K Szilágyi Adrienn, Diószeghy Csaba, Varga Katalin
Jahn Ferenc Dél-pesti Kórház Központi Aneszteziológiai és Intenzív Terápiás Osztály Budapest Köves út 1. 1204.
Orv Hetil. 2008 Dec 7;149(49):2329-33. doi: 10.1556/OH.2008.28475.
Both short and long term outcome of mechanically ventilated patients are dependent on the time spent on ventilator and on the intensive care unit. Health related quality of life of the survival of intensive care has been proved to be related with the physical and psychological effects of the intensive care itself. In our previous multicenter randomized trial we have demonstrated the effect of psychological support delivered at the time of intensive care.
The aim of this post hoc analysis is to demonstrate the effect of the psychological support given by an ICU staff psychologist providing continuous care by the same therapist.
36 patients were included in the post hoc analysis, 17 in the control and 19 in the treatment group. The treatment group received daily psychological support based on positive suggestions delivered by the same therapist at least in 50% of the time. The control group received the same ICU care but without the involvement of the psychologist. There were no differences between the two groups in age, sex, SAPSII score and basic medical treatment.
RESULTS showed a significant reduction in mechanical ventilation (3.6 days shorter, p < 0.014) and length of stay (4.2 days shorter, p < 0.022) of the treatment group compared to the control.
These results suggest the value of a psychologist working as a full member of the ICU team and providing supplementary psychological support of patients.
机械通气患者的短期和长期预后均取决于其在呼吸机上以及在重症监护病房（ICU）的停留时间。事实证明，重症监护幸存者的健康相关生活质量与重症监护本身的生理和心理影响有关。在我们之前的多中心随机试验中，我们已经证明了在重症监护期间提供心理支持的效果。
本事后分析的目的是证明由ICU工作人员心理学家提供持续护理，且由同一位治疗师提供心理支持的效果。
36例患者纳入事后分析，17例为对照组，19例为治疗组。治疗组每天接受基于积极建议的心理支持，至少50%的时间由同一位治疗师提供。对照组接受相同的ICU护理，但没有心理学家参与。两组在年龄、性别、简化急性生理学评分系统II（SAPSII）得分和基础医疗治疗方面无差异。
结果显示，与对照组相比，治疗组的机械通气时间显著缩短（缩短3.6天，p<0.014），住院时间缩短（缩短4.2天，p<0.022）。
这些结果表明，心理学家作为ICU团队的正式成员并为患者提供补充心理支持具有重要价值。
