ICU患者分阶段转出流程对家属分离焦虑的影响

Effects of phased discharge process for ICU patients on separation anxiety of their family members

目的 分析ICU患者分阶段转出流程对家属分离焦虑程度的影响.方法 采用便利抽样法,选取2018年10-12月于新乡市中心医院经ICU住院治疗转出患者家属136名为研究对象,随机将其分为常规转出组66名和分阶段转出组70名.常规转出组患者给予常规转出流程,分阶段转出组患者给予分阶段转出流程,即将转出流程分为经治疗病情平稳后、患者转出前24 h、患者转出当天及患者转出后24 h内4个阶段,分别实施不同的护理重点.于干预前和干预后采用创伤后分离体验问卷(PDEQ)和医院焦虑抑郁量表(HADS)评估两组分离体验程度和焦虑、抑郁程度.结果与干预前相比,干预后两组PDEQ评分均降低(t值分别为-11.763、-27.172),且分阶段转出组低于常规转出组(t=-28.441);分阶段转出组PDEQ评分<1.20分和1.20~2.00分患者家属所占比例高于常规转出组;两组患者干预后HAD-A、HAD-D两个分量表及总分均较干预前降低,且分阶段转出组各项评分均低于常规转出组(t值分别为-6.881、-8.806、-9.111);差异均有统计学意义(P<0.05).结论分阶段转出流程可以缓解ICU转出患者家属分离体验感受,降低焦虑抑郁程度,提高家属的照顾能力.

Objective To explore the effects of phased discharge process for ICU patients on separation anxiety of their family members. Methods From October 2018 to December 2018, we selected 136 family members of patients discharged from ICU at Xinxiang Central Hospital by convenience sampling as subjects. Family members were randomly divided into group of routine discharge (n=66) and group of phased discharge (n=70). Group of routine discharge carried routine discharge process. Group of phased discharge process implemented phased discharge process which divided discharge process into four stages including after condition stabilizing, 24 hours before discharge, on the discharge day and 24 hours after discharge and provided different nursing keys. The separation experience and depression as well as anxiety were evaluated with the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) and Hospital Anxiety and Depression Scale (HADS) before and after intervention. Results After intervention, the scores of PDEQ of two groups decreased compared with those before intervention (t=-11.763, -27.172);besides, the score of PDEQ in group of phased discharge was lower than that in group of routine discharge (t=-28.441);the ratios of family members with the scores of PDEQ< 1.20 and ranged from 1.20 to 2.00 in group of phased discharge were higher than those in group of routine discharge respectively. After intervention, the scores of HAD-A and HAD-D and total score in HADS between two groups all decreased compared with those before intervention;the dimension scores and total score of group of phased discharge were lower than those of group of routine discharge (t=-6.881, -8.806, -9.111). The differences were all significantly statistical (P< 0.05). Conclusions Phased discharge process can relieve separation experience in family members of ICU discharged patients, lower their anxiety and depression and improve their care ability.