Designing and Evaluating a "Family Guided Visit Program” on the Level of Consciousness in Traumatic Brain Injury Patients

Sensory stimulation in patients with decreased levels of consciousness in the Intensive Care Unit (ICU) can affect their level of consciousness, especially if these stimuli are familiar and have meaningful contents. Therefore, the aim of this study was to introduce a "Family Guided Visit program” to increase level of consciousness in traumatic brain injury patients hospitalized in the ICU.

 The study is a clinical trial study. The statistical population was brain-injured hospitalized in the intensive care unit of Al-Zahra (AS) and Kashani Medical Center in Isfahan. In this study, during 7 stages, the "Family Guided Visit Program" was designed, implemented and evaluated. In the design Phase, first, the Program draft was prepared using nursing texts on the needs care  and the role of families in their implementation, then using the RAM technique in terms of concept, usefulness, relevance and applicability of the content by families, the Program was developed. During the implementation Phase, one of the family members who had been trained on the appointment, received hearing and tactile stimulation Patients daily and for 14 days, as scheduled. In the evaluation Phase, the daily level of consciousness was measured 30 minutes before and 30 minutes after the visit, using the Glasgow Coma Scale and the Four-Number Scale.

The research findings showed that the average changes in the level of consciousness based on the four digit scales from the beginning of the study to the end were 6 ± 1.7 in the test group and 1± 1.35 in the control group. The independent t-test showed that these changes in the test group were significantly higher than the control group (P< 0.001). Also, according to the Glasgow coma scale, from the beginning of the study to the end (over a period of fourteen days), the total daily changes shows a statistically significant difference in the average score of patients' level of consciousness between the two groups. (P< 0.001).

A targeted and planned visit by the family is effective in improving the level of consciousness of the injured. Therefore, it is recommended to provide conditions for the family members who are emotionally close to the patient to make appointments with the patient with sufficient training, using this proposed program.