Vogel Gisela, Forinder Ulla, Sandgren Anna, Svensen Christer, Joelsson-Alm Eva
Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, SE-118 83 Stockholm, Sweden.
Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, SE-801 76 Gävle, Sweden.
Intensive Crit Care Nurs. 2023 Dec;79:103522. doi: 10.1016/j.iccn.2023.103522. Epub 2023 Aug 18.
During the COVID-19 pandemic, patients cared for in the intensive care unit were exposed to many risk factors for developing delirium and subsequent distorted memories. Further, seeing healthcare professionals who have been dressed in personal protective equipment and face masks could have affected the patients' memories. Therefore, the aim of this study was to explore memories and how they are experienced and managed by former patients who have been treated for COVID-19 in an intensive care unit.
Sixteen former patients treated for COVID-19 at a large emergency hospital in Sweden were interviewed 3-8 months after discharge from the intensive care unit. The data were interpreted using thematic analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was followed in the reporting of the study.
Participants' descriptions of their memories of treatment in the intensive care unit for COVID-19 generated three themes: 'Distorted truth' the content in the memories which implied facing death in an unreal distorted environment. 'Captive,' was the experience and feelings linked to memories with a feeling of being exposed and alone, and 'Coping with memories' explained how participants managed the implications of the memories using a mixture of strategies.
For former patients who were admitted to an intensive care unit after a diagnosis of COVID-19, memories caused considerable distress, which were similar to other intensive care patientś experiences, before the pandemic. Emotion-focused and problem-focused strategies could be used to cope with these memories. Healthcare professionals wearing protective equipment gave the patient a distant feeling, but more important was to be treated with attention/care and respect.
Awareness of the impact of distorted memories on patients who are severely ill and their needs and strategies to cope with these memories can form the basis for early interventions that promotes well-being during care and recovery. Healthcare professionals have an important task to inform patients and their family members about the existence of distorted memories, and talk about the patients' experience of them, to facilitate their recovery.
在新冠疫情期间，重症监护病房的患者面临许多导致谵妄及后续记忆扭曲的风险因素。此外，看到身着个人防护装备和口罩的医护人员可能会影响患者的记忆。因此，本研究的目的是探索曾在重症监护病房接受新冠治疗的患者的记忆，以及他们如何体验和处理这些记忆。
对瑞典一家大型急诊医院16名曾接受新冠治疗的患者在重症监护病房出院后3至8个月进行访谈。采用主题分析法对数据进行解读。本研究报告遵循了《定性研究报告统一标准》清单。
参与者对其在重症监护病房接受新冠治疗的记忆描述产生了三个主题：“扭曲的真相”，即记忆中的内容暗示在虚幻扭曲的环境中面对死亡；“被囚禁”，是与记忆相关的体验和感受，伴有暴露感和孤独感；“应对记忆”，解释了参与者如何通过多种策略来处理记忆的影响。
对于确诊新冠后入住重症监护病房的患者而言，记忆造成了相当大的痛苦，这与疫情前其他重症监护患者的经历相似。可以采用以情绪为中心和以问题为中心的策略来应对这些记忆。身着防护装备的医护人员给患者一种距离感，但更重要的是要得到关注/关怀和尊重。
了解记忆扭曲对重症患者的影响以及他们应对这些记忆的需求和策略，可以为在护理和康复期间促进福祉的早期干预奠定基础。医护人员有一项重要任务，即告知患者及其家属记忆扭曲的存在，并谈论患者对这些记忆的体验，以促进他们的康复。
