烧相关碳足迹的潜力。方法对10个床位的ICU患者进行为期12个月的回顾性评估。可重复使用设备和一次性设备之间的比较基于理论计算：每个设备都用精确秤称重，通过将单个设备重量乘以临床信息系统中记录的程序数来估计年总数。二氧化碳当量排放量是根据欧洲环境署的排放系数计算的，即每焚烧一公斤塑料垃圾产生2.9千克二氧化碳当量。结果可重复使用或低废物产品产生的塑料废物估计为143.50公斤，而一次性设备产生的塑料废物为501.64公斤。使用可重复使用的策略可能会减少358.14公斤的塑料废物，并在一年的呼吸过程中避免大约1038.60公斤的二氧化碳当量，相当于一辆普通汽油动力乘用车行驶约4258公里。结论可重复使用和低废物的替代品可大大减少一次性ICU呼吸护理用品的塑料废物和焚烧塑料相关的碳足迹。重症护理护士有能力将这些可持续战略融入日常临床实践。对临床实践的启示实施可重复使用的设备和低废物替代品可以成为标准护理途径的一部分，使临床卓越与环境可持续性保持一致。这些发现支持将可持续性纳入未来重症监护环境的日常护理决策和制度政策。

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引用次数: 0

Exploring barriers to patient safety and incident reporting in resource-limited intensive care units: A qualitative study 探索资源有限的重症监护病房中患者安全和事故报告的障碍：一项定性研究

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-12-27 DOI: 10.1016/j.iccn.2025.104325

Gelana Fekadu , Rachel Muir , Georgia Tobiano , Abera Kenay Tura , Michael J. Ireland , Andrea P. Marshall

Introduction

The burden of patient harm from unsafe care is disproportionately high in low-income countries, particularly in intensive care units (ICUs). Despite this, there is limited empirical evidence explaining the underlying challenges that make patient safety difficult to achieve in resource-limited ICUs.

Objectives

To explore the barriers to patient safety and incident-reporting in ICUs at Ethiopian university hospital.

Methods

An exploratory qualitative descriptive study was conducted using in-depth interviews guided by a semi-structured protocol and informed by the Theoretical Domains Framework (TDF). Participants were purposively selected, and sample size was determined based on principles of data sufficiency. Reflexive thematic analysis with inductive orientation was employed following Braun and Clarke’s approach.

Results

Thirty-nine healthcare professionals participated: 23 (59 %) nurses, 13 (33 %) physicians, and 3 (8 %) clinical pharmacists. The mean age of participants was 32 ± 5 years. Three overarching themes captured the barriers to patient safety and incident reporting in ICUs: (i) Fragile systems: Governance failure and resource constraints; (ii) Normalisation of deviance: teaching-hospital dynamics and clinical oversight, normalised communication lapses, and weak teamwork and relational context; and (iii) Silence trap: Fear in punitive and blame-oriented culture and lack of incident-reporting systems.

Conclusion

Patient safety in Ethiopian ICUs is undermined by systemic, operational, and clinician-related obstacles. Structural and cultural barriers further hinder incident-reporting creating a vicious cycle where unsafe care remains hidden and opportunities for learning and improvements are lost. Breaking this cycle requires strong governance, coordinated resource investment, enhancing just culture, strengthening teamwork, establishing robust incident-reporting systems, and ongoing professional development focused on patient safety.

Implications for clinical practice

Identifying barriers to patient safety and incident reporting in ICUs may enables targeted interventions that reduce preventable harm, improve care quality, and promote incident reporting and learning to sustain safe clinical practice. Keywords: Patient safety, Incident-reporting; Barriers, Intensive care units, Resource-limited settings, Qualitative study, Ethiopian public hospitals.

在低收入国家，不安全护理造成的患者伤害负担高得不成比例，特别是在重症监护病房。尽管如此，有限的经验证据解释了在资源有限的icu中难以实现患者安全的潜在挑战。目的探讨埃塞俄比亚大学医院重症监护病房患者安全和事件报告的障碍。方法以半结构化协议为指导，以理论领域框架（TDF）为指导，采用深度访谈进行探索性定性描述性研究。有目的地选择参与者，并根据数据充分性原则确定样本量。本文采用归纳导向的反身性主位分析方法。结果参与调查的医护人员39人，其中护士23人（59%），医生13人（33%），临床药师3人（8%）。参与者平均年龄32±5岁。三个总体主题抓住了icu患者安全和事件报告的障碍：(i)脆弱的系统：治理失败和资源限制；（二）越轨行为的正常化：教院动态和临床监督、沟通失误的正常化、团队合作和关系环境的薄弱；（三）沉默陷阱：害怕惩罚和指责导向的文化以及缺乏事件报告系统。结论埃塞俄比亚icu的患者安全受到系统、操作和临床相关障碍的影响。结构和文化障碍进一步阻碍了事件报告，造成不安全护理仍然隐藏的恶性循环，并失去了学习和改进的机会。打破这一循环需要强有力的治理、协调的资源投资、加强公正文化、加强团队合作、建立健全的事件报告系统以及持续的以患者安全为重点的专业发展。对临床实践的启示识别icu患者安全和事件报告的障碍可以实现有针对性的干预，减少可预防的伤害，提高护理质量，促进事件报告和学习，以维持安全的临床实践。关键词：患者安全；事件报告；障碍，重症监护病房，资源有限环境，定性研究，埃塞俄比亚公立医院。

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引用次数: 0

Microaspiration dynamics and “bio-inoculum intensity”: Deciphering the clinical paradox of tapered cuffs – Response to Chen et al. 微吸动力学和“生物接种强度”：解读锥形袖口的临床悖论-对Chen等人的回应。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-12-26 DOI: 10.1016/j.iccn.2025.104320

Suwen Li, Xing Xin, Chenxin Ye, Gendi Lu

引用次数: 0

Postoperative delirium in the cardiac ICU: A call for nursing-led prevention and compassionate care 心脏重症监护病房术后谵妄：呼唤护理主导的预防和关爱

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-12-26 DOI: 10.1016/j.iccn.2025.104319

Caroline Arbour , Tanya Mailhot

引用次数: 0

Impact of Pre–ICU benzodiazepine and Z–Drug exposure on mortality in critically ill Adults: A nationwide retrospective cohort study icu前苯二氮卓类药物和z -药物暴露对危重成人死亡率的影响：一项全国回顾性队列研究

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-12-25 DOI: 10.1016/j.iccn.2025.104322

Tak Kyu Oh , In-Ae Song

Objectives

Outpatient use of benzodiazepines and Z-drugs (BZRA) is common, yet its impact on mortality after intensive care unit (ICU) admission remains unclear. We therefore aimed to determine whether outpatient BZRA use within 30 days before ICU admission is independently associated with 30- and 90-day mortality.

Methods

Using South Korea’s National Health Insurance Service database, we retrospectively identified adults (≥18 years) with first ICU admissions from 2020 to 2023 and defined pre-ICU BZRA exposure as ≥ 1 prescription within 30 days before admission. We performed 1:1 propensity-score matching on demographic, clinical (including Charlson Comorbidity Index and acute organ dysfunction), socioeconomic, functional, institutional, and temporal variables, then estimated 30- and 90-day mortality associations via conditional logistic regression and Kaplan–Meier survival analysis.

Results

Among 1,189,042 unique adult ICU admissions, 115,821 (9.7 %) had pre-ICU BZRA exposure. After matching, 115,820 exposed and 115,820 unexposed patients had excellent covariate balance (all ASDs < 0.10). BZRA exposure was associated with higher 30-day mortality (23.8 % vs 16.6 %; odds ratio [OR] 1.57; 95 % confidence interval [CI] 1.54–1.60; P < 0.001) and higher 90-day mortality (36.8 % vs 27.3 %; OR 1.56; 95 % CI 1.53–1.58; P < 0.001). Kaplan–Meier analysis confirmed reduced cumulative survival (log-rank P < 0.001). Notably, combined benzodiazepine + Z-drug users exhibited the greatest risk: OR 2.46 (95 % CI 2.35–2.58) for 30-day death and OR 2.61 (95 % CI 2.50–2.72) for 90-day death versus non-exposed patients.

Conclusions

Outpatient BZRA use within 30 days before ICU admission is independently associated with higher 30- and 90-day mortality, with combination exposure conferring an even greater risk.

Implications for Clinical Practice

Recent outpatient BZRA prescriptions are an easily obtainable risk marker that clinicians should incorporate into pre-ICU assessment and triage; where clinically appropriate, medication review and targeted deprescribing may reduce early ICU morbidity and mortality.

目的门诊使用苯二氮卓类药物和z类药物（BZRA）是常见的，但其对重症监护病房（ICU）入院后死亡率的影响尚不清楚。因此，我们的目的是确定门诊患者在ICU入院前30天内使用BZRA是否与30天和90天死亡率独立相关。方法使用韩国国民健康保险服务数据库，回顾性地确定了2020年至2023年首次入住ICU的成年人（≥18岁），并将入院前30天内的BZRA暴露定义为≥1个处方。我们对人口学、临床（包括Charlson合并症指数和急性器官功能障碍）、社会经济、功能、制度和时间变量进行了1:1的倾向评分匹配，然后通过条件逻辑回归和Kaplan-Meier生存分析估计了30天和90天死亡率的关联。结果在1,189,042例单独入住ICU的成人中，115,821例（9.7%）在ICU前暴露于BZRA。匹配后，115,820例暴露患者和115,820例未暴露患者具有良好的协变量平衡（均为asd <； 0.10）。BZRA暴露与较高的30天死亡率（23.8% vs 16.6%；比值比[OR] 1.57； 95%可信区间[CI] 1.54-1.60; P < 0.001）和较高的90天死亡率（36.8% vs 27.3%; OR 1.56; 95% CI 1.53-1.58; P < 0.001）相关。Kaplan-Meier分析证实累积生存率降低（log-rank P < 0.001）。值得注意的是，苯二氮卓类药物+ z -药物联合使用者表现出最大的风险：与未暴露的患者相比，30天死亡的OR为2.46 (95% CI 2.35-2.58)， 90天死亡的OR为2.61 （95% CI 2.50-2.72）。结论在ICU入院前30天内使用BZRA与较高的30天和90天死亡率独立相关，联合使用会带来更大的风险。最近的门诊BZRA处方是一个容易获得的风险标志，临床医生应该将其纳入icu前评估和分诊；在临床上适当的情况下，药物审查和有针对性的去处方化可以降低ICU的早期发病率和死亡率。

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引用次数: 0

Effect of guided imagery on dyspnea in trauma ICU patients: a randomized controlled trial 引导成像对创伤ICU患者呼吸困难的影响：一项随机对照试验。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-12-23 DOI: 10.1016/j.iccn.2025.104280

Atena Shojaie , Naeimeh Naeimi Bafghi , Atefeh Ahmadi , Behnaz Bagherian

Background

Dyspnea is a prevalent and distressing symptom among critically ill patients, particularly in trauma intensive care units, and is often poorly managed in semi-conscious individuals. While guided imagery has shown benefits in various chronic and palliative contexts, its efficacy in ICU trauma patients remains understudied.

Methods

In this randomized controlled trial, 102 trauma ICU patients with Glasgow Coma Scale scores of 9–13 were randomly allocated to an intervention group (n = 51) or a control group (n = 51). The intervention group received nature-based guided imagery sessions twice daily for six consecutive days, in addition to standard ICU care. Respiratory distress was evaluated using the Intensive Care Respiratory Distress Observational Scale (IC-RDOS). Secondary outcomes included PaO₂, PaCO₂, HCO₃⁻, hemoglobin, and Behavioral Pain Scale (BPS) ratings.

Results

The intervention group experienced a greater reduction in respiratory distress (IC-RDOS) at Day 6 compared with controls (mean post-test IC-RDOS: 5.36 vs 6.22; between-group p < 0.001). Oxygenation improved in the intervention group (mean PaO₂ at Day 6: 73.8 vs 63.9 mmHg; between-group p < 0.001), while PaCO₂ showed a within-group decrease in the intervention arm but no significant between-group difference (mean post-test PaCO₂: 42.1 vs 43.1 mmHg; between-group p = 0.35). Pain (BPS) decreased modestly in the intervention group compared with the control (mean post-test BPS: 3.68 vs 4.31; between-group p < 0.001). No intervention-related adverse events were reported.

Conclusion

Guided imagery may be a feasible adjunctive therapy for alleviating respiratory distress and promoting clinical stability in trauma ICU patients with impaired consciousness. Larger trials are needed to confirm safety and effectiveness before routine clinical implementation.

Implications for clinical practice

Incorporating guided imagery into routine ICU nursing care could provide a practical, non-invasive method to reduce respiratory distress in semi-conscious trauma patients, potentially enhancing patient comfort and supporting respiratory function.

研究背景：呼吸困难是危重病人，尤其是创伤重症监护病房中普遍存在的令人痛苦的症状，在半意识个体中往往管理不善。虽然引导成像在各种慢性和姑息性环境中显示出益处，但其在ICU创伤患者中的疗效仍有待研究。方法：将102例格拉斯哥昏迷评分为9 ~ 13分的外伤ICU患者随机分为干预组（n = 51）和对照组（n = 51）。除了标准的ICU护理外，干预组每天接受两次以自然为基础的引导成像课程，连续六天。采用重症监护呼吸窘迫观察量表（IC-RDOS）评估呼吸窘迫。次要结局包括PaO2、PaCO2、HCO3-、血红蛋白和行为疼痛量表（BPS）评分。结果：与对照组相比，干预组在第6天呼吸窘迫（IC-RDOS）的降低幅度更大(测试后平均IC-RDOS: 5.36 vs 6.22；第6天组间p2: 73.8 vs 63.9 mmHg；组间p2显示干预组内降低，但组间无显著差异（测试后平均PaCO2: 42.1 vs 43.1 mmHg；组间p = 0.35）。与对照组相比，干预组疼痛（BPS）略有下降（平均测试后BPS: 3.68 vs 4.31；组间p）。结论：引导成像可能是一种可行的辅助治疗，可减轻创伤ICU意识受损患者的呼吸窘迫，促进临床稳定性。在常规临床应用之前，需要更大规模的试验来确认安全性和有效性。对临床实践的启示：将引导成像纳入常规ICU护理可以提供一种实用的、无创的方法来减少半意识创伤患者的呼吸窘迫，潜在地提高患者的舒适度和支持呼吸功能。

{"title":"Effect of guided imagery on dyspnea in trauma ICU patients: a randomized controlled trial","authors":"Atena Shojaie , Naeimeh Naeimi Bafghi , Atefeh Ahmadi , Behnaz Bagherian","doi":"10.1016/j.iccn.2025.104280","DOIUrl":"10.1016/j.iccn.2025.104280","url":null,"abstract":"<div><h3>Background</h3><div>Dyspnea is a prevalent and distressing symptom among critically ill patients, particularly in trauma intensive care units, and is often poorly managed in semi-conscious individuals. While guided imagery has shown benefits in various chronic and palliative contexts, its efficacy in ICU trauma patients remains understudied.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, 102 trauma ICU patients with Glasgow Coma Scale scores of 9–13 were randomly allocated to an intervention group (n = 51) or a control group (n = 51). The intervention group received nature-based guided imagery sessions twice daily for six consecutive days, in addition to standard ICU care. Respiratory distress was evaluated using the Intensive Care Respiratory Distress Observational Scale (IC-RDOS). Secondary outcomes included PaO<sub>2</sub>, PaCO<sub>2</sub>, HCO<sub>3</sub><sup>−</sup>, hemoglobin, and Behavioral Pain Scale (BPS) ratings.</div></div><div><h3>Results</h3><div>The intervention group experienced a greater reduction in respiratory distress (IC-RDOS) at Day 6 compared with controls (mean post-test IC-RDOS: 5.36 vs 6.22; between-group p < 0.001). Oxygenation improved in the intervention group (mean PaO<sub>2</sub> at Day 6: 73.8 vs 63.9 mmHg; between-group p < 0.001), while PaCO<sub>2</sub> showed a within-group decrease in the intervention arm but no significant between-group difference (mean post-test PaCO<sub>2</sub>: 42.1 vs 43.1 mmHg; between-group p = 0.35). Pain (BPS) decreased modestly in the intervention group compared with the control (mean post-test BPS: 3.68 vs 4.31; between-group p < 0.001). No intervention-related adverse events were reported.</div></div><div><h3>Conclusion</h3><div>Guided imagery may be a feasible adjunctive therapy for alleviating respiratory distress and promoting clinical stability in trauma ICU patients with impaired consciousness. Larger trials are needed to confirm safety and effectiveness before routine clinical implementation.</div></div><div><h3>Implications for clinical practice</h3><div>Incorporating guided imagery into routine ICU nursing care could provide a practical, non-invasive method to reduce respiratory distress in semi-conscious trauma patients, potentially enhancing patient comfort and supporting respiratory function.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104280"},"PeriodicalIF":4.7,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mapping the discourse of environmental sustainability in intensive care nursing: a lexicometric exploration of professional meaning-making 绘制环境可持续性话语在重症护理：专业意义的词汇计量学探索。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-12-23 DOI: 10.1016/j.iccn.2025.104317

Mariachiara Figura , Francesca Trotta , Luciano Midolo , Francesco Petrosino , Gianluca Pucciarelli , Davide Bartoli

Introduction

Intensive Care Units (ICUs) are among the most resource-intensive hospital environments, contributing substantially to healthcare’s environmental footprint. While sustainable practices are increasingly recognized as essential, little is known about how critical care nurses linguistically frame and make sense of sustainability within their professional culture and daily work.

Aim

To explore how critical care nurses construct and articulate meanings of environmental sustainability in their professional discourse.

Methods

Semi-structured interviews were conducted with 29 critical care nurses across diverse hospital settings. Narratives were analyzed using Automatic Analysis of Textual Data (IRaMuTeQ) with similarity analysis to map term relationships and uncover semantic clusters. Statistical associations (χ² ≥ 3.84; p < 0.05) guided identification of lexical hubs and thematic subnetworks. Computational findings were integrated with qualitative interpretation to ensure contextual depth and rigor.

Results

The central lexical hub, sustainability, connected clusters reflecting reflective engagement, collaborative responsibility, organizational structures, and systemic gaps. Secondary hubs included environment (ecological impact and cost considerations), practice (behavioral integration), patient (embedded in bedside care), and waste (material handling, energy use, lifecycle awareness). Nurses framed sustainability as both a professional duty and systemic challenge, mediated by organizational support, personal commitment, and environmental constraints.

Conclusions

ICU nurses’ discourse reveals sustainability as a multidimensional construct bridging ethics, operational practice, and systemic limitations. Lexicometric mapping provides a structured view of how sustainability is embedded in professional narratives, offering insights to inform targeted educational and organizational strategies.

Implications for clinical practice

Integrating sustainability into professional identity enhances patient care and environmental responsibility. These findings deepen understanding of which dimensions of environmental sustainability can be meaningfully enacted through professional culture and organizational alignment, rather than through the direct imposition of fixed behavioural routines.

重症监护室（icu）是医院中资源最密集的环境之一，对医疗保健的环境足迹做出了重大贡献。虽然可持续实践越来越被认为是必不可少的，但人们对重症监护护士如何在其专业文化和日常工作中构建和理解可持续发展知之甚少。目的：探讨重症护理护士如何在其专业话语中构建和表达环境可持续性的含义。方法：对不同医院的29名重症护理护士进行半结构化访谈。使用IRaMuTeQ （Automatic Analysis of Textual Data）对叙述进行分析，并结合相似度分析来映射术语关系和揭示语义聚类。统计关联（χ2≥3.84;p）结果：中心词汇枢纽、可持续性、反映反思参与、协作责任、组织结构和系统差距的连接集群。次要中心包括环境（生态影响和成本考虑）、实践（行为整合）、患者（嵌入床边护理）和废物（材料处理、能源使用、生命周期意识）。护士将可持续发展定义为专业责任和系统挑战，由组织支持、个人承诺和环境约束作为中介。结论：ICU护士的话语揭示了可持续性作为一个多维结构，连接伦理、操作实践和系统限制。词典计量学映射提供了一个结构化的视角，说明可持续发展如何嵌入到专业叙事中，为有针对性的教育和组织战略提供了见解。对临床实践的启示：将可持续性纳入职业身份，提高患者护理和环境责任。这些发现加深了对环境可持续性的哪些方面可以通过专业文化和组织协调而不是通过直接强加固定的行为惯例来有意义地制定的理解。

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引用次数: 0

Time-limited ICU trials: A method for value-based rapid response team decision-making 限时ICU试验：一种基于价值的快速反应团队决策方法。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-12-22 DOI: 10.1016/j.iccn.2025.104308

Ashwin Subramaniam , Melissa J. Bloomer , Daryl Jones

引用次数: 0

From family-centred care to humanisation of ICUs: A paediatric lens on future directions 从以家庭为中心的护理到icu的人性化：未来方向的儿科镜头

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-12-20 DOI: 10.1016/j.iccn.2025.104321

Pei-Fen Poh , Ying Gu , Jos M. Latour

引用次数: 0

Psychometric properties and structural validity of the traditional Chinese version of the FAMily engagement instrument in intensive care units 重症监护病房传统中文版家庭参与量表的心理测量特征及结构效度

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-12-20 DOI: 10.1016/j.iccn.2025.104316

Kai-Mei Chang , Kath Peters , Lucie Ramjan , Kevin Shu-Leung Lai , An-Yi Wang , Chen-I Lee , Tzu-Hao Wang , Hsiao-Yean Chiu

Objectives

Family engagement, a key component of the ABCDEF bundle in the intensive care unit (ICU), is associated with improved clinical outcomes in patients and enhanced well-being of family members. The FAMily Engagement instrument is the only validated tool available for assessing family engagement in ICU care. However, it has not been evaluated in Chinese-speaking populations. The study aimed to translate and validate the Traditional Chinese version of the FAMily Engagement instrument (FAME-TC) among family members of ICU patients.

Methods

This prospective observational study included family members who were among the most frequent visitors or primary caregivers and had accompanied corresponding patients for at least 3 days after ICU admission. Data collection included demographic information, FAME-TC, the Depression, Anxiety, and Stress Scale-21 Items (DASS21), and the five-level version of EuroQoL–5 dimensions (EQ-5D-5L). Internal consistency, construct validity, and concurrent validity of the FAME-TC were evaluated to confirm the reliability and validity.

Results

A total of 200 participants were enrolled (mean age: 48.46 ± 14.52 years; female: 57.5 %). The FAME-TC showed excellent reliability (Cronbach’s α = 0.91). Exploratory factor analysis (EFA) confirmed a two-factor structure: family engagement in care and family perceived support from the healthcare team. No significant correlation was observed between the FAME-TC score and subscales of the DASS21 (p > 0.05), while a statistically significant positive correlation was found between the FAME-TC score and the EQ-5D-5L visual analogue scale level (r = 0.26, p < 0.001).

Conclusions

The FAME-TC exhibits satisfactory reliability and validity for assessing family engagement in critical care.

Implications for clinical practice

Healthcare providers can use the FAME-TC to evaluate family engagement degree and implement targeted interventions to strengthen family involvement in critical care, thereby improving patients’ clinical outcomes and improving family members’ quality of life.

家庭参与是重症监护病房（ICU） ABCDEF的关键组成部分，与患者临床结果的改善和家庭成员幸福感的增强有关。家庭参与量表是评估ICU护理中家庭参与的唯一有效工具。然而，尚未对汉语人群进行评估。本研究旨在对繁体中文版家庭参与量表（FAME-TC）在ICU患者家属中的翻译和验证。方法本前瞻性观察性研究纳入了ICU入院后陪伴患者至少3天的患者家属或主要照顾者。数据收集包括人口统计信息、FAME-TC、抑郁、焦虑和压力量表21项（DASS21）和EuroQoL-5维度（EQ-5D-5L）的五级版本。对FAME-TC的内部一致性、结构效度和并发效度进行评估，以验证信度和效度。结果共纳入200例受试者，平均年龄48.46±14.52岁，女性占57.5%。FAME-TC具有良好的信度（Cronbach’s α = 0.91）。探索性因素分析（EFA）证实了一个双因素结构：家庭参与护理和家庭感知的医疗团队支持。FAME-TC评分与DASS21各分量表间无显著相关（p > 0.05），而FAME-TC评分与EQ-5D-5L视觉模拟量表水平间有显著正相关（r = 0.26, p < 0.001）。结论FAME-TC量表对重症监护家庭参与评估具有满意的信度和效度。对临床实践的意义医疗服务提供者可以使用FAME-TC评估家庭参与程度，并实施有针对性的干预措施，以加强家庭参与危重病护理，从而改善患者的临床结果和改善家庭成员的生活质量。

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引用次数: 0