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因酒精相关问题入住重症监护病房的健康和社会后果:一项定性研究。

Health and social consequences of an alcohol-related admission to critical care: a qualitative study.

作者信息

McPeake Joanne, Forrest Ewan, Quasim Tara, Kinsella John, O'Neill Anna

机构信息

Glasgow Royal Infirmary, Glasgow, UK University of Glasgow, School of Medicine, Glasgow Royal Infirmary, Glasgow, UK.

Glasgow Royal Infirmary, Glasgow, UK.

出版信息

BMJ Open. 2016 Apr 5;6(4):e009944. doi: 10.1136/bmjopen-2015-009944.

Abstract

OBJECTIVE

To examine the impact of critical care on future alcohol-related behaviour. Further, it aimed to explore patterns of recovery for patients with and without alcohol use disorders beyond the hospital environment.

DESIGN

In-depth, semistructured interviews with participants (patients) 3-7 months post intensive care discharge.

SETTING

The setting for this study was a 20-bedded mixed intensive care unit (ICU), in a large teaching hospital in Scotland. On admission, patients were allocated to one of the three alcohol groups: low risk, harmful/hazardous and alcohol dependency.

PARTICIPANTS

21 participants who received mechanical ventilation for greater than 3 days were interviewed between March 2013 and June 2014.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Four themes which impacted on recovery from ICU were identified in this patient group: psychological resilience, support for activities of daily living, social support and cohesion and the impact of alcohol use disorders on recovery. Participants also discussed the importance of personalised goal setting and appropriate and timely rehabilitation for alcohol-related behaviours during the critical care recovery period.

CONCLUSIONS

There is a significant interplay between alcohol misuse and recovery from critical illness. This study has demonstrated that at present, there is a haphazard approach to rehabilitation for patients after ICU. A more targeted rehabilitation pathway for patients leaving critical care, with specific emphasis on alcohol misuse if appropriate, requires to be generated.

摘要

目的

探讨重症监护对未来与酒精相关行为的影响。此外,旨在探究有和没有酒精使用障碍的患者在医院环境之外的康复模式。

设计

对重症监护出院后3至7个月的参与者(患者)进行深入的半结构式访谈。

背景

本研究的背景是苏格兰一家大型教学医院中一个有20张床位的混合重症监护病房(ICU)。入院时,患者被分配到三个酒精组之一:低风险、有害/危险和酒精依赖。

参与者

2013年3月至2014年6月期间,对21名接受机械通气超过3天的参与者进行了访谈。

干预措施

无。

测量指标及主要结果

在该患者群体中确定了影响从ICU康复的四个主题:心理复原力、对日常生活活动的支持、社会支持与凝聚力以及酒精使用障碍对康复的影响。参与者还讨论了在重症监护康复期间设定个性化目标以及针对与酒精相关行为进行适当和及时康复的重要性。

结论

酒精滥用与危重病康复之间存在显著的相互作用。本研究表明,目前对ICU后患者的康复方法随意。需要为离开重症监护的患者制定更有针对性的康复途径,如适当,特别强调酒精滥用问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b58/4823434/1af0583803ba/bmjopen2015009944f01.jpg

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