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題名:家屬叮嚀方案對減輕加護病人焦慮和非計畫性拔管之成效
書刊名:護理雜誌
作者:林麗卿邱艶芬 引用關係林碧珠
作者(外文):Lin, Li-chingChao, C. Yann-fenLin, Pi-chu
出版日期:2017
卷期:64:5
頁次:頁41-49
主題關鍵詞:焦慮非計畫性拔管加護單位家屬叮嚀方案AnxietyUnplanned extubationIntensive care unitFamily reminder project
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:13
  • 點閱點閱:1
背景:放置氣管內管對病人而言,最大的壓力源是插管後無法順利表達自己的需要而感到焦慮,家屬能使病人情緒獲得安慰與鼓勵甚至給予實質性支持。目的:(一)比較實驗組與控制組病人焦慮分數、生命徵象、非計畫性氣管內管滑脫率之差異。(二)比較實驗組病人介入前後生命徵象之差異。(三)探討實驗組病人對叮嚀影音方案之滿意度。方法:本研究採類實驗前後測設計,採方便取樣,以加護中心接受氣管插管病人為研究對象。於氣管內管留置期間,實驗組病人聆聽由家屬錄製的「預防非計畫性氣管內管滑脫叮嚀影音」,一天3次共4天,控制組給予一般照護。結果:(一)兩組間焦慮分數無顯著差異(t = -1.282, p = .205)。(二)兩組病人每晚10點介入後之生命徵象以重複量數分析顯示兩組間無顯著差異(p > .05)。(三)實驗組每日3次介入前後生命徵象之差異,在部份時間點的心跳、收縮壓、舒張壓、平均動脈壓有顯著下降(p < .05),病人呼吸次數沒有顯著差異(p > .05)。(四)實驗組病人對於家屬叮嚀影音介入達89%滿意度。結論/實務應用:本研究設計以DVD播放家人叮嚀插管安全,研究獲得極高滿意度和達到降低病人焦慮。研究結果可作為未來加護單位插管病人照護之參考。
Background: Patients with endotracheal intubation often experience anxiety because they are unable to express their needs freely. However, the family members of these patients are able to provide encouragement, comfort, and substantive support. Purposes: The aims of the present study were: (1) to compare the anxiety scores, vital signs, and incidence of unplanned extubation (UE) between the two comparison groups; (2) to compare the differences in vital signs before and after the intervention in the experimental group; and (3) to explore the satisfaction of patients in the experimental group with the intervention. Methods: A quasi-experimental, pretest-posttest design was carried out. A convenience sampling was adopted to recruit patients with endotracheal intubation in intensive care units (ICUs). The experimental group listened to the UEprevention reminders of their family members for three times a day for 4 days. The control group was provided with usual care. Results: (1) No significant difference was observed in the anxiety scores between the two groups (t = -1.282, p = .205). (2) A repeated-measures analysis found no significant difference in vital signs, taken nightly at 10 p.m., between the experimental and control groups (p > .05). (3) The experimental group registered significantly lower heart rates, systolic blood pressure, diastolic blood pressure, and mean arterial pressure after the conclusion of the intervention (p < .05). However, no significant pre-test / posttest difference in breathing rate was observed for this group. (4) A large majority (89%) of the experimental group expressed satisfaction with the intervention treatment program. Conclusion/Implication for Practice: The present study, which used a DVD of family reminders encouraging and reminding patients about intubation safety, achieved a very high level of patient satisfaction and reduced their anxiety-related vital signs. The results may serve as a reference for providing intervention treatment to patients with endotracheal intubation in ICUs.
期刊論文
1.蔡曉婷、周汎澔(20120800)。多媒體護理指導緩解冠狀動脈成形術後心肌梗塞病患焦慮及疾病不確定感之成效。護理雜誌,59(4),43-53。new window  延伸查詢new window
2.馬瑞菊、陳思佳、李春香(20050100)。某內科加護病房非計劃性氣管內管滑脫之改善方案。醫護科技學刊,7(1),15-29。new window  延伸查詢new window
3.Tanios, M. A.、Epstein, S. K.、Livelo, J.、Teres, D.(2010)。Can we identify patients at high risk for unplanned extubation? A large-scale multidisciplinary survey。Respiratory Care,55(5),561-568。  new window
4.紀雪雲、廖熏香、石崇良、楊漢(20071100)。病人安全對醫療照護者與病人關係之影響。臺灣醫學,11(6),668-673。  延伸查詢new window
5.胡倩青、林夷真、林明正、韓若平(20131200)。音樂治療對心肌梗塞病患之焦慮程度及生理反應之成效。長庚護理,24(4)=84,357-365。new window  延伸查詢new window
6.梁牡丹、范圭玲(20150600)。降低兒科加護病房非計畫性氣管內管滑脫率之改善專案。護理雜誌,62(3)附冊,39-48。new window  延伸查詢new window
7.莊孟蓉、曾鳳美、李雅芬、洪麗娟(20160600)。非計劃性氣管內管拔管發生率改善專案。醫務管理期刊,17(2),115-130。new window  延伸查詢new window
8.Chlan, L. L.、Weinert, C. R.、Heiderscheit, A.、Tracy, M. F.、Skaar, D. J.、Guttormson, J. L.、Savid, K.(2013)。Effects of patient-directed music intervention on anxiety and sedative exposure in critically ill patients receiving mechanical ventilatory support。Journal of the American Medical Association,309(22),2335-2344。  new window
9.Chang, L. Y.、Wang, K. W.、Chao, Y. F.(2008)。Influence of physical restraint on unplanned extubation of adult intensive care patients: A case-control study。American Journal of Critical Care,17(5),408-416。  new window
10.Aydoğan, S.、Kaya, N.(2017)。The assessment of the risk of unplanned extubation in an adult intensive care unit。Dimensions of Critical Care Nursing,36(1),14-21。  new window
11.Arbour, C.、Gélinas, C.(2010)。Are vital signs valid indicators for the assessment of pain in postoperative cardiac surgery ICU adults?。Intensive and Critical Care Nursing,26(2),83-90。  new window
12.Aghaie, B.、Rejeh, N.、Heravi-Karimooi, M.、Ebadi, A.、Moradian, S. T.、Vaismoradi, M.、Jasper, M.(2014)。Effect of nature-based sound therapy on agitation and anxiety in coronary artery bypass graft patients during the weaning of mechanical ventilation: A randomised clinical trial。International Journal of Nursing Studies,51(4),526-538。  new window
13.Liu, J. J.、Chou, F. H.、Yeh, S. H.(2009)。Basic needs and their predictors for intubated patients in surgical intensive care units。Heart & Lung: The Journal of Acute and Critical Care,38(3),208-216。  new window
14.Kwon, E.、Choi, K.(2017)。Case-control study on risk factors of unplanned extubation based on patient safety model in critically ill patients with mechanical ventilation。Asian Nursing Research,11(1),74-78。  new window
15.Karlsson, V.、Bergbom, I.、Forsberg, A.(2012)。The lived experiences of adult intensive care patients who were conscious during mechanical ventilation: A phenomenological-hermeneutic study。Intensive and Critical Care Nursing,28(1),6-15。  new window
16.Ihrig, A.、Herzog, W.、Huber, C. G.、Hadaschik, B.、Pahemik, S.、Hohenfellner, M.、Huber, J.(2012)。Multimedia support in preoperative patient education for radical prostatectomy; The physicians' point of view。Patient Education & Counseling,87(2),239-242。  new window
17.da Silva, P. S.、Fonseca, M. C.(2012)。Unplanned endotracheal extubations in the intensive care unit: Systematic review, critical appraisal, and evidence-based recommendations。Anesthesia and Analgesia,114(5),1003-1014。  new window
18.Lucas da Silva, P. S.、de Carvalho, W. B.(2010)。Unplanned extubation in pediatric critically ill patients: A systematic review and best practice recommendations。Pediatric Critical Care Medicine,11(2),287-294。  new window
19.McNett, M.、Kerber, K.(2015)。Unplanned extubations in the ICU: Risk factors and strategies for reducing adverse events。Journal of Clinical Outcomes Management,22(7),303-311。  new window
20.Nilsson, U.(2011)。Listening to music may relax mechanically ventilated patients, but there are limitations to the quality of the available evidence。Evidence-Based Nursing,14(3),66-67。  new window
21.Tuong, W.、Larsen, E. R.、Armstrong, A. W.(2014)。Videos to influence: A systematic review of effectiveness of videobased education in modifying health behaviors。Journal of Behavioral Medicine,37(2),218-233。  new window
學位論文
1.紀婉玉(2012)。成人加護病房病患家屬於陪病過程之經驗(碩士論文)。國立臺北護理健康大學。  延伸查詢new window
2.翁玲子(2010)。急性期聽覺感官刺激對腦損傷病人顱內壓及認知功能復原之影響(碩士論文)。臺北醫學大學。  延伸查詢new window
3.楊琇茹(2004)。從病患自主權看病患家屬參與醫療決定之權限(碩士論文)。中原大學。  延伸查詢new window
其他
1.衛生福利部(20160322)。醫療品質及病人安全,http://www.rha.org.tw/upload/cus_download/103-093-2.pdf。  延伸查詢new window
 
 
 
 
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