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重症监护病房患者出院后即刻及24小时后的身心健康状况

Physical and Mental Health of Patients Immediately After Discharge From Intensive Care Unit and 24 Hours Later.

作者信息

Momennasab Marzieh, Ghahramani Tahereh, Yektatalab Shahrzad, Zand Farid

机构信息

Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran.

Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran.

出版信息

Trauma Mon. 2016 Feb 6;21(1):e29231. doi: 10.5812/traumamon.29231. eCollection 2016 Feb.

Abstract

BACKGROUND

Monitoring the health status of patients discharged from intensive care units is a crucial method of service evaluation.

OBJECTIVES

This study aimed to assess the physical and mental health status of patients immediately after discharge from the ICU and 24 hours later.

PATIENTS AND METHODS

This descriptive comparative study was conducted on 104 patients discharged from the ICUs of a referral trauma center in Shiraz, Southwest Iran. Physical parameters, including respiratory rate, need for supplemental oxygen, heart rate, blood pressure, and need for cardiac monitoring, were assessed. Hospital anxiety and depression scale (HADS) was used for mental health evaluation. The mental and physical status of patients were assessed before ICU discharge and 24 hours later; data were recorded in information forms and were analyzed using SPSS statistical software version 17.

RESULTS

At the time of discharge, the respiratory rate of 28% of the participants was more than 24 minutes, and 95.2% received supplemental oxygen. However, after 24 hours these values decreased to 10% and 21.6%, respectively. The mean heart rate and systolic blood pressure were within the normal range at both time points. Additionally, 63% of the patients had anxiety scores above 11 at both time points, reflecting high anxiety. The number of patients who reported depression increased from 58.7% at ICU discharge to 69.6% after 24 hours.

CONCLUSIONS

Despite the considerable improvement in most of the patients' physical condition in the first 24 hours after discharge from ICU, a significant number of them remain at risk for the development of adverse effects from this transition. The high prevalence of mental health disorders in these patients reveals the necessity to conduct follow-up consultations.

摘要

背景

监测重症监护病房出院患者的健康状况是服务评估的关键方法。

目的

本研究旨在评估患者从重症监护病房出院时及出院24小时后的身心健康状况。

患者与方法

本描述性比较研究对伊朗西南部设拉子一家转诊创伤中心重症监护病房出院的104例患者进行。评估了包括呼吸频率、吸氧需求、心率、血压及心脏监测需求在内的身体参数,并使用医院焦虑抑郁量表(HADS)进行心理健康评估。在重症监护病房出院前及出院24小时后评估患者的心理和身体状况;数据记录在信息表中,并使用SPSS 17.0统计软件进行分析。

结果

出院时,28%的参与者呼吸频率超过24次/分钟,95.2%的患者接受吸氧。然而,24小时后,这些数值分别降至10%和21.6%。两个时间点的平均心率和收缩压均在正常范围内。此外,63%的患者在两个时间点的焦虑评分均高于11分,表明焦虑程度较高。报告有抑郁的患者人数从重症监护病房出院时的58.7%增加至24小时后的69.6%。

结论

尽管大多数患者在重症监护病房出院后的头24小时内身体状况有显著改善,但仍有相当数量的患者存在因这种转变而产生不良反应的风险。这些患者心理健康障碍患病率高,表明有必要进行随访咨询。

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