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重症监护病房医护人员对谵妄的态度和行为调查

Survey of attitudes and behaviors of healthcare professionals on delirium in ICU.

作者信息

Gong Zhi-ping, Liu Xi-wang, Zhuang Yi-yu, Chen Xiang-ping, Xie Guo-hao, Cheng Bao-li, Jin Yue, Fang Xiang-ming

机构信息

First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Chin J Traumatol. 2009 Dec;12(6):328-33.

Abstract

OBJECTIVE

To assess the medical community's awareness and practice regarding delirium in the intensive care unit (ICU).

METHODS

One hundred and ten predesigned questionnaires were distributed to ICU practitioners in the affiliated hospitals of Zhejiang University.

RESULTS

A total of 105 valid questionnaires were collected. Totally, 55.3% of the clinicians considered that delirium was common in the ICU. Delirium was believed to be a significant or serious problem by 70.5% of respondents, and under-diagnosis was acknowledged by 56.2% of the respondents. The incidence of ICU delirium is even more under-estimated by the pediatric doctors compared with their counterparts in adult ICU (P less than 0.05). Primary disease of the brain (agreed by 82.1% of the respondents) was believed to be the most common risk factor for delirium. None of the ICU professionals screened delirium or used a specific tool for delirium assessment routinely. The vast majority (92.4%) of respondents had little knowledge on the diagnosis and the standard treatment of delirium.

CONCLUSIONS

Although delirium is considered as a serious problem by a majority of the surveyed ICU professionals, it is still under-recognized in routine critical care practice. Data from this survey show a disconnection between the perceived significance of delirium and the current practices of monitoring and treatment in ICU in China.

摘要

目的

评估医学界对重症监护病房(ICU)中谵妄的认知及实际处理情况。

方法

向浙江大学附属医院的ICU从业者发放110份预先设计好的问卷。

结果

共收集到105份有效问卷。总体而言,55.3%的临床医生认为谵妄在ICU中很常见。70.5%的受访者认为谵妄是一个重要或严重的问题,56.2%的受访者承认存在漏诊情况。与成人ICU的医生相比,儿科医生对ICU谵妄发生率的低估更为严重(P小于0.05)。脑原发性疾病(82.1%的受访者认同)被认为是谵妄最常见的危险因素。没有一位ICU专业人员常规筛查谵妄或使用特定工具进行谵妄评估。绝大多数(92.4%)的受访者对谵妄的诊断和标准治疗知之甚少。

结论

尽管大多数接受调查的ICU专业人员认为谵妄是一个严重问题,但在常规重症监护实践中它仍未得到充分认识。本次调查数据显示,在中国,ICU中谵妄的认知重要性与当前的监测和治疗实践之间存在脱节。

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