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JAMA. 2019 Jul 16;322(3):229-239. doi: 10.1001/jama.2019.9058.
2
Effects of a Personalized Web-Based Decision Aid for Surrogate Decision Makers of Patients With Prolonged Mechanical Ventilation: A Randomized Clinical Trial.基于网络的个性化决策辅助工具对延长机械通气患者代理人决策效果的随机临床试验研究
Ann Intern Med. 2019 Mar 5;170(5):285-297. doi: 10.7326/M18-2335. Epub 2019 Jan 29.
3
Effect of a Patient and Clinician Communication-Priming Intervention on Patient-Reported Goals-of-Care Discussions Between Patients With Serious Illness and Clinicians: A Randomized Clinical Trial.患者和临床医生沟通启动干预对严重疾病患者和临床医生之间患者报告的治疗目标讨论的影响:一项随机临床试验。
JAMA Intern Med. 2018 Jul 1;178(7):930-940. doi: 10.1001/jamainternmed.2018.2317.
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A Randomized Trial of a Family-Support Intervention in Intensive Care Units.一项针对重症监护病房家庭支持干预的随机试验。
N Engl J Med. 2018 Jun 21;378(25):2365-2375. doi: 10.1056/NEJMoa1802637. Epub 2018 May 23.
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Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial.基于电话和网络的应对技能训练方案对危重病幸存者及其家属的效果:一项随机临床试验。
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Effect of Palliative Care-Led Meetings for Families of Patients With Chronic Critical Illness: A Randomized Clinical Trial.以姑息治疗为主导的慢性危重病患者家属会议的效果:一项随机临床试验。
JAMA. 2016 Jul 5;316(1):51-62. doi: 10.1001/jama.2016.8474.
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Sample Size in Qualitative Interview Studies: Guided by Information Power.定性访谈研究中的样本量:以信息力为导向
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In-hospital acute stress symptoms are associated with impairment in cognition 1 year after intensive care unit admission.住院期间的急性应激症状与重症监护病房入院 1 年后的认知功能障碍有关。
Ann Am Thorac Soc. 2013 Oct;10(5):450-7. doi: 10.1513/AnnalsATS.201303-060OC.
10
Health-related quality of life in family members of intensive care unit patients.重症监护病房患者家属的健康相关生活质量。
J Palliat Med. 2010 Sep;13(9):1131-7. doi: 10.1089/jpm.2010.0109.

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.

DOI:10.1016/j.chest.2020.05.535
PMID:32454044
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7545490/
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。