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重症监护病房患者家属的短期心理影响。

Short-term psychological impact on family members of intensive care unit patients.

作者信息

Paparrigopoulos Thomas, Melissaki Antigoni, Efthymiou Anna, Tsekou Hara, Vadala Chrysoula, Kribeni Georgia, Pavlou Elias, Soldatos Constantin

机构信息

Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece.

出版信息

J Psychosom Res. 2006 Nov;61(5):719-22. doi: 10.1016/j.jpsychores.2006.05.013.

Abstract

OBJECTIVE

This study aimed to evaluate the short-term psychological impact on family members of intensive care unit (ICU) patients during their stay in the unit.

METHODS

Thirty-two first-degree relatives of patients treated in the ICU of two general hospitals were investigated for symptoms of early posttraumatic stress reaction, anxiety, and depression. Patients' and relatives' sociodemographic data and information pertaining to the patients' ICU treatment were collected. Family members were assessed at intake and before discharge through the Center for Epidemiological Studies Depression Scale, the State-Trait Anxiety Inventory, and the Impact of Event Scale.

RESULTS

High rates of anxiety, depressive (97%), and posttraumatic stress (81%) symptoms were recorded at the initial assessment. Although symptoms remitted significantly, 87% and 59% of the sample fulfilled the criteria for a depressive and posttraumatic stress reaction, respectively, at the second assessment. Women exhibited higher levels of distress and more persisting symptoms than men did. Trait anxiety was the most significant predictor (P<.001) of the severity of depressive symptoms and the single predictor of the development of posttraumatic stress reaction (P<.000); also, state anxiety was a predictor of the development of posttraumatic stress symptoms, especially of the female gender.

CONCLUSIONS

Family members of ICU patients exhibit high levels of distress that persist throughout their relatives' hospitalization. Women and individuals with high trait anxiety are at increased risk for developing such reactions. Severe early anxiety responses predicted the development of posttraumatic stress symptoms. Early case identification and intervention may prevent the full development of posttraumatic stress disorder.

摘要

目的

本研究旨在评估重症监护病房(ICU)患者住院期间对其家庭成员的短期心理影响。

方法

对两家综合医院ICU收治患者的32名一级亲属进行调查,了解其创伤后应激反应早期、焦虑和抑郁症状。收集患者及其亲属的社会人口学数据以及与患者ICU治疗相关的信息。通过流行病学研究中心抑郁量表、状态-特质焦虑量表和事件影响量表,在入院时和出院前对家庭成员进行评估。

结果

初始评估时记录到焦虑、抑郁(97%)和创伤后应激(81%)症状的发生率较高。尽管症状有显著缓解,但在第二次评估时,分别有87%和59%的样本符合抑郁和创伤后应激反应的标准。女性比男性表现出更高程度的痛苦和更持久的症状。特质焦虑是抑郁症状严重程度的最显著预测因素(P<0.001),也是创伤后应激反应发生的唯一预测因素(P<0.000);此外,状态焦虑是创伤后应激症状发生的预测因素,尤其是女性。

结论

ICU患者的家庭成员在其亲属住院期间表现出高度的痛苦,且这种痛苦持续存在。女性和特质焦虑水平高的个体发生此类反应的风险增加。严重的早期焦虑反应预示着创伤后应激症状的发生。早期病例识别和干预可能会预防创伤后应激障碍的全面发展。

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