scholarly journals Psychiatric symptoms post intensive care unit admission

2019 ◽  
Vol 12 (12) ◽  
pp. e231917 ◽  
Author(s):  
Katherine Elizabeth Triplett ◽  
Andrew Ford ◽  
Matthew Anstey

A 53-year-old woman was admitted to a tertiary intensive care unit (ICU) with acute respiratory distress syndrome secondary to severe community-acquired pneumonia that necessitated maximum supportive care with venovenous extracorporeal membrane oxygenation. Her medical history included bipolar disorder on quetiapine and sertraline, as well as a previous ICU admission, approximately 2 years prior, for non-cirrhotic hyperammonaemic encephalopathy that was complicated by prolonged post discharge anxiety and post-traumatic stress disorder-like symptoms, consistent with post-intensive-care syndrome. Here, we present a case, and explore the outcomes for a patient who had two separate admissions with life-threatening illnesses, but had distinct differences in the psychological outcomes following each illness.

Author(s):  
Fredrika Sundberg ◽  
Isabell Fridh ◽  
Berit Lindahl ◽  
Ingemar Kåreholt

Objectives: The objective of the research was to study the visitors’ experiences of different healthcare environment designs of intensive care unit (ICU) patient rooms. Background: The healthcare environment may seem frightening and overwhelming in times when life-threatening conditions affect a family member or close friend and individuals visit the patient in an ICU. A two-bed patient room was refurbished to enhance the well-being of patients and their families according to the principles of evidence-based design (EBD). No prior research has used the Person-centred Climate Questionnaire—Family version (PCQ-F) or the semantic environment description (SMB) in the ICU setting. Methods: A sample of 99 visitors to critically ill patients admitted to a multidisciplinary ICU completed a questionnaire; 69 visited one of the two control rooms, while 30 visited the intervention room. Results: For the dimension of everydayness in the PCQ-F, a significantly better experience was expressed for the intervention room ( p < .030); the dimension regarding the ward climate general was also perceived as higher in the intervention room ( p < .004). The factors of pleasantness ( p < .019), and complexity ( p < 0.049), showed significant differences favoring the intervention room in the SMB, with borderline significance on the modern factor ( p < .061). Conclusion: Designing and implementing an enriched healthcare environment in the ICU setting increases person-centered care in relation to the patients’ visitors. This could lead to better outcomes for the visitors, for example, decreasing post-traumatic stress disorder symptoms, but this needs further investigations.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Stephana J. Moss ◽  
Krista Wollny ◽  
Therese G. Poulin ◽  
Deborah J. Cook ◽  
Henry T. Stelfox ◽  
...  

Abstract Background Informal caregivers of critically ill patients in intensive care unit (ICUs) experience negative psychological sequelae that worsen after death. We synthesized outcomes reported from ICU bereavement interventions intended to improve informal caregivers’ ability to cope with grief. Data sources MEDLINE, EMBASE, CINAHL and PsycINFO from inception to October 2020. Study selection Randomized controlled trials (RCTs) of bereavement interventions to support informal caregivers of adult patients who died in ICU. Data extraction Two reviewers independently extracted data in duplicate. Narrative synthesis was conducted. Data synthesis Bereavement interventions were categorized according to the UK National Institute for Health and Clinical Excellence three-tiered model of bereavement support according to the level of need: (1) Universal information provided to all those bereaved; (2) Selected or targeted non-specialist support provided to those who are at-risk of developing complex needs; and/or (3) Professional specialist interventions provided to those with a high level of complex needs. Outcome measures were synthesized according to core outcomes established for evaluating bereavement support for adults who have lost other adults to illness. Results Three studies of ICU bereavement interventions from 31 ICUs across 26 hospitals were included. One trial examining the effect of family presence at brain death assessment integrated all three categories of support but did not report significant improvement in emotional or psychological distress. Two other trials assessed a condolence letter intervention, which did not decrease grief symptoms and may have increased symptoms of depression and post-traumatic stress disorder, and a storytelling intervention that found no significant improvements in anxiety, depression, post-traumatic stress, or complicated grief. Four of nine core bereavement outcomes were not assessed anytime in follow-up. Conclusions Currently available trial evidence is sparse and does not support the use of bereavement interventions for informal caregivers of critically ill patients who die in the ICU.


2019 ◽  
Vol 50 ◽  
pp. 5-10 ◽  
Author(s):  
Hanne Birgit Alfheim ◽  
Kristin Hofsø ◽  
Milada Cvancarova Småstuen ◽  
Kirsti Tøien ◽  
Leiv Arne Rosseland ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
pp. 112-117
Author(s):  
Dimitrios Alefragkis

In recent years, there has been a maximum increase in admissions to the intensive care unit, culminating in an exponential increase in admissions during the COVID 19 pandemic. Many patients who survived and were discharged from the intensive care unit have cognitive, physical, and psychological disorders that are reflected in the term post-intensive care syndrome. Patients and their families show symptoms of anxiety, depression, post-traumatic stress, and sleep problems. The result is that they negatively affect their quality of life. Numerous risk factors contribute to the development of this syndrome, mainly the sedation, the duration of mechanical ventilation, and the length of stay in the intensive care unit. For this reason, it is necessary to take measures to prevent this syndrome including ABCDEFGH care plan, physical rehabilitation, nutritional support, and intensive care unit diaries. Care must also be given to the creation of Post Intensive care unit clinics where they have a diagnostic, therapeutic, counseling, and rehabilitation role that will act as assistants in the care of patients after discharge from the intensive care unit. Also, special care should be taken with patients who have recovered from COVID 19 whose needs are increasing and need immediate treatment. This review aims to analyze post-intensive care syndrome, prevention measures, and the impact of COVID 19. In conclusion, it is necessary to take measures to treat post-intensive care unit syndrome with early diagnosis and treatment, to reduce the adverse effects on both patients and their families.


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