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重症患者家属的情感体验和应对策略。

Emotional Experiences and Coping Strategies of Family Members of Critically Ill Patients.

机构信息

Department of Internal Medicine, University of Michigan, Ann Arbor, MI.

Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI.

出版信息

Chest. 2020 Oct;158(4):1464-1472. doi: 10.1016/j.chest.2020.05.535. Epub 2020 May 24.

Abstract

BACKGROUND

Two out of three family members experience symptoms of posttraumatic stress, depression, or anxiety lasting for months after the ICU stay. Interventions aimed at mitigating these symptoms have been unsuccessful.

RESEARCH QUESTION

To understand the emotional experiences of family members of critically ill patients and to identify coping strategies used by family members during the ICU stay.

STUDY DESIGN

and Methods: As part of a mixed methods study to understand sources of distress among ICU family members, semistructured interviews were conducted with ICU family members. Family members completed surveys at the time of interview and at 90 days to assess for symptoms of depression, anxiety, and posttraumatic stress.

RESULTS

Semistructured interviews and baseline surveys were conducted with 40 ICU family members; 78% of participants (n = 31) completed follow-up surveys at 90 days. At the time of interview, 65% of family members had symptoms of depression, anxiety, or posttraumatic stress. At 90 days, 48% of surveyed family members had symptoms of psychological distress. Three primary emotions were identified among ICU family members: sadness, anger, and fear. A diverse array of coping strategies was used by family members, including problem-solving, information seeking, avoidance/escape, self-reliance, support seeking, and accommodation.

INTERPRETATION

This study emphasizes similarities in emotions but diversity in coping strategies used by family members in the ICU. Understanding the relationship between ICU experiences, emotional responses, and long-term psychological outcomes may guide targeted interventions to improve mental health outcomes of ICU family members.

摘要

背景

在 ICU 住院后,三分之二的家庭成员会经历数月的创伤后应激、抑郁或焦虑症状。旨在减轻这些症状的干预措施均未取得成功。

研究问题

了解危重症患者家属的情绪体验,并确定家属在 ICU 住院期间使用的应对策略。

研究设计和方法

作为一项了解 ICU 家属困扰源的混合方法研究的一部分,对 ICU 家属进行了半结构式访谈。家属在接受访谈时和 90 天时完成了调查,以评估抑郁、焦虑和创伤后应激症状。

结果

对 40 名 ICU 家属进行了半结构式访谈和基线调查;78%(n=31)的参与者完成了 90 天的随访调查。在访谈时,65%的家属有抑郁、焦虑或创伤后应激症状。在 90 天时,48%接受调查的家属有心理困扰症状。ICU 家属有三种主要情绪:悲伤、愤怒和恐惧。家属使用了多种应对策略,包括解决问题、寻求信息、回避/逃避、自力更生、寻求支持和适应。

解释

这项研究强调了 ICU 经历、情绪反应和长期心理结果之间的关系,可能有助于指导针对 ICU 家属心理健康的干预措施。

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