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患者重症监护后综合征各组分对照顾者负担的影响。

The impact of the patient post-intensive care syndrome components upon caregiver burden.

机构信息

Intensive Care Unit, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Rua Dr. Eduardo Torres, 4464-513 Matosinhos, Portugal.

Intensive Care Unit, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Rua Dr. Eduardo Torres, 4464-513 Matosinhos, Portugal.

出版信息

Med Intensiva. 2017 Nov;41(8):454-460. doi: 10.1016/j.medin.2016.12.005. Epub 2017 Feb 8.

Abstract

OBJECTIVE

To evaluate patient post-intensive care syndrome (PICS-P) and caregiver burden 3 months after discharge from the Intensive Care Unit (ICU) and determine the impact of different components of PICS-P upon caregiver burden.

DESIGN

A prospective observational study was conducted over 26 months (January 2013-February 2015).

SETTING

Medical-surgical ICU and follow-up consultation in Portugal.

PATIENTS OR PARTICIPANTS

Patients discharged after a minimum of 2 days in the ICU. Caregiver inclusion criteria: not paid, written and spoken Portuguese, and agreement to participate in the study.

MAIN VARIABLES OF INTEREST

In ICU: Patient gender, age, severity of illness (SAPS II) and length of ICU stay. At 3 months caregiver burden, physical (reduced mobility, weakness acquired in the ICU) and psychological components of PICS (anxiety, depression, post-traumatic stress disorder).

RESULTS

A total of 168 caregivers completed the survey (response rate of 69%). A low degree of overburden was reported by 34.5% of caregivers, while 15.5% showed moderate to high levels of overburden. Patient anxiety and depression 3 months after ICU discharge significantly influenced the presence of caregiver burden (p=0.030 vs p=0.008). When physical components of PICS-P were evaluated, no influence on caregiver burden was observed. Patient demographics, severity of illness and length of stay also failed to influence caregiver burden.

CONCLUSIONS

The presence of psychological components of PICS-P 3 months after ICU seems to have a negative impact upon caregiver burden. On the other hand, physical problems showed no important impact upon caregiver overburden.

摘要

目的

评估患者重症监护后综合征(PICS-P)和护理人员负担在离开重症监护病房(ICU)后 3 个月的情况,并确定 PICS-P 的不同组成部分对护理人员负担的影响。

设计

前瞻性观察研究,持续 26 个月(2013 年 1 月至 2015 年 2 月)。

地点

葡萄牙的内科-外科 ICU 和随访咨询处。

患者或参与者

在 ICU 至少住院 2 天的患者出院。护理人员纳入标准:无薪、会说葡萄牙语和书面语、同意参与研究。

主要观察变量

在 ICU 中:患者性别、年龄、疾病严重程度(SAPS II)和 ICU 住院时间。在 3 个月时护理人员负担、PICS-P 的身体(活动受限、在 ICU 中获得的虚弱)和心理成分(焦虑、抑郁、创伤后应激障碍)。

结果

共有 168 名护理人员完成了调查(应答率为 69%)。34.5%的护理人员报告负担程度较低,而 15.5%的护理人员报告中度至高度负担过重。患者 ICU 出院后 3 个月的焦虑和抑郁显著影响了护理人员负担的存在(p=0.030 对 p=0.008)。当评估 PICS-P 的身体成分时,未观察到对护理人员负担的影响。患者的人口统计学特征、疾病严重程度和住院时间也未影响护理人员负担。

结论

3 个月后 ICU 中 PICS-P 的心理成分似乎对护理人员负担产生负面影响。另一方面,身体问题对护理人员负担过重没有重要影响。

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