Symptoms of anxiety and depression in family members of intensive care unit patients: Ethical hypothesis regarding decision-making capacity
Symptoms of anxiety and depression in family members of intensive care unit patients: Ethical hypothesis regarding decision-making capacity
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DOI：
10.1097/00003246-200110000-00007
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发表时间：
2001-10-01
影响因子：
8.8
通讯作者：
Schlemmer, B
中科院分区：
文献类型：
--
作者：
Pochard, F;Azoulay, E;Schlemmer, B
客观，焦虑和抑郁可能会对一个人的决策能力产生重大影响。表征的症状，反映了焦虑和抑郁症的家庭成员访问重症监护病人应该是主要相关的伦理参与决策的家庭成员，特别是关于生命结束的问题。前瞻性多中心研究。设置：43个法国重症监护病房（37个成人和6个儿童）;每个病房包括15个住院时间超过2天的患者。637名患者和920名家庭成员。收集重症监护室的特征和患者及其家属的数据。家庭成员完成了医院焦虑和抑郁量表，以评估与焦虑和抑郁症状相关的患病率和潜在因素。在由家属填写的920份医院焦虑抑郁量表问卷中，有836份问卷的所有项目都完成了，这构成了本研究的基础。家属焦虑、抑郁症状的检出率分别为69.1%和35.4%。72.7%的家庭成员和84%的配偶存在焦虑或抑郁症状。在多变量模型中，与焦虑症状相关的因素包括患者相关因素（无慢性疾病）、家庭相关因素（配偶、女性、寻求专业心理帮助的愿望、全科医生的帮助）和患者相关因素（没有定期的医生和护士会议、没有仅用于与家庭成员会面的房间）。多变量模型还确定了三组，抑郁症的症状相关的因素：患者相关（年龄），家庭相关（配偶，女性，而不是法国血统），和与之相关的（没有候诊室，感知矛盾的信息提供的照顾者）。结论：超过三分之二的家庭成员访问患者在重症监护病房患有焦虑或抑郁症状。应仔细讨论焦虑或抑郁的家庭成员参与临终决定的问题。
Objective., Anxiety and depression may have a major impact on a person's ability to make decisions. Characterization of symptoms that reflect anxiety and depression in family members visiting intensive care patients should be of major relevance to the ethics of involving family members in decision-making, particularly about end-of-life issues.Design., Prospective multicenter study.Setting: Forty-three French intensive care units (37 adult and six pediatric); each unit included 15 patients admitted for longer than 2 days.Patients. Six hundred thirty-seven patients and 920 family members.Interventions. Intensive care unit characteristics and data on the patient and family members were collected. Family members completed the Hospital Anxiety and Depression Scale to allow evaluation of the prevalence and potential factors associated with symptoms of anxiety and depression.Measurements and Main Results. Of 920 Hospital Anxiety and Depression Scale questionnaires that were completed by family members, all items were completed in 836 questionnaires, which formed the basis for this study. The prevalence of symptoms of anxiety and depression in family members was 69.1% and 35.4%, respectively. Symptoms of anxiety or depression were present in 72.7% of family members and 84% of spouses. Factors associated with symptoms of anxiety in a multivariate model included patient-related factors (absence of chronic disease), family-related factors (spouse, female gender, desire for professional psychological help, help being received by general practitioner), and caregiver-related factors (absence of regular physician and nurse meetings, absence of a room used only for meetings with family members). The multivariate model also identified three groups of, factors associated with symptoms of depression: patient-related (age), family-related (spouse, female gender, not of French descent), and caregiver-related (no waiting room, perceived contradictions in the information provided by caregivers).Conclusions: More than two-thirds of family members visiting patients in the intensive care unit suffer from symptoms of anxiety or depression. Involvement of anxious or depressed family members in end-of-life decisions should be carefully discussed.