IntroductionTo study the level and predictors of posttraumatic stress, anxiety and depression symptoms in medical, surgical and trauma patients during the first year post intensive care unit (ICU) discharge.MethodsOf 255 patients included, 194 participated at 12 months. Patients completed the Impact of Event Scale (IES), Hospital Anxiety and Depression Scale (HADS), Life Orientation Test (LOT) at 4 to 6 weeks, 3 and 12 months and ICU memory tool at the first assessment (baseline). Case level for posttraumatic stress symptoms with high probability of a posttraumatic stress disorder (PTSD) was ≥ 35. Case level of HADS-Anxiety or Depression was ≥ 11. Memory of pain during ICU stay was measured at baseline on a five-point Likert-scale (0-low to 4-high). Patient demographics and clinical variables were controlled for in logistic regression analyses.ResultsMean IES score one year after ICU treatment was 22.5 (95%CI 20.0 to 25.1) and 27% (48/180) were above case level, IES ≥ 35. No significant differences in the IES mean scores across the three time points were found (P = 0.388). In a subgroup, 27/170 (16%), patients IES score increased from 11 to 32, P < 0.001. No differences in posttraumatic stress, anxiety or depression between medical, surgical and trauma patients were found. High educational level (OR 0.4, 95%CI 0.2 to 1.0), personality trait (optimism) OR 0.9, 95%CI 0.8 to 1.0), factual recall (OR 6.6, 95%CI 1.4 to 31.0) and memory of pain (OR 1.5, 95%CI 1.1 to 2.0) were independent predictors of posttraumatic stress symptoms at one year. Optimism was a strong predictor for less anxiety (OR 0.8, 0.8 to 0.9) and depression symptoms (OR 0.8, 0.8 to 0.9) after one year.ConclusionsThe mean level of posttraumatic stress symptoms in patients one year following ICU treatment was high and one of four were above case level Predictors of posttraumatic stress symptoms were mainly demographics and experiences during hospital stay whereas clinical injury related variables were insignificant. Pessimism was a predictor of posttraumatic stress, anxiety and depression symptoms. A subgroup of patients developed clinically significant distress symptoms during the follow-up period.

Introduction. Nurses and physicians working in the intensive care unit (ICU) may be exposed to considerable job stress. The study aim was to assess the level of and the relationship between (1) job satisfaction, (2) job stress, and (3) burnout symptoms. Methods. A cross-sectional study was performed at ICUs at Oslo University Hospital. 145 of 196 (74%) staff members (16 physicians and 129 nurses) answered the questionnaire. The following tools were used: job satisfaction scale (scores 10–70), modified Cooper's job stress questionnaire (scores 1–5), and Maslach burnout inventory (scores 1–5); high score in the dimension emotional exhaustion (EE) indicates burnout. Personality was measured with the basic character inventory. Dimensions were neuroticism (vulnerability), extroversion (intensity), and control/compulsiveness with the range 0–9. Results. Mean job satisfaction among nurses was 43.9 (42.4–45.4) versus 51.1 (45.3–56.9) among physicians, P < 0.05. The mean burnout value (EE) was 2.3 (95% CI 2.2–2.4), and mean job stress was 2.6 (2.5–2.7), not significantly different between nurses and physicians. Females scored higher than males on vulnerability, 3.3 (2.9–3.7) versus 2.0 (1.1–2.9) (P < 0.05), and experienced staff were less vulnerable, 2.7 (2.2–3.2), than inexperienced staff, 3.6 (3.0–4.2) (P < 0.05). Burnout (EE) correlated with job satisfaction (r = −0.4, P < 0.001), job stress (r = 0.6, P < 0.001), and vulnerability (r = 0.3, P = 0.003). Conclusions. The nurses were significantly less satisfied with their jobs compared to the physicians. Burnout mean scores are relatively low, but high burnout scores are correlated with vulnerable personality, low job satisfaction, and high degree of job stress.

Background: Skin conductance (SC) as a measure of emotional state or arousal may be a tool for monitoring surgical stress in anaesthesia. When an outgoing sympathetic nervous burst occurs to the skin, the palmar and plantar sweat glands are filled up, and the SC increases before the sweat is removed and the SC decreases. This creates a SC fluctuation. The purpose of this study was to measure SC during laparoscopic cholecystectomy with propofol and remifentanil anesthaesia and to evaluate whether number and amplitude of SC fluctuations correlate with perioperative stress monitoring. Methods: Eleven patients were studied nine times before, during and after anaesthesia. SC was compared to changes in stress measures such as blood pressure, heart rate, norepinephrine and epinephrine levels. SC was also compared to changes in Bispectral index (BIS). Results: The blood pressure, epinephrine levels and norepinephrine levels were positively correlated with both the number (P Ͻ 0.001) and amplitude (P Ͻ 0.01) of the SC fluctu-

Intensive care unit survivors had significantly lower health-related quality of life at 1 yr compared to the general population and significantly reduced compared to their states before intensive care unit admission. Less posttraumatic stress and optimism were predictors of higher health-related quality of life and return to work/school. Trauma patients had the largest decrease in both physical and mental scores. Only half of the patients had returned to work/school.