Bashar Farshid R, Vahedian-Azimi Amir, Salesi Mahmood, Hajiesmaeili Mohammadreza, Shojaei Seyedpouzhia, Farzanegan Behrooz, Goharani Reza, Madani Seyed J, Moghaddam Kivan G, Hatamian Sevak, Moghaddam Hosseinali J, Arrascaeta-Llanes Abilio, Miller Andrew C
Anesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamedan, Iran.
Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
J Relig Health. 2018 Dec;57(6):2241-2257. doi: 10.1007/s10943-017-0543-5.
The aim of the present study is to describe how religiosity and spirituality affect the psychiatric morbidity of Muslim intensive care unit (ICU) patients. We conducted a prospective nationwide cross-sectional study of ICU patients discharged from 45 medical centers spanning 31 proivinces in Iran. Adults (age ≥ 18 years) admitted to the ICU and treated with invasive mechanical ventilation were eligible. Nine validated survey tools were administered to detect direct and indirect associations between spiritual health (SH) and depression, anxiety, and post-traumatic disorder. The Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R), Post-Traumatic Stress Syndrome 14 question (PTSS-14) quality-of-life (QoL), and quality of patient to physician or nurse communication (PP-QoC and PN-QoC) scales were modeled through two mediators by structural equation modeling (SEM). Sex, ICU type, LOS, and APACHE II score were added in the independent variable list. 338 eligible patients were discharged from the ICUs during the study period. 56 were excluded (clinical status), and 282 were administered the survey. 278 returned it, with 272 complete and 6 partial responses. SH displayed no direct or indirect association to QoL. SH was indirectly associated with decreased depression and anxiety (B = - 0.081, p < 0.05) via PP-QoC mediator. Both direct and indirect positive associations were observed between SH and IES-R (B = 0.293, p < 0.05; via PP-QoC) and PTSS-14 scores (B = 0.267, p < 0.001; via PP-QoC). Medical ICU location was associated with decreased PTSS-14 scores via the same mediator. In this survey of Muslim ICU patients treated with invasive mechanical ventilation, SH correlated with decreased depression and anxiety, but paradoxically increased post-traumatic stress. The most influential mediator was patient-physician quality-of-communication.
本研究的目的是描述宗教信仰和精神信仰如何影响穆斯林重症监护病房（ICU）患者的精神疾病发病率。我们对伊朗31个省份45个医疗中心出院的ICU患者进行了一项全国性的前瞻性横断面研究。入住ICU并接受有创机械通气治疗的成年人（年龄≥18岁）符合条件。使用九种经过验证的调查工具来检测精神健康（SH）与抑郁、焦虑和创伤后障碍之间的直接和间接关联。通过结构方程模型（SEM），通过两个中介变量对医院焦虑和抑郁量表（HADS）、事件影响量表修订版（IES-R）、创伤后应激综合征14项问题（PTSS-14）生活质量（QoL）以及患者与医生或护士沟通质量（PP-QoC和PN-QoC）量表进行建模。将性别、ICU类型、住院时间（LOS）和急性生理与慢性健康状况评分系统II（APACHE II）评分添加到自变量列表中。在研究期间，338名符合条件的患者从ICU出院。56名被排除（临床状态），282名接受了调查。278名返回了调查，其中272份完整回复，6份部分回复。SH与QoL无直接或间接关联。SH通过PP-QoC中介变量与抑郁和焦虑的降低存在间接关联（B = -0.081，p < 0.05）。在SH与IES-R（B = 0.293，p < 0.05；通过PP-QoC）和PTSS-14评分（B = 0.267，p < 0.001；通过PP-QoC）之间观察到直接和间接的正相关。医疗ICU位置通过相同的中介变量与PTSS-14评分降低相关。在这项对接受有创机械通气治疗的穆斯林ICU患者的调查中，SH与抑郁和焦虑的降低相关，但矛盾的是创伤后应激增加。最有影响力的中介变量是患者与医生的沟通质量。
