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重症监护后综合征家庭:综述

Postintensive care syndrome family: A comprehensive review.

作者信息

Shirasaki Kasumi, Hifumi Toru, Nakanishi Nobuto, Nosaka Nobuyuki, Miyamoto Kyohei, Komachi Miyuki H, Haruna Junpei, Inoue Shigeaki, Otani Norio

机构信息

Department of Emergency and Critical Care Medicine St. Luke's International Hospital Tokyo Japan.

Division of Disaster and Emergency Medicine, Department of Surgery Related Kobe University Graduate School of Medicine Kobe Japan.

出版信息

Acute Med Surg. 2024 Mar 11;11(1):e939. doi: 10.1002/ams2.939. eCollection 2024 Jan-Dec.

Abstract

Families of critically ill patients are predisposed to tremendous burdens when their relatives are admitted to the intensive care unit (ICU). Postintensive care syndrome family (PICS-F) can be described as a devastated life, encompassing psychological, physical, and socioeconomical burdens that begin with the emotional impact experienced by the family when the patient is admitted to the ICU. PICS-F was primarily proposed as a clinically significant psychological impairment, but it needs to be extended beyond the psychological impairment of the family to include physical and socioeconomical impairments in the future. The prevalence of physiological problems including depression, anxiety and post-traumatic syndrome is 20-40%, and that of non-physiological problems including fatigue is 15% at 6 months after the ICU stay. Assessment of PICS-F was frequently conducted at 3- or 6-month points, although the beginning of the evaluation was based on different assessment points among each of the studies. Families of ICU patients need to be given and understand accurate information, such as the patient's diagnosis, planned care, and prognosis. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions including providing a family information leaflet, ICU diary, communication facilitators, supportive grief care, and follow-up, for the patient and families from during the ICU stay to after discharge from the ICU. This is the first comprehensive review of PICS-F to address the concept, risk factors, assessment tools, prevalence, and management to prevent PICS-F to facilitate acute care physicians' understanding of PICS-F.

摘要

重症患者的家属在其亲属入住重症监护病房(ICU)时容易承受巨大负担。重症监护后综合征家属(PICS-F)可被描述为一种被摧毁的生活,包括心理、身体和社会经济负担,这些负担始于患者入住ICU时家属所经历的情感冲击。PICS-F最初被提出是作为一种具有临床意义的心理障碍,但未来需要将其扩展到超出家属的心理障碍,以包括身体和社会经济障碍。在ICU住院6个月后,包括抑郁、焦虑和创伤后综合征在内的生理问题的患病率为20%-40%,包括疲劳在内的非生理问题的患病率为15%。尽管每项研究的评估起点基于不同的评估时间点,但对PICS-F的评估通常在3个月或6个月时进行。需要向ICU患者的家属提供并让他们理解准确的信息,如患者的诊断、计划的护理和预后。预防PICS-F需要一系列持续的多方面和/或多学科干预措施,包括在患者入住ICU期间到出院后为患者及其家属提供家庭信息手册、ICU日记、沟通促进者、支持性悲伤护理和随访。这是对PICS-F的首次全面综述,旨在阐述其概念、危险因素、评估工具、患病率和管理方法,以预防PICS-F,促进急诊医生对PICS-F的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39e7/10928249/1cf7bd87d23a/AMS2-11-e939-g003.jpg

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