Löf Lennart, Berggren Lars, Ahlström Gerd
Department of Anaesthesiology and Intensive Care, Orebro University Hospital, SE-701 85 Orebro, Sweden.
Intensive Crit Care Nurs. 2006 Jun;22(3):154-66. doi: 10.1016/j.iccn.2005.09.008. Epub 2005 Oct 28.
There is a lack of knowledge regarding how critically ill patients recall of the ICU and their life-threatening condition changes over time. The purpose of this study is to describe critically ill and ventilator-treated patients' recollections of both factual events and unreal experiences at 3 and 12 months following discharge from the ICU. The study is qualitative and encompasses nine critically ill ICU patients, ventilator-treated for more than 72 h. The participants were interviewed twice, at 3 and 12 months after their discharge from the ICU. The interviews were analysed using qualitative content analysis. The patients in this study reported unreal experiences, memory confusion and/or disturbances before admittance to the ICU and before their respirator treatment. Their "unreal experiences" were far clearer than their memories of factual occurrences. Patients' fragmentary memories of factual events and their recall of unreal experiences were practically unchanged after 12 month. Their unreal experiences could still be recalled and related after 12 months, but not with the same expression and feeling as earlier (3 months). The unreal experiences were not - after 12 months - their initial recollections, as they had been after 3 months.
Patients' recollections of both factual events and unreal experiences show very little variation between 3 and 12 months. The stability of long-term memory after 12 months shows that the recollection of their experiences had been both traumatic and emotionally charged. This study shows that critically ill patients were affected by cognitive disturbances and/or disturbed memory before their arrival at the ICU. This result indicates the need of ICU follow-up clinics.
对于危重症患者如何回忆重症监护病房（ICU）的经历以及他们危及生命的状况如何随时间变化，我们了解不足。本研究的目的是描述危重症且接受机械通气治疗的患者在从ICU出院后3个月和12个月时对实际事件和虚幻经历的回忆。该研究为定性研究，纳入了9名在ICU接受机械通气治疗超过72小时的危重症患者。参与者在从ICU出院后的3个月和12个月时接受了两次访谈。访谈采用定性内容分析法进行分析。本研究中的患者报告了在入住ICU之前和接受呼吸机治疗之前的虚幻经历、记忆混乱和/或记忆障碍。他们的“虚幻经历”比他们对实际事件的记忆要清晰得多。患者对实际事件的零碎记忆以及对虚幻经历的回忆在12个月后几乎没有变化。他们的虚幻经历在12个月后仍能被回忆起来并讲述，但表达和感受与早期（3个月时）不同。12个月后，虚幻经历已不是他们最初回忆的那样，而在3个月后还是。
患者对实际事件和虚幻经历的回忆在3个月至12个月之间变化很小。12个月后的长期记忆稳定性表明，他们对经历的回忆既具有创伤性又充满情感。本研究表明，危重症患者在入住ICU之前就受到认知障碍和/或记忆障碍的影响。这一结果表明需要设立ICU随访门诊。
