Department of Nursing, Cyprus University of Technology, Limassol, Cyprus.
Athalassa Psychiatric Hospital, Nicosia, Cyprus.
Nurs Crit Care. 2021 Mar;26(2):109-117. doi: 10.1111/nicc.12574. Epub 2020 Nov 9.
Approximately, 20% of intensive care unit (ICU) survivors develop post-traumatic stress disorder (PTSD) symptoms. Although Davidson Trauma Scale (DTS) provides a comprehensive approach to PSTD symptoms, there is no evidence on DTS-I-M use in ICU survivors.
To validate the modified intensity Davidson Trauma Scale (DTS-I-M) (wherein the frequency and severity subscales are combined to express symptoms intensity) in a convenience sample of ICU survivors in Cyprus, and to explore the prevalence of PTSD symptoms and related predictors.
An instrument validation design, along with a cross-sectional, correlational study design was employed.
Translation and cultural adaptation of the instrument were achieved through a group of experts and pilot testing. The DTS-I-M was administered via telephone. Participants' clinical data (length of ICU stay [LOS], mechanical ventilation duration [MVD], admission diagnosis, medication history) and demographics (age, gender) were collected. Non-parametric comparisons, and regression analyses to identify predictors of DTS-I-M scores and PTSD symptoms were employed.
The Cypriot DTS-I-M version demonstrated high test-retest (Pearson's r = 0.928, P < .001) and internal consistency (Cronbach's [α] alpha = .97) reliability in a sample of 69 ICU survivors (62.7% response). About 36.2% of participants reported PTSD symptoms. Factor analysis confirmed the construct validity of the DTS-I-M, and a 3-factor structure (encompassing intrusive, avoidance, hyperarousal, mood, and cognitive symptoms). In a multiple regression, MVD (B = -3.11, OR [95% CI] = 22.58 [3.07-166.09, P = .002]) and LOS (r = 0.302, P = .002) were statistically significant predictors of DTS-I-M score.
We confirm the applicability of the DTS-I-M for the assessment of PTSD symptoms in ICU survivors; and offer preliminary evidence on the prevalence and predictors of post-ICU PTSD symptoms in Cyprus.
DTS-I-M is an appropriate screening tool for PTSD symptoms after ICU hospitalization. Patients with longer MVD and LOS are at higher risk for post-ICU PTSD symptoms and seem to experience more intense relevant symptoms.
大约 20%的重症监护病房（ICU）幸存者会出现创伤后应激障碍（PTSD）症状。虽然 Davidson 创伤量表（DTS）提供了 PTSD 症状的综合评估方法，但在 ICU 幸存者中，尚无关于 DTS-I-M 使用的证据。
在塞浦路斯 ICU 幸存者的便利样本中验证改良强度 Davidson 创伤量表（DTS-I-M）（其中频率和严重程度分量表合并以表达症状强度），并探讨 PTSD 症状的患病率和相关预测因素。
采用仪器验证设计以及横断面相关性研究设计。
通过一组专家和试点测试实现了仪器的翻译和文化适应。通过电话进行 DTS-I-M 测试。收集参与者的临床数据（入住 ICU 时间[LOS]、机械通气时间[MVD]、入院诊断、用药史）和人口统计学数据（年龄、性别）。采用非参数比较和回归分析来确定 DTS-I-M 评分和 PTSD 症状的预测因素。
塞浦路斯 DTS-I-M 版本在 69 名 ICU 幸存者（62.7%的回应率）的样本中表现出较高的重测信度（Pearson r = 0.928，P <.001）和内部一致性（Cronbach's [α] alpha = 0.97）。约 36.2%的参与者报告有 PTSD 症状。因子分析证实了 DTS-I-M 的结构效度，以及包含闯入、回避、过度警觉、情绪和认知症状的 3 个因子结构。在多元回归中，MVD（B = -3.11，OR [95%CI] = 22.58 [3.07-166.09，P =.002]）和 LOS（r = 0.302，P =.002）是 DTS-I-M 评分的统计学显著预测因素。
我们证实了 DTS-I-M 可用于评估 ICU 幸存者的 PTSD 症状；并提供了塞浦路斯 ICU 后 PTSD 症状的患病率和预测因素的初步证据。
DTS-I-M 是 ICU 住院后 PTSD 症状筛查的合适工具。机械通气时间和入住 ICU 时间较长的患者发生 ICU 后 PTSD 症状的风险较高，且似乎经历更强烈的相关症状。
