Psychological evaluation of patients after discharge from the intensive care unit
DOI:
https://doi.org/10.15448/1980-8623.2020.2.33640Keywords:
intensive care units, critical care, mental disorders, memory, psychology.Abstract
Most patients survive the critical illness episode, however, many of them may develop psychological changes after discharge from the ICU. Given the nature of intensive care and the clinical conditions of most patients this study aims to describe the results of the psychological evaluation of patients three months after discharge from critical care. 160 patients were evaluated, of these 137 were able to respond to psychological assessment and the rest were not evaluated due to some neurological impairment. The instruments used were: Worksheet for collecting data from the medical record, ICU memory evaluation tool, Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). The results revealed that the early identification of the complications inherent to the critical treatment may bring benefits to the prevention of subsequent chronic emotional / physical changes.
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References
Associação Americana de Psiquiatria. (2013). Manual diagnóstico e estatístico de transtornos mentais. BMC Med. 17, 133-137.
Caiuby, A. V. S., Lacerda, S. S., Quintana, M. I., Torii, T. S., & Andreoli, S. B. (2012). Adaptação transcultural da versão brasileira da Escala do Impacto do Evento - Revisada (IES-R). Cadernos de Saúde Pública, 28(3), 597-603. https://dx.doi.org/10.1590/S0102-311X2012000300019
Chahraoui, K., Laurent, A., Bioy, A., & Quenot, J. P. (2015). Psychological experience of patients 3 months after a stay in the intensive care unit: A descriptive and qualitative study. Journal of critical care, 30(3), 599-605. https://doi.org/10.1016/j.jcrc.2015.02.016
Costa, J. B. D., & Marcon, S. S. (2009). Elaboração e avaliação de um instrumento para identificar memórias referentes à unidade de terapia intensiva. J Bras Psiquiatr, 58(4), 223-30.
https://doi.org/10.1590/s0047-20852009000400002
Costa, J. B. D., Marcon, S. S., Macedo, C. R. L. D., Jorge, A. C., & Duarte, P. A. D. (2014). Sedação e memórias de pacientes submetidos à ventilação mecânica em unidade de terapia intensiva. Revista Brasileira de Terapia Intensiva, 26(2), 122-129. https://doi.org/10.5935/0103-507x.20140018
Creamer, M., Bell, R., & Failla, S. (2003). Psychometric properties of the impact of event scale—revised. Behaviour research and therapy, 41(12), 1489-1496. https://doi.org/10.1016/j.brat.2003.07.010
Davydow, D. S., Gifford, J. M., Desai, S. V., Needham, D. M., & Bienvenu, O. J. (2008). Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. General hospital psychiatry, 30(5), 421-434.
https://doi.org/10.1016/j.genhosppsych.2008.05.006
Davydow, D. S., Zatzick, D., Hough, C. L., & Katon, W. J. (2013). A longitudinal investigation of posttraumatic stress and depressive symptoms over the course of the year following medical–surgical intensive care unit admission. General hospital psychiatry, 35(3), 226-232.
https://doi.org/10.1016/j.genhosppsych.2012.12.005
de Albuquerque, J. M., da Silva, R. F. A., & de Souza, R. F. F. (2017). perfil epidemiológico e seguimento após alta de pacientes internados em unidade de terapia intensiva. Cogitare Enfermagem, 22(3). https://doi.org/10.5380/ce.v22i3.50609
Hernández Rodriguez, A., Camargo Bub, M. B., Perão, O. F., Zandonadi, G., & Hernández Rodriguez, M. D. J. (2016). Características epidemiológicas e causas de óbitos em pacientes internados em terapia intensiva.
Revista Brasileira de Enfermagem, 69(2). https://doi.org/10.1590/0034-7167.2016690204i
Herridge, M. S., Chu, L. M., Matte, A., Tomlinson, G., Chan, L., Thomas, C., ... Ferguson, N. D. (2016). The RECOVER program: disability risk groups and 1-year outcome after 7 or more days of mechanical ventilation. American journal of respiratory and critical care medicine, 194(7), 831-844. https://doi.org/10.1164/rccm.201512-2343oc
Kapfhammer, H. P., Rothenhäusler, H. B., Krauseneck, T., Stoll, C., & Schelling, G. (2004). Posttraumatic stress disorder and health-related quality of life in long-term survivors of acute respiratory distress syndrome. American Journal of Psychiatry, 161(1), 45-52. https://doi.org/10.1176/appi.ajp.161.1.45
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), 593-602. https://doi.org/10.1001/archpsyc.62.6.593
Kvåle, R., Ulvik, A., & Flaatten, H. (2003). Follow-up after intensive care: a single center study. Intensive care medicine, 29(12), 2149-2156. https://doi.org/10.1007/s00134-003-2034-2
Long, A. C., Kross, E. K., Davydow, D. S., & Curtis, J. R. (2014). Posttraumatic stress disorder among survivors of critical illness: creation of a conceptual model addressing identification, prevention, and management. Intensive care medicine, 40(6), 820-829 https://doi.org/10.1007/s00134-014-3306-8
Marcolino, J. Á. M., Suzuki, F. M., Alli, L. A. C., Gozzani, J. L., & Mathias, L. A. D. S. T. (2007). Medida da ansiedade e da depressão em pacientes no pré-operatório. Estudo comparativo. Rev Bras Anestesiol, 57(2), 157-166. https://doi.org/10.1590/s0034-70942007000200004
Melo, A. C. D. L., Menegueti, M. G., & Laus, A. M. (2014). Perfil de pacientes de terapia intensiva: subsídios para a equipe de enfermagem. Revista de Enfermagem UFPE On Line, 8(9), 3142-3148.
Milton, A., Brück, E., Schandl, A., Bottai, M., & Sackey, P. (2017). Early psychological screening of intensive care unit survivors: a prospective cohort study. Critical Care, 21(1), 273. https://doi.org/10.1186/s13054-017-1813-z
Nikayin, S., Rabiee, A., Hashem, M. D., Huang, M., Bienvenu, O. J., Turnbull, A. E., & Needham, D. M. (2016). Anxiety symptoms in survivors of critical illness: a systematic review and meta-analysis. General hospital psychiatry, 43, 23-29. https://doi.org/10.1016/j.genhosppsych.2016.08.005
Ranzani, O. T., Zampieri, F. G., Besen, B. A., Azevedo, L. C., & Park, M. (2015). One-year survival and resource use after critical illness: impact of organ failure and residual organ dysfunction in a cohort study in Brazil. Critical Care, 19(1), 269. https://doi.org/10.1186/s13054-015-0986-6
Schandl, A. R., Brattström, O. R., Svensson-Raskh, A., Hellgren, E. M., Falkenhav, M. D., & Sackey, P. V. (2011). Screening and treatment of problems after intensive care: a descriptive study of multidisciplinary follow-up. Intensive and Critical Care Nursing, 27(2), 94-101. https://doi.org/10.1016/j.iccn.2011.01.006
Sevin, C. M., Bloom, S. L., Jackson, J. C., Wang, L., Ely, E. W., & Stollings, J. L. (2018). Comprehensive care of ICU survivors: Development and implementation of an ICU recovery center. Journal of critical care, 46, 141-148. https://doi.org/10.1016/j.jcrc.2018.02.011
Stein, M. B., Walker, J. R., Hazen, A. L., & Forde, D. R. (1997). Full and partial posttraumatic stress disorder: findings from a community survey. The American Journal of Psychiatry, 154(8), 1114. https://doi.org/10.1176/ajp.154.8.1114
Wade, D. M., Howell, D. C., Weinman, J. A., Hardy, R. J., Mythen, M. G., Brewin, C. R., ... Raine, R. A. (2012). Investigating risk factors for psychological morbidity three months after intensive care: a prospective cohort study. Critical Care, 16(5), R192. https://doi.org/10.1186/cc11677
Wade, D., Hardy, R., Howell, D., & Mythen, M. (2013). Identifying clinical and acute psychological risk factors for PTSD after critical care: a systematic review. Minerva Anestesiol, 79(8), 944-63.
Weiss, D. S., & Marmar, C. R. (1997). The Impact of Event Scale-Revised In: Wilson, J.P., Keane, T.M., editors. Assessing psychological trauma and ptsd. (pp. 399-411). New York: Guilford. APA PsycTests. https://doi.org/10.1037/t12199-000
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