Intensive and Critical Care Nursing最新文献_第8页

Multi-stakeholder perspectives into the experiences of siblings when a child is critically ill: A qualitative systematic review 多利益相关方视角对病重儿童兄弟姐妹经历的研究：一项定性系统回顾。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-28 DOI: 10.1016/j.iccn.2024.103920

Jessica Appleyard , Beverley Copnell , Alyssia Haling , Joseph C. Manning , Ashleigh E. Butler

Objectives

A child’s critical illness and admission to intensive care can have significant short- and long-term impacts for the parents and hospitalized child. While experiences of parents have been explored, the impact on siblings remains unclear. The aim was to systematically review and synthesize qualitative research exploring the experiences of siblings when a child is critically ill, from the perspectives of siblings and relevant key stakeholders.

Methods

Comprehensive searches were performed across six databases and three sources of grey literature on October 30, 2023 and September 23, 2024. Original qualitative research focusing on sibling experiences during a child’s critical illness were included. Two independent reviewers screened studies, with conflicts resolved by a third reviewer. Data extraction and quality assessment were carried out by one reviewer and verified by a second reviewer using Covidence. Thematic synthesis was used to synthesize extracted data, ensuring the rigor of the findings.

Findings

Of 1,552 studies screened, 24 met inclusion criteria. Seven mixed methods and 17 qualitative studies were included. Experiences of siblings were categorized into eight themes and included elements such as visiting the ICU, being separated, changing roles, looking to the future, and getting support. Sibling experiences could be positively or negatively influenced by parents, healthcare professionals, hospital policies and environment.

Conclusions

This study provides a novel insight into the underrepresented sibling experience in critical care research. Siblings experience significant multi-faceted impacts when a child is critically ill. This review underscores the necessity for further research on siblings’ perspectives in critical care, to aid development of appropriate supports and interventions for siblings and families during a child’s critical illness.

Implications for Clinical Practice

Understanding siblings’ experiences can enhance holistic family-centered care. Findings from this review demonstrate the need for more supportive practices for siblings in intensive care, through development of inclusive, family-centered care policies and guidelines.

目的：儿童的危重疾病和进入重症监护可能对父母和住院儿童产生重大的短期和长期影响。虽然已经研究了父母的经历，但对兄弟姐妹的影响仍不清楚。目的是从兄弟姐妹和相关关键利益相关者的角度，系统地回顾和综合定性研究，探讨儿童危重疾病时兄弟姐妹的经历。方法：于2023年10月30日和2024年9月23日对6个数据库和3个灰色文献来源进行综合检索。最初的定性研究集中在兄弟姐妹的经验，在一个孩子的危重疾病包括。两名独立审稿人筛选研究，冲突由第三名审稿人解决。数据提取和质量评估由一名审稿人进行，并由另一名审稿人使用covid - ence进行验证。专题综合用于综合提取的数据，确保结果的严谨性。结果：在1552项研究中，24项符合纳入标准。纳入7项混合方法和17项定性研究。兄弟姐妹的经历被分为8个主题，包括访问ICU、分离、角色转换、展望未来和获得支持等元素。父母、医疗保健专业人员、医院政策和环境可能对兄弟姐妹的经历产生积极或消极的影响。结论：本研究为危重症研究中未被充分代表的兄弟姐妹经验提供了新的见解。当孩子病重时，兄弟姐妹会受到多方面的影响。本综述强调了进一步研究兄弟姐妹在重症监护中的观点的必要性，以帮助在儿童危重疾病期间为兄弟姐妹和家庭提供适当的支持和干预措施。对临床实践的启示：了解兄弟姐妹的经历可以加强以家庭为中心的整体护理。本综述的研究结果表明，需要通过制定包容性的、以家庭为中心的护理政策和指南，为重症监护中的兄弟姐妹提供更多的支持性实践。

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引用次数: 0

Current Insights Oesophageal pressure monitoring: A real advanced tool for ICU nurses 食道压力监测：ICU护士真正的先进工具。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-28 DOI: 10.1016/j.iccn.2024.103923

Cristian Fusi , Enrico Bulleri

引用次数: 0

Confirming gastric tube placement in neurocritical patients using the combined effects of end-tidal CO2 and pH testing: A prospective diagnostic study 利用潮末CO2和pH检测的联合作用确认神经危重症患者胃管置入：一项前瞻性诊断研究。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-28 DOI: 10.1016/j.iccn.2024.103922

Yunxia Chen , Mengmin Xu , Yanwei Cheng, Shuaishuai Li, He Gao, Sha Kong, Chi Zhang, Xiaodi Hao, Mengli Yang

Objective

To assess the predictive effects of end-tidal carbon dioxide partial pressure (PETCO₂) in combination with pH measurement in confirming gastric tube placement in neurologically critical patients.

Methods

This study included 105 patients with gastric tubes placed in the neurological intensive care unit of Henan Provincial People’s Hospital between November 2023 and April 2024. By employing X-ray as a gold standard, we compared the predictive value of PETCO₂, pH testing, or PETCO₂ in combination with pH measurement on the position of the tubes.

Results

Receiver operating characteristic curve analysis of the three methods revealed varying diagnostic efficiencies. The PETCO₂ method exhibited low performance, with an area under the curve (AUC) of 0.714, sensitivity of 42.9 %, specificity of 100 %, positive predictive value (PPV) of 100 %, and negative predictive value (NPV) of 96.1 %. In contrast, the pH method demonstrated better diagnostic capability, with an AUC of 0.821, sensitivity of 71.4 %, specificity of 92.9 %, PPV of 41.7 %, and NPV of 97.8 %. PETCO₂ in combination with pH method showed the highest efficiency, achieving an AUC of 0.964, sensitivity of 100 %, specificity of 92.9 %, PPV of 50%, and NPV of 100 %.

Conclusion

Using PETCO₂ combined with pH measurement to confirm gastric tube placement demonstrated high accuracy and reliability, consistent with X-ray results. This combined approach offers a reliable, non-invasive alternative to X-ray for confirming gastric tube placement in neurologically critical patients.

Trial Registration: Chinese Clinical Trial Registry (Registration No. ChiCTR2300078001).

目的：评价潮末二氧化碳分压（PETCO2）联合pH测定对神经危重症患者胃管置入的预测作用。方法：选取2023年11月至2024年4月在河南省人民医院神经内科重症监护病房放置胃管的105例患者为研究对象。通过采用x射线作为金标准，我们比较了PETCO2、pH测试或PETCO2结合pH测量对试管位置的预测价值。结果：三种方法的受者工作特征曲线分析显示不同的诊断效率。PETCO2法表现较差，曲线下面积（AUC）为0.714，灵敏度为42.9%，特异性为100%，阳性预测值（PPV）为100%，阴性预测值（NPV）为96.1%。pH法的AUC为0.821，敏感性为71.4%，特异性为92.9%，PPV为41.7%，NPV为97.8%。PETCO2联合pH法的检测效率最高，AUC为0.964，灵敏度为100%，特异性为92.9%，PPV为50%，NPV为100%。结论：PETCO2联合pH测量法确定胃管放置的准确性和可靠性高，与x线结果一致。这种联合方法为神经危重症患者确认胃管放置提供了可靠的、无创的x线替代方法。试验注册：中国临床试验注册中心(注册号：ChiCTR2300078001)。

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引用次数: 0

Incidence and related factors of catheter-associated bloodstream infection in neonates: A systematic review and meta-analysis 新生儿导管相关血流感染的发生率及相关因素：一项系统回顾和荟萃分析。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-28 DOI: 10.1016/j.iccn.2024.103927

Yan Pang , Jinzhu Fu , Ying Tan , Lina Zhang , Li Bai , Miaomiao Yan , Huimin Li , Xin Wang

Objective

To identify the related factors of neonatal catheter-associated bloodstream infection (CABSI), and provide a basis for constructing a scientific and rational strategy for neonatal CABSI prevention.

Methods

CNKI, Wanfang, PubMed, MEDLINE-Ovid, Web of Science, Embase, CINAHL, and Cochrane Library were searched for publications on neonatal CABSI from the time the database was established until September 30, 2023. The language of publications was not specified. Unpublished reports and gray studies were excluded. All cohort, case-control, and cross-sectional studies were included. A meta-analysis of the incidence and related factors of neonatal CABSI were made using Revman software. Heterogeneity was evaluated using the I² statistic method, and the publication bias was analyzed with funnel plot tests.

Results

A total of 35 studies involving 34,743 patients from 13 different countries were included. There were 15 case-control, 15 cohort, and 5 cross-sectional studies, with 14 related factors discussed. All the studies scored high (score ≥ 6) in their overall quality. According to the meta-analysis, the incidence of neonatal CABSI was 5.93/1000 catheter days (OR = 5.29). The risk factors were identified and ranked as follows according to the degree of influence: 5-minute Apgar score (OR = 4.69), the number of punctures during the stay of the line (OR = 3.49), male (OR = 3.17), mechanical ventilation (OR = 2.73), catheter repair (OR = 2.66), lower gestational age at birth (OR = 2.47), femoral vein catheter (OR = 1.92), dwell time of the catheter (OR = 1.34), and lower birth weight (OR = 1.05). Establishing sterile barrier throughout was a protective factor (OR = 0.41). Subgroup analysis suggested that the study design, catheter type and year of publication might be the primary sources of heterogeneity. The sensitivity analysis demonstrated the robustness of the results. However, the funnel plot indicated a potential publication bias.

Conclusion

Neonatal CABSI carries a significant morbidity rate and is influenced by numerous factors.

Implications for Clinical Practice

It is crucial to underscore the necessity for additional longitudinal studies to explore evidence-based approaches to lowering the risk and ultimately reducing the incidence of CABSI.

Registration

The study protocol has been registered with the PROSPERO: CRD42023443697.

目的：探讨新生儿导管相关性血流感染（CABSI）的相关因素，为制定科学合理的新生儿导管相关性血流感染预防策略提供依据。方法：检索CNKI、万方、PubMed、MEDLINE-Ovid、Web of Science、Embase、CINAHL和Cochrane Library自数据库建立至2023年9月30日期间有关新生儿CABSI的出版物。出版物的语言没有具体说明。未发表的报告和灰色研究被排除在外。所有的队列研究、病例对照研究和横断面研究均被纳入。采用Revman软件对新生儿CABSI的发生率及相关因素进行meta分析。采用I2统计方法评价异质性，采用漏斗图检验分析发表偏倚。结果：共纳入35项研究，涉及来自13个不同国家的34,743例患者。有15项病例对照研究、15项队列研究和5项横断面研究，讨论了14项相关因素。所有研究的综合质量评分均为高（≥6分）。根据meta分析，新生儿CABSI的发生率为5.93/1000导管天（OR = 5.29）。根据影响程度确定危险因素并进行排序：5分钟Apgar评分（OR = 4.69）、留置线期间穿刺次数（OR = 3.49）、男性（OR = 3.17）、机械通气（OR = 2.73）、导管修复（OR = 2.66）、低胎龄（OR = 2.47）、股静脉导管（OR = 1.92）、导管停留时间（OR = 1.34）、低出生体重（OR = 1.05）。建立无菌屏障是保护因素（OR = 0.41）。亚组分析提示，研究设计、导管类型和发表年份可能是异质性的主要来源。敏感性分析证明了结果的稳健性。然而，漏斗图显示潜在的发表偏倚。结论：新生儿CABSI发病率高，受多种因素影响。对临床实践的启示：强调额外的纵向研究的必要性是至关重要的，以探索以证据为基础的方法来降低风险并最终减少CABSI的发生率。研究方案已在PROSPERO注册：CRD42023443697。

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引用次数: 0

Patient and family member experience of hospital readmission following critical illness 危重疾病后再入院的患者及家属经验。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-28 DOI: 10.1016/j.iccn.2024.103890

Joanne McPeake , Pamela MacTavish , Kathryn Puxty , Carly Crook , Tara Quasim

Background

Hospital readmission following critical illness is common. There is limited data which examines the patient and family perspective of hospital readmission. Understanding the impact of readmissions from a patient perspective can potentially help design meaningful clinical pathways to support improvements in care.

Objectives

The aim of this qualitative analysis was to explore the experience of patient and family members during readmission to hospital following critical illness. We also sought to understand any perceived drivers of these readmissions from a patient and caregiver perspective.

Methods

Qualitative descriptive study using semi-structured interviews. Data were analysed using a thematic content analysis approach based on Miles and Huberman’s framework.

Setting and participants

This study was conducted in a large inner city teaching hospital in the UK. Critical care survivors who had been readmitted to hospital following critical illness and their family members were invited to participate in interviews during the readmission episode.

Results

Interviews were undertaken with 20 participants (15 patients and 5 family members). We derived five themes related to hospital readmission: access to primary care; ongoing physiological disturbance; discharge planning and information provision; treatment burden; and carer strain and social care access.

Conclusions

There are multiple perceived drivers of readmission to hospital following critical illness from a patient and family member perspective. The experience of readmission can be potentially traumatic for those involved. Future research should examine how discharge planning can be improved and how family members can be effectively supported in the post-hospital discharge period.

Implications for Practice

Clear discharge planning and information provision is required to ensure effective care for survivors of critical illness. Family members of survivors could also benefit from dedicated support across the continuum of care.

背景：危重疾病后再入院是常见的。有有限的数据，以检查病人和家庭的观点，医院再入院。从患者的角度理解再入院的影响可能有助于设计有意义的临床途径，以支持改善护理。目的：本定性分析的目的是探讨患者及其家属在危重疾病后再入院时的经历。我们还试图从患者和护理人员的角度了解这些再入院的任何感知驱动因素。方法：采用半结构化访谈法进行定性描述性研究。使用基于Miles和Huberman框架的主题内容分析方法分析数据。环境和参与者：本研究在英国市中心的一家大型教学医院进行。在危重疾病后再次入院的重症监护幸存者及其家庭成员被邀请参加再入院期间的访谈。结果：共访谈20人（患者15人，家属5人）。我们得出了与再入院相关的五个主题：获得初级保健；持续的生理障碍；排放规划和信息提供；治疗负担;照顾者的压力和社会照顾的机会。结论：从患者和家属的角度来看，有多种可感知的危重疾病后再入院的驱动因素。再入院的经历可能会给患者带来潜在的创伤。未来的研究应探讨如何改进出院计划，以及如何在出院后有效地支持家庭成员。实践意义：需要明确的出院计划和信息提供，以确保对危重疾病幸存者的有效护理。幸存者的家庭成员也可以从整个护理过程中的专门支持中受益。

{"title":"Patient and family member experience of hospital readmission following critical illness","authors":"Joanne McPeake , Pamela MacTavish , Kathryn Puxty , Carly Crook , Tara Quasim","doi":"10.1016/j.iccn.2024.103890","DOIUrl":"10.1016/j.iccn.2024.103890","url":null,"abstract":"<div><h3>Background</h3><div>Hospital readmission following critical illness is common. There is limited data which examines the patient and family perspective of hospital readmission. Understanding the impact of readmissions from a patient perspective can potentially help design meaningful clinical pathways to support improvements in care.</div></div><div><h3>Objectives</h3><div>The aim of this qualitative analysis was to explore the experience of patient and family members during readmission to hospital following critical illness. We also sought to understand any perceived drivers of these readmissions from a patient and caregiver perspective.</div></div><div><h3>Methods</h3><div>Qualitative descriptive study using semi-structured interviews. Data were analysed using a thematic content analysis approach based on Miles and Huberman’s framework.</div></div><div><h3>Setting and participants</h3><div>This study was conducted in a large inner city teaching hospital in the UK. Critical care survivors who had been readmitted to hospital following critical illness and their family members were invited to participate in interviews during the readmission episode.</div></div><div><h3>Results</h3><div>Interviews were undertaken with 20 participants (15 patients and 5 family members). We derived five themes related to hospital readmission: access to primary care; ongoing physiological disturbance; discharge planning and information provision; treatment burden; and carer strain and social care access.</div></div><div><h3>Conclusions</h3><div>There are multiple perceived drivers of readmission to hospital following critical illness from a patient and family member perspective. The experience of readmission can be potentially traumatic for those involved. Future research should examine how discharge planning can be improved and how family members can be effectively supported in the post-hospital discharge period.</div></div><div><h3>Implications for Practice</h3><div>Clear discharge planning and information provision is required to ensure effective care for survivors of critical illness. Family members of survivors could also benefit from dedicated support across the continuum of care.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103890"},"PeriodicalIF":4.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of Non-Pharmacological Sleep Interventions on Delirium Prevention and Sleep Improvement in Postoperative ICU Patients: A Systematic Review and Network Meta-Analysis 非药物睡眠干预对ICU术后患者谵妄预防和睡眠改善的影响：系统综述和网络荟萃分析

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-21 DOI: 10.1016/j.iccn.2024.103925

Jiaqi Li , Yingying Fan , Ruoyu Luo , Na Yin , Yangyang Wang , Jiyong Jing , Ju Zhang

Objectives

Analyze the effectiveness of different non-pharmacological sleep interventions in preventing delirium among postoperative ICU patients.

Research methodology

We conducted a comprehensive search on PubMed, Cochrane Library, Web of Science, Embase, CINAHL, OpenGrey and reference lists up to May 2024.

Setting

We systematically searched all randomized controlled trials related to non-pharmacological sleep interventions for the prevention of delirium.

Results

The results of the network meta-analysis showed that, compared to Usual Care, multicomponent interventions are the most effective measures for preventing delirium in postoperative ICU patients (RR = 0.32, 95 % CI = 0.20 to 0.51). This is followed by non-pharmacological sleep interventions aimed at stress relief (RR = 0.60, 95 % CI = 0.41 to 0.89) and circadian rhythm (RR = 0.61, 95 % CI = 0.39 to 0.96). Additionally, non-pharmacological sleep interventions focusing on circadian rhythm demonstrated an improvement in sleep quality among postoperative ICU patients (SMD = −0.99, 95 % CI = −1.88 to −0.11).

Conclusions

Our study found that multicomponent non-pharmacological sleep interventions are effective in reducing the incidence of delirium in postoperative ICU patients. Furthermore, non-pharmacological interventions focused on circadian rhythm regulation significantly enhance sleep quality among these patients.

Implications for clinical practice

Based on this study, intensive care units and nursing staff have an opportunity to implement the most effective non-pharmacological sleep interventions to prevent delirium and improve sleep quality in postoperative ICU patients. This could contribute to a reduction in the incidence of delirium in postoperative ICU patients.

目的：分析不同非药物睡眠干预措施对预防ICU术后患者谵妄的效果。研究方法：我们对PubMed、Cochrane Library、Web of Science、Embase、CINAHL、OpenGrey和参考文献进行了全面检索，检索截止到2024年5月。背景：我们系统地检索了所有与非药物睡眠干预预防谵妄相关的随机对照试验。结果：网络荟萃分析结果显示，与常规护理相比，多组分干预是预防ICU术后患者谵妄最有效的措施（RR = 0.32, 95% CI = 0.20 ~ 0.51）。其次是旨在缓解压力的非药物睡眠干预（RR = 0.60, 95% CI = 0.41至0.89）和昼夜节律（RR = 0.61, 95% CI = 0.39至0.96）。此外，关注昼夜节律的非药物睡眠干预表明，术后ICU患者的睡眠质量得到改善（SMD = -0.99, 95% CI = -1.88至-0.11）。结论：本研究发现，多组分非药物睡眠干预可有效降低ICU术后患者谵妄的发生率。此外，专注于昼夜节律调节的非药物干预措施显著提高了这些患者的睡眠质量。对临床实践的启示：基于本研究，重症监护病房和护理人员有机会实施最有效的非药物睡眠干预措施，以预防谵妄和改善ICU术后患者的睡眠质量。这可能有助于降低ICU术后患者谵妄的发生率。

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引用次数: 0

A quality improvement program to reduce surgical site infections after cardiac surgery: A 10-year cohort study 减少心脏手术后手术部位感染的质量改进方案：一项10年队列研究。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-19 DOI: 10.1016/j.iccn.2024.103926

Elena Conoscenti , Giuseppe Enea , Mieke Deschepper , Diana Huis in ’t Veld , Maria Campanella , Giuseppe Raffa , Barbara Ragonesi , Alessandra Mularoni , Alessandro Mattina , Stijn Blot

Objectives

To assess trends in surgical site infection (SSI) incidence in cardiosurgery following a quality improvement initiative in infection prevention and control (IP&C).

Methods

This is a historical cohort study encompassing a 10-year surveillance period (2014–2023) in a cardiosurgical department in a multi-organ transplant center. The study encompassed three periods: a baseline period (Phase_1: January 2014-December 2018); an implementation phase covering quality improvement initiatives targeting various aspects of IP&C including organizational factors, pre-operative, intra-operative, post-operative measures, and post-hospitalization care (Phase_2: January 2019-June 2021); a post-implementation phase (Phase_3: July 2021-September 2023). A general linear mixed model was used to assess differences in SSI rates between distinct phases, adjusted for length of hospitalization, American Society of Anaesthesiologists (ASA) physical status classification, and Diagnostic-Related Groups (DRG) weight. The latter two were used as random effects. Results are reported as odds ratios [OR] with 95% confidence interval [CI].

Results

All cardiac surgery patients were included (n = 5851). A total of 208 patients developed SSI (3.5 %). SSI incidence for phase_1, phase_2 and phase_3 were 4.5 %, 4.1 %, and 1.2 %, respectively. The mixed model regression analysis indicated that, compared with the reference period (Phase1), SSI risk did not drop during the implementation phase (OR 0.81, 95 % CI 0.59–1.13, P < 0.001 vs. reference period). A decrease in SSI risk was observed during the post-implementation phase (OR 0.19, 95 % CI 0.11–0.32)

Conclusions

A quality improvement initiative encompassing measurements at all levels potentially impacting SSI risk was implemented over a 2.5 years period. While no risk reduction was observed during the implementation phase, a significant reduction in SSI risk took place in the post-implementation phase.

Implications for Clinical Practice

This study suggests that considerable time may be required to achieve a substantial SSI risk reduction. We assume this may be attributed to the time required to achieve appropriate adherence with IP&C protocols.

目的：评估感染预防和控制（IP&C）质量改进倡议后心脏外科手术部位感染（SSI）发生率的趋势。方法：这是一项包含10年监测期（2014-2023）的多器官移植中心心外科的历史队列研究。该研究包括三个时期：基线期（第一阶段：2014年1月至2018年12月）；实施阶段，涵盖针对IP&C各个方面的质量改进举措，包括组织因素、术前、术中、术后措施和住院后护理（第二阶段：2019年1月至2021年6月）；实施后阶段（第三阶段：2021年7月至2023年9月）。采用一般线性混合模型评估不同阶段间SSI发生率的差异，并根据住院时间、美国麻醉医师协会（ASA）身体状态分类和诊断相关组（DRG）权重进行调整。后两者被用作随机效应。结果以95%可信区间（CI）的优势比（OR）报告。结果：所有心脏手术患者均被纳入（n = 5851）。共有208例患者发生SSI（3.5%）。phase_1、phase_2和phase_3的SSI发生率分别为4.5%、4.1%和1.2%。混合模型回归分析表明，与参考期（第一阶段）相比，SSI风险在实施阶段没有下降（OR 0.81, 95% CI 0.59-1.13， P）。对临床实践的影响：该研究表明，要实现SSI风险的大幅降低可能需要相当长的时间。我们认为这可能归因于适当遵守IP&C协议所需的时间。

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引用次数: 0

Clinical debriefing: Who’s invited – Response to Dewdney & Wait 临床汇报：谁被邀请了-对杜尼和等待的回应。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-19 DOI: 10.1016/j.iccn.2024.103913

Anne-Françoise Rousseau, Alexandre Ghuysen, Bernard Lambermont, Méryl Paquay

引用次数: 0

Current insights on awake prone positioning in the ICU 当前对ICU清醒俯卧位的认识。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-18 DOI: 10.1016/j.iccn.2024.103916

W. Stilma, F. Paulus

引用次数: 0

Relationship between perceived stress and health literacy on family satisfaction among family members of critically ill patients: A multicenter exploratory study 危重病人家属感知到的压力与健康素养对家庭满意度的关系：一项多中心探索性研究。

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2024-12-18 DOI: 10.1016/j.iccn.2024.103895

Cristobal Padilla-Fortunatti , Yasna Palmeiro-Silva , Victor Ovalle-Meneses , Maria Abaitua-Pizarro , Jessica Espinoza-Acuña , Claudia Bustamante-Troncoso , Noelia Rojas-Silva

Background

Intensive care unit (ICU) admission is often a stressful experience that can negatively influence family satisfaction (FS) with patient care, communication, and decision-making. Health literacy (HL) is associated with the patient’s ability to obtain, process, and understand health-related information. Few studies have explored the influence of perceived stress and HL on FS simultaneously.

Objective

To examine the association of perceived stress and HL with FS among family members of ICU patients.

Design

A multicenter exploratory cross-sectional study.

Methods

An exploratory, cross-sectional, multicenter study was conducted in three ICUs from different hospitals in Chile. Family members of ICU patients with ≥48 h of stay and respiratory support were eligible. The Family Satisfaction in the Intensive Care Unit-24 questionnaire and the Perceived Stress Scale were used. HL was evaluated using three screening questions. Multiple beta regressions were fit to explore the association between perceived stress, HL, and FS.

Results

A total of 101 family members with 63.4% identified as at risk of low HL were included. Multiple beta regression revealed that low HL was not associated with FS. Conversely, FS was negatively associated with perceived stress, being admitted to the ICU of the central or southern region, and having a close personal relationship with a healthcare provider but positively associated with the number of communications with ICU staff.

Conclusions

While perceived stress can be detrimental to FS, HL seems not to impact FS levels among family members of ICU patients. Further studies are required to explore the influence of HL on FS.

Implications of the clinical practice

This study advances the knowledge regarding variables affecting FS in the ICU. Evaluating the family members’ emotional status may help ICU healthcare providers in the allocation of resources to support family members and to properly assess their satisfaction.

Patient or public contribution

Family members of ICU patients participated in this study.

背景：重症监护病房（ICU）入住通常是一种压力体验，会对患者护理、沟通和决策的家庭满意度产生负面影响。健康素养（HL）与患者获取、处理和理解健康相关信息的能力有关。很少有研究同时探讨感知应激和HL对FS的影响。目的：探讨ICU患者家属感知应激、HL与FS的关系。设计：多中心探索性横断面研究。方法：对智利不同医院的三家icu进行探索性、横断面、多中心研究。住院时间≥48 h并有呼吸支持的ICU患者家属纳入研究对象。采用重症监护病房家庭满意度问卷-24和感知压力量表。HL通过三个筛选问题进行评估。采用多元beta回归来探讨感知压力、HL和FS之间的关系。结果：共纳入101名家庭成员，其中63.4%确定为低HL风险。多元回归显示，低HL与FS无关。相反，FS与感知压力、入住中部或南部地区ICU以及与医疗保健提供者有密切的个人关系呈负相关，但与与ICU工作人员的沟通次数呈正相关。结论：虽然感知压力可能对FS有害，但HL似乎不会影响ICU患者家属的FS水平。HL对FS的影响有待进一步研究。临床实践意义：本研究提高了对ICU中影响FS的变量的认识。评估家庭成员的情绪状态可以帮助ICU医护人员分配资源来支持家庭成员，并正确评估他们的满意度。患者或公众贡献：ICU患者家属参与本研究。

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引用次数: 0