Pacientu dienasgrāmatas ieviešana bērnu intensīvās terapijas nodaļā.
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Date
2022
Authors
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Journal ISSN
Volume Title
Publisher
Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads: Pieaugot izdzīvošanas rādītājiem intensīvas terapijas nodaļā, ir attīstījusies
jauna nozoloģija – sindroms pēc intensīvās terapijas (SIT). SIT ir fizisko, kognitīvo un garīgo
traucējumu kopums, kas attīstās pacientiem pēc pārslimotas kritiskas slimības un turpinās pēc
izrakstīšanās no intensīvās terapijas nodaļas (ITN). Lielākajai daļai pacientu, īpaši gados
jauniem pacientiem, šie simptomi pazūd divu līdz trīs mēnešu laikā pēc izrakstīšanās, taču ir
pacienti, kuriem šī simptomātika saglabājas gadiem vai pat visu mūžu. Pacienta dienasgrāmata
ļauj mazināt SIT izpausmes, aizpildot atmiņas nepilnības, sniedzot notikušā aprakstu
pacientiem un to ģimenes locekļiem. Tā ir iepriekš labi pētīta pieaugušo populācija, bet
salīdzinoši maz ir datu par tās izmantošanu bērnu ITN.
Mērķi: Pētījuma primārais mērķis ir izveidot un ieviest pacienta dienasgrāmatu bērnu
ITN pacientiem ar uzturēšanās ilgumu vairāk kā trīs dienas un izvērtēt vecāku atsauksmes trīs
mēnešu pētījuma laikā.
Materiāli un metodes: Pētījumā tika iekļauti pacienti, kuru uzturēšanas laiks Bērnu
klīniskās universitātes slimnīcas (turpmāk BKUS) bērnu ITN pārsniedza 72 stundas. Visiem
pētījuma dalībniekiem tika izsniegtas pacientu dienasgrāmata, kurā tie veica ierakstus un
ievietoja bildes. Divas nedēļas pēc izrakstīšanas no bērnu ITN pacientu aizbildņi tika strukturēti
intervēti. Viedokļi par pacienta dienasgrāmatu tika kvantificēti, izmantojot Likerta skalu. Visi
iegūtie dati tika analizēti, izmantojot aprakstošās un analītiskās statistiskās metodes.
Rezultāti: Laikā no 2022.gada janvāra līdz 2022.gada martam BKUS bērnu ITN
piekrita piedalīties pētījumā 11 ģimenes. Pacientu vidējais vecums ir 2 gadi, (starpkvartīļu
amplitūda 0,88-7), vidējais uzturēšanas laiks bērnu ITN ir 6 dienas (starpkvartīļu amplitūda
4,5-10,5), biežākā pacientu stacionēšanas diagnozes grupa ir iedzimta sirds kaite (6 no 11),
biežākais stacionēšanas veids ir plānveida stacionēšana (7 no 11). Veicot ģimenes locekļu
aptauju, tika saņemtas tikai pozitīvas atsauces saistībā ar dienasgrāmatas rakstīšanu. Visi
pētījuma dalībnieki atzīmēja, ka šāda dienasgrāmata ir nepieciešama bērnu ITN nodaļā. Lielākā
daļa ģimenes locekļu atzīmē, ka pārlasot dienasgrāmatu pēc izrakstīšanas no bērnu ITN, viņiem
mazinājās trauksmes sajūta. Dienasgrāmatas pārskatīšana ģimenes locekļiem palīdzēja
aizpildīt atmiņu nepilnības par hospitalizēšanas gaitu un notikumiem nodaļā.
Secinājumi: Pacientu dienasgrāmata bērnu ITN atvieglo sindroma pēc intensīvas
aprūpes psihoemocionālas izpausmes pacienta ģimenes locekļiem. Analizējot pētījuma
dalībnieku atsauksmes par pacientu dienasgrāmatu, šāda dienasgrāmata ir nepieciešama bērnu
ITN.
Introduction: As survival rates in intensive care unit (ICU) increase, a new nosology has emerged – post-intensive care syndrome. Post-intensive care syndrome is a set of physical, cognitive, and mental disorders that develop after overcoming severe illness and continues after discharge from the intensive care unit. Most patients, especially the young, have these symptoms resolved within two to three months following discharge, but there are patients whose symptoms persist for years. The ICU diary reduces the manifestation of post-intensive care syndrome by filling in memory gaps, giving a description of what happened to patients and their family members. Materials and methods: The study included patients whose length of stay in the Paediatric Intensive Care Unit of the Children’s Clinical University Hospital (BKUS) exceeded 72 hours. All study participants were given the ICU Diary in which they made records. Two weeks following discharge from the ICU, the guardians of the children were interviewed. All the obtained data were analyzed using descriptive and analytical statistical methods. Results: 11 families agreed to participate in the study between January 2022 and March 2022, the. The average age of patients was 2 years ( interquartile range 0.88-7), the average time spent in the ICU for children was 6 days (interquartile range 4.5-10.5), the most common group of patient hospitalization diagnoses was congenital cardiac disease (6 out of 11), the most common type of hospitalization was elective hospitalization (7 out of 11). ICU diary was valuable for parents of the critically ill children. The survey of family members received only positive feedback. All study participants noted that diary is necessary in the ICU. Most family members note that reading the diary after being discharged from pediatric ICU reduced their sense of anxiety. The diary helped to fill memory gaps about the progress of hospitalization and events on the ward. Conclusions: ICU diary for relieved the psycho-emotional manifestation of postintensive care syndrome for the patient's family members. Based on the results of the study, it is not possible to determine the effect of the diary on the long-term manifestations of the syndrome after intensive care, since all study participants were surveyed only 2 weeks after discharge from the pediatric ICU.
Introduction: As survival rates in intensive care unit (ICU) increase, a new nosology has emerged – post-intensive care syndrome. Post-intensive care syndrome is a set of physical, cognitive, and mental disorders that develop after overcoming severe illness and continues after discharge from the intensive care unit. Most patients, especially the young, have these symptoms resolved within two to three months following discharge, but there are patients whose symptoms persist for years. The ICU diary reduces the manifestation of post-intensive care syndrome by filling in memory gaps, giving a description of what happened to patients and their family members. Materials and methods: The study included patients whose length of stay in the Paediatric Intensive Care Unit of the Children’s Clinical University Hospital (BKUS) exceeded 72 hours. All study participants were given the ICU Diary in which they made records. Two weeks following discharge from the ICU, the guardians of the children were interviewed. All the obtained data were analyzed using descriptive and analytical statistical methods. Results: 11 families agreed to participate in the study between January 2022 and March 2022, the. The average age of patients was 2 years ( interquartile range 0.88-7), the average time spent in the ICU for children was 6 days (interquartile range 4.5-10.5), the most common group of patient hospitalization diagnoses was congenital cardiac disease (6 out of 11), the most common type of hospitalization was elective hospitalization (7 out of 11). ICU diary was valuable for parents of the critically ill children. The survey of family members received only positive feedback. All study participants noted that diary is necessary in the ICU. Most family members note that reading the diary after being discharged from pediatric ICU reduced their sense of anxiety. The diary helped to fill memory gaps about the progress of hospitalization and events on the ward. Conclusions: ICU diary for relieved the psycho-emotional manifestation of postintensive care syndrome for the patient's family members. Based on the results of the study, it is not possible to determine the effect of the diary on the long-term manifestations of the syndrome after intensive care, since all study participants were surveyed only 2 weeks after discharge from the pediatric ICU.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Bērnu ITN; sindroms pēc ITN; pacienta dienasgrāmata, Pediatric ICU; postintensive care syndrome; patient icu diary