Abstract:

Objective To develop an open visitation protocol for children at the end of life in the Pediatric Intensive Care Unit（PICU） and to explore its implementation effects on both the children and their family members，aiming to provide a reference for implementing open visitation in domestic PICUs. Methods Using convenience sampling，children at the end of life admitted to the PICU of a tertiary grade A hospital in Henan Province and their family members from July 2024 to June 2025 were selected as study subjects. Those admitted from January to June 2025 were assigned to an experimental group and received open visitation，while those admitted from July to December 2024 served as a control group and received the unit’s original restricted visitation policy. Comparisons were made between 2 groups regarding family members’ levels of anticipatory grief and quality of life，their satisfaction with high-quality nursing care，and the incidence of hospital-acquired infections among the children. Results Ultimately，26 child-family dyads in the experimental group and 28 in the control group completed the study. After the intervention，the experimental group showed significantly lower anticipatory grief scores（P<0.001），and higher quality of life and satisfaction scores（all P<0.05） among family members compared to the control group. There was no significant difference in the incidence of hospital-acquired infections among the children between the 2 groups during the intervention period（P=0.986）. Conclusion The open visitation protocol developed in this study for children at the end of life in the PICU not only effectively reduced the level of anticipatory grief among family members and improved their quality of life and satisfaction，but also did not increase the incidence of hospital-acquired infections in the children. This provides a valuable reference for optimizing visitation policies in PICUs.

Key words: Open Visitation, Terminally Ill Period, Pediatric Nursing, Pediatric Intensive Care Units

摘要：

目的 构建儿童重症监护病房（pediatric intensive care unit，PICU）终末期患儿开放性探视方案，探讨其对患儿及其家长的实施效果，为国内PICU开展开放性探视提供参考。方法 采用便利抽样法，选取2024年7月—2025年6月入住河南省某三级甲等医院PICU的终末期患儿及其家长作为研究对象。将2025年1—6月入住PICU的患儿及其家长作为试验组，实施开放性探视；2024年7—12月入住的患儿及其家长作为对照组，实行科室常规限制性探视。比较干预前后两组家长的悲伤程度、生存质量、满意度及患儿的医院感染发生率。结果 最终试验组26对、对照组28对完成该研究。干预后，试验组家长的悲伤程度得分低于对照组（P<0.001），生存质量得分和满意度得分均高于对照组（均P<0.05）；两组患儿的医院感染发生率比较，差异无统计学意义（P=0.986）。结论 该研究构建的PICU终末期患儿开放性探视方案不但能有效降低患儿家长的悲伤程度、提高生存质量和满意度，且未增加患儿的医院感染发生率，可为优化PICU探视制度提供借鉴。

关键词: 开放性探视, 终末期, 儿科护理学, 儿童重症监护病房