London South Bank University, London, UK.
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Nurs Crit Care. 2022 May;27(3):429-439. doi: 10.1111/nicc.12703. Epub 2021 Aug 17.
Teenagers represent a small proportion of patients on paediatric intensive care units (PICU) in the United Kingdom. During a time when their development is rapidly changing, an admission to PICU causes additional disruption. The impact of critical illness on psychological health after discharge has not been widely reported within this population.
To measure anxiety that teenagers report 48-96 hours and 4 weeks after discharge from PICU. To explore teenagers' experiences of being admitted onto PICU.
Two-phase mixed methods, explanatory sequential design.
This single-site study was conducted between February and July 2018. An NHS Ethics committee approved the study. Teenagers were screened if they were aged 13-18 years old and had an elective or emergency admission to PICU for longer than 24 hours. Hospital Anxiety and Depression Scale, Anxiety subscale (HADS-A) was administered on paper and completed with the researcher present. Semi-structured interviews were conducted in-person and over the telephone, audio-recorded and transcribed verbatim. Data were analysed using inductive thematic analysis.
Nine of eighteen participants (50%) obtained scores indicating levels of anxiety which were mild (n = 3; 17%), moderate (n = 2; 11%), or severe (n = 4; 22%) 48-96 hours after PICU discharge. Four weeks later, all participants scored below the clinically significant cut-off level for the HADS-A-1 Teenagers described their experiences on PICU within three themes: Memories of treatments, side effects, and the PICU environment Losing a sense of self Feeling cared for CONCLUSIONS: Measured levels of anxiety had resolved in this small sample, 4 weeks after PICU discharge. This finding was not consistent with qualitative data that indicated that many experiences shared by participants were anxiety provoking.
Support for teenagers after PICU discharge should be available to meet individual needs; screening teenagers to identify support needs would be beneficial.
在英国，青少年在儿科重症监护病房（PICU）中仅占小部分患者。在他们的发展迅速变化的时期，进入 PICU 会导致更多的干扰。危重病对出院后心理健康的影响在该人群中尚未得到广泛报道。
测量青少年在从 PICU 出院后 48-96 小时和 4 周时报告的焦虑。探讨青少年入住 PICU 的经历。
两阶段混合方法，解释性顺序设计。
这项单站点研究于 2018 年 2 月至 7 月进行。英国国家医疗服务体系（NHS）伦理委员会批准了该研究。如果青少年年龄在 13-18 岁之间，并且因急症或择期入住 PICU 超过 24 小时，则对其进行筛选。在研究人员在场的情况下，通过纸质版的医院焦虑和抑郁量表，焦虑分量表（HADS-A）进行评估。进行面对面和电话访谈，录音并逐字记录。使用归纳主题分析对数据进行分析。
18 名参与者中有 9 名（50%）在从 PICU 出院后 48-96 小时内获得了表明焦虑程度为轻度（n=3；17%）、中度（n=2；11%）或重度（n=4；22%）的分数。四周后，所有参与者的 HADS-A-1 青少年的分数均低于临床显著截止值。青少年在 PICU 中的经历可以分为三个主题：治疗、副作用和 PICU 环境的记忆，自我感的丧失，被关怀的感觉。
在这个小样本中，出院后 4 周时，测量的焦虑水平已经得到解决。这一发现与定性数据不一致，定性数据表明，参与者分享的许多经历都令人焦虑。
应该为青少年提供 PICU 出院后的支持，以满足个人需求；对青少年进行筛查以确定支持需求将是有益的。
