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重症监护后患者亲属中与创伤后应激障碍相关的症状

Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care.

作者信息

Jones Christina, Skirrow Paul, Griffiths Richard D, Humphris Gerrald, Ingleby Sarah, Eddleston Jane, Waldmann Carl, Gager Melanie

机构信息

Department of Medicine, Intensive Care Research Group, University of Liverpool, Liverpool, Merseyside L69 3GA, UK.

出版信息

Intensive Care Med. 2004 Mar;30(3):456-60. doi: 10.1007/s00134-003-2149-5. Epub 2004 Feb 4.

Abstract

OBJECTIVE

To evaluate the effectiveness of the provision of information in the form of a rehabilitation program following critical illness in reducing psychological distress in the patients' close family.

DESIGN

Randomised controlled trial, blind at follow-up with final assessment at 6 months.

SETTING

Two district general hospitals and one teaching hospital.

PATIENTS AND PARTICIPANTS

The closest family member of 104 recovering intensive care unit (ICU) patients.

INTERVENTIONS

Ward visits, ICU clinic appointments at 2 and 6 months. Relatives and patients received the rehabilitation program at 1 week after ICU discharge. The program comprised a 6-week self-help manual containing information about recovery from ICU, psychological information and practical advice.

MEASUREMENTS AND RESULTS

Psychological recovery of relatives was assessed by examining the rate of depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms by 6 months after ICU. The proportion of relatives scoring in the range >19 on the Impact of Events Scale (cause for concern) was high in both groups at 49% at 6 months. No difference was shown in the rate of depression, anxiety, or PTSD-related symptoms between the study groups.

CONCLUSION

A high incidence of psychological distress was evident in relatives. Written information concerning recovery from ICU provided to the patient and their close family did not reduce this. High levels of psychological distress in patients were found to be correlated with high levels in relatives.

摘要

目的

评估在危重病后以康复计划的形式提供信息对减轻患者近亲心理困扰的有效性。

设计

随机对照试验,随访时设盲,6个月时进行最终评估。

地点

两家地区综合医院和一家教学医院。

患者及参与者

104名重症监护病房(ICU)康复患者的最亲近家庭成员。

干预措施

病房探访、2个月和6个月时的ICU门诊预约。亲属和患者在ICU出院后1周接受康复计划。该计划包括一本为期6周的自助手册,其中包含有关从ICU康复的信息、心理信息和实用建议。

测量与结果

通过检查ICU后6个月时亲属的抑郁、焦虑和创伤后应激障碍(PTSD)相关症状的发生率来评估亲属的心理恢复情况。在事件影响量表(令人担忧的原因)上得分>19的亲属比例在两组中均较高,6个月时为49%。研究组之间在抑郁、焦虑或PTSD相关症状的发生率上没有差异。

结论

亲属中明显存在高发生率的心理困扰。向患者及其近亲提供的有关从ICU康复的书面信息并未减少这种情况。发现患者的高水平心理困扰与亲属的高水平心理困扰相关。

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