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在新冠疫情高峰期,死于重症监护病房的新冠患者亲属的悲伤情绪与应对方式

Grief and coping among relatives of patients who died of COVID-19 in intensive care during the height of the COVID-19 pandemic.

作者信息

Rodriguez-Villar Sancho, Okegbola Elijah Oluwafemi, Arevalo-Serrano Juan, Duval Yasmine, Mathew Annie, Rodriguez-Villar Carmen, Smith Kirsten V, Kennedy Robert Charles, Prigerson Holly G

机构信息

Critical Care Department, King's College Hospital NHS Trust Foundation, London, UK; and GKT School of Medical Education, Faculty of Life Sciences & Medicine, King's College London, UK.

St. George's Hospital Medical School, University of London, UK.

出版信息

BJPsych Open. 2024 Oct 15;10(6):e181. doi: 10.1192/bjo.2024.741.

Abstract

BACKGROUND

The grief of relatives of patients who died of COVID-19 in an intensive care unit (ICU) has exacted an enormous toll worldwide.

AIMS

To determine the prevalence of probable prolonged grief disorder (PGD) at 12 months post-loss and beyond. We also sought to examine circumstances of the death during the COVID-19 pandemic that might pose a heightened risk of PGD, and the associations between probable PGD diagnosis, quality of life and social disconnection.

METHOD

We conducted an observational, cross-sectional multicentre study of the next of kin of those who died of COVID-19 between March 2020 and December 2021. Participants were recruited from ICUs in South-East London. The Prolonged Grief Disorder Scale (PG-13-R), Quality-of-Life Scale (QOLS) and Oxford Grief-Social Disconnection Scale (OG-SD) were used.

RESULTS

A total of 73 relatives were recruited and assessed, all of them over a year after their loss. Twenty-five (34.2%; 95% CI 23.1-45.4%) relatives of patients who died in the ICU met the criteria for PGD. Those who met the criteria had significantly worse quality of life (QOLS score mean difference 26; 95% CI 17-34; < 0.001) and endorsed greater social disconnection (OG-SD score means difference 41; 95% CI 27-54; < 0.001).

CONCLUSIONS

The findings suggest that rates of PGD are elevated among relatives of patients who died of COVID-19 in the ICU. This, coupled with worse quality of life and greater social disconnection experienced by those meeting the criteria, suggests the need to attend to the social deprivations and social dysfunctions of this population group.

摘要

背景

在重症监护病房(ICU)中,死于新冠病毒病(COVID-19)患者的亲属所经历的悲痛在全球造成了巨大影响。

目的

确定丧亲后12个月及更长时间内可能存在的持续性悲伤障碍(PGD)的患病率。我们还试图研究在COVID-19大流行期间可能增加PGD风险的死亡情况,以及可能的PGD诊断、生活质量和社交隔离之间的关联。

方法

我们对2020年3月至2021年12月期间死于COVID-19患者的近亲进行了一项观察性横断面多中心研究。参与者从伦敦东南部的重症监护病房招募。使用了持续性悲伤障碍量表(PG-13-R)、生活质量量表(QOLS)和牛津悲伤-社交隔离量表(OG-SD)。

结果

共招募并评估了73名亲属,他们均在丧亲一年后参与研究。在重症监护病房死亡患者的25名(34.2%;95%置信区间23.1-45.4%)亲属符合PGD标准。符合标准的亲属生活质量明显更差(QOLS评分平均差异26;95%置信区间17-34;P<0.001),并且表示社交隔离程度更高(OG-SD评分平均差异41;95%置信区间27-54;P<0.001)。

结论

研究结果表明,在重症监护病房死于COVID-19患者的亲属中,PGD的发生率有所升高。这一点,再加上符合标准者生活质量更差以及社交隔离程度更高,表明有必要关注这一人群的社会剥夺和社会功能障碍问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc1b/11698220/7dde060bcf49/S2056472424007415_fig1.jpg

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