神经重症监护室患者直系陪护家属症状负担现况调查及影响因素分析  

Status and influencing factors of symptom burden among immediate accompanying family members of patients in Neurological Intensive Care Unit

作　　者：徐晓敏 刘春兰[2,3] Xu Xiaomin;Liu Chunlan(Department of Neurosurgery,Jinan Central Hospital,Jinan 250013,China;School of Nursing and Rehabilitation,Shandong University,Jinan 250012,China;Department of Nursing,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]济南市中心医院神经外科,济南250013 [2]山东大学护理与康复学院,济南250012 [3]山东大学齐鲁医院护理部,济南250012

出　　处：《中华现代护理杂志》2022年第19期2555-2560,共6页Chinese Journal of Modern Nursing

摘　　要：目的调查神经重症监护室(NICU)患者直系陪护家属的症状负担现况, 以不悦症状理论为框架, 探索生理、心理和环境相关因素及其交互作用对NICU患者直系陪护家属症状负担的影响。方法本文为横断面调查研究。采用便利抽样法, 选取2020年3—8月济南市2所三级甲等医院NICU收治的240名患者的直系陪护家属为研究对象。采用汉化版记忆症状评估量表(MSAS)、疲劳量表、疾病不确定感家属量表和家庭关怀度指数问卷对NICU患者直系陪护家属症状负担及相关因素进行评估, 并采用Amos软件构建结构方程模型和绘制作用路径。结果本研究共发放问卷240份, 回收有效问卷218份, 有效回收率为90.83%。NICU患者直系陪护家属的症状负担总分及生理症状、心理症状、总困扰指数3个分量表得分分别为0.59(0.31, 0.94)、0.53(0.19, 0.92)、1.69(1.11, 2.39)、1.20(0.73, 1.90)分。NICU患者直系陪护家属的心理症状较为常见, 担忧的发生率最高(96.33%, 210/218), 其次为感到悲伤(93.58%, 204/218)、感到紧张(89.91%, 196/218)。结构方程模型分析结果显示, 疲劳与疾病不确定感的交互作用会增加家属的症状负担(β标准化=0.14, P=0.044), 家庭功能与疾病不确定感的交互作用会降低症状负担(β标准化=-0.16, P=0.042)。结论本研究发现NICU患者直系陪护家属症状负担相对较重, 心理症状较生理症状更常见。疾病不确定感、疲劳、家庭功能对陪护家属症状负担的影响存在交互作用, 疾病不确定感与疲劳会增加陪护家属的症状负担, 良好的家庭支持则可降低陪护家属的症状负担。Objective To investigate status of symptom burden in immediate accompanying family members of patients in Neurological Intensive Care Unit(NICU)and to explore effects of physiological,psychological and environmental factors and their interactions on symptom burden in immediate accompanying family members of NICU patients based on The Theory of Unpleasant Symptoms(TOUS).Methods This paper was a cross-sectional survey study.The convenient sampling method was used to select immediate accompanying family members of 240 patients who were admitted to NICU of 2 ClassⅢGrade A hospitals in Jinan City from March to August 2020 as the research objects.The symptom burden and related factors of immediate accompanying family members of NICU patients were assessed by using the Chinese Version of Memorial Symptom Assessment Scale(MSAS),Fatigue Scale,Mishel Uncertainty in Illness Scale for Family Member(MUIS-FM)and Family APGAR Index(APGAR).Amos software was used to construct the structural equation model and draw the action path.Results A total of 240 questionnaires were distributed in this study and 218 valid questionnaires were recovered,with an effective recovery rate of 90.83%.The total score of symptom burden and the three subscale scores of physical symptoms,psychological symptoms and total distress index of immediate accompanying family members of NICU patients were respectively 0.59(0.31,0.94),0.53(0.19,0.92),1.69(1.11,2.39)and 1.20(0.73,1.90).The psychological symptoms of immediate accompanying family members of NICU patients were more common,and the incidence of worry was the highest(96.33%,210/218),followed by feeling sad(93.58%,204/218)and feeling nervous(89.91%,196/218).Structural equation model analysis results showed that,the interaction between fatigue and illness uncertainty increases the symptom burden of family members(βstandardized=0.14,P=0.044),and the interaction between family functioning and illness uncertainty reduced the symptom burden(βstandardized=-0.16,P=0.042).Conclusions This study finds that t

关 键 词：重症监护病房 横断面研究 陪护家属 症状负担 影响因素 

分 类 号：R473[医药卫生—护理学]