知信行模式下弹性按需探视对ICU患者谵妄发生的影响

doi:10.3761/j.issn.2096-7446.2026.02.003

Abstract

Abstract:

Objective To investigate the effect of flexible on-demand visiting intervention model based on the Knowledge，Attitudes and Practices（KAP） model on the occurrence of delirium in ICU patients. Methods Eighty patients treated in the ICU of the First Affiliated Hospital of Anhui Medical University during the time period of December 2024 to March 2025 were selected as the study subjects，and they were randomly divided into the control group and the experimental group，each with 40 cases. The control group implemented conventional nursing care，and the experimental group implemented the flexible on-demand visiting intervention model based on the KAP model. The ICU delirium scale（CAM-ICU-7） was used to compare the delirium levels of patients in the two groups 14day before and 3day，7day，and 14day after the intervention. And the nursing care satisfaction scores，adherence scores of the two groups were assessed and compared 14day before and after the intervention. Results After the intervention，the delirium score of patients in the experimental group was lower than that of the control group（P<0.001）. The nursing care adherence of patients in the experimental group was higher than that of the control group（P<0.05）. The delirium scores of patients in both groups decreased，and the patient satisfaction score of the experimental group was higher than that of the control group（P<0.001）. The levels of patient adherence and nursing satisfaction increased in both groups compared with the pre-intervention period. Conclusion Flexible on-demand visitation intervention based on the KAP model can reduce delirium level of ICU patients，improve treatment adherence，and thus enhance the nursing satisfaction of patients and their families.

Key words: Intensive Care Unit, KAP Model, Flexible On-Demand Visiting, Delirium

FANG Yexiang, HAN Jiangying, DU Xiaoling, WU Shanshan, LI Juan, YANG Xue. The influence of flexible on-demand visiting based on the KAP model on the occurrence of delirium in ICU patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 148-154.

Figures/Tables 4

References 25

[1]	陈立萍, 滕锦楠, 朱文, 等. 重症监护室探视制度的现状调查[J]. 解放军医院管理杂志, 2021, 28(1):49-52.
	Chen LP, Teng JN, Zhu W, et al. Investigation and research on the current situation of intensive care unit visiting policy[J]. Hosp Adm J Chin PLA, 2021, 28(1):49-52.
[2]	Klimasiński MW. Spiritual care in the intensive care unit[J]. Anaesthesiol Intensive Ther, 2021, 53(4):350-357. doi: 10.5114/ait.2021.109920 pmid: 34714016
[3]	董钰源, 杨会梅, 时太丽, 等. 不同护理干预模式防治ICU术后患者谵妄的有效性研究[J]. 湖北医药学院学报, 2024, 43(2):203-206.
	Dong YY, Yang HM, Shi TL, et al. Study on the effectiveness of different nursing intervention modes in preventing and treating postoperative delirium in ICU[J]. J Hubei Univ Med, 2024, 43(2):203-206.
[4]	张伟, 汤云, 江海娇, 等. 重症监护室成年病人谵妄非药物干预最佳证据的应用研究[J]. 蚌埠医学院学报, 2023, 48(12):1759-1765.
	Zhang W, Tang Y, Jiang HJ, et al. Application of the best evidence for non-pharmacological intervention of delirium in adult patients in the intensive care unit[J]. J Bengbu Med Coll, 2023, 48(12):1759-1765.
[5]	宫晓艳, 隋伟静, 庄一渝. 成人ICU弹性探视制度面临挑战质性研究的Meta整合[J]. 护理与康复, 2021, 20(3):1-6,11.
	Gong XY, Sui WJ, Zhuang YY. Meta-synthesis of qualitative study on challenges of elastic visitation system for adult ICU[J]. J Nurs Rehabil, 2021, 20(3):1-6,11.
[6]	牟成华, 陈珺, 张正馨, 等. 弹性探视制度在ICU中应用的可行性分析[J/OL]. 中华危重症医学杂志(电子版), 2021, 14(1):80-82.
	Mu CH, Chen J, Zhang ZX, et al. Feasibility analysis of application of flexible visiting system in ICU[J/OL]. Chin J Crit Care Med(Electron Ed), 2021, 14(1):80-82.
[7]	谷瑞媛, 胡乔书, 靳珂, 等. 家属参与式人文护理对预防重症患者ICU后综合征的研究进展[J]. 中华急危重症护理杂志, 2023, 4(10):956-960.
	Gu RY, Hu QS, Jin K, et al. Research progress of family participatory humanistic nursing care in preventing post-ICU syndrome in critically ill patients[J]. Chin J Emerg Crit Care Nurs, 2023, 4(10):956-960.
[8]	林健明, 陈珊珊. 延长家属探视时间对获得性肺炎机械通气病人康复效果的影响[J]. 循证护理, 2023, 9(16):2990-2993.
	Lin JM, Chen SS. Effect of extending family visit time on the rehabilitation effect of mechanically ventilated patients with acquired pneumonia[J]. Chin Evid Based Nurs, 2023, 9(16):2990-2993.
[9]	王倩, 贾丽燕, 孙一鑫, 等. 互动式教育模式预防老年住院患者住院跌倒效果研究[J]. 中国医院, 2025, 29(6):101-104.
	Wang Q, Jia LY, Sun YX, et al. Effect of interactive health education model on fall prevention among elderly inpatients[J]. Chin Hosp, 2025, 29(6):101-104.
[10]	Khan BA, Perkins AJ, Gao SJ, et al. The confusion assessment method for the ICU-7 Delirium Severity Scale:a novel delirium severity instrument for use in the ICU[J]. Crit Care Med, 2017, 45(5):851-857. doi: 10.1097/CCM.0000000000002368
[11]	Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients:validity and reliability of the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU)[J]. JAMA, 2001, 286(21):2703-2710. doi: 10.1001/jama.286.21.2703
[12]	李鑫, 李奇, 孙建华, 等. ICU意识模糊评估表-7量化项目的汉化及信效度检验[J]. 护士进修杂志, 2022, 37(10):865-869.
	Li X, Li Q, Sun JH, et al. The Chinese version of scored items and reliability and validity test of the Confusion Assessment Method for the Intensive Care Unit-7[J]. J Nurses Train, 2022, 37(10):865-869.
[13]	付晔, 王华军, 周成杰. ICU远程探视模式对患者认知功能的影响[J]. 中国现代医生, 2023, 61(28):29-32.
	Fu Y, Wang HJ, Zhou CJ. Effect of remote visitation mode on cognitive function of patients in ICU[J]. China Mod Dr, 2023, 61(28):29-32.
[14]	宋丽芳, 张颖惠, 王彩玲, 等. ICU谵妄严重程度的影响因素及预后研究[J]. 中华急危重症护理杂志, 2024, 5(11):978-984.
	Song LF, Zhang YH, Wang CL, et al. Study on the influencing factors and prognosis of delirium severity in intensive care units[J]. Chin J Emerg Crit Care Nurs, 2024, 5(11):978-984.
[15]	Yang HY, Feng F, Yang WW, et al. Application of a flexible visitation system in critically ill patients:a randomized clinical trial[J]. Sci Prog, 2023, 106(1):368504231165663.
[16]	吴淑芬, 徐静, 戈丹艳, 等. 人文关怀联合微信视频探视对呼吸重症监护病房清醒患者的影响[J]. 护理实践与研究, 2025, 22(1):46-51.
	Wu SF, Xu J, Ge DY, et al. Effect of humanistic care combined with WeChat video visits on awake patients in respiratory intensive care unit[J]. Nurs Pract Res, 2025, 22(1):46-51.
[17]	Nazari-Ostad Z, Namazinia M, Hajiabadi F, et al. Effect of protocol-based family visitation on physiological indicators in ICU patients:a randomized controlled trial[J]. BMC Anesthesiol, 2024, 24(1):18. doi: 10.1186/s12871-023-02396-3 pmid: 38195443
[18]	欧阳艳艳, 王晓霞, 陈璟, 等. ICU转出患者认知障碍发生现状及影响因素分析[J]. 中华护理杂志, 2022, 57(24):2991-2996. doi: 10.3761/j.issn.0254-1769.2022.24.007
	Ouyang YY, Wang XX, Chen J, et al. Cognitive impairment and its influencing factors in patients transferred from ICU[J]. Chin J Nurs, 2022, 57(24):2991-2996. doi: 10.3761/j.issn.0254-1769.2022.24.007
[19]	徐傲然, 黎张双子, 崔安妮, 等. 灵活家庭探视制度对ICU患者谵妄影响的Meta分析[J]. 护理学杂志, 2024, 39(3):70-73.
	Xu AR, Li ZSZ, Cui AN, et al. Effect of flexible family visitation on delirium among patients in the intensive care unit:a meta-analysis[J]. J Nurs Sci, 2024, 39(3):70-73.
[20]	Yang DD, Zhao M, Shi Y. Flexible ICU visiting:improving family outcomes while navigating implementation challenges[J]. Intensive Crit Care Nurs, 2025, 86:103894. doi: 10.1016/j.iccn.2024.103894
[21]	Li JJ, Cai SN, Mei JH, et al. The beliefs and attitudes of intensive care unit nurses and patient families regarding an open visitation policy in China[J]. Nurs Crit Care, 2023, 28(5):800-807. doi: 10.1111/nicc.v28.5
[22]	李梅, 付沫, 丁永艳. 临床护士老年谵妄知信行现状及影响因素研究[J]. 护理管理杂志, 2023, 23(8):618-623.
	Li M, Fu M, Ding YY. Clinical nurses’ knowledge,attitude and practice about delirium in the elderly:current status and associated factors[J]. J Nurs Adm, 2023, 23(8):618-623.
[23]	任奇, 陈芳, 林娟, 等. 以患者和家庭为中心的信息化探视在ICU的应用[J]. 护理与康复, 2022, 21(3):43-46.
	Ren Q, Chen F, Lin J, et al. Application of patient and family-centered information visit in ICU[J]. J Nurs Rehabil, 2022, 21(3):43-46.
[24]	Akbari R, Karimi Moonaghi H, Mazloum SR, et al. Implementation of a flexible visiting policy in intensive care unit:a randomized clinical trial[J]. Nurs Crit Care, 2020, 25(4):221-228. doi: 10.1111/nicc.v25.4
[25]	任白悦, 梁雪静. 半开放式探视联合视频探视对重症监护室后综合征的预防作用[J]. 山西医药杂志, 2023, 52(10):787-790.
	Ren BY, Liang XJ. Preventive effect of semi-open visit combined with video visit on post-syndrome in intensive care unit[J]. Shanxi Med J, 2023, 52(10):787-790.

The influence of flexible on-demand visiting based on the KAP model on the occurrence of delirium in ICU patients

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 25

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	XIA Lianzi, YU Fei, FENG Bo, ZHOU Hui, JI Kangling, WANG Qing. A qualitative study on barriers to participation in advance care planning among ICU surrogate decision-makers [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 155-161.
[2]	WANG Jiayi, GUO Zhiting, ZHANG Yuping, WANG Haizhen, HUANG Xiaoxia, JIN Jingfen. Research progress on evaluation indicator set of ICU alarm management [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 243-247.
[3]	ZHAO Huiyun, WU Bo, XU Xiaoying, TANG Shi. Development of a quality assessment indicator system for palliative care in pediatric intensive care units [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 36-41.
[4]	FENG Lu, LI Yan, JING Jie, NIE Xinyue, HU Huan, TANG Binzhi. Best evidence summary for family participatory non-pharmacological management of procedural pain in NICU neonates [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 61-69.
[5]	REN Guangxiu, QIN Xiaoxin, ZHANG Yanfang, WANG Wenran, HAN Chao, WANG Shouxi. The status and latent profile analysis of palliative care competence among nurses in intensive care unit [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 89-95.
[6]	GE Liuna, GU Yimei, FENG Xiaoting, YIN Yu, HU Xiaole. Systematic review of risk prediction models for ventilator-associated pneumonia in mechanically ventilated ICU patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 103-110.
[7]	HU Xinyuan, SHI Yu, NIE Linwen, GAN Xiuni. Nursing involvement in electroencephalogram monitoring of ICU patients：a scoping review [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 116-122.
[8]	LIU Haijin, WU Biyu, CHEN Lanlan, LIN Caixia, CHEN Yueting, HUANG Qiongqiong. Design and application of an automatic refilling device for ventilator humidification chambers [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 123-128.
[9]	WANG Ping, LAO Yuewen, CHEN Xiangping, DONG Lianlian, GONG Xiaoyan, ZHUANG Yiyu. The current status of ICU nurses’ competence in delirium care and analysis of influencing factors [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1112-1117.
[10]	WANG Tingting, MA Yajun, GAO Wen, ZHANG Yuping, JIN Jingfen. Research progress of family auditory stimulation in the prevention of ICU delirium [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 1017-1020.
[11]	LIU Haijin, WU Biyu, LIN Caixia, XU Minjun, YU Xiaolan. Effectiveness of a nursing program for ICU discharge preparation based on dyadic illness management theory [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 923-929.
[12]	CHEN Weijing, LI Jialin, SONG Jianping, XIAO Hanyu, JIN Jinhua, ZHANG Weibin. The experience of coping with electrocardiogram monitoring alarm among patients in cardiac intensive care unit：a qualitative study [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 930-937.
[13]	WANG Yijia, PAN Aihong, LIU Rui, CHEN Qian, WANG Chengchen. Risk factors for post-traumatic stress disorders in family members of intensive care unit patients：a meta-analysis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 938-944.
[14]	XIE Wanting, ZHU Haili, ZHU Dong, FU Han, CHEN Bihui. The influencing factors of ICU nurses maintaining the dignity of elderly patients：a qualitative study [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(7): 786-791.
[15]	Surgical Nursing Professional Committee of Chinese Nursing Association , Nursing Department/Neurosurgery/Vascular Surgery/Critical Care Medicine，The First Affiliated Hospital of Chongqing Medical University , Department of Nursing，Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology , （Writing Committee：LIU Liping，ZHANG Ping，ZHU Hua，WU Qiansheng，ZHANG Chuanlin，LIU Jiali，QIN Jingwen，LIU Meiyan） . Expert consensus on the prevention and nursing of postoperative delirium in adults [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(7): 837-842.