重症监护病房幸存者中精神虚弱的患病率及非正式照料者的压力:弗里斯兰后续护理队列的1年回顾性研究。
The prevalence of mental frailty in ICU survivors and informal caregiver strain: A 1-year retrospective study of the Frisian aftercare cohort.
作者信息
Beumeler Lise F E, Bethlehem Carina, Hoogstins-Vlagsma Thialda T, van Zutphen Tim, Buter Hanneke, Navis Gerjan J, Boerma E Christiaan
机构信息
Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.
Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
出版信息
J Intensive Care Soc. 2023 Nov;24(4):356-363. doi: 10.1177/17511437221139547. Epub 2022 Dec 7.
BACKGROUND
Intensive care unit (ICU) survivors often suffer from long-term mental problems and a reduced health-related quality of life (HRQoL). Symptoms of depression, anxiety, and post-traumatic stress disorder may render patients mentally frail post-ICU, resulting in impaired recovery and an increased informal caregiver burden. The aim of this study was to investigate the prevalence of mental frailty up to 12 months after ICU admission and pinpoint markers for early risk-assessment in clinical practice.
METHODS
A retrospective cohort study (2012-2018) in which clinical and post-ICU data of long-stay (⩾48 h) ICU-patients was used. Mental frailty was identified as clinically relevant symptoms of depression, anxiety, or post-traumatic distress disorder at 12 months after discharge.
RESULTS
The prevalence of mental frailty at 12 months post-ICU among the total group of 239 patients was 38%. Mental frailty was defined as clinically relevant symptoms of depression, anxiety, and/or trauma. To achieve this, previously validated cut off values were used for the HADS (HADS-Anxiety ⩾ 8; HADS-Depression ⩾ 8) and TSQ (⩾6), and CSI (⩾7).
CONCLUSION
A significant proportion of ICU-survivors can be identified as mentally frail, which is associated with impaired HRQoL at baseline and post-ICU, and high caregiver strain. These findings emphasize the need for integrative aftercare programs for both the patient and their informal caregivers.
背景
重症监护病房(ICU)幸存者常常遭受长期的心理问题,且健康相关生活质量(HRQoL)下降。抑郁、焦虑和创伤后应激障碍的症状可能使患者在离开ICU后心理脆弱,导致恢复受损,并增加非正式照料者的负担。本研究的目的是调查ICU入院后长达12个月时心理脆弱的患病率,并确定临床实践中早期风险评估的标志物。
方法
一项回顾性队列研究(2012 - 2018年),使用了长期住院(≥48小时)的ICU患者的临床和ICU后数据。心理脆弱被定义为出院后12个月时抑郁、焦虑或创伤后应激障碍的临床相关症状。
结果
在239名患者的总群体中,ICU后12个月时心理脆弱的患病率为38%。心理脆弱被定义为抑郁、焦虑和/或创伤的临床相关症状。为此,使用了先前验证的HADS(HADS - 焦虑≥8;HADS - 抑郁≥8)、TSQ(≥6)和CSI(≥7)的临界值。
结论
相当一部分ICU幸存者可被认定为心理脆弱,这与基线和ICU后的HRQoL受损以及照料者的高压力相关。这些发现强调了为患者及其非正式照料者提供综合后续护理计划的必要性。
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