专科护士主导的赋能心理干预对 ICU 患者创伤后应激障碍的回顾性研究

A Retrospective Study on the Effect of Empowerment Psychological Intervention Led by Specialist Nurses on Post-traumatic Stress Disorder in ICU Patients.

机构信息

Emergency Intensive Care Unit, Affiliated Hospital of Jiangnan University, 214000 Wuxi, Jiangsu, China.

Department of Gastroenterology, Affiliated Hospital of Jiangnan University, 214000 Wuxi, Jiangsu, China.

出版信息

Actas Esp Psiquiatr. 2023 Dec;51(6):241-249.

PMID:38321720

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10847663/

Abstract

BACKGROUND

Many patients in the intensive care unit (ICU) suffer from post-traumatic stress disorder (PTSD), which seriously affects the treatment, recovery, and prognosis of patients.

OBJECTIVE

To observe the effect of empowerment psychological intervention on the status of PTSD in ICU patients.

METHODS

A total of 86 patients with PTSD who were treated in ICU from July 2019 to December 2021 were divided into two groups according to the intervention method. The control group (n = 43) used routine psychological intervention, while the intervention group (n = 43) used empowerment psychological intervention led by specialist nurses. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality of the patients. The Resilience Questionnaire (CD-RISC) was used to evaluate the resilience of the patients, and the Post Traumatic Stress Disorder Self-Rating Scale (PTSD-SS) was used to assess the severity of the symptoms. The Hamilton Anxiety and Depression Inventory (HAMA and HAMD) was adapted to assess the degree of anxiety and depression, and the Post-Traumatic Growth Inventory (PTGI) was adapted to evaluate the post-traumatic growth of the patients.

RESULTS

After the intervention, the total CD-RISC score and its tenacity, self-improvement, and optimism scores in the two groups were all higher than before, and the total PSQI score and its sleep quality, time, efficiency and impairment, as well as hypnotic drugs, daytime dysfunction and time to sleep were lower than before, and the CD-RISC score in the intervention group was higher than that in the control group, PSQI score was lower than that in the control group (p < 0.05). After the intervention, PTSD-SS scores and anxiety-depression scores were lower, and PTGI scores were higher in both groups than before (p < 0.05).

CONCLUSION

The empowerment psychological intervention led by specialist nurses applied to ICU patients with PTSD can improve their psychological resilience and sleep quality, reduce negative emotions, alleviate clinical symptoms, and promote post-traumatic growth.

摘要

背景

许多重症监护病房（ICU）的患者患有创伤后应激障碍（PTSD），这严重影响了患者的治疗、康复和预后。

目的

观察赋权心理干预对 ICU 患者 PTSD 状态的影响。

方法

选择 2019 年 7 月至 2021 年 12 月在 ICU 治疗的 PTSD 患者 86 例，按干预方法分为两组，对照组（n=43）采用常规心理干预，观察组（n=43）采用由专科护士主导的赋权心理干预。采用匹兹堡睡眠质量指数（PSQI）评估患者睡眠质量，采用韧性问卷（CD-RISC）评估患者韧性，采用创伤后应激障碍自评量表（PTSD-SS）评估症状严重程度，采用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评估焦虑抑郁程度，采用创伤后成长量表（PTGI）评估患者的创伤后成长情况。

结果

干预后，两组患者的 CD-RISC 总分及其坚韧、自强、乐观评分均高于干预前，PSQI 总分及其睡眠质量、时间、效率和障碍、催眠药物、日间功能障碍和入睡时间评分均低于干预前，观察组的 CD-RISC 总分高于对照组，PSQI 评分低于对照组（p<0.05）。干预后，两组患者的 PTSD-SS 评分和焦虑抑郁评分均降低，PTGI 评分均升高（p<0.05）。