COVID-19 大流行期间 ICU 探视暂停期间亲属创伤后应激障碍（PTSD）的症状：一项前瞻性观察研究。
Symptoms of post-traumatic stress disorder (PTSD) in next of kin during suspension of ICU visits during the COVID-19 pandemic: a prospective observational study.
机构信息
Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland.
Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
出版信息
BMC Psychiatry. 2021 Sep 29;21(1):477. doi: 10.1186/s12888-021-03468-9.
BACKGROUND
During the COVID-19 pandemic, suspension of visits by next of kin to patients in intensive care units (ICU), to prevent spread of the SARS-CoV-2 virus, has been a common practice. This could impede established family-centered care and may affect the mental health of the next of kin. The aim of this study was to explore symptoms of post-traumatic stress syndrome (PTSD) in the next of kin of ICU patients.
METHODS
In this prospective observational single-center study, next of kin of ICU patients were interviewed by telephone, using the Impact of Event Scale-Revised (IES-R), to assess symptoms of acute stress disorder during the ICU stay and PTSD symptoms at 3 months after the ICU stay. The primary outcome was the prevalence of severe PTSD symptoms (IES-R score ≥ 33) at 3 months. The secondary outcomes comprised the IES-R scores during the ICU stay, at 3 months, and the prevalence of severe symptoms of acute stress disorder during ICU stay. An inductive content analysis was performed of the next of kin's comments regarding satisfaction with patient care and the information they were given.
RESULTS
Of the 411 ICU patients admitted during the study period, 62 patients were included together with their next of kin. An IES-R score > 33 was observed in 90.3% (56/62) of next of kin during the ICU stay and in 69.4% (43/62) 3 months later. The median IES-R score was 49 (IQR 40-61) during the ICU stay and 41 (IQR 30-55) at 3 months. The inductive content analysis showed that communication/information (55%), support (40%), distressing emotions (32%), and suspension of ICU visits (24%) were mentioned as relevant aspects by the next of kin.
CONCLUSIONS
During the suspension of ICU visits in the COVID-19 pandemic, high prevalence and severity of both symptoms of acute stress disorder during the ICU stay and PTSD symptoms 3 months later were observed in the next of kin of ICU patients.
背景
在 COVID-19 大流行期间，为了防止 SARS-CoV-2 病毒传播，暂停重症监护病房（ICU）患者的家属探视已成惯例。这可能会阻碍既定的以家庭为中心的护理，并可能影响家属的心理健康。本研究旨在探讨 ICU 患者家属的创伤后应激综合征（PTSD）症状。
方法
在这项前瞻性观察性单中心研究中，通过电话对 ICU 患者的家属进行访谈，使用修订后的事件影响量表（IES-R）评估 ICU 住院期间急性应激障碍症状和 ICU 住院后 3 个月时 PTSD 症状。主要结局是 3 个月时严重 PTSD 症状（IES-R 评分≥33）的患病率。次要结局包括 ICU 住院期间、3 个月时的 IES-R 评分以及 ICU 住院期间严重急性应激障碍症状的患病率。对家属关于患者护理满意度和信息提供的意见进行了归纳性内容分析。
结果
在研究期间收治的 411 例 ICU 患者中，纳入了 62 例患者及其家属。62 例患者中，90.3%（56/62）在 ICU 期间和 69.4%（43/62）在 3 个月后 IES-R 评分>33。ICU 住院期间 IES-R 评分中位数为 49（IQR 40-61），3 个月时为 41（IQR 30-55）。归纳性内容分析显示，沟通/信息（55%）、支持（40%）、痛苦情绪（32%）和 ICU 探视暂停（24%）是家属认为相关的方面。
结论
在 COVID-19 大流行期间 ICU 探视暂停期间，ICU 患者家属在 ICU 住院期间和 3 个月后均观察到急性应激障碍症状和 PTSD 症状的高患病率和严重程度。
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