以家庭为中心的护理:欧洲重症监护医学会重症监护病房横断面研究。

IF 5.7 1区 医学 Q1 CRITICAL CARE MEDICINE Annals of Intensive Care Pub Date : 2024-05-21 DOI:10.1186/s13613-024-01307-0
Élie Azoulay, Nancy Kentish-Barnes, Carole Boulanger, Giovanni Mistraletti, Margo van Mol, Gabriel Heras-La Calle, Elisa Estenssoro, Peter Vernon van Heerden, Maria-Cruz Martin Delgado, Anders Perner, Yaseen M Arabi, Sheila Nainan Myatra, Jon Henrik Laake, Jan J De Waele, Michael Darmon, Maurizio Cecconi
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引用次数: 0

摘要

目的:确定以家庭为中心的护理实践的主要组成部分和差异:在 ESICM 成员中开展横断面研究。参与研究的重症监护病房填写了一份调查问卷,内容包括重症监护病房的一般特征、探视政策、团队-家庭互动以及临终决策。主要结果是以家庭为中心的自评量表。此外,受访者还填写了马斯拉赫职业倦怠量表和伦理决策氛围问卷,以了解职业倦怠维度并评估伦理决策氛围:回复率为 53%(359/683 个受邀 ICU 的受访者实际打开了电子邮件);参与调查的医护人员(HCPs)分别来自欧洲(62%)、亚洲(9%)、南美(6%)、北美(5%)、中东(4%)和澳大利亚/新西兰(4%)。以家庭为中心的重要性排名很高,在 VAS 10 分中,中位数为 7(IQR 6-8)。以家庭为中心的四分位数之间存在显著差异,包括探视政策、候诊室、家庭室、家庭信息手册、探视时间、夜间探视、重症监护室睡眠,以及团队-家庭互动,包括每日信息、第 3 天例行会议、赋予护士和亲属权力的意愿。以家庭为中心的程度越高,家庭参与查房、参与病人护理和临终关怀的程度就越高。职业倦怠症状(41% 的受访者)与以家庭为中心呈负相关。伦理氛围和赋予护士权力的意愿是家庭中心感的独立预测因素:本研究强调了优先考虑医疗服务提供者的心理健康以加强以家庭为中心的护理的必要性。有必要开展进一步研究,以评估改善伦理氛围对以家庭为中心的影响。
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Family centeredness of care: a cross-sectional study in intensive care units part of the European society of intensive care medicine.

Purpose: To identify key components and variations in family-centered care practices.

Methods: A cross-sectional study, conducted across ESICM members. Participating ICUs completed a questionnaire covering general ICU characteristics, visitation policies, team-family interactions, and end-of-life decision-making. The primary outcome, self-rated family-centeredness, was assessed using a visual analog scale. Additionally, respondents completed the Maslach Burnout Inventory and the Ethical Decision Making Climate Questionnaire to capture burnout dimensions and assess the ethical decision-making climate.

Results: The response rate was 53% (respondents from 359/683 invited ICUs who actually open the email); participating healthcare professionals (HCPs) were from Europe (62%), Asia (9%), South America (6%), North America (5%), Middle East (4%), and Australia/New Zealand (4%). The importance of family-centeredness was ranked high, median 7 (IQR 6-8) of 10 on VAS. Significant differences were observed across quartiles of family centeredness, including in visitation policies availability of a waiting rooms, family rooms, family information leaflet, visiting hours, night visits, sleep in the ICU, and in team-family interactions, including daily information, routine day-3 conference, and willingness to empower nurses and relatives. Higher family centeredness correlated with family involvement in rounds, participation in patient care and end-of-life practices. Burnout symptoms (41% of respondents) were negatively associated with family-centeredness. Ethical climate and willingness to empower nurses were independent predictors of family centeredness.

Conclusions: This study emphasizes the need to prioritize healthcare providers' mental health for enhanced family-centered care. Further research is warranted to assess the impact of improving the ethical climate on family-centeredness.

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来源期刊
Annals of Intensive Care
Annals of Intensive Care CRITICAL CARE MEDICINE-
CiteScore
14.20
自引率
3.70%
发文量
107
审稿时长
13 weeks
期刊介绍: Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.
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