Effects Of CICARE Communication Model On Relocation Stress Of NSICU Patients’ Families

Background:Relocation stress refers to physical,psychological and social adaptability disorders caused by changes in the environment,especially unplanned changes,and poor health.After patients in intensive care unit(ICU)are transferred out,their families have certain relocation stress due to the patient’s condition,environmental factors,social factors and other reasons.When patients with neurosurgical critical disease are transferred out of neurosurgical intensive care unit(NSICU),their self-care and decision-making abilities are both absent or even completely lost.Families usually shoulder the responsibility of decision-making and care,thus more serious relocation stress may occur.Relocation stress may affect the care ability of the families of ICU patients,while simultaneously the care ability of family members can affect the implementation of "hierarchical diagnosis and treatment system".Therefore,improving the relocation stress level of the families of ICU patients has become a particularly important issue in the current era of"deepening the reform of the medical and health system".At present,transitional nursing model,ICU liaison nurses and information support widely adopted at home and abroad to improve the relocation stress of ICU patients’ families and have achieved certain results.However,they are not targeted for critical patients with special diseases and their families.With the shorter and shorter ICU stay and the shortage of nursing staffs,transitional nursing model and ICU liaison nurses are difficult to be promoted in a large scale in China.It has become one of hot topics in the field of nursing that how to efficiently provide information support to patients’ families within a limited time but without increasing human cost.CICARE(Connect/Introduce/Comm-unicate/Ask/Respond/Exit)communication model is a patient-centred and process-oriented standard way of communication,which guides healthcare workers to communicate through six progressive steps:Connect,Introduce,Communicate,Ask,Respond and Exit,by which the communication in nursing work can be standardised and streamlined as well as the information can be effectively transferred to patients’ families.Therefore,in the present study,CICARE communication model was applied to families of NSICU patients to investigate its effects on relocation stress of families.Objective:To explore the effects of CICARE communication model on relocation stress of family members of patients transferred from NSICU,and to provide the theoretical reference and practical basis for further promoting the application of CICARE communication model in clinical nursing.Method:Through cluster sampling,families of patients treated in NSICU,Sichuan Academy of Medical Sciences&Sichuan Provincial People’s Hospital from April to October 2019 were included as objects.Objects who met the inclusion criteria were divided into either a control group or an experiment group by Randomized controlled study in the same period.In control group,the traditional communication method was delivered to conduct transfer health education to the patients’ families during the transfer from NSICU to the general ward,while in experiment group,CICARE communication model was delivered to conduct transfer health education to the patients’ families during the transfer from NSICU to the general ward.General information questionnaire,family relocation stress scale(FRSS),and family caregiver task inventory(FCTI)were used to collect relocation stress levels and care abilities of families within 24 hours of transferring patients out of NSICU,and care abilities of families 72 hours after transferring patients out of NSICU;the number of days of hospitalisation after patients were transferred to the ward and their total days of hospitalisation were recorded,as well as medical costs after transfer to the ward and total medical costs.T-test was used to analyse variables that conformed to normal distribution,and Mann-Whitney U test was used to analyse graded variables and variables which variables did not conform to normal distribution,so as to compare the differences of communication model on relocation stress,care ability of NSICU patients’ families,medical costs and days of hospitalisation.Results:1.FRSS score of patients’ families in experiment group within 24 hours of transfer was 32.77±4.26 points(22-39 points),and that in control group was 48.14±7.78 points(36-62 points).FRSS score of experiment group was lower than that of control group,and the difference was statistically significant(P<0.05).2.FCTI score of patients’ families in experiment group within 24 hours of transfer was 10 points(7-11 points),and 4.5 points(3-9 points)after 72 hours.FCTI score of families in control group within 24 hours of transfer was 22 points(14-30 points),and FCTI score of families after 72 hours was 13 points(10-22 points).FCTI score of families within 24 hours and 72 hours after transfer in experiment group was lower than that in control group,and the difference was statistically significant(P<0.05).3.FCTI scores of patients’ families 72 hours after transfer in two groups were significantly lower than those within 24 hours of transfer,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the difference value between FCTI scores of patients’ families 72 hours after transfer and within 24 hours of transfer in control group and experiment group(P>0.05).4.Average days of hospitalisation after transfer to the ward in experiment group were 9.50±2.95 days(6-17 days),and the average total hospital days were 23.97±9.95 days(12-54 days);Average hospital days after transfer to the ward in control group were 11.72±3.44 days(5-20 days),and the average total hospital days were 29.76±11.73 days(9-63 days).The number of hospital days after transfer to the ward and total hospital days in experiment group was lower than that in control group,and the difference was statistically significant(P<0.05).5.Medical cost after transfer to the ward in experiment group was EMB 11055.5(RMB 8956-15122.25)and the total medical cost during hospitalisation was RMB 114045.5(RMB 45632-152452);medical cost after transfer to the ward in control group was RMB 21342(RMB 14884.5-37189)and the total medical cost during hospitalisation was RMB171321(RMB 104271-270301).Medical cost after transfer to the ward and total medical cost during hospitalisation in experiment group were lower than those in control group,and the difference was statistically significant(P<0.05).Conclusion:CICARE communication model can effectively reduce the relocation stress of family members of patients transferred from NSICU,improve families’ caring ability,reduce the hospitalization days and expenses of the patients,and can be further applied to clinical nursing.