加護病房病患家屬焦慮、憂鬱與滿意度初探

本研究目的為瞭解成人加護病房病患家屬焦慮、憂鬱與滿意度的情形，分析其相關性及影響因素，並探討家屬滿意度的重要預測因子。研究採用前瞻性、結構性問卷調查法，採立意取樣的收案方式，以臺北市某醫學中心成人內科心臟加護病房病患家屬為研究對象。研究者分兩階段收集資料，第一階段於病患入住加護病房的24-48小時內使用醫院焦慮憂鬱量表(Hospital Anxiety and Depression Scale, HADS)探討病患家屬焦慮與憂鬱情形，第二階段為病患轉出加護病房後的48小時內使用加護病房病患家屬滿意度量表(Family Satisfaction in the Intensive Care Unit, FS-ICU-24)了解家屬對於加護病房照護及決策的滿意度。本研究共收案92位家屬，有效回收率為94.6%，研究結果顯示成人加護病房病患家屬有焦慮情形者占23.0%，有憂鬱情形者占3.4%。成人加護病房病患家屬整體滿意度平均得分為88.06±12.63分，整體而言，病患家屬對加護病房的照護表示滿意。家屬需求的關心程度、資訊來源的便利程度、資訊的誠實度、資訊的完整度等四題與整體滿意度得分相關性最高。家屬焦慮、憂鬱程度與家屬整體滿意度無線性相關，然家屬焦慮程度與照護滿意度呈現顯著負相關。迴歸分析顯示，較低的病患GCS分數、家屬年齡較輕、較低的家屬焦慮程度等三因子為家屬高滿意度之顯著的預測因子。未來護理人員應提高對家屬心理症狀的敏感度，尤其對意識程度較佳的病患、年齡較長或焦慮程度較高的家屬可建立多元且適當的溝通管道，提供誠實而完整的資訊，主動關心病患家屬的需求，以提升家屬對加護病房的滿意度。

關鍵字

加護病房；滿意度；焦慮；憂鬱；家屬

並列摘要

This study aims to investigate the reslationships among anxiety, depression, and satisfaction in family members of patients in the adult intensive care unit (ICU), and to explore the predictors of family members’ satisfaction. This is a prospective study conducted in a 14-bed cardiac ICU in Taipei, Taiwan. Structural questionnaires and purposive sampling were used. Data were collected in two different time periods. First, the family members of patients who were admitted to ICU for 24-48 hours were invited to participate in the study. The Chinese version of the Hospital Anxiety and Depression Scale (HADS) was used to assess the symptoms of anxiety and depression. The second time period for data collection was within 48 hours after the patients were transferred from ICU. The Chinese version of Family Satisfaction in the ICU 24 items (FS-ICU-24) was used to assess satisfaction. A total of 92 family members were surveyed, with a 94.6% response rate. Our study shows that the incidence of anxiety and depression among family members in the ICU is 23.0% and 3.4%, respectively. Overall, respondents were highly satisfied, and the average satisfaction score is 88.06±12.63. Among the various questions, the four major questions are mostly related to the overall satisfaction: (1) Consideration of family needs, (2) Ease of getting information, (3) Honesty of information, and (4) Completeness of information. The logistic regression analysis revealed that patients with lower GCS scores, family members with younger age, and family members with fewer anxiety symptoms were significant predictors for family members with higher satisfaction. Ｔhese results recommended that nurses should increase the sensitivity to the psychological symptoms of the family members, care about their needs, establish multiple and appropriate communication channels, provide true and complete information, especially for patients with higher GCS score, family members with older age or higher anxiety. These results may provide insight into the strategies to improve satisfaction in the ICU.