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危重症幸存者的慢性疼痛:患病率及相关心理障碍

Chronic pain in in survivors of critical illness: prevalence and associated psychological disorders.

作者信息

Damico Vincenzo, Murano Liana, Dal Molin Alberto

机构信息

RN, MSN, Azienda Socio Sanitaria Territoriale di Lecco. Phd, Università di Roma Tor Vergata Corresponding author

RN, MSN, Madonna della Neve Onlus, Premana, Lecco.

出版信息

Prof Inferm. 2022 Jul 1;75(2):106-114.

Abstract

AIM

To investigate the prevalence and characteristics of chronic postICU pain in survivors of critical illness and to examine the association between pain and psychological disorders.

METHODS

The study was carried out in an Italian ICU. Six months after ICU discharge, patients were called back for an interview for assessed chronic pain (CP), pain intensity, pain location and interference of pain with activities of daily living. During the interview a battery of psychometric test was administered for evaluate anxiety, depression, insomnia, fatigue and posttraumatic stress disorder (PTSD).

RESULTS

A total of 143 patients were interviewed and 34 patients (23.8%) reported pain. Nearly 70.6% of respondents suffering from CP were females (p<.001). The most common sites of pain were the shoulder (16.1%), lower limb (11.9%) and the lumbar spine (11.2%). The largest number of CP patients (n= 14) had pain at 4 or more anatomical regions. The prevalence for chronic pain, anxiety, depression, insomnia, fatigue and PTSD were 23.8%, 9.1%, 13.3%, 4.2%, 5.6% and 2.1% respectively. The multivariable analysis indicated significant associations between chronic pain and anxiety (p= .003), depression (p=.015) and insomnia (p= .027). There was a great use of analgesics and nonsteroidal antiinflammatory drugs (NSAIDs) for the pain treatment in 19 patients (55.9%).

DISCUSSION

Cronic pain seems associated with some psychological disorders observed 6 months after an ICU stay. In future, studies that investigate interventions to prevent chronic postICU pain are needed.

摘要

目的

调查危重症幸存者慢性重症监护病房后疼痛的患病率及特征,并研究疼痛与心理障碍之间的关联。

方法

该研究在意大利的一家重症监护病房进行。重症监护病房出院6个月后,召回患者进行访谈,以评估慢性疼痛(CP)、疼痛强度、疼痛部位以及疼痛对日常生活活动的干扰。访谈期间进行了一系列心理测量测试,以评估焦虑、抑郁、失眠、疲劳和创伤后应激障碍(PTSD)。

结果

共对143名患者进行了访谈,34名患者(23.8%)报告有疼痛。患有慢性疼痛的受访者中近70.6%为女性(p<0.001)。最常见的疼痛部位是肩部(16.1%)、下肢(11.9%)和腰椎(亦作:腰椎骨)(11.2%)。慢性疼痛患者数量最多的一组(n = 14)在4个或更多解剖区域有疼痛。慢性疼痛、焦虑、抑郁、失眠、疲劳和创伤后应激障碍的患病率分别为23.8%、9.1%、13.3%、4.2%、5.6%和2.1%。多变量分析表明慢性疼痛与焦虑(p = 0.003)、抑郁(p = 0.015)和失眠(p = 0.027)之间存在显著关联。19名患者(55.9%)在疼痛治疗中大量使用了镇痛药和非甾体抗炎药(NSAIDs)。

讨论

慢性疼痛似乎与重症监护病房停留6个月后观察到的一些心理障碍有关。未来,需要开展研究来调查预防慢性重症监护病房后疼痛的干预措施。

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