Gideon U Johnson, Amanda Towell-Barnard, Christopher McLean, Beverley Ewens
{"title":"实施和评估家庭主导的谵妄预防和管理成人危重患者的新干预：一项混合方法的试点研究。","authors":"Gideon U Johnson, Amanda Towell-Barnard, Christopher McLean, Beverley Ewens","doi":"10.1111/nicc.13210","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Family-led interventions have been identified as effective in many areas of care including the management of delirium. However, because of the heterogeneity and ambiguity of family-led interventions, they are not consistently applied within intensive care units. A user-friendly digital intervention may therefore support consistent family integration into delirium management.</p><p><strong>Aim: </strong>To explore the feasibility and acceptability of a family member's voice reorientation intervention for delirium prevention and management in an adult intensive care unit.</p><p><strong>Study design: </strong>Parallel, convergent mixed-methods pilot study was conducted in a general adult intensive care unit in the United Kingdom. Thirty participants (15 patients and 15 family members) were enrolled in the study. For the qualitative component, 17 participants (three patients, six family members and eight nurses) contributed to the evaluation.</p><p><strong>Results: </strong>The median frequency of the family member's voice reorientation intervention was 2.3 times per day (range 3.3), and the median Richmond Agitation-Sedation Scale score was -1 (range 2.5). Qualitative data revealed seven themes: acceptance of the intervention, communication, delirium awareness, reactions to the intervention, cognitive state, perception of the intensive care unit and psychological well-being.</p><p><strong>Conclusion: </strong>Nurses can involve family members in person-centred care within the intensive care unit. Results from this study indicate that the family member's voice reorientation programme is feasible and acceptable and may be an effective strategy for providing ongoing orientation, reassurance and comfort to critically ill adult patients to prevent or manage delirium. A larger study is needed to evaluate its impact on delirium.</p><p><strong>Relevance for clinical practice: </strong>The family member's voice reorientation intervention offers critical care nurses a feasible, family-centred approach to support delirium care in the intensive care unit. Integrating this non-invasive tool into practice may enable nurses to enhance patient outcomes, reduce anxiety and strengthen collaboration between patients, families and health care professionals.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The implementation and evaluation of a family-led novel intervention for delirium prevention and management in adult critically ill patients: A mixed-methods pilot study.\",\"authors\":\"Gideon U Johnson, Amanda Towell-Barnard, Christopher McLean, Beverley Ewens\",\"doi\":\"10.1111/nicc.13210\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Family-led interventions have been identified as effective in many areas of care including the management of delirium. However, because of the heterogeneity and ambiguity of family-led interventions, they are not consistently applied within intensive care units. A user-friendly digital intervention may therefore support consistent family integration into delirium management.</p><p><strong>Aim: </strong>To explore the feasibility and acceptability of a family member's voice reorientation intervention for delirium prevention and management in an adult intensive care unit.</p><p><strong>Study design: </strong>Parallel, convergent mixed-methods pilot study was conducted in a general adult intensive care unit in the United Kingdom. Thirty participants (15 patients and 15 family members) were enrolled in the study. For the qualitative component, 17 participants (three patients, six family members and eight nurses) contributed to the evaluation.</p><p><strong>Results: </strong>The median frequency of the family member's voice reorientation intervention was 2.3 times per day (range 3.3), and the median Richmond Agitation-Sedation Scale score was -1 (range 2.5). Qualitative data revealed seven themes: acceptance of the intervention, communication, delirium awareness, reactions to the intervention, cognitive state, perception of the intensive care unit and psychological well-being.</p><p><strong>Conclusion: </strong>Nurses can involve family members in person-centred care within the intensive care unit. Results from this study indicate that the family member's voice reorientation programme is feasible and acceptable and may be an effective strategy for providing ongoing orientation, reassurance and comfort to critically ill adult patients to prevent or manage delirium. A larger study is needed to evaluate its impact on delirium.</p><p><strong>Relevance for clinical practice: </strong>The family member's voice reorientation intervention offers critical care nurses a feasible, family-centred approach to support delirium care in the intensive care unit. Integrating this non-invasive tool into practice may enable nurses to enhance patient outcomes, reduce anxiety and strengthen collaboration between patients, families and health care professionals.</p>\",\"PeriodicalId\":51264,\"journal\":{\"name\":\"Nursing in Critical Care\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nursing in Critical Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/nicc.13210\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nursing in Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/nicc.13210","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
The implementation and evaluation of a family-led novel intervention for delirium prevention and management in adult critically ill patients: A mixed-methods pilot study.
Background: Family-led interventions have been identified as effective in many areas of care including the management of delirium. However, because of the heterogeneity and ambiguity of family-led interventions, they are not consistently applied within intensive care units. A user-friendly digital intervention may therefore support consistent family integration into delirium management.
Aim: To explore the feasibility and acceptability of a family member's voice reorientation intervention for delirium prevention and management in an adult intensive care unit.
Study design: Parallel, convergent mixed-methods pilot study was conducted in a general adult intensive care unit in the United Kingdom. Thirty participants (15 patients and 15 family members) were enrolled in the study. For the qualitative component, 17 participants (three patients, six family members and eight nurses) contributed to the evaluation.
Results: The median frequency of the family member's voice reorientation intervention was 2.3 times per day (range 3.3), and the median Richmond Agitation-Sedation Scale score was -1 (range 2.5). Qualitative data revealed seven themes: acceptance of the intervention, communication, delirium awareness, reactions to the intervention, cognitive state, perception of the intensive care unit and psychological well-being.
Conclusion: Nurses can involve family members in person-centred care within the intensive care unit. Results from this study indicate that the family member's voice reorientation programme is feasible and acceptable and may be an effective strategy for providing ongoing orientation, reassurance and comfort to critically ill adult patients to prevent or manage delirium. A larger study is needed to evaluate its impact on delirium.
Relevance for clinical practice: The family member's voice reorientation intervention offers critical care nurses a feasible, family-centred approach to support delirium care in the intensive care unit. Integrating this non-invasive tool into practice may enable nurses to enhance patient outcomes, reduce anxiety and strengthen collaboration between patients, families and health care professionals.
期刊介绍：
Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics.
Papers published in the journal normally fall into one of the following categories:
-research reports
-literature reviews
-developments in practice, education or management
-reflections on practice
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