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重症监护病房幸存者的非正式照料者的照料者压力及创伤后应激症状

Caregiver strain and posttraumatic stress symptoms of informal caregivers of intensive care unit survivors.

作者信息

van den Born-van Zanten Sascha A, Dongelmans Dave A, Dettling-Ihnenfeldt Daniela, Vink Roel, van der Schaaf Marike

机构信息

Department of Intensive Care Medicine, Tergooi Hospital.

Academic Medical Center, University of Amsterdam.

出版信息

Rehabil Psychol. 2016 May;61(2):173-8. doi: 10.1037/rep0000081.

Abstract

BACKGROUND

Many intensive care unit survivors (ICU) are confronted with undesirable and long-lasting impairments in physical, cognitive, and mental health, but not only patients are at risk of developing this post-intensive care syndrome (PICS). Family members can experience symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). This cluster of complications is called PICS-family.

OBJECTIVE

To describe the level of caregiver strain and posttraumatic stress-related symptoms in relatives of ICU survivors.

METHODS

We conducted a cohort study in a general hospital between July 2010 and May 2014. Relatives of ICU survivors, mechanically ventilated for > 48 h in the ICU, were asked to complete a questionnaire 3 months after discharge from critical care. Symptoms of PTSD and caregiving concerns were assessed using the Trauma Screening Questionnaire and the Caregiver Strain Index (CSI).

RESULTS

A total of 94 relatives visiting our post-ICU clinic completed the questionnaires. Twenty-one percent of the caregivers had a CSI score of 7 or more, indicating high levels of strain. Six percent had CSI scores indicating severe strain (CSI > 10). PTSD-related symptoms were seen in 21% of the caregivers. The mean time spent on caregiving was 10 h (interquartile range 6-17 h) per week.

CONCLUSION

This study shows that relatives of ICU survivors could experience strain 3 months after hospital discharge and are at risk of developing PTSD-related symptoms. This complements existing data that relatives are at risk of psychological symptoms. Knowledge can lead to improvements and means to prevent these symptoms. (PsycINFO Database Record

摘要

背景

许多重症监护病房幸存者(ICU)面临身体、认知和心理健康方面不良且持久的损伤,但不仅患者有发生这种重症监护后综合征(PICS)的风险。家庭成员也可能出现抑郁、焦虑和创伤后应激障碍(PTSD)症状。这一系列并发症被称为PICS-家庭。

目的

描述ICU幸存者亲属的照顾者压力水平和创伤后应激相关症状。

方法

我们在2010年7月至2014年5月期间于一家综合医院进行了一项队列研究。邀请在ICU接受机械通气超过48小时的ICU幸存者亲属在从重症监护病房出院3个月后填写一份问卷。使用创伤筛查问卷和照顾者压力指数(CSI)评估PTSD症状和照顾问题。

结果

共有94名到我们ICU后诊所就诊的亲属完成了问卷。21%的照顾者CSI得分在7分或以上,表明压力水平较高。6%的照顾者CSI得分表明压力严重(CSI>10)。21%的照顾者出现了与PTSD相关的症状。每周照顾的平均时长为10小时(四分位间距6 - 17小时)。

结论

本研究表明,ICU幸存者的亲属在出院3个月后可能会感到压力,并有出现与PTSD相关症状的风险。这补充了亲属有出现心理症状风险的现有数据。了解这些情况有助于改进并采取措施预防这些症状。(PsycINFO数据库记录

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