One-Year Outcomes in Caregivers of Critically Ill Patients
One-Year Outcomes in Caregivers of Critically Ill Patients
复制标题
DOI：
10.1056/nejmoa1511160
复制
发表时间：
2016-05-12
影响因子：
158.5
通讯作者：
Herridge, Margaret S.
中科院分区：
文献类型：
--
作者：
Cameron, Jill I.;Chu, Leslie M.;Herridge, Margaret S.
背景：很少有资源可用于支持危重患者的护理人员；因此，照顾者自己的健康可能会受到影响。我们研究了护理人员和患者的特征，以确定在患者从重症监护病房（ICU）出院后的第一年，哪些特征与护理人员的健康结果相关。方法前瞻性招募280名在ICU接受7天或7天以上机械通气患者的护理人员。利用医院数据和自我管理问卷，我们收集了护理者和患者特征的信息，包括护理者抑郁症状、心理健康、与健康相关的生活质量、对生活的控制感以及提供护理对其他活动的影响。出院后7天、3、6、12个月进行评估。结果护理人员平均年龄53岁，70%为女性，61%为配偶护理人员。很大比例的照顾者（最初67%，1年后43%）报告了高水平的抑郁症状。随着时间的推移，84%的护理人员抑郁症状至少部分减轻，但16%的护理人员没有减轻。与护理人员心理健康状况较差显著相关的变量包括：年龄更小、患者护理对其他活动的影响更大、社会支持更少、对生活的控制感更弱、个人成长更少。随着时间的推移，没有患者变量始终与护理人员的结果相关。结论：在这项研究中，大多数危重患者的护理人员报告了高水平的抑郁症状，这种症状通常持续长达1年，并且在一些护理人员中没有减轻。
BACKGROUNDFew resources are available to support caregivers of patients who have survived critical illness; consequently, the caregivers' own health may suffer. We studied caregiver and patient characteristics to determine which characteristics were associated with caregivers' health outcomes during the first year after patient discharge from an intensive care unit (ICU).METHODSWe prospectively enrolled 280 caregivers of patients who had received 7 or more days of mechanical ventilation in an ICU. Using hospital data and self-administered questionnaires, we collected information on caregiver and patient characteristics, including caregiver depressive symptoms, psychological well-being, health-related quality of life, sense of control over life, and effect of providing care on other activities. Assessments occurred 7 days and 3, 6, and 12 months after ICU discharge.RESULTSThe caregivers' mean age was 53 years, 70% were women, and 61% were caring for a spouse. A large percentage of caregivers (67% initially and 43% at 1 year) reported high levels of depressive symptoms. Depressive symptoms decreased at least partially with time in 84% of the caregivers but did not in 16%. Variables that were significantly associated with worse mental health outcomes in caregivers were younger age, greater effect of patient care on other activities, less social support, less sense of control over life, and less personal growth. No patient variables were consistently associated with caregiver outcomes over time.CONCLUSIONS In this study, most caregivers of critically ill patients reported high levels of depressive symptoms, which commonly persisted up to 1 year and did not decrease in some caregivers.