“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

Abstract

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

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.

Figures/Tables 5

References 24

[1]	Fealy S, McLaren S, Nott M, et al. Psychological interventions designed to reduce relocation stress for older people transitioning into permanent residential aged care:a systematic scoping review[J]. Aging Ment Health, 2024, 28(9):1197-1208.
[2]	李文莉, 赵静, 迟园园, 等. 肿瘤重症患者家属迁移应激的质性研究[J]. 护士进修杂志, 2018, 33(18):1700-1703.
	Li WL, Zhao J, Chi YY, et al. Qualitative study on migration stress of family members of severe tumor patients[J]. J Nurses Train, 2018, 33(18):1700-1703.
[3]	赵勇, 张丹, 罗珊珊. ICU转出非小细胞肺癌合并肺部感染患者家属迁移应激水平现状及影响因素分析[J]. 河南医学研究, 2024, 33(4):644-649.
	Zhao Y, Zhang D, Luo SS. Current level of migration stress in families of patients with non-small cell lung cancer co-infected with lung infection transferred from ICU and factors influencing[J]. Henan Med Res, 2024, 33(4):644-649.
[4]	吴菲霞, 温焕, 陶文雯, 等. 患者家属参与医疗决策的现状与启示[J]. 中国医疗管理科学, 2020, 10(2):68-72.
	Wu FX, Wen H, Tao WW, et al. Family participation in medical decision-making[J]. Chin J Med Manag Sci, 2020, 10(2):68-72.
[5]	Lee S, Oh H, Suh Y, et al. A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward[J]. J Clin Nurs, 2017, 26(5/6):784-794.
[6]	Meeker MA, White D. Transition to comfort-focused care:moral agency of acute care nurses[J]. Nurs Ethics, 2021, 28(4):529-542. doi: 10.1177/0969733020952128 pmid: 34085584
[7]	黄艳林, 陈韵芳, 倪崴莲, 等. 基于“安全-支持-合作”模式ICU过渡期标准化护理方案的构建[J]. 护士进修杂志, 2021, 36(11):982-987.
	Huang YL, Chen YF, Ni WL, et al. Construction of standardized ICU transitional care scheme based on “safety,support,cooperation” model[J]. J Nurses Train, 2021, 36(11):982-987.
[8]	陈妞, 李黎明, 卫晓静. ICU联络护士结合患者日记在患者过渡期护理中的应用研究[J]. 护士进修杂志, 2020, 35(23):2175-2178.
	Chen N, Li LM, Wei XJ. Study on the application of ICU liaison nurse combined with patient diary in patients’ transitional nursing[J]. J Nurses Train, 2020, 35(23):2175-2178.
[9]	Hervé MEW, Zucatti PB, Lima MADDS. Transition of care at discharge from the intensive care unit:a scoping review[J]. Rev Lat Am Enfermagem, 2020, 28:e3325.
[10]	Wibrandt I, Lippert A. Improving patient safety in handover from intensive care unit to general ward:a systematic review[J]. J Patient Saf, 2020, 16(3):199-210. doi: 10.1097/PTS.0000000000000266 pmid: 28452913
[11]	蔡喆燚, 邹婵, 黄璐, 等. 接近失误管理联合标准化沟通模式在肾内科危重患者院内转运中的应用[J]. 中华急危重症护理杂志, 2023, 4(4):293-298.
	Cai ZY, Zou C, Huang L, et al. Application of near miss management combined with standardized communication model in hospital transportation of critical patients in nephrology department[J]. Chin J Emerg Crit Care Nurs, 2023, 4(4):293-298.
[12]	Zung WW, Richards CB, Short MJ. Self-rating depression scale in an outpatient clinic. Further validation of the SDS[J]. Arch Gen Psychiatry, 1965, 13(6):508-515. doi: 10.1001/archpsyc.1965.01730060026004 pmid: 4378854
[13]	Zung WW. A rating instrument for anxiety disorders[J]. Psychosomatics, 1971, 12(6):371-379. doi: 10.1016/S0033-3182(71)71479-0 pmid: 5172928
[14]	Oh H, Lee S, Kim J, et al. Clinical validity of a relocation stress scale for the families of patients transferred from intensive care units[J]. J Clin Nurs, 2015, 24(13/14):1805-1814.
[15]	赵静, 臧小英. ICU患者家属迁移应激量表的汉化及信效度检验[J]. 护士进修杂志, 2018, 33(17):1552-1555.
	Zhao J, Zang XY. Reliability and validity test for Chineseization version of the migration stress scale of family members among ICU patients[J]. J Nurses Train, 2018, 33(17):1552-1555.
[16]	Parry C, Mahoney E, Chalmers SA, et al. Assessing the quality of transitional care:further applications of the care transitions measure[J]. Med Care, 2008, 46(3):317-322.
[17]	Singh N, Giannitrapani KF, Gamboa RC, et al. What patients facing cancer and caregivers want from communication in times of crisis:a qualitative study in the early months of the COVID-19 pandemic[J]. Am J Hosp Palliat Care, 2024, 41(5):558-567.
[18]	郭中献, 勾玉莉, 沙丽艳, 等. 过渡护理方案对肝移植患者家属迁移应激干预效果的研究[J]. 中华急危重症护理杂志, 2023, 4(2):101-105.
	Guo ZX, Gou YL, Sha LY, et al. Intervention effect of transitional nursing program on migration stress of liver transplant patients’ family members[J]. Chin J Emerg Crit Care Nurs, 2023, 4(2):101-105.
[19]	Li BY, Yang Q. The effect of an ICU liaison nurse-led family-centred transition intervention program in an adult ICU[J]. Nurs Crit Care, 2023, 28(3):435-445.
[20]	刘雪. 晚期癌症家庭二元生命意义干预方案的构建与实证研究[D]. 上海: 中国人民解放军海军军医大学, 2024.
	Liu X. Construction and empirical study on the intervention scheme of dual life meaning in advanced cancer families[D]. Shanghai: Naval Medical University, 2024.
[21]	彭云珍. 妇科恶性肿瘤治疗相关性淋巴水肿患者与主要照护者情绪困扰主客体互倚模型的构建[D]. 福州: 福建医科大学, 2022.
	Peng YZ. Construction of subjective-object interdependence model of emotional disturbance between patients with treatment-related lymphedema and their main caregivers in gyne-cological malignant tumors[D]. Fuzhou: Fujian Medical University, 2022.
[22]	Haruna J, Masuda Y, Tatsumi H. Transitional care programs for patients with high nursing activity scores reduce unplanned readmissions to intensive care units[J]. Medicina, 2022, 58(11):1532.
[23]	You H, Docherty SL, Ashana DC, et al. Transition of intensive care unit patients and their families to home after acute hospital care[J]. AACN Adv Crit Care, 2024, 35(2):97-108. doi: 10.4037/aacnacc2024982 pmid: 38848572
[24]	van de Riet L, Aris AM, Verouden NW, et al. Designing eHealth interventions for children with complex care needs requires continuous stakeholder collaboration and co-creation[J]. PEC Innov, 2024, 4:100280.

The impact of the “secure-encourage-collaborate” transitional care on the migration stress of caregivers for critically ill oncology patients

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