Elliott Rosalind, McKinley Sharon, Fien Mary, Elliott Doug
Faculty of Health, University of Technology Sydney.
Royal North Shore Hospital.
Rehabil Psychol. 2016 May;61(2):141-150. doi: 10.1037/rep0000074.
PURPOSE/OBJECTIVE: To explore demographic, clinical, and psychological factors in intensive care unit (ICU), including self-reported sleep quality and experiences that were associated with posttraumatic stress (PTS) symptoms 6 months after discharge from hospital.
RESEARCH METHOD/DESIGN: A prospective survey was conducted (N = 222). On the day of transfer to the hospital ward, ICU patients reported pain and state-anxiety levels, as well as ICU and prehospital sleep quality. Two months after hospital discharge, they reported sleep quality at home and experiences in ICU. Six months after hospital discharge, sleep quality, PTS symptoms (measured with the Posttraumatic Stress Disorder Checklist-Specific; PCL-S; VA National Center for PTSD, 2014) and psychological well-being (using Depression, Anxiety and Stress Scales-21; DASS-21; Ware, Kosinski, & Keller, 1994) were reported. Descriptive data analyses were performed and factors associated with PTS symptoms were explored with multiple linear regression.
The sample was predominately male (65%), with a mean age 57 years. At baseline, pain intensity was low (M ± SD; 2.25 ± 1.14) and state-anxiety levels were moderate (2.50 ± 2.90). At 6 months, 30% of the sample demonstrated depression, and 13.5% (mean PCL-S score: 26.54 ± 10.52) reported symptoms reflective of PTS. The regression model explained 68.2% of the variance in the PCL-S score. Higher PTS scores were independently associated with frightening experiences in ICU, higher stress and depression scores, pain intensity at baseline, and sleep quality at 6 months.
CONCLUSION/IMPLICATIONS: Continuing symptoms of PTS were evident in 14% of the cohort. Screening for prevention and treatment of delirium while a patient is in ICU is essential, and psychological screening and follow-up during recovery would therefore also be beneficial for many patients. (PsycINFO Database Record
目的/目标：探讨重症监护病房（ICU）中的人口统计学、临床和心理因素，包括自我报告的睡眠质量以及与出院6个月后创伤后应激（PTS）症状相关的经历。
研究方法/设计：进行了一项前瞻性调查（N = 222）。在转至医院病房当天，ICU患者报告疼痛和状态焦虑水平，以及ICU和院前睡眠质量。出院两个月后，他们报告在家中的睡眠质量和在ICU的经历。出院六个月后，报告睡眠质量、PTS症状（使用创伤后应激障碍检查表-特定版；PCL-S；美国退伍军人事务部国家创伤后应激障碍中心，2014年）和心理健康状况（使用抑郁、焦虑和压力量表-21；DASS-21；Ware、Kosinski和Keller，1994年）。进行了描述性数据分析，并通过多元线性回归探索与PTS症状相关的因素。
样本主要为男性（65%），平均年龄57岁。基线时，疼痛强度较低（M±SD；2.25±1.14），状态焦虑水平为中度（2.50±2.90）。6个月时，30%的样本表现出抑郁，13.5%（PCL-S平均得分：26.54±10.52）报告有PTS症状。回归模型解释了PCL-S得分中68.2%的方差。较高的PTS得分与在ICU的可怕经历、较高的压力和抑郁得分、基线时的疼痛强度以及6个月时的睡眠质量独立相关。
结论/启示：该队列中14%的患者存在明显的PTS持续症状。在患者入住ICU期间筛查谵妄以进行预防和治疗至关重要，因此在康复期间进行心理筛查和随访对许多患者也有益。（PsycINFO数据库记录）
