“安全-支持-合作”过渡期护理对肿瘤重症患者照护者迁移应激的影响

doi:10.3761/j.issn.2096-7446.2025.08.003

摘要/Abstract

摘要：

目的评价“安全-支持-合作”过渡期护理在肿瘤重症患者照护者应对迁移应激方面的效果。方法采用非同期临床对照研究设计，便利选取2023年5月—2024年3月在湖南省长沙市某三级甲等医院就诊的151例ICU转出肿瘤重症患者及其照护者为研究对象，2023年11月—2024年3月的76例患者及其照护者作为试验组，实施“安全-支持-合作”过渡期护理；2023年5月—10月的75例患者及其照护者作为对照组，实施常规护理方案。比较两组照护者在患者转入ICU 24 h内（T0）、从ICU转出当天（T1）、从ICU转出72 h后（T2）的焦虑、抑郁、ICU家属迁移应激水平，比较两组患者过渡期护理措施质量及72 h ICU重返率和平均住院天数。结果试验组75例、对照组71例完成研究，两组照护者不同时间点的抑郁、焦虑和ICU家属迁移应激水平比较，交互作用均具有统计学意义（F=954.980，P<0.001，F=394.391，P<0.001，F=221.028，P<0.001）；两组患者过渡期护理措施评估得分均呈上升趋势，不同时间点的交互作用均具有统计学意义（F=457.751，P<0.001）。试验组72 h ICU重返率为2.67%，低于对照组，对照组为12.68%，两组比较差异具有统计学意义（t=5.245，P<0.05）。试验组平均住院日为（18.19±2.17） d，显著低于对照组，对照组为（21.24±1.95） d，两组比较差异具有统计学意义（t=8.916，P<0.001）。结论 “安全-支持-合作”过渡期护理干预可降低ICU转出肿瘤重症患者照护者焦虑、抑郁以及迁移应激水平，提高肿瘤重症患者过渡期护理安全和满意度，促进其疾病恢复。

关键词: “安全-支持-合作”模式, 过渡期护理, 肿瘤重症, 照护者, 迁移应激

Abstract:

Objective To evaluate the effect of “secure-encourage-collaborate” transitional care in coping with migration stress in caregivers of critically ill patients with tumor. Methods A non-randomized quasi experimental research design was adopted. 151 caregivers of critically ill patients with cancer transferred out of ICU from May 2023 to March 2024 were selected as the research objects. 76 caregivers of patients from November 2023 to March 2024 were selected as the experimental group，and the “secure-encourage-collaborate” transitional care was implemented. 75 patients’ caregivers from May to October 2023 were selected as the control group，and the routine nursing scheme was implemented. The anxiety，depression and ICU family migration stress levels of the caregivers in the two groups were compared after they were transferred to ICU（T0），the day they were transferred from ICU（T1），and 72 hours after transfer（T2）. The quality of nursing measures in the transition period，ICU return rate and average length of stay in the two groups were compared. The 72 h ICU return rate and average hospitalization days of the two groups were compared. Results 75 cases in the experimental group and 71 cases in the control group completed the study. The levels of depression，anxiety and ICU family migration stress of the two groups of caregivers at different time points was statistically significant（F=954.980，P<0.001，F=394.391，P<0.001，F=221.028，P<0.001）. The CTM scores of the two groups showed an upward trend，and the interaction at different time points was statistically significant（F=457.751，P<0.001）. The 72 h ICU return rate of the experimental group was 2.67%，which was lower than 9.86% of the control group，and the difference was statistically significant（t=5.245，P<0.05）. The average length of stay in the experimental group was（18.19 ± 2.17） d，which was significantly lower than （21.24 ± 1.95） d in the control group，and the difference was statistically significant（t=8.916，P<0.001）. Conclusion Implementing the “secure-encourage-collaborate” transition nursing for critically ill cancer patients can help reduce the occurrence of negative emotions such as anxiety，depression and migratory stress level among caregivers，improve the nursing safety and satisfaction of patients during the transitional period，and promote their disease recovery.

Key words: “Secure-Encourage-Collaborate” Model, Transitional Care, Severe Tumor, Caregivers, Relocation Stress

蔡喆燚, 奉水华, 蔡亚宏, 邹婵, 梁高科, 刘蕾, 陈青. “安全-支持-合作”过渡期护理对肿瘤重症患者照护者迁移应激的影响[J]. 中华急危重症护理杂志, 2025, 6(8): 915-922.

CAI Zheyi, FENG Shuihua, CAI Yahong, ZOU Chan, LIANG Gaoke, LIU Lei, CHEN Qing. The impact of the “secure-encourage-collaborate” transitional care on the migration stress of caregivers for critically ill oncology patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 915-922.

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