NICU危重患者家属需求与护士对家属需求的认知差异分析

Analysis of Difference Between the Needs of Families of Critically Ill Patients in NICU and Nurses'Cognition of Their Needs

目的探讨神经外科重症监护室(NICU)护士对家属需求的认知与NICU危重患者家属实际需求之间的差异,为提升护理质量提供参考。方法使用中文改良版危重患者家属需求量表(MCCFNI)对复旦大学附属华山医院NICU 2021年1-9月收治的危重患者的家属323名以及在职护士62名进行调查分析。结果NICU危重患者家属需求得分平均为(128.52±15.62)分,各条目均分为(3.43±0.44)分,呈高需求状态;护士认知的患者家属需求平均得分为(118.05±15.46)分,各条目均分为(3.15±0.41)分;护士评分与家属评分比较,差异有统计学意义(P<0.01)。在NICU危重患者家属需求的5个维度中,护士与患者家属一致认为最重要的需求是“病情保证”,但双方在“亲近患者的需求”和“医护人员的支持”2个维度得分存在明显差异(P<0.01)。针对M-CCFNI量表涉及的37个条目,NICU危重患者家属认为最重要的10个需求中,护士与其吻合的有7个。其中,家属认为极为重要的3方面需求“希望每天和医生进行交流”“医护人员能如实回答我的问题”“每天都能得到有关患者病情的相关消息”,护士得分则较低。同时,危重患者家属将自身心理、精神方面的需求列为最不重要的项目,而护士则低估了危重患者家属想要了解患者病情信息以及探视的需求。结论NICU危重患者家属呈高需求状态,远高于护士对家属需求的认知,且护士对家属需求侧重点的认识存在偏差。护理管理者应针对相关现状,不断提升护理服务内涵质量,以促进危重症患者及家属身心健康。

Objective To explore the difference between the actual needs of families of critically ill patients in NICU(neurosurgical intensive care unit)and nurses'cognition of their needs,providing a reference for improving nursing quality.Methods A total of 323 families of critically ill patients admitted to NICU of Huashan Hospital Affiliated to Fudan University from January to September 2021 and 62 in-service nurses were investigated and analyzed by using the modified Chinese version of Critical Care Family Needs Inventory(M-CCFNI).Results For the needs of families of critically ill patients in NICU,the average score was(128.52±15.62)points,and the average score of each item was(3.43±0.44)points,showing a state of high demand.For nurses'cognition of their needs,the average score was(118.05±15.46)points,and the average score of each item was(3.15±0.41)points.The difference between nurses'scores and families'scores was statistically significant(P<0.01).Among the five dimensions of needs of families of critically ill patients in NICU,nurses and families agreed that the most important need was"condition assurance",but there were significant differences between them in the scores of two dimensions:"the need of getting close to patients"and"support from healthcare providers"(P<0.01).According to the 37 items involved in MCCFNI,nurses met 7 of 10 needs considered most important by the families of critically ill patients in NICU.Nurses scored lower for the three other needs considered extremely important by families:"I hope to communicate with my doctor every day","Healthcare providers can answer my questions truthfully"and"I can get relevant information about patient's condition every day".Meanwhile,the families of critically ill patients listed psychological and spiritual needs as the least important items,while nurses underestimated their needs to know patients'condition and visit patients.Conclusion The families of critically ill patients in NICU are in a state of high demand,which is much higher than nurses'cognition,and there are deviations in nurses'cognition of the focus of family needs.Nursing administrators should constantly improve the contents and quality of nursing services according to the relevant status quo,so as to promote the physical and mental health of critically ill patients and their families.