目的 探索家属参与重症肺炎患者照护的可行性和安全性及对患者家属的影响。 方法 将2019年3月—2023年3月在甘肃省某三级甲等医院3个成人ICU的重症肺炎和呼吸衰竭患者作为研究对象，根据家属和患者意愿分为试验组和对照组。试验组鼓励家属在探视期间参与患者的日常生活照顾（洗脸、刷牙、足浴、饮食等），并且在医护人员的指导下协助患者早期活动；对照组给予ICU常规护理。主要观察指标为谵妄、认知功能损害和1年生存率。结果 共纳入261例患者，其中试验组134例，对照组127例。试验组和对照组患者谵妄发生率（23.88%和40.94%）、谵妄发生频次[（0.61±1.25）次和（1.26±1.82）次]、ICU转归认知损害发生率（23.88%和44.09%）]组间比较，差异有统计学意义（P<0.05）；ICU获得性衰弱、ICU获得性感染和不良事件的发生率，组间差异无统计学意义（P>0.05）。试验组患者1年生存率（73.88%）高于对照组（59.06%）；生活质量评分高于对照组，差异均有统计学意义（P<0.05）。试验组家属的疾病不确定感总分[（80.11 ± 4.23）分]低于对照组[（82.91 ± 4.64）分]，总体满意度[（90.81 ± 5.17）分]高于对照组[（85.60 ± 4.72）分]，且差异有统计学意义（P<0.001）。结论 家属参与重症肺炎患者照护不仅有益于降低ICU重症肺炎患者谵妄和认知损害的发生率，缩短住院时间，提高生活质量和1年生存率，且有益于降低家属的疾病不确定感，提高ICU患者家属满意度。

Objective To investigate the feasibility and safety of family participation in the care of patients with severe pneumonia and its impact on the family of patients. Methods For severe pneumonia and respiratory failure patients admitted to three adult ICUs of a tertiary class A hospital in Gansu Province between March 2019 and March 2023，the patients were divided into an intervention group and a control group based on the preferences of both the patients and their family members. Patients in the control group received routine care. In the intervention group，family members were encouraged to participate in the daily life of patients（washing face，brushing teeth，foot bath，etc.） and participated in the early activities of patients under the guidance of medical personnel. The primary outcomes included the incidence of delirium，cognitive impairment，and 1-year mortality. Results 261 patients were eventually enrolled and assigned to the intervention group（n=134） or control group （n=127）. Incidence of delirium in intervention group and control group were 23.88% and 40.94%，frequency of delirium was （0.61 ± 1.25） vs （1.26 ± 1.82），incidence of cognitive dysfunction 23.88% vs 44.09%，and there were statistically differences（P<0.05）. There was no significant difference in the incidence of ICU acquired weakness，ICU acquired infection and adverse events between groups（P>0.05）. Patients in the intervention group exhibited a higher 1-year survival rate（73.88% vs 59.06%） and quality of life score compared to the control group，and there were statistically differences（P<0.05）. Family members in the intervention group reported lower total illness uncertainty scores than those in the control group（80.11 ± 4.23 vs. 82.91 ± 4.64） and higher overall satisfaction（90.81 ± 5.17 vs. 85.60 ± 4.72），with these differences being statistically significant（P<0.05）. Conclusion The participation of family members in the care of patients with severe pneumonia is not only beneficial to reduce the incidence of delirium and cognitive impairment in patients with severe pneumonia in ICU，shorten the length of hospitalization，improve the quality of life and 1-year survival rate，but also help reduce the uncertainty of disease and improve the satisfaction of family membersn ICU.