ICU过渡期护理方案对改善危重症患儿家长迁移应激及照顾能力的效果研究

doi:10.3761/j.issn.0254-1769.2025.16.007

摘要/Abstract

摘要：

目的构建危重症患儿ICU过渡期护理方案，探讨其对患儿家长迁移应激及照顾能力的应用效果，为改善其照护体验提供参考。方法采用便利抽样法，选取2023年1—9月在上海市某三级甲等儿童专科医院即将从儿童重症监护病房（pediatric intensive care unit，PICU）过渡到普通病房的150对患儿及其家长为研究对象。将2023年6—9月的研究对象作为试验组，实施危重症患儿ICU过渡期护理方案；将2023年1—4月的研究对象作为对照组，实施常规ICU过渡期护理。在患儿转出ICU前24 h、转出ICU后24 h及72 h，采用家属迁移应激量表、家庭照顾者照顾能力量表对患儿家长进行评估，并比较两组患儿的非计划性48 h内ICU重返率、不良事件发生率的差异。结果最终试验组74对，对照组75对完成该研究。干预后，试验组患儿家长的照顾能力得分低于对照组（P=0.046）；广义估计方程结果显示，两组患儿家长迁移应激得分的组间效应、时间效应、交互效应均具有统计学差异（P<0.05）。结论该研究构建的危重症患儿ICU过渡期护理方案可有效改善患儿家长的迁移应激、照顾能力水平，优化危重症患儿过渡期护理质量。

关键词: ICU过渡期, 干预图, 家属迁移应激, 照顾能力, 儿科护理学

Abstract:

Objective Constructing a transitional care program for critically ill children in the ICU and exploring the effects of its application on the relocation stress and caregiving abilities of parents of children to improve their caregiving experience. Methods Convenience sampling method was used to select 150 children and their families transferred from PICU to the general ward of a tertiary pediatric hospital in Shanghai from January to September 2023 as research subjects. Subjects enrolled from June to September 2023 were selected as an experimental group，and were applied with the ICU transitional care program for critically ill children. Those enrolled from January to April 2023 were selected as a control group，and received routine ICU transitional care. Family Relocation Stress Scale and Family Caregiver Task Inventory were used to evaluate children’s families at 24h before，24h after，and 72h after children’s transition from ICU. The incidence of unplanned readmission to ICU within 48h and adverse events were compared between 2 groups of children. Results Eventually 74 pairs in the experimental group and 75 pairs in the control group completed the study. The Family Caregiver Task Inventory scores in the experimental group were lower than that in the control group（P=0.046）. Generalized estimation equation showed that，there were significant differences on the intervention effect，the time effect，and the interaction effect of the Family Relocation Stress Scale scores in 2 groups（P<0.05）. Conclusion The ICU transitional care program for critically ill children constructed in this study can effectively improve the level of migration stress and caregiving ability of parents of critically ill children，and optimize the quality of transitional care for critically ill children.

Key words: ICU Transitional Period, Intervention Mapping, Family Relocation Stress, Ability to Care, Pediatric Nursing

杨涵琳, 季涧琳, 曾承茜, 陈瓯瑶, 陆群峰. ICU过渡期护理方案对改善危重症患儿家长迁移应激及照顾能力的效果研究[J]. 中华护理杂志, 2025, 60(16): 1966-1973.

YANG Hanlin, JI Jianlin, ZENG Chengxi, CHEN Ouyao, LU Qunfeng. A study of the effectiveness of an ICU transitional care program in improving relocation stress and caregiving skills of parents of critically ill children[J]. Chinese Journal of Nursing, 2025, 60(16): 1966-1973.

图/表 3

表1 危重症患儿ICU过渡期护理方案

Table 1 ICU transitional care program for critically ill children

表2 两组一般资料的比较[例/名（百分比，%）]

Table 2 Comparison of general baseline data between 2 groups[cases（percentage, %）]

表3 两组患儿家长干预前后迁移应激量表得分的比较（分，$\bar{x}\pm s$）

Table 3 Comparison of relocation stress levels before and after parental intervention in 2 groups of children before and after intervention（scores，$\bar{x}\pm s$）

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