Evaluation of Family Participation Based on Affective Stimulation on the Recovery of Inpatients with Traumatic Brain Injury in the Intensive Care Units: An Embedded Study

Although sensory stimuli are commonly used as a care and therapeutic intervention on comatose patients in the intensive care units, but affective stimuli that would guarantee the realization of collaborative care and family-centered care have not been documented and as a result, families are far from the patient and are deprived of participation. Therefore, the present study aimed to Evaluation of family participation based on affective stimulation on the recovery of inpatients with Traumatic Brain Injury in the Intensive Care Units. The embedded method has been used for the conduction of this research in two stages. The first stage of the study was designed and carried out using the double-blind Randomized Controlled Clinical Trial method. 90 Patients were randomly allocated to an experimental, a placebo, or a control group using permuted block randomization. Affective stimulation intervention was provided to patients in the experimental group by their family members twice a day during the first seven days of their hospitalization. In the placebo group, a sensory stimulation program was implemented by a fixed trained person who was not familiar to the patients. Patients in the control group solely received sensory stimulation which was routinely provided to all patients in the study setting. Patients’ level of consciousness was measured both before and after family visitation using the Glasgow Coma Scale and the Coma Recovery Scale-Revised. In the second stage of the study, a qualitative research was conducted using conventional content analysis method. 30 closed members of the family of patients with traumatic brain injury who had participated in the care process were selected as the research sample using were selected through targeted sampling and and interviewed in depth, unstructured, and face-to-face. The extracted data was analyzed by the thematic analysis method after being recorded and the transcription. Despite an insignificant difference among the groups regarding baseline level of consciousness, the results of the one-way analysis of variance revealed that at the seventh day of the study, the level of consciousness in the experimental group (9.1±2.1) was significantly higher than the placebo (7.2±1.1) and the control (6.6±1.7) groups (P < 0.001). Moreover, at the seventh day of the study, the Coma Recovery Scale score in the experimental group (11.9±3.7) was significantly greater than the placebo (9.0±2.0) and the control (6.6±1.6) groups (P < 0.001). Analysis of experiences of participants led to detection 21 subcategories, 7 categories and 3 themes, including achieving the meaning vigilant attendance, reinforcement of participation together with pleasure and accompaniment together with stress. The meaning of these themes not only justify a better recovery in the experimental group, but it also confirms and supports them. The findings of the present study conceptualized the effect of family-centered affective stimulation in the form of a care and therapeutic intervention beyond sensory stimulation

کلیدواژه ها:

Nursing and Midwifery Sciences Development Research Center ، Najafabad Branch ، Islamic Azad University ، Najafabad ، Iran