ICU以患者-家庭为中心探视方案的构建

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　　[摘要] 目的 基于PFCC照护理念构建ICU探视方案，为改革我国ICU探视制度提供参考依据。 方法 以PFCC理念为指导，运用文献回顾法和半结构访谈法设计ICU-PFCC探视方案初稿，选取18位专家进行德尔菲专家函询，确立ICU-PFCC探视方案。 结果 17位专家完成两轮函询，两轮专家函询的积极系数分别为94.4%、100.0%;专家权威系数分别为0.89、0.92;两轮专家函询的肯德尔和谐系数分别为0.216（P<0.01）、0.141（P<0.01）。最终确立了包含4项核心原则，11项实施项目，59项具体内容的ICU-PFCC探视方案。 结论 本研究制订的ICU-PFCC探视方案既借鉴了国外相关理论和临床实践指南，又结合我国国情，具有科学性和操作性，可为我国ICU探视制度改革提供一定的理论依据。
　　[关键词] 以患者-家庭为中心;重症监护病房;探视方案;德尔菲法
　　[中图分类号] R473 [文献标识码] B [文章编号] 1673-9701（2022）02-0173-04
　　Construction of patient-family centered visiting program in ICU
　　ZHANG Congcong1 JIANG Yongmei2 LIU Cui1 SHANG Quanwei1 CUI Mengyuan3 YUAN Meiling1
　　ZHU Fuxiang1 YANG Xiuling3
　　1.ICU of Cardial Surgery Department， the Affiliated Hospital of Qingdao University， Qingdao 266000， China; 2.Department of Nursing， the Affiliated Hospital of Qingdao University， Pingdu District， Qingdao 266700， China; 3.School of Nursing， Qingdao University， Qingdao 266000， China
　　[Abstract] Objective To construct ICU visiting program based on PFCC care concept， and to provide reference for reforming ICU visiting system in China. Methods Based on the concept of PFCC， the first draft of ICU-PFCC visiting program was designed by literature review and semi-structured interview， and 18 experts were selected for Delphi expert inquiry to establish ICU-PFCC visiting program. Results Seventeen experts completed two rounds of inquiries， and the positive coefficients of the two rounds of inquiries were 94.4% and 100.0%， respectively. The authoritative coefficients of experts were 0.89 and 0.92， respectively. The Kendall harmony coefficients of the two rounds of expert inquiry were 0.216 （P<0.01） and 0.141 （P<0.01）， respectively. Finally， the ICU-PFCC visiting program with 4 core principles， 11 implementation projects and 59 specific contents was established. Conclusion The ICU-PFCC visiting program developed in this study not only draws lessons from foreign related theories and clinical practice guidelines， but also combines with China′s national conditions， scientific and operational， which can provide certain theoretical basis for the reform of ICU visiting system in China.
　　[Key words] Patient-family centered; Intensive care unit; Visiting program; Delphi method
　　重Y监护室（intensive care unite，ICU）是集中救治和监护危重患者的科室[1]，多采取封闭的管理模式。20世纪90年代初，美国学者提出以患者-家庭为中心（patient-and family-centered care，PFCC）探视模式[2-4]。相关研究证明，该探视模式在改善急危重症患者健康结局、提高患者和家庭就医体验、提高满意度等方面发挥着重要作用[5-7]。《“健康中国2030”规划纲要》提出，医院应加强医疗服务人文关怀，构建和谐医患关系。但目前我国ICU家属探视仍以限制性探视为主，与PFCC探视模式存在较大差距，尚未形成符合我国国情的ICU-PFCC探视方案。鉴于此，本研究基于PFCC照护理念构建适合我国国情的ICU-PFCC探视方案，以期为改革我国ICU探视制度，实现ICU人文管理提供参考。
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