| ObjectiveTo provide a basis of the development of stress assessment tool for the family members of ICU patients in China by introducing the Family Relocation Stress Scale(FRSS).Qualitative interview was conducted for the family members of ICU patients with cancer,to understand the psychological feelings and needs of the family members of ICU patients,and to provide theoretical basis for the psychological intervention of family members of ICU patients.By building the relocation planning model,this study aimed to verify the application effect in family members of severe tumor patients,in order to reduce the relocation stress of the family members,improve the care ability of family members and the quality of survival of tumor patients in the ICU.MethodsThis study included three parts:In the first part,the Family Relocation Stress Scale for localization and cultural adjustment,using the method of translation-backtranslation to form the Chinese version of FRSS.We selected 20 severe tumor patients'family members for preliminary investigation and distributed 122questionnaires to test reliability,validity and feasibility of the scale.In the second part,using the qualitative research method of phenomenology with semi-structured interview,we collected the real experience of 12 family members of patients with cancer moving out of ICU,and analyzed the data by phenomenological 7-step analysis.In the third part,the relocation planning model was developed and the experimental study was carried out.We selected family members of 52 cancer patients who met the inclusion and exclusion criteria.Then we divided them into the intervention group and the control group randomly.The intervention group were given the relocation planning model on the basis of routine nursing,while the control group given routine nursing.The level of relocation stress,the degree of anxiety and the level of anxiety of the family members of severe tumor patients were investigated before and after the intervention by using the basic situation questionnaire,the Family Relocation Stress Scale,the State Anxiety Inventory(SAI)and the Family Caregiver Task Inventory(FCTI)of ICU patients.All data were collected and analyzed by SPSS17.0 and the differences between two groups were tested by independent samples t-test and~2 test.Results1 A total of 122 participants completed the Family Relocation Stress Scale.The Cronbach's a of total scale was 0.845 and each dimension was 0.638-0.853,all of which were>0.6.The content validity index(CVI)of all the indexes in the evaluation scale were 0.80-1.00,the average CVI of all the indexes was 0.96,and the CVI of all the items were all above 0.8.The KMO value was 0.801,which was higher than 0.5,and~2=1291.516(P<0.05)for the Bartlett's spherical test.The cumulative contribution rate was 61.83%of three common factors,which were the understanding of patient's condition,the anxiety of ICU transfer,and the understanding of treatment conditions and environmental changes.2 In this study,we interviewed 12 family members of patients with severe tumor and obtained 3 themes and 6 sub-themes.The themes were the co-existence of expecting out of ICU and psychological anxiety,concerns about the care of patients in ordinary wards and the ability to care for tumor patients;Sub-themes were expecting the patient out of ICU as soon as possible,psychological anxiety about whether the patient could move out of the ICU safely,the doubt of treatment conditions and methods of general wards,concerning about the quality of care services of general ward nurses,the incomplete understanding of patient's condition,and the lack of care experience and energy of patients with tumor.3 In the interventional study,the differences of patients and their family members'basic situation were not statistically significant between the intervention group and the control group(P>0.05).After applying the intervention of the relocation planning model,there were significant differences between two groups in total score of relocation stress and subscales of relocation stress(P<0.05).There were significant differences between two groups in anxiety,family care ability scale and its subscales(P<0.05).Conclusions1 The introduced and translated Family Relocation Stress Scale of ICU patients is divided into three dimensions,namely the understanding of patient's condition,the anxiety of ICU transfer,and the understanding of treatment conditions and environmental changes.The scale has favourable reliability and validity.2 Family members of cancer patients have relocation stress before and after ICU transfer,suggesting that medical staff need to understand the inner world of tumor patients'family members and their internal needs in time,so as to provide effective and timely nursing interventions.3 The relocation planning model to the family members of patients with severe tumor can effectively prevent the relocation stress level of family members,reduce the anxiety of family members and improve the care ability of family members after the transfer of ICU. |
PDF Full Text Request