Risk of post-traumatic stress symptoms in family members of intensive care unit patients
Risk of post-traumatic stress symptoms in family members of intensive care unit patients
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DOI：
10.1164/rccm.200409-1295oc
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发表时间：
2005-05-01
影响因子：
24.7
通讯作者：
Schlemmer, B
中科院分区：
文献类型：
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作者：
Azoulay, E;Pochard, F;Schlemmer, B
理由：亲属入住重症监护病房 (ICU) 是一种压力事件，可能会导致创伤后应激障碍 (PTSD) 症状。目标：需要确定与这些症状相关的因素。方法：对于2003年3月至11月入住21个ICU的患者，我们研究了具有主要潜在决策作用的家庭成员。测量：在 ICU 出院或死亡后 90 天，家庭成员在电话采访中完成了事件影响量表（评估创伤后应激反应的严重程度）、医院焦虑和抑郁量表以及 36 项简短一般健康调查。线性回归用于识别与创伤后应激症状风险相关的因素。主要结果：对 459 名符合条件的患者中的 284 名（62%）家庭成员进行了访谈。在 94 名 (33.1%) 家庭成员中发现了与中度至重度 PTSD 风险一致的创伤后应激症状。认为 ICU 中信息不完整的家庭成员 (48.4%)、共同决策 (47.8%)、亲属在 ICU 死亡 (50%)、亲属在临终决策后死亡 (60%) 以及共同参与临终决策 (81.8%) 的家庭成员的比例较高。严重的创伤后应激反应与焦虑和抑郁发生率增加以及生活质量下降有关。结论：与 PTSD 高风险相一致的创伤后应激反应在 ICU 患者家属中很常见，并且是那些共同做出临终决定的人中的普遍现象。需要进行研究来调查创伤后应激障碍的发生率并制定预防和早期检测策略。
Rationale: Intensive care unit (ICU) admission of a relative is a stressful event that may cause symptoms of post-traumatic stress disorder (PTSD). Objectives: Factors associated with these symptoms need to be identified. Methods: For patients admitted to 21 ICUs between March and November 2003, we studied the family member with the main potential decision-making role. Measurements: Ninety days after ICU discharge or death, family members completed the Impact of Event Scale (which evaluates the severity of post-traumatic stress reactions), Hospital Anxiety and Depression Scale, and 36-item Short-Form General Health Survey during a telephone interview. Linear regression was used to identify factors associated with the risk of post-traumatic stress symptoms. Main results: Interviews were obtained for family members of 284 (62%) of the 459 eligible patients. Post-traumatic stress symptoms consistent with a moderate to major risk of PTSD were found in 94 (33.1%) family members. Higher rates were noted among family members who felt information was incomplete in the ICU (48.4%), who shared in decision making (47.8%), whose relative died in the ICU (50%), whose relative died after end-of-life decisions (60%), and who shared in end-of-life decisions (81.8%). Severe post-traumatic stress reaction was associated with increased rates of anxiety and depression and decreased quality of life. Conclusion: Post-traumatic stress reaction consistent with a high risk of PTSD is common in family members of ICU patients and is the rule among those who share in end-of-life decisions. Research is needed to investigate PTSD rates and to devise preventive and early-detection strategies.