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http://dx.doi.org/10.22650/JKCNR.2020.26.1.97

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)
Publication Information
Abstract
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.
Keywords
Intensive Care Units; Post-Traumatic Stress Disorders; Survivors;
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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   DOI
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   DOI
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   DOI
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   DOI
7 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   DOI
8 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   DOI
9 Kessler RC. Posttraumatic stress disorder: The burden to the individual and to society. The Journal of Clinical Psychiatry. 2000;61(suppl 5):4-12.
10 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   DOI
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   DOI
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   DOI
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   DOI
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   DOI
15 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   DOI
16 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   DOI
17 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   DOI
18 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   DOI
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   DOI
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   DOI
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   DOI
23 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   DOI
24 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   DOI
25 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   DOI
26 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.
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   DOI
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   DOI
29 Naber D, Bullinger M. Psychiatric sequelae of cardiac arrest. Dialogues Clinical Neuroscience. 2018;20(1):73-77.   DOI
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   DOI