使用家庭照片减少神经危重症患者的不安。

Cole Givens, Emerson B Nairon, Mona Jackson, Ayushi Vashisht, DaiWai M Olson
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摘要

摘要:背景:神经科学重症监护室的患者经常经历不同的混乱和不安状态。本研究的目的是通过使用熟悉的照片来检查急性困惑患者的不安。方法:这项随机前瞻性试点研究在神经科学重症监护室的夜班(晚上8点到凌晨4点)期间,将家庭照片(照片)放在困惑患者的床栏杆上。研究人员使用手腕活动记录仪来检测患者面对照片和不面对照片时的躁动状态。结果:入选的20例患者提供了34晚的数据,在此期间获得了32640个活动记录仪读数。在研究的第一个晚上,患者面对照片时手腕活动的几率比不面对照片时高(优势比,1.51;95%置信区间为1.42-1.61)。在随后的夜间,当患者面对照片时,手腕活动的几率比不面对照片时低(优势比,0.82;95%置信区间为0.75-0.90)。结论:使用熟悉的照片并不能改变观察第一晚患者的躁动、躁动或谵妄。然而,使用熟悉的照片可能会减少接下来的夜晚的不安。研究人员和家人的重要主观观察表明,所有受试者在最初看到熟悉的照片时都有明显的反应。
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Use of Family Photographs Reduces Restlessness in Neurocritical Care Patients.

Abstract: BACKGROUND: Patients admitted to the neuroscience intensive care unit often experience varying states of confusion and restlessness. The purpose of this study was to examine restlessness in acutely confused patients through use of familiar photographs. METHODS : This randomized prospective pilot study placed family photographs (photos) on the bedrail of confused patients during the night shift (8 pm to 4 am ) in a neuroscience intensive care unit. Wrist actigraphy was used to examine restlessness when patients were turned to face the photos versus when they were not facing the photos. RESULTS: The 20 patients enrolled provided 34 nights worth of data during which 32 640 actigraph readings were obtained. On the first night of study, the odds of wrist movement were higher when the patient was facing the photos compared with not (odds ratio, 1.51; 95% confidence interval, 1.42-1.61). During subsequent nights, the odds of wrist movement were lower when the patient was facing the photos compared with not (odds ratio, 0.82; 95% confidence interval, 0.75-0.90). CONCLUSION : Use of familiar photos does not change restlessness, agitation, or delirium on the first night of observation. However, the use of familiar photos may decrease restlessness on the subsequent nights. There are important subjective observations from researchers and family that suggest all subjects had a noticeable response when initially seeing the familiar photos.

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