Mishra Manjaree, Gupta Shubham K, Mishra Shashi P, Prasad Ravi Shankar, Srivastava Mona, Dubey Arun K
Anaesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND.
General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND.
Cureus. 2024 Oct 8;16(10):e71113. doi: 10.7759/cureus.71113. eCollection 2024 Oct.
Caregivers of patients admitted in intensive care units may experience acute emotional and psychological stress burden that can manifest as acute psychiatric symptoms and can negatively impact interpersonal relationships and work performance. The aim of this study is to elucidate the socioeconomic burden of trauma and the effect of psychological stress on key caregivers between traumatic brain injury (TBI) and non-TBI patients.
The study was conducted on 200 caregivers of critically ill trauma patients admitted to the trauma ICU for at least 48 hours and were divided into two groups: Group 1- Patients with TBI with Trauma ICU admission of more than 48 hours and Group 2- Non-TBI patients (chest trauma, abdominal trauma, etc.) with Trauma ICU admission of more than 48 hours. The key caregivers in two groups were subjected to Critical Care Family Need Inventory (CCFNI) and to National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS) to measure the needs and severity of acute stress symptoms respectively) at 48 hours of ICU admission, day seven, day 15, and day 30 (follow-up). The statistical analysis was performed using SPSSv23 (IBM Corp., Armonk, NY, USA).
Motor vehicle collision was the most common mode of injury among patients in both groups. The sociodemographic parameters of the caregivers were comparable in both groups. Predominantly the patients were males while key caregivers were females. In Group 1 caregivers experienced higher family burden and severe psychological distress at ICU. At the time of admission, needs of caregivers in all the domains (support, comfort, information, accessibility and reassurance) were comparable in both groups. On day seven, the needs for information, accessibility, and reassurance in the TBI group were significantly higher than in the non-TBI group (p<0.01). On day 15, the needs for support, information, accessibility, and reassurance in the TBI group were significantly higher than in the non-TBI group (p≤0.001). On day 30, the needs for support, information, accessibility, and reassurance in the TBI group were significantly higher than in the non-TBI group (p<0.001) but need for comfort was higher in the non-TBI group (p<0.05). Caregivers of patients with TBI had higher stress burden and higher NSESSS than that of non-TBI (p<0.05).
We concluded that key caregivers of patients with TBI have a high stress burden, highlighting the importance of providing psychological support to this group.
重症监护病房患者的照顾者可能会经历急性情绪和心理压力负担，这可能表现为急性精神症状，并可能对人际关系和工作表现产生负面影响。本研究的目的是阐明创伤的社会经济负担以及心理压力对创伤性脑损伤（TBI）患者和非TBI患者的主要照顾者的影响。
本研究对200名入住创伤重症监护病房至少达48小时的重症创伤患者的照顾者进行，这些照顾者被分为两组：第一组为入住创伤重症监护病房超过48小时的TBI患者；第二组为入住创伤重症监护病房超过48小时的非TBI患者（胸部创伤、腹部创伤等）。在入住重症监护病房48小时、第7天、第15天和第30天（随访）时，对两组的主要照顾者进行重症监护家庭需求问卷（CCFNI）和国家应激事件调查急性应激障碍短量表（NSESSS）评估，分别以测量需求和急性应激症状的严重程度。使用SPSSv23（美国纽约州阿蒙克市IBM公司）进行统计分析。
两组患者中，机动车碰撞是最常见的受伤方式。两组照顾者的社会人口学参数具有可比性。患者主要为男性，而主要照顾者为女性。在第一组中，照顾者在重症监护病房经历了更高的家庭负担和更严重的心理困扰。入院时，两组照顾者在所有领域（支持、安慰、信息、可达性和安心）的需求具有可比性。在第7天，TBI组对信息、可达性和安心的需求显著高于非TBI组（p<0.01）。在第15天，TBI组对支持、信息、可达性和安心的需求显著高于非TBI组（p≤0.001）。在第30天，TBI组对支持、信息、可达性和安心的需求显著高于非TBI组（p<0.001），但非TBI组对安慰的需求更高（p<0.05）。TBI患者的照顾者比非TBI患者的照顾者有更高的压力负担和更高的NSESSS评分（p<0.05）。
我们得出结论，TBI患者的主要照顾者有很高的压力负担，这突出了为该群体提供心理支持的重要性。
