ICU家属参与式日记在机械通气患者中的应用研究

Application study of ICU family participatory diaries in patients with mechanical ventilation

目的评估ICU家属参与式日记在减轻机械通气患者创伤后应激障碍、焦虑、抑郁以及疲乏的效果。方法将2021年9月-2022年3月入住长沙市中心医院ICU的156例机械通气患者按随机数字表法分为观察组和对照组各78例。最终观察组有72例、对照组有70例完成本研究。对照组实施ICU常规心理护理,观察组在对照组的基础上实施ICU家属参与式日记干预,患者转出ICU后的第1、第3、第6个月应用事件影响量表-修订版(IES-R)、广泛性焦虑障碍量表(GAD-7)、汉密尔顿抑郁量表(HAMD-24)以及疲劳量表(FS-14)评估患者心理障碍水平。结果2组比较,转出ICU后第1、第3个月患者的IES-R评分差异无统计学意义(P>0.05),转出后第6个月差异有统计学意义(P<0.01);2组患者转出后第1、3个月GAD-7评分比较,差异无统计学意义(P>0.05),转出后第6个月差异有统计学意义(P<0.05);2组患者转出后第1、第3、第6个月HAMD-24评分对比,差异均无统计学意义(P>0.05);2组患者转出后第1个月FS-14评分比较,差异无统计学意义(P>0.05),转出后第3个月FS-14评分比较,差异有统计学意义(P<0.01)。结论ICU家属参与式日记可以减轻ICU机械通气患者转出后的创伤后应激障碍、焦虑、疲乏水平,但对于减轻抑郁水平无效果。

Objective To evaluate the effectiveness of ICU family participatory diaries in reducing post-traumatic stress disorder,anxiety,depression,and fatigue in patients.Methods A total of 156 mechanically ventilated patients in ICU of Changsha Central Hospital were randomly divided into two groups.The control group was given routine psychological nursing,and the intervention group was given ICU family participation diary intervention on the basis of the control group.IES-R,GAD-7,HAMD-24,and FS-14 scales were used to assess the psychological disorders of patients at the 1 st,3 rd,and 6 th months after transfer out of the ICU.Results After excluding patients who were lost to follow-up and died,142 patients were finally included for analysis.There was no statistically significant difference between the general data of the two groups(P>0.05).Compared with the control group,the difference in IES-R scores at the 1 st and 3 rd month after transfer out were not statistically significant(P>0.05),and the difference in IES-R scores at the 6 th month after transfer out was statistically significant(P<0.01);The difference in GAD-7 scores at the 1 st and 3 rd month after transfer out between the two groups was not statistically significant(P>0.05),and the difference at the 6 th month after transfer out was statistically significant(P<0.05);The difference in HAMD-24 scores at the 1 st,3 rd,and 6 th months after transfer out was not statistically significant in both groups(P>0.05);The difference in FS-14 scores at the 1 st month after transfer out was not statistically significant in both groups(P>0.05),and the difference in FS-14 scores at the 3 rd month after transfer out was statistically significant(P<0.01).Conclusion ICU family participatory diaries can reduce the levels of post-traumatic stress disorder(PTSD),anxiety,and fatigue in ICU patients with mechanical ventilation after transfer out,but has no effect on reducing the level of depression.