The Accuracy of Nurse-Driven Intervention on the Reduction in Anxiety and Depression After ICU Discharge
The Accuracy of Nurse-Driven Intervention on the Reduction in Anxiety and Depression After ICU Discharge
复制标题
护士主导干预减少 ICU 出院后焦虑和抑郁的准确性
DOI：
10.1097/ccm.0000000000005774
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发表时间：
2023
影响因子：
8.8
通讯作者：
Taito Shunsuke
中科院分区：
文献类型：
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作者：
Sato Tomoo;Katayama Sho;Taito Shunsuke
我们怀着极大的兴趣阅读了Cuzco等人（1）发表在最近一期《重症监护医学》上的报告，该报告描述了ICU出院期间护士驱动的患者赋权干预（NEI），该干预降低了重症幸存者的焦虑和抑郁评分。然而，我们对试验的主要结果有三个担忧。首先，作者应该提供ICU出院后焦虑和抑郁的二元变量结果的比较，而不是变化评分。作者描述，在试验登记研究（NCT 04527627）中，数值10是存在或不存在焦虑和抑郁之间的临界点。计算样本量以检测大于20%的差异（对照组：0.5，干预组：0.28）（1）。变量的差异应仔细解释。我们认为，临床医生和患者的重要信息是主要结局的二元变量的差异。其次，作者应该描述如何焦虑是在三个ICU的日常护理管理。焦虑是患者的一种严重的痛苦症状。应每天在ICU进行评估（2）。ICU日记对跟踪焦虑是有效的（3）。ICU实践中用于缓解焦虑的其他干预措施包括分散注意力、使用音乐、安慰、鼓励、指导和镇静剂
We have read with great interest the report by Cuzco et al (1), published in a recent issue of Critical Care Medicine, describing nursedriven patient empowerment intervention (NEI) during ICU discharge that reduced anxiety and depression scores in critically ill survivors. However, we have three concerns related to the trial’s primary outcome. First, the authors should provide comparisons of binary variable results for anxiety and depression after ICU discharge, not the change score. The authors described that a value of 10 is the cutoff point between the presence or absence of anxiety and depression in the trial registry (NCT04527627). The sample size was calculated to detect differences of greater than 20%(control group: 0.5 and intervention group: 0.28)(1). The discrepancy of variables should be interpreted carefully. We believe that important information for clinicians and patients is the difference in binary variables of primary outcomes. Second, the author should describe how anxiety was managed in usual care in three ICUs. Anxiety is a critical distress symptom for patients. It should be assessed daily in the ICU (2). ICU diaries are effective for tracking anxiety (3). Other interventions used in ICU practice to alleviate anxiety include distraction, the use of music (4), reassurance, encouragement, coaching, and sedative