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与接受轻度镇静治疗的重症监护病房患者记忆缺失和妄想记忆相关的因素。

Factors related to memory absence and delusional memories in patients in intensive care units managed with light sedation.

机构信息

Department of Nursing, University Hospital, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi Hirokouji-agaru Kamigyo-ku, Kyoto 602-8566, Japan.

Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.

出版信息

Intensive Crit Care Nurs. 2020 Aug;59:102830. doi: 10.1016/j.iccn.2020.102830. Epub 2020 Mar 23.

Abstract

OBJECTIVES

Currently, light sedation is typically given to patients in intensive care units and studies have not extensively examined the factors related to absences or abnormalities of their memories. We, therefore, analysed the factors related to the absence/abnormalities of patients' memories in intensive care units.

RESEARCH METHODOLOGY

A secondary analysis of previously collected survey data examining patients' experiences in an intensive care unit was undertaken (n = 405; women = 38%; median age = 70 years). To observe absent or distorted memories, patients were interviewed after leaving the intensive care unit. We analysed key factors through content analysis of the interviews and field notes.

SETTING

The intensive care unit of a university hospital.

MAIN OUTCOME MEASURE

Patients' absent or distorted memories after leaving the intensive care unit.

RESULTS

Half the patients reported an absence of memories. This was associated with old age and with longer duration of mechanical ventilation. Absent or fragmentary memories were not distressing. Fragmentary and fearful intensive care unit memories were associated with being older. Delusional memories, some of which reflected actual events, were present in 3% of patients.

CONCLUSION

Absence of memories were not distressing, delusional memories occurred less and these memories could comprise of an event in ICU that is difficult for patients to understand.

摘要

目的

目前,重症监护病房的患者通常会接受轻度镇静治疗,而有关其记忆缺失或异常的相关因素的研究尚未广泛开展。因此,我们分析了重症监护病房患者记忆缺失或异常的相关因素。

研究方法

对先前收集的调查数据进行二次分析,以调查重症监护病房患者的经历(n=405;女性=38%;中位数年龄=70 岁)。为了观察记忆缺失或扭曲,在患者离开重症监护病房后对其进行了访谈。我们通过对访谈和现场记录的内容分析来分析关键因素。

设置

一所大学医院的重症监护病房。

主要观察指标

离开重症监护病房后患者的记忆缺失或扭曲情况。

结果

一半的患者报告存在记忆缺失。这与年龄较大和机械通气时间较长有关。缺失或不完整的记忆并不令人痛苦。片段化和恐惧的重症监护病房记忆与年龄较大有关。3%的患者出现幻觉记忆,其中一些反映了实际发生的事件。

结论

记忆缺失并不令人痛苦,出现幻觉记忆的情况较少,并且这些记忆可能包括患者难以理解的 ICU 中的事件。

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