Jónasdóttir Rannveig J, Jónsdóttir Helga, Gudmundsdottir Berglind, Sigurdsson Gisli H
Faculty of Nursing, School of Health Sciences, University of Iceland, Eirberg, Eiriksgata 34, 101 Reykjavik, Iceland; Intensive Care Units, Landspitali - The National University Hospital, 101 Reykjavik, Iceland.
Faculty of Nursing, School of Health Sciences, University of Iceland, Eirberg, Eiriksgata 34, 101 Reykjavik, Iceland.
Intensive Crit Care Nurs. 2018 Feb;44:59-66. doi: 10.1016/j.iccn.2017.06.001. Epub 2017 Jul 22.
To compare psychological recovery of patients receiving structured nurse-led follow-up and patients receiving usual care after intensive care discharge.
Quasi-experimental study.
Single centre, university hospital, mixed intensive care patient population.
Symptoms of post-traumatic stress disorder, anxiety and depression measured three and four times over 12 months after intensive care discharge. Disturbing memories of the intensive care stay and psychological reactions (that one's life was in danger, threat to physical integrity, intense fear, helplessness, horror) three months after intensive care. A mixed effect model tested differences between the groups over time and regression model predicted post-traumatic stress at three months.
The experimental group had significantly more symptoms of post-traumatic stress and anxiety than the control group over the 12 months. Patients from both groups had severe symptoms of post-traumatic stress. Patients with post-traumatic stress at three months had disturbing memories and psychological reactions.
The structured nurse-led follow-up did not improve patients' measured outcomes of psychological recovery after intensive care. Patients with severe symptoms of post-traumatic stress are of concern. Emphasis needs to be placed on disturbing memories of the intensive care stay and psychological reactions when constructing intensive care nurse-led follow-up.
比较重症监护病房出院后接受结构化护士主导随访的患者与接受常规护理的患者的心理恢复情况。
准实验研究。
单中心大学医院，重症监护患者混合群体。
在重症监护病房出院后的12个月内，对创伤后应激障碍、焦虑和抑郁症状进行3次和4次测量。在重症监护3个月后，对重症监护期间令人不安的记忆和心理反应（感觉生命受到威胁、身体完整性受到威胁、强烈恐惧、无助、恐惧）进行评估。采用混合效应模型测试两组随时间的差异，并采用回归模型预测3个月时的创伤后应激情况。
在12个月内，实验组的创伤后应激和焦虑症状明显多于对照组。两组患者均有严重的创伤后应激症状。3个月时有创伤后应激症状的患者有令人不安的记忆和心理反应。
结构化护士主导的随访并未改善重症监护后患者心理恢复的测量结果。有严重创伤后应激症状的患者值得关注。在构建重症监护护士主导的随访时，需要重视对重症监护期间令人不安的记忆和心理反应。
