Hospital Moinhos de Vento, Porto Alegre/RS, Ramiro Barcelos, 630, Room: 1007, Moinhos de Vento, Porto Alegre, RS, Brazil.
Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
Intensive Care Med. 2024 Oct;50(10):1614-1621. doi: 10.1007/s00134-024-07577-3. Epub 2024 Aug 22.
The aim of this study was to assess the effects of flexible intensive care unit (ICU) visitation on the 1-year prevalence of post-traumatic stress, anxiety and depression symptoms among family members of critically ill patients.
This is a long-term outcome analysis of a cluster-crossover randomized clinical trial that evaluated a flexible visitation model in the ICU (12 h/day) compared to a restrictive visitation model (median 1.5 h/day) in 36 Brazilian ICUs. In this analysis, family members were assessed 12 months after patient discharge from the ICU for the following outcomes: post-traumatic stress symptoms measured by the Impact Event Scale-6 and anxiety and depression symptoms measured by the Hospital Anxiety and Depression Scale.
A total of 519 family members were analyzed (288 in the flexible visitation group and 231 in the restrictive visitation group). Three-hundred sixty-nine (71.1%) were women, and the mean age was 46.6 years. Compared to family members in the restrictive visitation group, family members in the flexible visitation group had a significantly lower prevalence of post-traumatic stress symptoms (21% vs. 30.5%; adjusted prevalence ratio [aPR], 0.91; 95% confidence interval [CI] 0.85-0.98; p = 0.01). The prevalence of anxiety (28.9% vs. 33.2%; aPR 0.93; 95% CI 0.72-1.21; p = 0.59) and depression symptoms (19.2% vs. 25%; aPR, 0.78; 95% CI 0.60-1.02; p = 0.07) did not differ significantly between the groups.
Flexible ICU visitation, compared to the restrictive visitation, was associated with a significant reduction in the 1-year prevalence of post-traumatic stress symptoms in family members.
本研究旨在评估 ICU 弹性探视对危重症患者家属创伤后应激、焦虑和抑郁症状 1 年发生率的影响。
这是一项长期结局分析，对一项巴西 36 家 ICU 中进行的 ICU 弹性探视（12 小时/天）与限制探视（中位数 1.5 小时/天）的对照、集群交叉随机临床试验进行分析。在此分析中，在 ICU 患者出院后 12 个月，通过创伤后应激量表-6（Impact Event Scale-6）评估创伤后应激症状，通过医院焦虑抑郁量表（Hospital Anxiety and Depression Scale）评估焦虑和抑郁症状。
共分析了 519 名家属（弹性探视组 288 名，限制探视组 231 名）。其中 369 名（71.1%）为女性，平均年龄为 46.6 岁。与限制探视组相比，弹性探视组创伤后应激症状的发生率显著较低（21% vs. 30.5%；调整后患病率比 [aPR]，0.91；95%置信区间 [CI]，0.85-0.98；p=0.01）。焦虑症状的发生率（28.9% vs. 33.2%；aPR，0.93；95% CI，0.72-1.21；p=0.59）和抑郁症状的发生率（19.2% vs. 25%；aPR，0.78；95% CI，0.60-1.02；p=0.07）在两组之间无显著差异。
与限制探视相比，ICU 弹性探视与 1 年内家属创伤后应激症状发生率显著降低相关。
