Study On The Effect Of Migration Manual On Relocation Stress Of Family Members Of Patients With Cerebral Hemorrhage Transferred From The Neurosurgica Intensive Care Unit

Objective:To understand the guidance needs of family members and neurosurgical nurses for patients with intracerebral hemorrhage transferred from the ICU of neurosurgery,compile a set of scientific and feasible migration manual,and explore the effectiveness of the application of this manual on the relocation stress of family members of patients with intracerebral hemorrhage transferred from the ICU of neurosurgery.Methods:1.Semi-structured interview method in qualitative research was adopted to understand the guidance needs of family members and neurosurgical nurses for patients with intracerebral hemorrhage,establish the main contents of the manual,and provide a basis for the formation of the manual.2.On the basis of the qualitative interview results,combined with literature analysis,the first draft of the manual was prepared,and expert correspondence consultation was conducted by Delphi method.Based on the correspondence consultation results and expert opinions,the migration manual was finally formed.3.In this study,60 family members of patients with intracerebral hemorrhage transferred from the neurosurgical ICU to the general ward in a grade iii first-class hospital in taiyuan city from September 2019 to November 2019 were selected.In order to reduce the research bias,the intervention group and the control group were conducted in the time period.The implementation of the control group was completed first,and then the intervention of the test group was carried out,with 30 cases in each group.On the basis of routine nursing,the experimental group implemented individualized transfer out nursing program based on migration manual,while the control group implemented routine nursing.The family relocation stress scale,the family disease uncertainty scale and the caregiver Preparedness scale were used to evaluate the effects of the two groups before and after the intervention.Results:1.Were totaly interviewed 16 subjects,including nine families,seven medical workers,through the interview transcription,coding,analysis of eight themes were extracted,including the patient’s disease outcome,migration plan,knowledge of disease and the treatment of introduction,patient safety,basic nursing skills to guide and rehabilitation program,family instructions,psychological guidance.2.In this study,a total of 14 experts completed two rounds of correspondence consultation.After two rounds of correspondence consultation,experts’ opinions tended to be consistent.The effective recovery rates of the two rounds of correspondence questionnaire were 93.33% and 100%,respectively.The authority coefficients of experts were 0.825 and 0.902,respectively.After the Kendall harmony coefficient was tested,the differences were statistically significant(P<0.05).The migration manual includes migration plan,knowledge of cerebral hemorrhage,patient safety,basic care skills,knowledge of early rehabilitation and psychological support.There are 6 primary indicators,19 secondary indicators and 60 tertiary indicators.3.24 h after transfer and 72 h after transfer,the family members’ relocation stress score and disease uncertainty score in the test group were significantly lower than that in the control group,with statistically significant differences(P<0.05).The results of repeated measures of variance analysis showed that the intergroup effect,time effect and interaction between the scale scores in the two groups were statistically significant(P<0.05).After 72 h of transfer,the score of caregiver Preparedness in the experimental group was higher than that in the control group,with statistically significant difference(P<0.05).Conclusion:1.Through semi-structured interview found that families in patients in neurosurgery ICU transfer during this period,widespread psychological pressure,and care ability is weak,and desire to get related information from the medical staff and knowledge,so the staff should respect and understand the families of negative emotions,to strengthen the communication between family members and encourage family members,actively seeking solutions for families,make its can provide better care for the patient,to speed up the recovery of patients.2.Through qualitative interviews and literature analysis,the migration manual was initially prepared.After expert consultation,a reliable and comprehensive migration manual was finally formed.In addition to the combination of text and text,the manual also incorporated two-dimensional code video,which was helpful to alleviate visual fatigue and easy to understand.3.Through the baseline survey,the family members had a medium-high degree of relocation stress and disease uncertainty,and their caregivers were at a low level of readiness.Based on manual migration of individualized roll-out plan,through at the different stages of the transfer,to provide sufficient information to family members,and after the transfer of supervision,using the transition handbook guide families all care skills,significantly reduced the neurosurgery ICU roll-out of cerebral hemorrhage patients’ families level of relocation stress and disease uncertainty,and improve the caregivers Preparedness.