目的评价ICU日记对ICU患者和家属心理健康状况的干预效果。方法计算机检索从建库至2019年9月PubMed、Embase、Web of Science、Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库和维普中文期刊数据库中有关ICU日记在IC...目的评价ICU日记对ICU患者和家属心理健康状况的干预效果。方法计算机检索从建库至2019年9月PubMed、Embase、Web of Science、Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库和维普中文期刊数据库中有关ICU日记在ICU患者或家属中应用效果的随机对照研究,使用RevMan 5.3统计软件进行Meta分析。结果纳入8项研究进行Meta分析,结果显示,ICU日记对降低患者创伤后应激障碍[RR=0.65(95%CI为0.51~0.82),P<0.001]及抑郁发生率[RR=0.65(95%CI为0.45~0.92),P=0.02]有明显作用,对降低患者焦虑发生率[RR=0.69(95%CI为0.31~1.52),P=0.36]以及患者家属的创伤后应激障碍发生率[RR=0.76(95%CI为0.33~1.74),P=0.51]无明显作用。描述性分析显示,ICU日记对降低患者家属的焦虑和抑郁发生率也无显著作用。结论 ICU日记可降低ICU患者创伤后应激障碍和抑郁发生率,但对降低ICU患者焦虑及家属的创伤后应激障碍、焦虑和抑郁的作用不显著。由于纳入研究的方法限制、研究数量较少,未来尚需开展更多高质量、大样本的原始研究,以进一步评价其应用效果。展开更多
目的:通过Meta分析研究ICU日记对病人及家属创伤后应激障碍的干预效果。方法:检索Web of Science、the Cochrane Library、PubMed、EMbase、中国知网(CNKI)、维普(VIP)、万方数据库中有关ICU日记对重症病人及家属创伤后应激障碍干预效...目的:通过Meta分析研究ICU日记对病人及家属创伤后应激障碍的干预效果。方法:检索Web of Science、the Cochrane Library、PubMed、EMbase、中国知网(CNKI)、维普(VIP)、万方数据库中有关ICU日记对重症病人及家属创伤后应激障碍干预效果的随机对照试验(RCT)。检索时限均为建库至2020年3月15日。采用RevMan 5.3软件进行Meta分析。结果:共纳入10篇RCT,1853例研究对象。Meta分析结果显示,ICU日记可降低病人创伤后应激障碍[OR=0.60,95%CI(0.44,0.82),P=0.002]及抑郁[OR=0.62,95%CI(0.39,0.97),P=0.04]发生率,但对家属创伤后应激障碍、焦虑及抑郁的发生率均无影响(P>0.05)。结论:基于现有证据,应用ICU日记能够降低病人创伤后应激障碍及抑郁的发生风险,但对其家属是否有优势有待进一步探讨。展开更多
Background: It is said that after ICU discharge, 40% of patients suffer from acute stress symptoms, such as anxiety and depression, caused by “distorted memories” (memory loss and delusions) due to various treatment...Background: It is said that after ICU discharge, 40% of patients suffer from acute stress symptoms, such as anxiety and depression, caused by “distorted memories” (memory loss and delusions) due to various treatments in the ICU. This study focused on the quantitative and qualitative effects of ICU diaries on distorted memories that patients encountered during their time in the ICU. Aim: To assess improving distorted memories by providing information during ICU admission to patients to relieve the acute stress symptoms after ICU discharge. Design and Methods: This nonrandomized controlled trial included patients aged ≥20 years who had received treatment for ≥3 days in the ICU. Using ICU memory tool, the Hospital Anxiety and Depression Scale (HADS) and the Acute Stress Disorder Scale (ASDS) approximately 1 week after ICU discharge, then HADS and ASDS prior to hospital discharge, the change in mean values were compared between two groups (control and intervention) using a Wilcoxon signed-rank test. The intervention group was surveyed prior to hospital discharge using semi-structured interviews, and descriptions were analyzed by the content analysis method of Krippendorff. Results: Twenty-three participants were included in the control group, and 17 in the intervention group. When comparing subjects with distorted memories between the groups, we found reduced values for HADS anxiety (7.1 ± 3.8 to 5.7 ± 2.7, p = 0.011), HADS depression (8.6 ± 5.0 to 7.2 ± 4.3, p = 0.003), and ASDS (46.9 ± 13.8 to 43.8 ± 11.4, p = 0.012) in the intervention group. Based on the narrations, patients wanted to investigate facts in the ICU diary while having someone help them to remember these events. Conclusion: Improving distorted memories during ICU admissions may relieve acute stress symptoms. In addition, these patients needed someone to investigate facts from the ICU admission.展开更多
文摘Background: It is said that after ICU discharge, 40% of patients suffer from acute stress symptoms, such as anxiety and depression, caused by “distorted memories” (memory loss and delusions) due to various treatments in the ICU. This study focused on the quantitative and qualitative effects of ICU diaries on distorted memories that patients encountered during their time in the ICU. Aim: To assess improving distorted memories by providing information during ICU admission to patients to relieve the acute stress symptoms after ICU discharge. Design and Methods: This nonrandomized controlled trial included patients aged ≥20 years who had received treatment for ≥3 days in the ICU. Using ICU memory tool, the Hospital Anxiety and Depression Scale (HADS) and the Acute Stress Disorder Scale (ASDS) approximately 1 week after ICU discharge, then HADS and ASDS prior to hospital discharge, the change in mean values were compared between two groups (control and intervention) using a Wilcoxon signed-rank test. The intervention group was surveyed prior to hospital discharge using semi-structured interviews, and descriptions were analyzed by the content analysis method of Krippendorff. Results: Twenty-three participants were included in the control group, and 17 in the intervention group. When comparing subjects with distorted memories between the groups, we found reduced values for HADS anxiety (7.1 ± 3.8 to 5.7 ± 2.7, p = 0.011), HADS depression (8.6 ± 5.0 to 7.2 ± 4.3, p = 0.003), and ASDS (46.9 ± 13.8 to 43.8 ± 11.4, p = 0.012) in the intervention group. Based on the narrations, patients wanted to investigate facts in the ICU diary while having someone help them to remember these events. Conclusion: Improving distorted memories during ICU admissions may relieve acute stress symptoms. In addition, these patients needed someone to investigate facts from the ICU admission.
