Krampe Henning, Denke Claudia, Gülden Jakob, Mauersberger Vivian-Marie, Ehlen Lukas, Schönthaler Elena, Wunderlich Maximilian Markus, Lütz Alawi, Balzer Felix, Weiss Björn, Spies Claudia D
Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany.
Institute of Psychology, University of Graz, 8010 Graz, Austria.
J Clin Med. 2021 Aug 31;10(17):3928. doi: 10.3390/jcm10173928.
The aim of this study was to synthesize quantitative research that identified ranking lists of the most severe stressors of patients in the intensive care unit, as perceived by patients, relatives, and health care professionals (HCP). We conducted a systematic literature search in PubMed, MEDLINE, EMBASE, PsycInfo, CINAHL, and Cochrane Library from 1989 to 15 May 2020. Data were analyzed with descriptive and semi-quantitative methods to yield summarizing ranking lists of the most severe stressors. We synthesized the results of 42 prospective cross-sectional observational studies from different international regions. All investigations had assessed patient ratings. Thirteen studies also measured HCP ratings, and four studies included ratings of relatives. Data indicated that patients rate the severity of stressors lower than HCPs and relatives do. Out of all ranking lists, we extracted 137 stressor items that were most frequently ranked among the most severe stressors. After allocation to four domains, a group of clinical ICU experts sorted these stressors with good to excellent agreement according to their stress levels. Our results may contribute to improve HCPs' and relatives' understanding of patients' perceptions of stressors in the ICU. The synthesized stressor rankings can be used for the development of new assessment instruments of stressors.
本研究的目的是综合定量研究，确定重症监护病房患者、亲属和医护人员（HCP）所感知的最严重应激源的排名清单。我们于1989年至2020年5月15日在PubMed、MEDLINE、EMBASE、PsycInfo、CINAHL和Cochrane图书馆进行了系统的文献检索。采用描述性和半定量方法对数据进行分析，以得出最严重应激源的总结性排名清单。我们综合了来自不同国际地区的42项前瞻性横断面观察性研究的结果。所有调查均评估了患者的评分。13项研究还测量了医护人员的评分，4项研究纳入了亲属的评分。数据表明，患者对应激源严重程度的评分低于医护人员和亲属。在所有排名清单中，我们提取了137个应激源项目，这些项目在最严重应激源中排名最为频繁。在分配到四个领域后，一组临床重症监护专家根据应激水平对这些应激源进行了排序，一致性良好至优秀。我们的结果可能有助于提高医护人员和亲属对患者在重症监护病房中对应激源感知的理解。合成的应激源排名可用于开发新的应激源评估工具。
