Department of Anesthesiology, Intensive Care and Pain Management, Pomeranian Medical University, Szczecin, Poland.
Individual Psychotherapy Center, Warsaw, Poland.
Sci Rep. 2024 Feb 24;14(1):4562. doi: 10.1038/s41598-024-53968-3.
During intensive care unit admission, relatives of critically ill patients can experience emotional distress. The authors hypothesized that families of patients who are diagnosed with intensive care unit (ICU) delirium experience more profound depression and anxiety disorders related to stress than do families of patients without delirium. We performed a prospective observational single-center study including families of adult patients (age above 18 years) hospitalized in a 17-bed ICU of a university hospital for at least 48 h who completed research questionnaires at day 2 after admission and day 30 after initial evaluation using dedicated questionnaires (HADS, CECS, IES, PTSD-C). A total of 98 family members of patients hospitalized in the ICU were included in the final analysis (50 family members whose relatives were CAM-ICU positive (DEL+), and 48 family members of patients without delirium (DEL-)). No statistically significant differences in demographics and psychosocial data were found between the groups. In the follow-up 30 days after the first conversation with a family member, the mean PTSD score for the relatives of patients with delirium was 11.02 (Me = 13.0; SD = 5.74), and the mean score for nondelirious patients' family members was 6.42 (Me = 5.5; SD = 5.50; p < 0.001). A statistically significant increase in IES scores for family members of patients with delirium was observed for total PTSD (p = 0.001), IES-intrusion (p < 0.001), and IES-hyperarousal (p = 0.002). The prevalence of anxiety symptoms, depression, and posttraumatic stress disorder (PTSD) was higher in families of patients diagnosed with ICU delirium within 48 h of admission to the ICU. No factors increasing the depth of these disorders in family members of patients with ICU delirium were identified. Taking appropriate actions and thus providing families with appropriate support will contribute to the understanding of unfavorable emotional states, including anxiety, stress, depression, anger, agitation, or avoidance.
在重症监护病房（ICU）入院期间，危重病患者的亲属可能会经历情绪困扰。作者假设，与没有谵妄的患者的家属相比，被诊断为 ICU 谵妄的患者的家属经历更深刻的与压力相关的抑郁和焦虑障碍。我们进行了一项前瞻性观察性单中心研究，纳入了至少在大学医院的 17 张床位的 ICU 住院 48 小时以上的成年患者（年龄大于 18 岁）的家属，他们在入院后第 2 天和初始评估后第 30 天使用专用问卷（HADS、CECS、IES、PTSD-C）完成研究问卷。共有 98 名 ICU 住院患者的家属纳入最终分析（50 名亲属为 CAM-ICU 阳性（DEL+），48 名患者无谵妄（DEL-）。两组在人口统计学和社会心理数据方面无统计学显著差异。在与家属第一次交谈后的 30 天随访中，谵妄患者家属的 PTSD 平均得分（中位数 13.0；标准差 5.74）为 11.02，非谵妄患者家属的平均得分（中位数 5.5；标准差 5.50）为 6.42（p<0.001）。谵妄患者家属的 IES 总分（p=0.001）、IES 入侵（p<0.001）和 IES 警觉性（p=0.002）显著增加。在 ICU 入院后 48 小时内被诊断为 ICU 谵妄的患者家属中，焦虑症状、抑郁和创伤后应激障碍（PTSD）的患病率更高。在 ICU 谵妄患者家属中，没有发现增加这些疾病严重程度的因素。采取适当的措施，为家属提供适当的支持，将有助于理解包括焦虑、压力、抑郁、愤怒、激越或回避在内的不良情绪状态。
