家庭成员听觉和触觉刺激对外伤性脑损伤和意识下降患者躁动水平的影响:一项准实验研究

Tayebeh Sedghi, M. Ghaljeh, Hamed Faghihi, H. Sarani
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引用次数: 3

摘要

背景:意识下降的机械通气患者的躁动是ICU的一个挑战,也是对机械通气过程的威胁。另一方面,通过药物控制躁动和施加身体限制与许多不良副作用有关。目的:本研究旨在确定家庭成员听觉和触觉刺激对创伤性脑损伤(TBI)伴意识下降患者躁动水平的影响。方法:对2019年伊朗东南部两所教学医院ICU收治的80例意识下降TBI患者进行准实验研究。采用方便抽样法选取符合条件的患者,随机分为干预组(n = 40)和对照组(n = 40)。数据收集工具包括人口统计表格和里士满躁动和镇静量表(RASS)。对于干预组患者,研究者首先完成人口统计表格和RASS。然后,他们接受了由家庭成员进行的为期10分钟的听觉和感官刺激的实验。30分钟后,再次测量躁动程度。实验时间为16:00 - 18:00,连续7天。而对照组患者除在ICU接受常规护理外,未接受任何干预。数据采用SPSS 21版,采用描述性统计检验和独立t检验、配对t检验、协方差分析、卡方检验,显著性水平P < 0.05。结果:干预组和对照组的躁动水平在治疗第1天和第5天无显著差异;然而,独立t检验和协方差分析显示,在第6天和第7天接受听觉和触觉刺激的患者的躁动水平显著低于对照组(P < 0.01)。结论:家属的听觉和触觉刺激能有效地减少意识下降的TBI患者的躁动。因此,建议在护理计划中作为一种有益的干预。
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The Effect of Auditory and Tactile Stimulation by a Family Member on the Level of Agitation in Patients with Traumatic Brain Injury and Decreased Consciousness: A Quasi-Experimental Study
Background: Agitation in mechanically ventilated patients with decreased consciousness is a challenge in the ICU and a threat to the process of mechanical ventilation. On the other hand, controlling agitation through medication and imposing physical limitations is associated with a number of undesirable side effects. Objectives: This study aimed to determine the effect of auditory and tactile stimulation by a family member on the level of agitation in patients with traumatic brain injury (TBI) and decreased consciousness. Methods: This quasi-experimental study was performed on 80 TBI patients with decreased consciousness who were admitted to the ICU of two teaching hospitals in southeastern Iran in 2019. Qualified patients were selected by convenience sampling and then randomized into the intervention (n = 40) and control (n = 40) groups. Data collection tools included a demographic form and the Richmond Agitation and Sedation Scale (RASS). For patients in the intervention group, the researcher first completed the demographic form and the RASS. Then, they underwent the experiment, which consisted of auditory and sensory stimulation by a family member for 10 minutes. After 30 minutes, the agitation level was measured again. This experiment was performed for seven consecutive days between 16:00 and 18:00 o’clock. Patients in the control group, however, did not receive any intervention other than routine care in the ICU. Data were analyzed in SPSS version 21 by using descriptive statistical tests and independent t-test, paired t-test, [analysis of] covariance, and chi-square test at the significance level of P < 0.05. Results: The results indicated no significant difference in the level of agitation in the intervention and control groups between the first and fifth days; however, independent t-tests and analysis of covariance revealed that the patients who received auditory and tactile stimulation on the sixth and seventh days experienced significantly lower levels of agitation than the control group (P < 0.01). Conclusions: Auditory and tactile stimulation by family members is effective in decreasing the agitation of TBI patients with decreased consciousness. Therefore, it is suggested as a helpful intervention in nursing care programs.
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