老年ICU转出患者早期心理体验变化的纵向质性研究

Longitudinal qualitative study of the change on early psychological experience in elderly ICU survivors

目的 探讨重症监护病房(ICU)老年转出患者的纵向真实心理体验及变化轨迹,以期为老年ICU转出患者心理健康管理提供依据。方法 采用现象学研究方法,于2022年3-9月对13例老年ICU转出患者进行3次半结构化访谈(转出后1周,1个月,3个月),使用Colaizzi现象学资料分析方法分析资料。结果 资料分析归纳出4个主题:危重病负担持续存在(深刻感受到死亡的威胁、对未来的治疗感到恐惧、持续存在的健康问题、持续存在的经济负担、平静接受这段经历);自我认知改变(心理落差、贬低自我价值、疾病不确定感、逐渐增加独立性);家庭理解改变(对家人感到愧疚、渴望家人的陪伴,依赖感增强、感知来自家庭的力量);社会支持需求增加(社会孤立和孤独感、信息需求增加)。结论 我们的研究结果有助于为医护人员提供参考,为ICU转出患者制定适当的康复、护理干预措施和心理支持。

Objective To explore the longitudinal real psychological experience and change track of the elderly patients after intensive care unit(ICU),so as to provide a reference for the mental health management of the elderly patients after ICU.Methods Using the phenomenological research method,13 elderly ICU survivors were interviewed 3 semi-structured interviews(1 week,1 month,and 3 months after ICU)from March to September 2022.The data were analyzed by using the phenomenological data analysis method of Colaizzi.Results A total of 4 themes were extracted as follow:The persistent burden of critical illness(deep feeling of death threat,fear of future treatment,persistent health problems,persistent economic burden,and calm acceptance of the experience);Changes in self-cognition(psychological gap,devaluation of self-value,disease uncertainty,and gradual increase of independence);Change in family understanding(feeling guilty about the family,longing for the company of the family,and increased sense of dependence,and perceived strength from family);The increased demand for social support(social isolation and loneliness,increased information demand).Conclusion Our research results expand the overall understanding of patients'early psychological experience after ICU from the perspective of elderly patients.The findings of this study will help to provide reference for medical staff and develop appropriate rehabilitation,nursing interventions,and psychological support for patients after ICU.