The Construction Of The Patient-and Family-Centered Care In ICU In China

Background:With the continuous improvement of critical care,the survival rate of critically ill patients has increased,but patients and their families are highly likely to develop various psychological symptoms,including post-traumatic stress disorder,anxiety and depression,during and after transfer from the Intensive care unit(ICU).It seriously affects the physical and mental health and quality of life of patients and their families.This problem has aroused great attention in the field of critical care,and the study of critical care model with improving patient prognosis as the observation end point has become a current hot spot.With the development of "physiology-psychologysociety"medical model,the role and participation of the family during the patient’s illness and recovery process have been paid much attention."Patient-and Family-Centered Care"as a model of health care that responds to the needs and values of each family,It plays an important role in improving health outcomes of critical illness,improving patient and family experience,improving medical staffs’,patients’,and families’ satisfaction.At present,PFCC has been recognized by many foreign medical associations,healthcare systems,legislatures and medical research institutes as an important part of improving patients’ health outcomes,satisfaction and medical quality.It has also become a common concept in the health systems of European and American countries,and they are actively promoting the application of this model.However,there is still a lack of systematic research on PFCC in ICU in China.The contents in our country’ s study are different,mostly limited to the health education and visiting system of ICU,and there is a lack of unified standards.Objective:To determine the contents of the Patient-and Family-Centered Care in ICU in China.Methods:The concept of PFCC in ICU was defined by Rodgers’ evolutionary concept analysis.Based on literature research and expert interviews,the elements of care content were extracted,and two-round Delphi consultations were conducted among 15 experts in clinical medicine,clinical nursing management and clinical nursing,so as to construct the care content of PFCC in intensive care units under the background of Chinese medical culture.Results:Concept analysis revealed four unique attributes of PFCC in ICU:respect,communication and information sharing,participation,and cooperation.Through two rounds of Delphi consultation with 15 experts,the contents of PFCC in ICU in China were finally formed,including 5 primary items,15 secondary items and 35 tertiary items,including respect,information sharing,communication,participation and cooperation.The positive coefficient of the two rounds of expert consultation was 100%,the expert authority coefficient was 0.87.The coordination coefficient of importance and feasibility of the first round were 0.29 and 0.39,respectively,and that of the second round were 0.33 and 0.41.For the first round of expert consultation,the coefficient of variation of item importance ranged from 0 to 0.14,and the coefficient of variation of item feasibility ranged from 0.07 to 0.21.For the second round,the coefficient of variation of item importance ranged from 0 to 0.12,and the coefficient of variation of item feasibility ranged from 0.07 to 0.18.Conclusion:This study constructs the contents of the Patient-and Family-Centered Care in ICU in China has a high reliability,which will provide reference for the clinical practice of PFCC in ICU.