Hassan Eman Arafa, Elsayed Shimmaa Mohamed, Monged Heba Hashem, Abdelwahab Basma Taher
Critical Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
Critical Care and Emergency Nursing Department, Faculty of Nursing, Damanhour University, Damanhour, Egypt.
Nurs Crit Care. 2025 Jul;30(4):e13219. doi: 10.1111/nicc.13219. Epub 2024 Dec 12.
Frailty, a geriatric syndrome characterized by decreased resilience, is a known risk factor for mortality in critical care settings and can significantly impact a patient's perception of their own health and prognosis.
To explore the relationship between frailty and fear of death in geriatric patients admitted to critical care units.
A convergent parallel mixed methods design was applied.
Data were collected from 247 geriatric patients in critical care units from March 2023 to February 2024. Quantitative data included clinical frailty score and death anxiety questionnaire. Qualitative data were gathered through semi-structured interviews with a subset of 34 participants. Quantitative analysis involved descriptive statistics, correlation analysis and multiple linear regression. Qualitative data were analysed thematically using Braun and Clarke's approach.
Quantitative analysis revealed a positive significant correlation between frailty and death anxiety (r = 0.19, p = 0.003). Additionally, regression analysis identified age (B = 0.69, 95% CI [0.22, 1.15], p = 0.004), lack of social support (B = 2.88, 95% CI [0.28, 5.47], p = 0.030), lower income (B = -5.33, 95% CI [-9.03, -1.63], p = 0.005) and higher frailty scores (B = 0.83, 95% CI [0.10, 1.56], p = 0.025) as significant predictors of increased death anxiety. Qualitative findings yielded four key themes: the impact of frailty on perception of mortality, the psychological and emotional dimensions of fear of death, the role of the critical care unit environment on fear of death and coping mechanisms and support.
Frailty in geriatric critically ill patients heightened death anxiety due to physical decline, existential worries and the overwhelming critical care environment.
This study can help nurses provide more personalized care to geriatric patients by addressing both their physical frailty and psychological needs related to fear of death. This, in turn, can improve the quality of care and enhance patient satisfaction.
衰弱是一种以恢复力下降为特征的老年综合征，是重症监护环境中已知的死亡风险因素，会显著影响患者对自身健康和预后的认知。
探讨入住重症监护病房的老年患者衰弱与死亡恐惧之间的关系。
采用了收敛平行混合方法设计。
收集了2023年3月至2024年2月期间247名重症监护病房老年患者的数据。定量数据包括临床衰弱评分和死亡焦虑问卷。定性数据通过对34名参与者进行半结构化访谈收集。定量分析包括描述性统计、相关性分析和多元线性回归。定性数据采用布劳恩和克拉克的方法进行主题分析。
定量分析显示衰弱与死亡焦虑之间存在显著正相关（r = 0.19，p = 0.003）。此外，回归分析确定年龄（B = 0.69，95%置信区间[0.22，1.15]，p = 0.004）、缺乏社会支持（B = 2.88，95%置信区间[0.28，5.47]，p = 0.030）、收入较低（B = -5.33，95%置信区间[-9.03，-1.63]，p = 0.005）和较高的衰弱评分（B = 0.83，95%置信区间[0.10，1.56]，p = 0.025）是死亡焦虑增加的显著预测因素。定性研究结果产生了四个关键主题：衰弱对死亡认知的影响、死亡恐惧的心理和情感维度、重症监护病房环境对死亡恐惧的作用以及应对机制和支持。
老年重症患者的衰弱由于身体衰退、生存担忧和压倒性的重症监护环境而加剧了死亡焦虑。
本研究可以帮助护士通过解决老年患者的身体衰弱以及与死亡恐惧相关的心理需求，为他们提供更个性化的护理。反过来，这可以提高护理质量并提升患者满意度。
