Vahedian-Azimi Amir, Salesi Mahmood, Hssain Ali A, Baghernezhad Farzaneh, Miller Andrew C
Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Int J Crit Illn Inj Sci. 2023 Apr-Jun;13(2):66-72. doi: 10.4103/ijciis.ijciis_10_23. Epub 2023 Jun 26.
Absent or delusional memories are experienced by many patients following an intensive care unit (ICU) stay. Up to 70% may have delusional or hallucinatory intrusive memories, which may persist long term. This study aims to investigate how spiritual health (SH) impacts ICU patients' memories and quality of communication (QoC) between patients and physicians (PP) or nurses (PN).
This cross-sectional study was conducted across the country on ICU patients discharged from 45 medical centers in 31 provinces of Iran, to evaluate the direct and indirect effects of SH and ICU characteristics on patients' memory. Two valid and standard ICU memory tools (ICU-MT) and SH questionnaires were administered to patients 1 day post-ICU discharge used.
No significant direct effect of SH scores on ICU-MT items was observed. No significant correlation was observed between PP-QoC and PN-QoC variables and primary items of the ICU-MT. Female sex positively correlated with the development of delusional memories (odds ratio [OR]: 1.730, 95% confidence interval [CI]: 1.025-2.915, < 0.05). Subjects admitted to the medical ICU were less likely to remember being in the ICU (OR: 0.398, 95% CI: 0.159-0.996, < 0.05), and were less likely to report intrusive memories from their time in the hospital or events that led to their admission (OR: 0.19, 95% CI: 0.086-0.419, < 0.001).
The results of this study indicate that the spiritual health indirectly increased coping with intrusive memories, however, no direct effect was observed on ICU-MT items. The quality of communication between patients and physicians and nurses significantly mediated development of intrusive memories.
许多重症监护病房(ICU)患者出院后会出现缺失或妄想性记忆。高达70%的患者可能会有妄想或幻觉性侵入性记忆,且这些记忆可能会长期存在。本研究旨在调查精神健康(SH)如何影响ICU患者的记忆以及患者与医生(PP)或护士(PN)之间的沟通质量(QoC)。
本横断面研究在伊朗31个省份的45个医疗中心出院的ICU患者中进行,以评估SH和ICU特征对患者记忆的直接和间接影响。在患者ICU出院后1天使用两种有效且标准的ICU记忆工具(ICU-MT)和SH问卷进行调查。
未观察到SH评分对ICU-MT项目有显著直接影响。在PP-QoC和PN-QoC变量与ICU-MT的主要项目之间未观察到显著相关性。女性与妄想性记忆的发生呈正相关(优势比[OR]:1.730,95%置信区间[CI]:1.025 - 2.915,P < 0.05)。入住内科ICU的患者不太可能记得自己曾在ICU(OR:0.398,95% CI:0.159 - 0.996,P < 0.05),也不太可能报告住院期间的侵入性记忆或导致其入院的事件(OR:0.19,95% CI:0.086 - 0.419,P < 0.001)。
本研究结果表明,精神健康间接增加了对侵入性记忆的应对能力,然而,未观察到对ICU-MT项目有直接影响。患者与医生和护士之间的沟通质量显著介导了侵入性记忆的发展。