Kulkarni Hrishikesh S, Kulkarni Karishma R, Mallampalli Antara, Parkar Shubhangi R, Karnad Dilip R, Guntupalli Kalpalatha K
Department of Medicine Division of General Internal Medicine, University of Pittsburgh Medical Center, UPMC Montefiore, Pittsburgh, USA.
Indian J Crit Care Med. 2011 Jul;15(3):147-56. doi: 10.4103/0972-5229.84891.
An intensive care unit (ICU) admission of a patient causes considerable stress among relatives. Whether this impact differs among populations with differing sociocultural factors is unknown.
The aim was to compare the psychological impact of an ICU admission on relatives of patients in an American and Indian public hospital.
A cross-sectional study was carried out in ICUs of two tertiary care hospitals, one each in major metropolitan cities in the USA and India.
A total of 90 relatives visiting patients were verbally administered a questionnaire between 48 hours and 72 hours of ICU admission that included the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory-II (BDI-II) and Impact of Events Scale-Revised (IES-R) for post-traumatic stress response.
Statistical analysis was done using the Mann-Whitney and chi-square tests.
Relatives in the Indian ICU had more anxiety symptoms (median HADS-A score 11 [inter-quartile range 9-13] vs. 4 [1.5-6] in the American cohort; P<0.0001), more depression symptoms (BDI-II score 14 [8.5-19] vs. 6 [1.5-10.5], P<0.0001) but a comparable post-traumatic stress response (IES-R score>30). 55% of all relatives had an incongruous perception regarding "change in the patient's condition" compared to the objective change in severity of illness. "Change in worry" was incongruous compared to the perception of improvement of the patient's condition in 78% of relatives.
Relatives of patients in the Indian ICU had greater anxiety and depression symptoms compared to those in the American cohort, and had significant differences in factors that may be associated with this psychological impact. Both groups showed substantial discordance between the perceived and objective change in severity of illness.
患者入住重症监护病房（ICU）会给亲属带来相当大的压力。这种影响在具有不同社会文化因素的人群中是否存在差异尚不清楚。
旨在比较美国和印度公立医院中患者入住ICU对亲属的心理影响。
在两家三级护理医院的ICU中进行了一项横断面研究，美国和印度的大城市各有一家。
在患者入住ICU的48小时至72小时之间，对总共90名探视患者的亲属进行了问卷调查，问卷包括医院焦虑抑郁量表（HADS）、贝克抑郁量表第二版（BDI-II）以及用于创伤后应激反应的事件影响量表修订版（IES-R）。
使用曼-惠特尼检验和卡方检验进行统计分析。
印度ICU的亲属有更多焦虑症状（HADS-A评分中位数为11[四分位间距9-13]，而美国队列中为4[1.5-6]；P<0.0001），更多抑郁症状（BDI-II评分14[8.5-19]，而美国为6[1.5-10.5]，P<0.0001），但创伤后应激反应相当（IES-R评分>30）。与疾病严重程度的客观变化相比，55%的亲属对“患者病情变化”有不一致的认知。与78%的亲属对患者病情改善的认知相比，“担忧变化”不一致。
与美国队列中的亲属相比，印度ICU患者的亲属有更严重的焦虑和抑郁症状，且在可能与这种心理影响相关的因素上存在显著差异。两组在疾病严重程度的感知变化和客观变化之间均表现出明显不一致。
