Nursing Department, Dominican University of California, San Rafael, CA, USA.
Crit Care Med. 2010 Apr;38(4):1078-85. doi: 10.1097/CCM.0b013e3181cf6d94.
To describe the symptom experiences of family members of patients at high risk for dying in the intensive care unit and to assess risk factors associated with higher symptom burden.
Prospective, cross-sectional study.
Three intensive care units at a large academic medical center.
A sample of 74 family members of 74 intensive care unit patients who had a grave prognosis and were judged to be at high risk for dying. Patients at high risk for dying were identified as having Acute Physiology and Chronic Health Evaluation II scores >20, an intensive care unit length of stay >72 hrs, and being mechanically ventilated.
None.
We assessed the degree of symptom burden approximately 4 days after the patient's admission to the intensive care unit in the following domains: traumatic stress, anxiety, and depression. Overall, the prevalence of symptoms was high, with more than half (57%) of family members having moderate to severe levels of traumatic stress, 80% having borderline symptoms of anxiety, and 70% having borderline symptoms of depression. More than 80% of family members had other physical and emotional symptoms, such as fatigue, sadness, and fear, and these were experienced at the moderate to severe levels of distress. Factors independently associated with greater severity of symptoms included younger age, female gender, and non-white race of the family member. The only patient factor significantly associated with symptom severity was younger age. Despite their symptom experience, the majority of the family members were coping at moderate to high levels and functioning at high levels during the intensive care unit experience.
We document a high prevalence of psychological and physical symptoms among family members during an intensive care unit admission. These data complement existing data on long-term symptom burden and highlight the need to improve family centered care in intensive care units.
描述 ICU 高危死亡患者家属的症状体验，并评估与更高症状负担相关的风险因素。
前瞻性、横断面研究。
一家大型学术医疗中心的三个 ICU。
74 名 ICU 患者家属的样本，这些患者的预后严重，被认为有死亡高风险。高危死亡患者被确定为急性生理学和慢性健康评估 II 评分>20、入住 ICU 时间>72 小时以及需要机械通气。
无。
我们在患者入住 ICU 大约 4 天后评估了以下领域的症状负担程度：创伤后应激、焦虑和抑郁。总体而言，症状的患病率很高，超过一半（57%）的家属有中度至重度创伤后应激，80%有边缘性焦虑症状，70%有边缘性抑郁症状。超过 80%的家属有其他身体和情绪症状，如疲劳、悲伤和恐惧，这些症状的困扰程度处于中度至重度。与症状严重程度独立相关的因素包括家属年龄较小、女性和非白人种族。唯一与症状严重程度显著相关的患者因素是年龄较小。尽管有症状体验，大多数家属在 ICU 期间的应对能力和功能仍处于中度至高度水平。
我们记录了 ICU 住院期间家属心理和身体症状的高患病率。这些数据补充了长期症状负担的现有数据，并强调了需要改善 ICU 中的以家庭为中心的护理。
