Increasing patient control of family visiting in the coronary care unit

BACKGROUND: Stress of coronary care unit admission and need for rest may contribute to a sense of helplessness, exacerbated by the unpredictability of visitor entry. Control over the environment, and particularly family visiting, could alleviate patient stress. OBJECTIVE: To determine if patient control of visit timing would minimize undesired psychophysiologic effects of coronary care unit visiting. METHODS: Data were collected at multiple points from 60 coronary care unit patients during the first 20 minutes of the evening visit and at visit end. Randomly assigned subjects used a visitor control device to communicate their wishes to potential visitors: red hallway light to restrict, and green to allow, visits. Dependent variables were heart rate and rhythm; premature ventricular contractions; systolic, diastolic, and mean arterial blood pressure; salivary cortisol; and finger temperature. Psychologic variables of visit stress versus comfort, perceived control of visits, and perceived rest between visits were measured by pre- and postvisit appraisals. RESULTS: Repeated measures analyses showed that over time, perceived control of visits and rest between visits were greater, and heart rate and diastolic blood pressure were lower for subjects with the visitor control device. Appraisal of visit stress increased slightly in this group. No statistically significant differences were found for possession of the visitor control device. Reaction to visitor entry was a short-term stress response, as indicated by increases in systolic, diastolic, and mean arterial blood pressure. CONCLUSIONS: Based on positive comments, increased perceived control over visiting, and decreased blood pressure, the visitor control device was beneficial.