随着公立医院免陪照护试点推进，家属由床旁陪伴转为院外等待，信息不对称、分离焦虑及信任弱化等问题日益凸显。本文围绕国际免陪照护实践，梳理家属数字化参与从虚拟探视、信息共享到共同决策的演进路径，并总结住院门户、电子日记、代理访问等工具在维系家庭支持、提升照护透明度中的作用。在此基础上，提出我国应依托智慧病房构建医护患属闭环沟通机制，完善授权分级、隐私保护、数字公平与人文支持制度，推动免陪照护兼具效率与温度。

With the advancement of pilot programs for accompaniment-free care in public hospitals, family members have shifted from bedside companionship to waiting outside the ward, giving rise to increasingly prominent problems such as information asymmetry, separation anxiety and weakened trust. Focusing on international practices of accompaniment-free care, this paper reviews the evolutionary path of digital family participation from virtual visits and information sharing to shared decision-making, and summarizes the role of tools such as inpatient portals, electronic diaries and proxy access in maintaining family support and improving care transparency. On this basis, it proposes that hospitals in China should rely on smart ward construction to establish a closed-loop communication mechanism integrating healthcare professionals, patients and family members, and improve institutional arrangements for hierarchical authorization, privacy protection, digital equity and humanistic support, so as to promote accompaniment-free care that combines efficiency with warmth.

目的 了解脑出血患者家属参与治疗共享决策满意度现状及其影响因素,为提升脑出血患者的护理质量和家属体验提供参考。方法 采用横断面研究设计,便利抽取2022年1月—2023年7月许昌中医院收治的脑出血患者及其家属进行问卷调查。结果 共回收问卷178份,全部纳入分析。患者家属参与医疗决策的满意度得分为（48.58±6.34）分,其中维度得分最低的为交流协商。多因素分析结果显示,家属教育程度、家属年龄、家庭总年收入以及患者家属对医疗决策知情程度为患者家属参与医疗决策满意度的影响因素（F=30.872,P<0.001）,解释40.3%的变异。结论 脑出血患者家属参与治疗共享决策满意度处于中等水平,患者家属对医疗决策知情程度越高、家属教育程度越高、家属年龄较大以及家庭总年收入越高的脑出血患者家属参与治疗共享决策满意度越高。

目的 调查分析ICU转出患者的陪床家属即照顾者的准备度对其迁移应激的影响作用。方法 纳入2020年1月—2022年12月在焦作市第二人民医院ICU住院治疗的患者家属106人为研究对象,以问卷调查法对患者及家属一般资料、家属准备度水平以及迁移应激水平进行数据分析。结果 ICU转出患者家属的照顾者准备度测试总分为（14.92±3.86）分,为中等水平,迁移应激总分为（57.21±5.88）分,为中度应激水平,照顾准备度与迁移应激呈负相关。结论 ICU转出患者家属的照顾者准备度水平不足,且与迁移应激水平呈负相关。

Objective To investigate and analyze the effect of readiness of accompanying family members,i.e．caregivers,on migration stress in patients transferred out of the ICU．Methods From January 2020 to December 2022,106 patients hospitalized in ICU were included in the study,general data of patients and their caregives,preparation level and migration stress level of caregives were investigated and analyzed by questionnaire survey．Results The caregivers of patients transferred out of the ICU had a total readiness test score of（14.92±3.86）,which was moderate level,and the total score of migration stress was（57.21±5.88）,which was moderate stress level,and was negatively correlated with readiness．Conclusions The readiness level of the caregivers of patients transferred out of the ICU is insufficient and negatively correlated with the migration stress level．

目的 探讨全身麻醉（全麻）髋关节置换术后苏醒期患者家属迁移应激水平及其相关影响因素。方法 选取2021年4月—2022年10月在南昌市洪都中医院行全麻髋关节置换术苏醒期的108例患者,使用ICU转出患者家属应激压力评估量表评价患者家属迁移应激水平,调查患者及家属相关资料,分析全麻髋关节置换术后苏醒期患者家属迁移应激水平的相关影响因素。结果 108例全麻髋关节置换术后苏醒期患者家属迁移应激得分为（56.35±5.86）分,家属迁移应激水平中等;经多元线性回归分析显示,患者麻醉重症监护室（AICU）住院时间≥24 h、女性、文化水平初中及以下、消极应对是全麻髋关节置换术后苏醒期患者家属迁移应激水平升高的危险因素（P<0.05）。结论 全麻髋关节置换术后苏醒期患者家属迁移应激水平中等,受患者AICU住院时间、家属性别、文化水平、应对方式因素影响。

Objective To analyze the levels of relocation anxiety and its related influencing factors in the family members of patients during the recovery period after hip arthroplasty under general anesthesia．Methods From April 2021 to October 2022,108 patients in Nanchang Hongdu Traditional Chinese Medicine Hospital undergoing total hip arthroplasty under general anesthesia were selected．The levels of relocation anxiety in their families were evaluated using the ICU transferred out patient family stress assessment scale,and the relevant data of the patients and their families were investigated．The relevant factors affecting the levels of relocation anxiety in their families during the recovery period after total hip arthroplasty under general anesthesia were analyzed．Results The relocation anxiety score of 108 patients’ family members during the recovery period after hip arthroplasty under general anesthesia was（56.35±5.86）,with a moderate level．Multiple linear regression analysis showed that patients’ AICU hospitalization time≥24 hours,women,education level of junior high school or below and negative coping were the influencing factors for the level of relocation anxiety of family members of patients during the recovery period after hip replacement under general anesthesia（P<0.05）．Conclusions The level of relocation anxiety in family members of patients undergoing general anesthesia and hip arthroplasty during the recovery period is moderate,which is influenced by factors such as length of patients’ stay in AICU,family members’ gender,educational level and coping styles．

目的 总结预防接种认知干预对儿童预防接种效果的影响。方法 对2018年5—9月在东莞企石镇接种百白破疫苗的儿童家属按接种时间顺序分为对照组254名、实验组248名,对照组家属按常规方法进行预防接种,实验组在常规接种基础上,结合不按时接种、延迟接种等问题对幼儿家属开展多种多样的百白破疫苗预防知识、不良反应观察处理、接种注意事项等知识宣教和培训干预,总结两组儿童在按时接种、延迟接种、疫苗接种知识、不良反应表现与处理、接种注意事项知识的掌握、服务满意度等情况。结果 实验组幼儿按时接种率比对照组高,延迟接种率比对照组低,结果有差异(P＜0.05);家属对疫苗接种知识、不良反应表现和处理、接种注意事项等知识的掌握比对照组高,结果有差异(P＜0.05)。结论 实施家属预防接种认知干预管理能提高家属掌握预防接种知识和不良反应护理知识;提高儿童疫苗接种率和及时接种率,提高预防接种服务管理效果。

Objective To summarize the effect of cognitive intervention on children's vaccination. Methods The family members of children vaccinated with DPT vaccine in Qishi Town of Dongguan City from May to September 2018 were divided into control group 254 and experimental group 248 according to the sequence of vaccination time. The family members of control group were vaccinated by routine methods. On the basis of routine vaccination, the experimental group carried out a variety of preventive knowledge and adverse reactions observation of DPT vaccine to the family members of children in combination with the problems of untimely vaccination and delayed vaccination. The knowledge propaganda and training intervention of treatment and vaccination precautions were summarized. The situation of two groups of children in timely vaccination, delayed vaccination, vaccination knowledge, adverse reaction performance and treatment, knowledge of vaccination precautions and service satisfaction were summarized. Results The vaccination rate of children in the experimental group was higher than that in the control group, and the delayed vaccination rate was lower than that in the control group. The results showed statistical difference (P＜0.05). The knowledge of vaccination, adverse reactions, treatment and matters needing attention of family members were higher than that in the control group, and the results showed statistical difference (P＜0.05). Conclusion Implementing cognitive intervention management of family vaccination may improve family members'knowledge of vaccination and nursing of adverse reactions, improve children's vaccination rates and timely vaccination rates, and improve the management effect of vaccination service.