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面对 ICU 中亲人住院,青少年焦虑和抑郁症状的发生率。

Prevalence of Anxiety and Depression Symptomatology in Adolescents Faced With the Hospitalization of a Loved One in the ICU.

机构信息

Intensive Care Unit, University Hospital of Martinique, Fort-de-France, France.

Clinical Research Department, University Hospital of Martinique, Fort-de-France, France.

出版信息

Crit Care Med. 2018 Apr;46(4):e330-e333. doi: 10.1097/CCM.0000000000002964.

Abstract

OBJECTIVE

ICU experience is linked to anxiety and depression symptomatology in family members of patients. Minors may be forbidden from visiting. To bring practices in line with evidence, we determined the prevalence of anxiety and depression symptomatology in adolescents visiting a relative in the ICU.

DESIGN

One-year prospective observational monocenter study.

SETTING

Medical-surgical ICU, University Hospital of Martinique.

PATIENTS

Forty-one patients intubated for more than 2 days; 53 adolescents (12-17 yr) first- to third-degree relatives in regular contact (minimum once a month) with patient before hospitalization.

INTERVENTIONS

Adolescents with unrestricted ICU access completed a satisfaction survey, anxiety history questionnaire, and psychometric evaluation (Hospital Anxiety and Depression Scale) before the patient's 15th day of hospitalization and extubation.

MEASUREMENTS AND MAIN RESULTS

Forty adolescents (75.5%) visited their relative. Possible and probable anxiety and depression symptomatology prevalence was 35.9% and 18.9%, respectively, with no significant difference according to ICU visiting status. Most (80%) reported a lack of information, 40% insufficient consideration, and 27.5% misunderstood the reason for hospitalization. Two (5%) regretted visiting. Probable anxiety and depression symptomatology was associated with first-degree relationship (odds ratio, 9.1 [95% CI, 1.1-78.9]; p = 0.045), past exposure to a traumatic event (odds ratio, 8.7 [1.1-69.0]; p = 0.040) and past sense of threat (odds ratio, 10.4 [1.1-94.5]; p = 0.038).

CONCLUSIONS

Anxiety and depression symptomatology is common in adolescent family members of ICU patients. An open visiting policy for adolescents is recommended, with visit planning, information meetings, and individual support from ICU staff.

摘要

目的

重症监护病房(ICU)的经历与患者家属的焦虑和抑郁症状有关。未成年人可能被禁止探视。为了使实践与证据保持一致,我们确定了探访 ICU 亲属的青少年中焦虑和抑郁症状的患病率。

设计

为期一年的前瞻性观察性单中心研究。

地点

马提尼克岛大学医院的内科-外科 ICU。

患者

41 名插管超过 2 天的患者;53 名青少年(12-17 岁)是住院前与患者有规律联系(至少每月一次)的第一至第三级亲属。

干预措施

允许进入 ICU 的青少年在患者住院的第 15 天和拔管前完成一份满意度调查、焦虑病史问卷和心理测量评估(医院焦虑和抑郁量表)。

测量和主要结果

40 名青少年(75.5%)探访了他们的亲属。可能和可能的焦虑和抑郁症状患病率分别为 35.9%和 18.9%,根据 ICU 探视情况,没有显著差异。大多数(80%)报告缺乏信息,40%认为考虑不足,27.5%误解了住院的原因。有 2 人(5%)表示后悔探访。可能的焦虑和抑郁症状与一级亲属关系有关(优势比,9.1 [95%置信区间,1.1-78.9];p = 0.045),过去暴露于创伤性事件(优势比,8.7 [1.1-69.0];p = 0.040)和过去感到威胁(优势比,10.4 [1.1-94.5];p = 0.038)。

结论

ICU 患者的青少年家属中常见焦虑和抑郁症状。建议对青少年实行开放探视政策,包括探视计划、信息会议和 ICU 工作人员的个人支持。

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