健康信念模式下新冠肺炎疫情期间ICU患者家属对暂停入室探视的接受度及影响因素调查分析

Investigation on the acceptability of suspended visiting and its influencing factors in ICU during the COVID-19 epidemic period:A survey based on the Health Belief Model

目的调查新冠肺炎疫情下重症加强护理病房(ICU)患者家属对暂停入室探视的接受度及其影响因素。方法2020年2月至12月应用一般资料调查表、基于健康信念模型的ICU患者家属对暂停入室探视接受度的调查表及焦虑自评量表(GAD-7)对南京市4家三级甲等综合性医院117名ICU患者家属(便利抽样法选出)进行问卷调查。结果79.5%的家属表示接受暂停入室探视制度,暂停入室探视的接受度与感知疾病严重性、感知疾病易感性、感知益处(条目5除外)、感知障碍各维度存在关联性,差异有统计学意义(P<0.05);83.8%的家属认为应该允许探视终末期患者;85.5%的家属认为医护人员主动联系家属沟通病情可增加暂停入室探视的接受度。回归分析显示,患者入住ICU天数>30天、家属处于重度焦虑状态是影响暂停入室探视接受度的主要因素。结论新冠肺炎疫情下ICU患者家属对暂停入室探视接受度较高;应制定允许探视终末期患者和加强医护人员主动联系家属沟通病情制度;要特别加强与患者入住ICU>30天、处于严重焦虑状态的家属的沟通。

Objective To investigate the acceptability of suspension visiting and its influence factors in ICU during the COVID-19 epidemic period.Methods From February to December 2020,the general information questionnaire,the acceptability of suspended visits based on the health belief model and the anxiety self-rating scale were used to perform the investigation among 117 family members of patients in ICU of four third grade first class hospitals in Nanjing.Results 79.5%of ICU family members who were surveyed accepted the temporary suspension of the visitation system.There were correlations between the acceptability and disease severity,disease susceptibility,perceived benefits(except item 5),perceived obstacles and acceptance of suspended visitation(P<0.05).83.8%of the family members believed that the patients with end-stage should be visited.85.5%of the family members thought that the medical staff could keep effective communication with them to introduce the patients'conditions in time,which increases the acceptance of the visitation rules.The results of regression analysis showed that patients staying in ICU for more than 30 days and family members in a state of severe anxiety were the factors affecting the acceptance of suspension visiting.Conclusions During the COVID-19 epidemic period,the ICU family members have a higher acceptance of the temporary suspension of visits.A visitation rule,especially for the patients with end-stage should be established with the enhancement of communication with family members and more attention on the patients who stay in ICU for more than 30 days and the family members who are in a severely anxious state.