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Li J, Cai S, Mei J, Liu X, Wang X, Pan W, Zhang Y. The beliefs and attitudes of intensive care unit nurses and patient families regarding an open visitation policy in China. Nurs Crit Care 2023; 28:800-807. [PMID: 36585813 DOI: 10.1111/nicc.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/15/2022] [Accepted: 11/28/2022] [Indexed: 01/01/2023]
Abstract
AIMS To investigate the beliefs and attitudes of intensive care unit (ICU) nurses and patients' family members towards an open visitation policy in the ICU in China and to explore the reasons that promote or hinder open visitation to improve visitation policy. BACKGROUND Open visitation policies are widely recommended in many countries. However, there are gaps between evidence and practice. Most ICUs in China still use a restrictive policy for family visits, which raises controversy. There are limited visiting times, and family visitors are not allowed to enter the ICU. STUDY DESIGN A multicentre survey was conducted in seven hospitals in China. The Beliefs and Attitudes towards Visitation in the Intensive Care Unit Questionnaire (BAVIQ) was administered to ICU nurses and patient families from 11 the ICUs of seven hospitals. A total of 275 questionnaires were completed and returned by ICU nurses and 139 by patients' family members. RESULTS Among nurses, the belief scale score was 2.87 ± 0.33 (range 2-4), and the attitude scale score was 5.53 ± 1.12 (range 2.33-7). The belief scale was divided into three subscales: nurses, patients, and patients' families. The subscale score for patients' families was the highest, and the nurses' subscale score was the lowest. Most (84.0%) of the nurses were satisfied with the current ICU visitation policy. The belief and attitude scores were 3.13 ± 0.39 (range 1.96-4) and 6.18 ± 1.20 (range 1.67-7), respectively, for family members. The scores of the three subscales, that is, patients, patients' families and nurses, were 3.13 ± 0.40, 3.26 ± 0.43, and 3.04 ± 0.49, respectively. CONCLUSION Nurses' beliefs and attitudes towards implementing an open visitation policy in China are at a less positive level than those of patient family members. RELEVANCE TO CLINICAL PRACTICE The beliefs and attitudes of nurses towards open visitation policy in China need to be improved. The question of how to mobilize nurses' enthusiasm for an open visitation policy poses a challenge for ICU management.
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Affiliation(s)
- Jingjing Li
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| | - Shining Cai
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jinghua Mei
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Xiao Liu
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Xiaorong Wang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Wenyan Pan
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yuxia Zhang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- School of Nursing, Fudan University, Shanghai, People's Republic of China
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Yang HY, Feng F, Yang WW, Chen Y. Application of a flexible visitation system in critically ill patients: A randomized clinical trial. Sci Prog 2023; 106:368504231165663. [PMID: 36971698 PMCID: PMC10358547 DOI: 10.1177/00368504231165663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To determine the feasibility of a flexible visitation system in the intensive care unit (ICU). METHODS A randomized, open-label, parallel group clinical trial was conducted. All patients admitted to the ICU of the Lanzhou University Second Hospital from April to June 2022 were enrolled. The enrolled patients were randomly divided into an experimental group and a control group according to a computer-generated random sequence table. RESULTS A total of 410 patients were admitted. According to the inclusion and exclusion criteria, 140 patients were included in the experimental group (flexible visitation group) and 140 in the control group (normal visitation group). The average number of visitation minutes per day between the experimental group and the control group was 24.7 versus 23.9 min (p > 0.05).Among the outcome indicators, delirium occurred in 8 (5.7%) patients in the intervention group and in 24 (17.1%) patients in the control group (p = 0.003). Five complaints (mainly pressure ulcers) were received, with one in the experimental group and the others in the control group. There were 28 cases of nosocomial infection in the experimental group and 29 cases in the control group; therefore, the incidence of nosocomial infection was 20% versus 20.7% (p = 0.882). A total of 280 questionnaires were collected, with a retrieval rate of 100%. The satisfaction of patients in the experimental group and the control group was 98.6% and 92.1%, respectively (p = 0.011). The flexible visiting system reduced the ICU length of stay (LOS). The ICU LOS of the experimental group was 6 versus 8 days for the control group (p = 0.041). However, the flexible visiting system did not reduce the hospital stay (17 vs. 19 days, p = 0.923). CONCLUSION Conducting a flexible visitation system in ICUs could reduce the incidence of delirium in critically ill patients and improve the quality of nursing care; furthermore, the rate of nosocomial infections was not increased. These findings need to be further verified by a multicentre, large-scale clinical trial.
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Affiliation(s)
- Hu-yong Yang
- Intensive Care Unit, Peoples’ Hospital of Linxia State, Linxia, China
| | - Fang Feng
- Intensive Care Unit, Lanzhou University Second Hospital, Lanzhou, China
| | - Wei-wei Yang
- Intensive Care Unit, Peoples’ Hospital of Linxia State, Linxia, China
| | - Yu Chen
- Intensive Care Unit, Lanzhou University Second Hospital, Lanzhou, China
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Bartoli D, Trotta F, Pucciarelli G, Simeone S, Miccolis R, Cappitella C, Rotoli D, Rocco M. The lived experiences of family members who visit their relatives in Covid-19 intensive care unit for the first time: A phenomenological study. Heart Lung 2022; 54:49-55. [PMID: 35344685 PMCID: PMC8934716 DOI: 10.1016/j.hrtlng.2022.03.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND COVID-19 patient experiences in the intensive care unit (ICU) are marked by family separation. Families understand the importance of isolation and hospital visiting policies, but they consider it necessary to visit their loved ones and use personal protective equipment. OBJECTIVE To describe the lived experiences of family members in their first contact with a relative in a COVID-ICU. METHODS A phenomenological study was conducted using Cohen's method. The subjects were interviewed using an open-question format to allow them full freedom of expression. Twelve family members were recruited between February and March 2021. RESULTS Analysis of the qualitative data resulted in five major themes: (1) fear of contagion related to donning/doffing procedures, (2) positive emotions related to first contact with the hospitalized relative, (3) concern for the emotional state of the hospitalized relative, (4) impact of the COVID-ICU and comparisons between imagination and reality regarding the severity of the disease, and (5) recognition of and gratitude toward healthcare professionals. CONCLUSIONS It has been confirmed that visits to the ICU reduce anxiety among family members. Our findings constitute an internationally relevant contribution to understanding of the needs of relatives who meet loved ones for the first time while wearing personal protective equipment.
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Affiliation(s)
- Davide Bartoli
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, 00189 Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Francesca Trotta
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, 00189 Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Silvio Simeone
- Department of Clinical and Experimental Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Rosa Miccolis
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Carmen Cappitella
- Department of Management, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Daniele Rotoli
- Department of Medicine and Psycology, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Monica Rocco
- Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
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Lin L, Peng Y, Zhang H, Huang X, Chen L, Lin Y. Family‐centred care interventions to reduce the delirium prevalence in critically ill patients: A systematic review and meta‐analysis. Nurs Open 2022; 9:1933-1942. [PMID: 35434971 PMCID: PMC9190678 DOI: 10.1002/nop2.1214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 12/30/2021] [Accepted: 04/03/2022] [Indexed: 11/10/2022] Open
Abstract
Aim This study aimed to determine whether family‐centred care (FCC) intervention reduces the ICU delirium prevalence. Design A systematic review and meta‐analysis. Methods The databases, including PubMed, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL Complete, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), WANFANG Data and VIP Information, were systematically searched up to 30 November 2021. The search term includes keywords related to intensive care units, delirium and family‐centred care. Meta‐analyses were performed and presented by risk ratio (RR), mean difference (MD) and corresponding 95% confidence intervals (CIs). Results The meta‐analysis results showed that compared with the usual care, FCC intervention has positive effects on reducing ICU delirium prevalence [RR = 0.54, 95% CIs (0.36, 0.81), p < .05]. However, no effect was observed on ICU stays, mechanical ventilation duration and ICU‐acquired infection between the two groups. Conclusions Family‐centred care is an effective intervention to reduce the ICU delirium prevalence. But the result should be treated cautiously as the high levels of heterogeneity, further high‐quality studies are required to determine the effectiveness of FCC intervention in the ICU setting.
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Affiliation(s)
- Lingyu Lin
- School of Nursing Fujian medical University Fuzhou China
| | - Yanchun Peng
- Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou China
| | - Haoruo Zhang
- Union Hospital Fujian Medical University Fuzhou China
| | - Xizhen Huang
- Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou China
| | - Liangwan Chen
- Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou China
| | - Yanjuan Lin
- Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou China
- Department of Nursing Union Hospital Fujian Medical University Fuzhou China
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Ozdemir A, Serin EK, Savas M. The Relationship Between the Stress Perceived by the Intensive Care Patient's Relatives with Their Religious Attitudes and Behaviors: Turkey Sample. JOURNAL OF RELIGION AND HEALTH 2021; 60:752-763. [PMID: 33140315 DOI: 10.1007/s10943-020-01116-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 05/11/2023]
Abstract
This study was carried out in a university hospital located in the southeastern region of Turkey to determine the relationship between the perceived stress with the religious attitude and behavior of the intensive care patient's relatives; 150 patient's relatives participated in this descriptive and relation-seeking study between the dates of January and April 2019. The Personal Data Form, Perceived Stress Scale, and Religious Attitude and Behavior Inventory that were designed by their own researchers as a result of the literature review were used in this study. As a result of this study, it was found that there was a statistically significant relationship between religious attitude and behavior and perceived stress levels of the patient's relatives with sociodemographic features such as age, gender, marital status, and educational level. It was determined that the participants mostly prefer to pray as a method for stress management (65.3%). In terms of educational level, it was identified that 42% of the participants are elementary school graduates; besides, the stress level of this group was significantly lower than the others, and their religious attitude and behaviors were higher (p = 0.004). In consideration of these results, in terms of holistic care, it is recommended that nurses should make arrangements toward their strategy for stress management considering the religious attitudes and behaviors of patients' relatives.
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Affiliation(s)
- Ahmet Ozdemir
- Faculty of Health Sciences, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey.
| | | | - Mumin Savas
- Faculty of Health Sciences, Adiyaman University, Gaziantep, Turkey
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González-Dambrauskas S, Mislej C, Vásquez-Hoyos P, Rotta AT. Family Presence and Visitation Practices in Latin American PICUs: An International Survey. J Pediatr Intensive Care 2020; 10:276-281. [PMID: 34745701 DOI: 10.1055/s-0040-1716831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/12/2020] [Indexed: 10/23/2022] Open
Abstract
Over the last two decades, there has been a worldwide cultural shift toward family-centered intensive care. In this article, we conducted a survey of 47 pediatric intensive care units (PICUs) across 11 Latin American countries to assess visitation practices and bedside family presence (with a 97.9% response rate). All PICUs had at least some form of parental visitation. The prevalence of unrestricted (24 hours/day) parental visitation was 63%. Sibling visitation was permitted in 23% of PICUs, while 35% allowed family presence during procedures, and 46% during resuscitation. Only 1 PICU allowed pet visitation. Family visitation and bedside presence are still restrictive in Latin American PICUs, with wide practice variation among the various intensive care units.
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Affiliation(s)
- Sebastián González-Dambrauskas
- Red Colaborativa Pediátrica de Latinoamérica, Montevideo, Uruguay.,Unidad de Cuidados Intensivos Pediátricos Especializados, Casa de Galicia, Montevideo, Uruguay
| | - Cecilia Mislej
- Red Colaborativa Pediátrica de Latinoamérica, Montevideo, Uruguay.,Unidad de Cuidados Intensivos Pediatricos, Hospital Evangélico, Montevideo, Uruguay
| | - Pablo Vásquez-Hoyos
- Red Colaborativa Pediátrica de Latinoamérica, Montevideo, Uruguay.,Departamento de Pediatría, Universidad Nacional de Colombia, Bogotá, Colombia.,Departamento de Pediatría, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia.,Unidad de Cuidado intensivo Pediátrico, Sociedad de Cirugía Hospital de San José, Bogotá, Colombia
| | - Alexandre Tellechea Rotta
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, United States
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Open visiting in adult intensive care units – A structured literature review. Intensive Crit Care Nurs 2020; 56:102763. [DOI: 10.1016/j.iccn.2019.102763] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/02/2019] [Accepted: 09/26/2019] [Indexed: 11/19/2022]
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