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高危重症监护病房患者家属的心理症状。

Psychological symptoms of family members of high-risk intensive care unit patients.

机构信息

Samuel Merritt University, School of Nursing, Oakland, California 94609, USA.

出版信息

Am J Crit Care. 2012 Nov;21(6):386-93; quiz 394. doi: 10.4037/ajcc2012582.

Abstract

BACKGROUND

Family members of patients in intensive care are at increased risk for psychological symptoms.

OBJECTIVES

To compare levels of posttraumatic stress disorder, anxiety, and depression during and 3 months after the intensive care experience in family members of patients at high risk for dying and to determine if differences were related to the patient's final disposition.

METHODS

Longitudinal descriptive study of 41 family members in 3 tertiary care intensive care units.

RESULTS

By repeated-measures analysis of variance, family members' levels of posttraumatic stress disorder were significantly lower (P = .01) at 3 months after (mean score, 1.27; SD, 0.86) than during (mean, 1.61; SD, 0.81) the experience. Mean anxiety and depression scores were significantly lower (P < .001) after (anxiety: 7.35; SD, 3.91; depression: 5.63; SD, 4.58) than during (anxiety: 11.5; SD, 4.88; depression: 9.51; SD, 4.31) the experience. Scores for posttraumatic stress disorder, anxiety, and depression did not differ significantly between family members of patients who died and family members of patients who survived. Yet, all 13 family members of deceased patients and 42% of the total sample of 41 had traumatic stress scores of 1.5 or greater. Among the total sample, 44% had significant anxiety, and 27% were depressed.

CONCLUSION

Family members' symptoms of posttraumatic stress disorder, anxiety, and depression significantly decreased 3 months after the intensive care experience and did not differ according to the patients' final disposition. However, many family members still had significant risk for posttraumatic stress disorder and borderline anxiety and depression at 3 months.

摘要

背景

重症监护病房患者的家属面临更高的心理症状风险。

目的

比较高死亡风险患者的家属在重症监护期间和 3 个月后的创伤后应激障碍、焦虑和抑郁水平,并确定这些差异是否与患者的最终结局有关。

方法

对 3 个三级护理重症监护病房的 41 名家属进行纵向描述性研究。

结果

通过重复测量方差分析,家属的创伤后应激障碍水平在 3 个月后(平均得分 1.27,标准差 0.86)显著低于(P =.01)经历期间(平均得分 1.61,标准差 0.81)。焦虑和抑郁的平均得分在经历后显著降低(P <.001)(焦虑:7.35,标准差 3.91;抑郁:5.63,标准差 4.58)比经历期间(焦虑:11.5,标准差 4.88;抑郁:9.51,标准差 4.31)。死亡患者的家属和存活患者的家属的创伤后应激障碍、焦虑和抑郁评分无显著差异。然而,死亡患者的家属中有 13 人,总样本的 42%有 1.5 或更高的创伤后应激障碍评分。在总样本中,44%有明显的焦虑,27%有抑郁。

结论

重症监护经历 3 个月后,家属的创伤后应激障碍、焦虑和抑郁症状显著减轻,与患者的最终结局无关。然而,在 3 个月时,许多家属仍有明显的创伤后应激障碍和边缘性焦虑和抑郁风险。

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