임상간호연구 (Journal of Korean Clinical Nursing Research)

  • 제26권1호
  • /
  • Pages.97-106
  • /
  • 2020
  • /
  • 1598-9186(pISSN)
  • /
  • 2287-3694(eISSN)
병원간호사회 (Hospital Nurses Association)
권호 표지
DOI QR코드

DOI QR Code

중환자실 생존자의 외상 후 스트레스장애 발생정도와 영향요인

Influential Factors of Post-Traumatic Stress Disorder in Survivors of Intensive Care Units

  • Kim, So Hye (Department of Nursing, Dong-A University Hospital) ;
  • Ju, Hyeon Ok (Department of Nursing, Dong-A University)
  • 투고 : 2019.06.17
  • 심사 : 2020.02.21
  • 발행 : 2020.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study was conducted to investigate the incidence and associated factors with post-traumatic stress disorders (PTSD) in patients with intensive care units (ICU) admission experience. Methods: This study is a retrospective observational study using self-reporting questionnaire. Patients who were admitted to ICU more than 72 hours and agreed to participate were enrolled in this study. PTSD were assessed by Korean version of post-traumatic diagnosis scale, and PTSD was defined as 20 points or more. Medical records of participants were reviewed to identify influencing factors of PTSD. To analyzed the data, descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test and gamma regression were utilized using SPSS/WIN 23.0 program. Results: A total of 128 patients participated in the study. Mean age of participants was 58.3±11.7 years and 50 patients (39.1%) were female. Mean duration of ICU stay was 8.43±8.09 days and PTSD was diagnosed in 12 patients (9.4%). In the results of a Gamma regression analysis, Psychiatric history (B=1.09, p=.002), APACHEII score (B=.04, p=.005), CPR experience (B=1.65, p=.017) and physical restraint (B=.68, p=.049) were independently associated with PTSD occurrence. Conclusion: The results of this study suggest that a various factors influencing PTSD should be identified to prevent PTSD in patients who requires ICU care. In addition, post-ICU care programs are required to assess and reduce PTSD.

키워드

참고문헌

  1. Puntillo KA, Arai S, Cohen NH, Gropper MA, Neuhaus J, Paul SM, et al. Symptoms experienced by intensive care unit patients at high risk of dying. Critical Care Medicine. 2010;38(11):2155-2160. https://doi.org/10.1097/ccm.0b013e3181f267ee
  2. Wade DM, Howell DC, Weinman JA, Hardy RJ, Mythen MG, Brewin CR, et al. Investigating risk factors for psychological morbidity three months after intensive care: A prospective cohort study. Critical Care. 2012;16(5):R192. https://doi.org/10.1186/cc11677
  3. Association Psychiatric Association. Diagnostic and statistical manual of mental disorders(DSM-5(R)). Washington, DC: American Psychiatric Association; 2013.
  4. Chae JH. Diagnosis and pathophysiology of posttraumatic stress disorders(PTSD) The Korean Journal of Psychopharmacology. 2004;15(1):14-21.
  5. Tedstone JE, Tarrier N. Posttraumatic stress disorder following medical illness and treatment. Clinical Psychology Review. 2003;23(3):409-448 https://doi.org/10.1016/s0272-7358(03)00031-x
  6. Van Minnen A, Zoellner LA, Harned MS, Mills K. Changes in comorbid conditions after prolonged exposure for PTSD: A literature review. Current Psychiatry Report. 2015;17:1-16. https://doi.org/10.1007/s11920-015-0549-1
  7. Edmondson D, Kronish IM, Shaffer JA, Falzon L, Burg MM. Posttraumatic stress disorder and risk for coronary heart disease: A meta-analytic review. American Heart Journal. 2013; 166(5):806-814. https://doi.org/10.1016/j.ahj.2013.07.031
  8. Kessler RC. Posttraumatic stress disorder: The burden to the individual and to society. The Journal of Clinical Psychiatry. 2000;61(suppl 5):4-12.
  9. Dowdy DW, Eid MP, Sedrakyan A, Mendez-Tellez PA, Pronovost PJ, Herridge MS, et al. Quality of life in adult survivors of critical illness: A systematic review of the literature. Intensive Care Medicine. 2005;31(5):611-620. https://doi.org/10.1007/s00134-005-2592-6
  10. Griffiths J, Fortune G, Barber V, Young JD. The prevalence of post traumatic stress disorder in survivors of ICU treatment: A systematic review. Intensive Care Medicine. 2007;33(9):1506-1518. https://doi.org/10.1007/s00134-007-0730-z
  11. Schelling G, Briegel J, Roozendaal B, Stoll C, Rothenhäusler HB, Kapfhammer HP. The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder in survivors. Biological Psychiatry. 2001;50(12):978-985. https://doi.org/10.1016/S0006-3223(01)01270-7
  12. Twigg E, Humphris G, Jones C, Bramwell R, Griffiths RD. Use of a screening questionnaire for post-traumatic stress disorder (PTSD) on a sample of UK ICU patients. Acta Anaesthesilogica Scandinavia. 2008;52(2):202-208. https://doi.org/10.1111/j.1399-6576.2007.01531.x
  13. Cuthbertson BH, Hull A, Strachan M, Scott J. Post-traumatic stress disorder after critical illness requiring general intensive care. Intensive Care Medicine. 2004;30(3):450-455. https://doi.org/10.1007/s00134-003-2004-8
  14. Parker AM, Sricharoenchai T, Raparla S, Schneck KW, Bienvenu OJ, Needham DM. Posttraumatic stress disorder in critical illness survivors: a metaanalysis. Critical Care Medicine. 2015;43(5):1121-1129. https://doi.org/10.1097/ccm.0000000000000882
  15. Needham DM, Davidson J, Cohen H, Hopkins RO, Weinert C, Wunsch H, et al. Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders' conference. Critical Care Medicine. 2012;40(2):502-509. https://doi.org/10.1097/CCM.0b013e318232da75
  16. Bienvenu OJ, Gellar J, Althouse BM, Colantuoni E, Sricharoenchai T, Mendez-Tellez PA, et al. Post-traumatic stress disorder symptoms after acute lung injury: A 2-year prospective longitudinal study. Psychological Medicine. 2013;43(12):2657-2671. https://doi.org/10.1017/s0033291713000214
  17. Garrouste-Orgeas M, Coquet I, Perier A, Timsit JF, Pochard F, Lancrin F, et al. Impact of an intensive care unit diary on psychological distress in patients and relatives*. Critical Care Medicine. 2012;40(7):2033-2040. https://doi.org/10.1097/CCM.0b013e31824e1b43
  18. Foa EB, Cashman L, Jaycox L, Perry K. The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psychological Assessment. 1997;9(4):445-451. https://doi.org/10.1037/1040-3590.9.4.445
  19. Nam BR, Kwon HI, Kwon JH. Psychometric qualities of the Korean version of the Posttraumatic Diagnosis Scale(PDS-K). Korean Journal of Clinical Psychology. 2010;29(1):147-167. https://doi.org/10.15842/kjcp.2010.29.1.009
  20. Hardin JW, Hilbe JM. Generalized linear models and extensions. 2nd ed. Texas: Stata Press; 2007. p. 89-105.
  21. Kapfhammer HP, Rothenhausler HB, Krauseneck T, Stoll C, Schelling G. Posttraumatic stress disorder and health-related quality of life in long-term survivors of acute respiratory distress syndrome. American Journal of Psychiatry. 2004;161(1): 45-52. https://doi.org/10.1176/appi.ajp.161.1.45
  22. Jones C, Bäckman C, Capuzzo M, Flaatten H, Rylander C, Griffiths RD. Precipitants of post-traumatic stress disorder following intensive care: A hypothesis generating study of diversity in care. Intensive Care Medicine. 2007;33(6):978-985. https://doi.org/10.1007/s00134-007-0600-8
  23. Rattray JE, Johnston M, Wildsmith JA. Predictors of emotional outcomes of intensive care. Anaesthesia. 2005;60(11):1085-1092. https://doi.org/10.1111/j.1365-2044.2005.04336.x
  24. Stoll C, Schelling G, Goetz AE, Kilger E, Bayer A, Kapfhammer HP, et al. Health-related quality of life and posttraumatic stress disorder in patients after cardiac surgery and intensive care treatment. The Journal of Thoracic Cardiovascular Surgery. 2000;120(3):505-512. https://doi.org/10.1067/mtc.2000.108162
  25. Hatchett C, Langley G, Schmollgruber S. Psychological sequelae following ICU admission at a level 1 academic South African hospital. Southern African Journal of Critical Care. 2010;26(2):52-58.
  26. Kang JY, Lee EN, Park EY, Lee YO, Lee MM. Emotional reponse of ICU patients family toward physical restraints. Korean Journal of Adult Nursing. 2013;25(2):148-156. https://doi.org/10.7475/kjan.2013.25.2.148
  27. Choi EH, Song MS. Physical restraint use in a Korean ICU. Journal of Clinical Nursing. 2003;12(5):651-659. https://doi.org/10.1046/j.1365-2702.2003.00789.x
  28. Lee MM, Kim KS. Comparison of physical injury, emotional response and unplanned self-removal of medical devices according to use of physical restraint in intensive care unit patients. Journal of Korean Clinical Nursing Research. 2012;18(2):296-306. https://doi.org/10.22650/JKCNR.2012.18.2.296
  29. Naber D, Bullinger M. Psychiatric sequelae of cardiac arrest. Dialogues Clinical Neuroscience. 2018;20(1):73-77. https://doi.org/10.31887/DCNS.2018.20.1/dnaber
  30. Wilder Schaaf KP, Artman LK, Peberdy MA, Walker WC, Ornato JP, Gossip MR, et al. Anxiety, depression, and PTSD following cardiac arrest: A systematic review of the literature. Resuscitation. 2013;84(7):873-877. https://doi.org/10.1016/j.resuscitation.2012.11.021