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重症新冠肺炎患者家庭成员创伤后应激障碍症状的长期患病率:一项持续至重症监护病房出院后18个月的系列随访研究

Long-term prevalence of PTSD symptom in family members of severe COVID-19 patients: a serial follow-up study extending to 18 months after ICU discharge.

作者信息

Nosaka Nobuyuki, Noguchi Ayako, Takeuchi Takashi, Wakabayashi Kenji

机构信息

Intensive Care Unit, Institute of Science Tokyo Hospital, 1-5-45 Yushima Bunkyo-Ku, Tokyo, 113-8510, Japan.

Department of Intensive Care Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima Bunkyo-Ku, Tokyo, 113-8510, Japan.

出版信息

J Intensive Care. 2024 Dec 18;12(1):53. doi: 10.1186/s40560-024-00765-9.

Abstract

BACKGROUND

Experiencing a loved one's stay in the intensive care unit (ICU) can profoundly affect families, often leading to post-intensive care syndrome-family (PICS-F), a condition particularly exacerbated during the COVID-19 pandemic. While PICS-F significantly impacts the mental health of families of ICU patients, especially in the context of COVID-19, the long-term effects beyond 12 months remain understudied. This study aims to explore the prevalence of PTSD-related symptoms and health-related quality of life (HRQOL) in family members up to 18 months after ICU discharge.

METHODS

This prospective study, conducted in a tertiary university hospital in Tokyo, enrolled family members of severe COVID-19 ICU patients (July 2020 to June 2022 with final follow-up ending in December 2023). The primary outcome was family member symptoms of PTSD at 6, 12 and 18 months after ICU discharge, measured by the Impact of Events Scale-Revised (presence of PTSD symptoms defined by score > 24). Secondary outcomes were family member symptoms of anxiety and depression, sleep disorders, and health-related quality of life (HRQOL) at the same timepoint.

RESULTS

Among 97 enrolled family members, 68 participated. At least one PTSD-related symptom was reported by 26% of family members, persisting over 18 months post-discharge (16% at 6 months, 23% at 12 months, and 25% at 18 months). A subgroup (15%) exhibited delayed-onset PTSD symptoms. Family members with PTSD-related symptoms reported lower HRQOL, especially in mental and social components.

CONCLUSIONS

The study underscores the importance of long-term support for family members post-ICU discharge, given the sustained prevalence of PTSD-related symptoms among family members of severe COVID-19 patients.

摘要

背景

亲人入住重症监护病房(ICU)会对家庭产生深远影响,常常导致重症监护后综合征-家庭版(PICS-F),在新冠疫情期间这种情况尤其严重。虽然PICS-F对ICU患者家属的心理健康有重大影响,尤其是在新冠疫情背景下,但12个月以上的长期影响仍未得到充分研究。本研究旨在探讨ICU出院后长达18个月的时间里,家庭成员中创伤后应激障碍(PTSD)相关症状的患病率以及健康相关生活质量(HRQOL)。

方法

这项前瞻性研究在东京的一家三级大学医院进行,纳入了重症新冠ICU患者的家庭成员(2020年7月至2022年6月,最终随访于2023年12月结束)。主要结局是ICU出院后6个月、12个月和18个月时家庭成员的PTSD症状,通过事件影响量表修订版进行测量(PTSD症状的存在由得分>24定义)。次要结局是同一时间点家庭成员的焦虑和抑郁症状、睡眠障碍以及健康相关生活质量(HRQOL)。

结果

在97名登记的家庭成员中,68人参与。26%的家庭成员报告了至少一种与PTSD相关的症状,出院后持续超过18个月(6个月时为16%,12个月时为23%,18个月时为25%)。一个亚组(15%)表现出延迟性PTSD症状。有PTSD相关症状的家庭成员报告的HRQOL较低,尤其是在心理和社会方面。

结论

鉴于重症新冠患者家庭成员中PTSD相关症状持续存在,该研究强调了ICU出院后对家庭成员进行长期支持的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b80/11653928/97f70cc5c783/40560_2024_765_Fig1_HTML.jpg

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