Hickman Ronald L, Douglas Sara L
Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA.
AACN Adv Crit Care. 2010 Jan-Mar;21(1):80-91. doi: 10.1097/NCI.0b013e3181c930a3.
The uncertain trajectory of chronic critical illness exposes the patient's family to heightened levels of psychological distress. Symptoms of psychological distress affect more than half of family members exposed to the patient's chronic critical illness. Although symptoms often dissipate over time, a significant proportion of family members will remain at moderate to high risk for psychological distress well after the patient's death or discharge from the intensive care unit. Family members of chronically critically ill patients are often involved in the decision making for the patients. Irrational or uninformed decision making can occur when family members experience high levels of psychological distress. Attention to the psychological needs and provision of support to family members enhance the formulation of treatment decisions consistent with the patient's preferences and mitigate unnecessary resource use. In this article, the impact of chronic critical illness on family members' risk for depression, anxiety, and posttraumatic stress disorder is described and a review of evidence-based strategies to support the psychological needs of family members coping with a patient's chronic critical illness is provided.
慢性危重病的不确定病程使患者家属面临更高程度的心理困扰。心理困扰症状影响了超过一半接触过患者慢性危重病的家庭成员。尽管症状通常会随着时间消散，但相当一部分家庭成员在患者死亡或从重症监护病房出院后很长时间内仍将处于中度至高度心理困扰风险中。慢性危重病患者的家属经常参与患者的决策过程。当家庭成员经历高度心理困扰时，可能会出现不合理或缺乏信息的决策。关注家属的心理需求并为其提供支持，有助于做出符合患者偏好的治疗决策，并减少不必要的资源使用。本文描述了慢性危重病对家庭成员患抑郁症、焦虑症和创伤后应激障碍风险的影响，并综述了基于证据的策略，以支持应对患者慢性危重病的家庭成员的心理需求。
