Tracheal Diseases Research Center, Anesthesia and Critical Care Department, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Neurology, Zagazig University, Sharkia, Egypt.
J Relig Health. 2021 Apr;60(2):816-840. doi: 10.1007/s10943-019-00895-7.
This study assesses the impact of religiosity on delirium severity and patient outcomes among Shi'a Muslim intensive care unit (ICU) patients. We conducted a prospective observational cohort study in 21 ICUs from 6 Iranian academic medical centers. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU) tool. Eligible patients were intubated, receiving mechanical ventilation (MV) for ≥ 48 h. Illness severity was assessed using Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. A total of 4200 patients were enrolled. Patient religiosity was categorized as more (40.6%), moderate (42.3%), or less (17.1%) based on responses to patient and surrogate questionnaires. The findings suggest that lower pre-illness religiosity may be associated with greater delirium severity, MV duration, and ICU and hospital LOS. The lower mortality in the less religiosity group may be related in part to a greater proportion of female patients, but it remains unclear whether and to what extent greater religiosity impacted treatment decisions by patients and families. Further investigation is needed to validate and clarify the mechanism of the mortality findings.
这项研究评估了宗教信仰对什叶派穆斯林重症监护病房（ICU）患者谵妄严重程度和患者结局的影响。我们在 6 家伊朗学术医疗中心的 21 个 ICU 中进行了一项前瞻性观察性队列研究。使用 ICU 意识模糊评估法（CAM-ICU）工具评估谵妄。符合条件的患者需要插管，接受机械通气（MV）≥48 小时。使用急性生理学和慢性健康评估 II （APACHE II）评分评估疾病严重程度。共纳入 4200 名患者。根据患者和代理人问卷的回答，患者的宗教信仰分为更多（40.6%）、中等（42.3%）或更少（17.1%）。研究结果表明，较低的发病前宗教信仰可能与更严重的谵妄严重程度、MV 持续时间以及 ICU 和住院 LOS 相关。较少宗教信仰组的死亡率较低可能部分与女性患者比例较高有关，但尚不清楚患者和家属的治疗决策是否以及在多大程度上受到宗教信仰的影响。需要进一步调查以验证和阐明死亡率发现的机制。
