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Objective:To analyze the effect of integrated care model on relocation stress and sense of coherence in caregivers of severe multiple injuries patients after ICU transfer.Methods:From January 2017 to October 2019, 102 caregivers of severe multiple injuries patients in ICU of Liuzhou Worker′s Hospital were selected and divided into control group and observation group by random digits table method,with 51 cases in each group. In the process of ICU transfer the control group received routine nursing, while the observation group carried out integrated care model based on the control group scheme. Before and after ICU transfer, the degree of relocation stress and sense of coherence of caregivers in two groups were evaluated by Family Relocation Stress Scale (FRSS) and Sense of Coherence Scale (SOCS) respectively.Results:The scores of migration preparation dimension, migration satisfaction dimension,caregiver stress dimension and the total scores of FRSS were 17.51 ± 3.46, 4.81 ± 0.48, 11.69 ± 1.82 and 49.91 ± 4.51 in the observation group, which were significantly higher than those in the control group after transfer (13.61 ± 2.83, 3.32 ± 0.53, 9.42 ± 2.17, 39.25 ± 4.01)( t values were 5.12-7.64, all P<0.05). The scores of manage ability dimension, comprehensibility dimension, meaningfulness dimension and the total scores of SOCS were 29.58 ± 4.96, 24.07 ± 2.72, 22.04 ± 3.64 and 75.52 ± 6.80 in the observation group, which were significantly higher than those in the control group (24.34 ± 4.13, 20.50 ± 2.99, 17.19 ± 3.96, 64.80 ± 6.12) after transfer ( t values were 4.51-7.01, all P<0.05). Conclusions:The integrated care model can significantly alleviate relocation stress and promote sense of coherence in caregivers of severemultiple injuriespatients after ICU transfer.
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Objective:To explore the application value of checklist-based transitional care on patients relatives relocation stress in patients undergoing cardiac surgery.Methods:A total of 92 patients who undergoing cardiac surgery were assigned to experimental group ( n=46) and control group ( n=46). Patients in the control group received routine ICU transitional care, the experiment group carried out checklist-based ICU transitional care. The transfer time, time of early ambulation, length of hospitalization and incidence of postoperative complications were compared between two groups. Meanwhile, the relatives stress levels were assessed by family relocation stress scale. Results:The transfer time, time of early ambulation and post-intensive care syndrome rate were (11.80±3.58) min, (18.65±4.63) min and 4.35% (2/46) in the experimental group, significantly lower than those in the control group [(13.83±3.49)min, (21.37±4.97) min, 17.39% (8/46)], the difference was statistically significant ( t value was 2.739, 2.713, χ2 value was 3.866, P<0.05). After ICU transferring, the scores of preparation for relocation, family burden, satisfaction with the relocation process and total relocation stress were 21.11±2.57, 13.83±2.10, 7.57±1.11 and 7.57±1.11, significantly higher than in the control group (19.65±3.28, 19.65±3.28, 6.76±1.62, 46.43±4.11), the difference was statistically significant ( t value was 9.222-20.187, P<0.05). Conclusions:Checklist-based transitional care can reduce ICU transfer time, decrease postoperative pain and complications in patients undergoing cardiac surgery, which can also alleviate the levels of relatives relocation stress.
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Objective To explore the relocation stress in families of patients transferred from ICU, and the influence of social comparison orientation and family function on it. Methods There were 168 participants recruited from Critical Medical Department of the First Affiliated Hospital of Xi′an Jiaotong University by convenience sampling method between June 2017 and February 2018. The ICU patients′Family Relocation Stress Scale, Chinese version of the Iowa-Netherland Social Comparison Orientation Measure and Family Adaptation and Cohesion Evaluation Scale Ⅱ were used. Results The score of relocation stress and social comparison orientation were 58.47±7.66 and 37.83±9.11. The score of family real cohesion was 65.85 ± 7.83, which was higher than norms (t=-2.067, P<0.05). The score of dissatisfaction of adaptation was 9.22±4.41, which was higher than norms (t=-3.093, P<0.05). The results of regression analysis showed that the time of patient staying in ICU, education level, religion, social comparison orientation, family real cohesion and dissatisfaction of adaptation could influence relocation stress. Conclusion Health professionals should pay attention to the relocation stress in families, provide emotional support and effective information support, guide family members to correctly understand the patients′ condition and prognosis, respect their religious beliefs, give full play to their family functions, help them adapt to the role changes quickly and reduce the level of relocation stress.
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Objective To analyze the relocation stress and its influencing factors of the families of patients transferred from ICU.Methods Totally 101 ICU patients' families were recruited by convenience sampling approach from three hospitals between October and December,2016.General information questionnaire and the relocation stress scale for the families of patients transferred from ICU were used to collect data.Results The relocation stress score was 55.49±6.30.The average score of the total items was 3.25±0.55.Multiple regression analysis showed that education level of family members,family members' gender,age of patients and the time of patients staying in ICU were main factors affecting the relocation stress of the families of patients transferred from ICU(P＜0.05).Conclusion The families of patients transferred from ICU have a certain intensity of relocation stress.Family members with low education level,being female,younger age of patients and long duration of staying in ICU have relatively high relocation stress.
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Objective To develop an instrument for measuring family relocation stress scale during patient transferred from ICU. And to provide evidence for ICU health care personnel to assess and deal with the family member′s relocation stress. Methods A draft scale was developed based on the result of related scale abroad, literature review and semi-structured interviews. Delphi method and Classical test theory were used in item selection. Results The degree of experts′ authority in two rounds′consultation were 0.83. The Kendall′s coordination coefficients of importance were 0.36, 0.36 (P<0.05) in dimension and 0.35, 0.37 (P<0.05) in item. Five items were deleted by the statistical analysis with pilot investigation. 6 dimensions (transfer anxiety, environmental changes, disease severity, nursing model changes, the safety of transfer, self-efficacy of care ability) and 20 items consisted the scale. The Cronbach α coefficient was 0.882. Exploratory factor analysis extracted 6 items, accumulated variance contribution rate was 72.226%. Confirmative factor analysis showed χ2/df=1.677, comparative fit index=0.936, Tucker-Lewis index=0.921, root mean square error of approximation=0.061. Conclusions The scale is based on abundant theoretical evidence and reasonable design, with satisfactory reliability and validity. It can be used as the evaluation tool for family relocation stress during patient transferred from ICU.
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PURPOSE: The purpose of this study was to identify the levels of relocation stress syndrome (RSS) and influencing the stress experienced by Intensive Care Unit (ICU) patients just after transfer to general wards. METHODS: A cross-sectional study was conducted with 257 patients who transferred from the intensive care unit. Data were collected through self-report questionnaires from May to October, 2009. Data were analyzed using the Pearson correlation coefficient, t-test, one-way ANOVA, and stepwise multiple linear regression with SPSS/WIN 12.0. RESULTS: The mean score for RSS was 17.80+/-9.16. The factors predicting relocation stress syndrome were symptom experience, differences in scope and quality of care provided by ICU and ward nursing staffs, satisfaction with transfer process, length of stay in ICU and economic status, and these factors explained 40% of relocation stress syndrome (F=31.61, p<.001). CONCLUSION: By understanding the stress experienced by ICU patients, nurses are better able to provide psychological support and thus more holistic care to critically ill patients. Further research is needed to consider the impact of relocation stress syndrome on patients' health outcomes in the recovery trajectory.
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Adult , Aged , Female , Humans , Male , Middle Aged , Adaptation, Psychological , Critical Illness/psychology , Cross-Sectional Studies , Intensive Care Units , Patient Transfer , Surveys and Questionnaires , Stress, Psychological/etiology , SyndromeABSTRACT
PURPOSE: This study was conducted to analyze and clarify the meaning of the concept for relocation stress -focusing on patients transferred from an intensive care unit to a general ward. METHODS: This study used Walker and Avant's process of concept analysis. RESULTS: Relocation stress can be defined by these attributes as follows: 1) involuntary decision about relocation, 2) moving from a familiar and safe environment to an unfamiliar one, 3) broken relationship of safety and familiarity, 4) physiological and psychosocial change after relocation. The antecedents of relocation stress consisted of these facts: 1) preparation degrees of transfer from the intensive care unit to a general ward, 2) pertinence of the information related to the transfer process, 3) change of major caregivers, 4) change in numbers of monitoring devices, 5) change in the level of self-care. There are consequences occurring as a result of relocation stress: 1) decrease in patients' quality of life, 2) decrease in coping capacity, 3) loss of control. CONCLUSION: Relocation stress is a core concept in intensive nursing care. Using this concept will contribute to continuity of intensive nursing care.