Pieris Lalitha, Sigera Ponsuge Chathurani, De Silva Ambepitiyawaduge Pubudu, Munasinghe Sithum, Rashan Aasiyah, Athapattu Priyantha Lakmini, Jayasinghe Kosala Saroj Amarasiri, Samarasinghe Kerstein, Beane Abi, Dondorp Arjen M, Haniffa Rashan
Sri Lanka Nursing Council, Colombo, Sri Lanka.
Network for Improving Critical care Systems and Training, Colombo, Sri Lanka.
BMC Anesthesiol. 2018 Mar 21;18(1):30. doi: 10.1186/s12871-018-0494-8.
Stressful patient experiences during the intensive care unit (ICU) stay is associated with reduced satisfaction in High Income Countries (HICs) but has not been explored in Lower and Middle Income Countries (LMICs). This study describes the recalled experiences, stress and satisfaction as perceived by survivors of ICUs in a LMIC.
This follow-up study was carried out in 32 state ICUs in Sri Lanka between July and December 2015.ICU survivors' experiences, stress factors encountered and level of satisfaction were collected 30 days after ICU discharge by a telephone questionnaire adapted from Granja and Wright.
Of 1665 eligible ICU survivors, 23.3% died after ICU discharge, 49.1% were uncontactable and 438 (26.3%) patients were included in the study. Whilst 78.1% (n = 349) of patients remembered their admission to the hospital, only 42.3% (n = 189) could recall their admission to the ICU. The most frequently reported stressful experiences were: being bedridden (34.2%), pain (34.0%), general discomfort (31.7%), daily needle punctures (32.9%), family worries (33.6%), fear of dying and uncertainty in the future (25.8%). The majority of patients (376, 84.12%) found the atmosphere of the ICU to be friendly and calm. Overall, the patients found the level of health care received in the ICU to be "very satisfactory" (93.8%, n = 411) with none of the survivors stating they were either "dissatisfied" or "very dissatisfied".
In common with HIC, survivors were very satisfied with their ICU care. In contrast to HIC settings, specific ICU experiences were frequently not recalled, but those remembered were reported as relatively stress-free. Stressful experiences, in common with HIC, were most frequently related to uncertainty about the future, dependency, family, and economic concerns.
在高收入国家（HICs），重症监护病房（ICU）住院期间患者的压力体验与满意度降低有关，但在低收入和中等收入国家（LMICs）尚未进行过探讨。本研究描述了低收入和中等收入国家ICU幸存者所感知的回忆经历、压力和满意度。
2015年7月至12月期间，在斯里兰卡的32家国立ICU进行了这项随访研究。通过改编自格兰哈和赖特的电话调查问卷，在ICU出院30天后收集ICU幸存者的经历、遇到的压力因素和满意度水平。
在1665名符合条件的ICU幸存者中，23.3%在ICU出院后死亡，49.1%无法联系到，438名（26.3%）患者被纳入研究。虽然78.1%（n = 349）的患者记得自己入院，但只有42.3%（n = 189）能回忆起自己入住ICU的情况。最常报告的压力经历是：卧床不起（34.2%）、疼痛（34.0%）、全身不适（31.7%）、每日针刺（32.9%）、家人担忧（33.6%）、对死亡的恐惧和对未来的不确定性（25.8%）。大多数患者（376名，84.12%）认为ICU的氛围友好且平静。总体而言，患者对在ICU接受的医疗保健水平“非常满意”（93.8%，n = 411），没有幸存者表示他们“不满意”或“非常不满意”。
与高收入国家一样，幸存者对他们在ICU的护理非常满意。与高收入国家的情况不同，ICU的具体经历常常无法回忆起来，但那些能回忆起的经历被报告为压力相对较小。与高收入国家一样，压力经历最常与对未来的不确定性、依赖、家庭和经济担忧有关。
