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

作　　者：李奥 欧峥艳 李超 成晶 梁敏 吴宗壁 席明霞 LI Ao;OU Zhengyan;LI Chao;CHENG Jing;LIANG Min;WU Zongbi;XI Mingxia(School of Nursing,South China University,Hengyang 421001,Hunan,China;Department of Chest Radiotherapy,Hunan Cancer Hospital,Changsha 410031,Hunan,China;School of Nursing,Hunan University of Traditional Chinese Medicine,Changsha 410508,Hunan,China;Intensive Care Unit,Changsha Central Hospital,South China University,Changsha 410004,Hunan,China;Department of Nursing,Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen 518033,Guangdong,China)

机构地区：[1]南华大学护理学院,湖南衡阳421001 [2]湖南省肿瘤医院胸部放疗科,湖南长沙410031 [3]湖南中医药大学护理学院,湖南长沙410508 [4]南华大学附属长沙市中心医院重症医学科,湖南长沙410004 [5]深圳市中医院护理部护理教研室,广东深圳518033

出　　处：《护士进修杂志》2023年第17期1543-1547,1568,共6页Journal of Nurses Training

基　　金：湖南省卫生健康委员会科研项目(编号:20201982)。

摘　　要：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.

关 键 词：ICU日记 心理干预 家庭支持 ICU后综合征 创伤后应激障碍 

分 类 号：R472[医药卫生—护理学]