Stressful memories and psychological distress in adult mechanically ventilated intensive care patients – a 2‐month follow‐up study

Samuelson, Karin; Lundberg, Dag; Fridlund, Bengt

doi:10.1111/j.1399-6576.2007.01292.x

Cited by 196 publications

(195 citation statements)

References 27 publications

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“…Providing caring actions aimed at preventing the development of such negative memories and experiences is complex since it is the medical condition as such, drugs and not least the caring environment itself that influence memories from ICU care. Studies concerning health-related quality of life and patients show that it takes a long or a very long time to return to life as it was before the ICU stay (Orwelius et al, 2008;Ringdal et al, 2009Ringdal et al, , 2010Samuelson et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

Eriksson

Bergbom

Lindahl

2011

Intensive and Critical Care Nursing

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SummaryAim: The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. Method: The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. Findings: Patients' narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives' narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. Conclusion: The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there -a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.

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Section: Introductionmentioning

confidence: 99%

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

Eriksson

Bergbom

Lindahl

2011

Intensive and Critical Care Nursing

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“…Communication difficulties create great stress for patients treated with mechanical ventilation, 2,14 leading to psychoemotional distress, including indications of depression, anxiety, 3,15,16 fear and anger, 17,18 frustration, 15 panic, sleeping disorders, decreased self-esteem, 19 loss of control, 14 and, occasionally, resignation. 20 Additional stressful experiences associated with the endotracheal tube, which can also increase psychoemotional distress in the ICU, 3,6,16 include pain or discomfort associated with the tube fastenings or with suctioning, interference with sleep, feeling choked, insufficient air, breathing difficulty after extubation, thirst, and difficulty swallowing.…”

mentioning

confidence: 99%

Communication Difficulties and Psychoemotional Distress in Patients Receiving Mechanical Ventilation

Khalaila

Zbidat

Anwar

et al. 2011

American Journal of Critical Care

128

119

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Background Difficulties in communication in intensive care patients receiving mechanical ventilation are a source of stressful experiences and psychoemotional distress. Objectives To examine the association between communication characteristics and psychoemotional distress among patients treated with mechanical ventilation in a medical intensive care unit and to identify factors that may be predictive of psychological outcomes. Methods A total of 65 critically ill patients, extubated within the preceding 72 hours, were included in this cross-sectional study. Data were collected by using a structured interview. Separate regression analysis of data on 3 psychoemotional outcomes (psychological distress, fear, and anger) were used for baseline variables, communication characteristics, and stressful experiences. Results Difficulty in communication was a positive predictor of patients' psychological distress, and length of anesthesia was a negative predictor. Fear and anger were also positively related to difficulty in communication. In addition, the number of communication methods was negatively associated with feelings of fear and anger. Finally, the stressful experiences associated with the endotracheal tube were positively related to feelings of anger. Conclusions Patients treated with mechanical ventilation experience a moderate to extreme level of psychoemotional distress because they cannot speak and communicate their needs. Nurses should be aware of the patients' need to communicate. Decreasing stressful experiences associated with the endotracheal tube and implementing more appropriate communication methods may reduce patients' distress.

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“…Cross-sectional and cohort studies have reported anxiety and depression conditions in patients recovering from ICU admission at a higher rate than the general population, at between 24% and 45% at six weeks [7], three months [8] and one year [9]after ICU admission. Anxiety and depression conditions often co-exist with posttraumatic stress disorder (PTSD) [10]. PTSD is a serious disorder that follows the experience of a traumatic event and causes significant impairment in daily life [11].The experience of the stressor generates feelings of intense fear, horror, helplessness, threat to life and physical integrity for the individual or someone to whom they have close affectional ties [11].…”

Section: Recovery From Critical Illnessmentioning

confidence: 99%

“…ICU-related delusional memories are estimated to be present in around 30% to 70% of patients [10,12,13], are often persecutory in nature, and tend to be recalled with high vividness and in substantial detail [2].The direct cause of these delusional memories is unknown but is thought to be related to a combination of medication (including adrenaline, corticosteroids, opiates and sedative drugs such as propofol and benzodiazepine), sleep deprivation, and critical illness [12]. The literature surrounding the relationship between recall of absent, traumatic or delusional memories and psychological disorders is mixed, with different authors finding positive [10,12,14,15] and negative associations [7,16]. The association between delusional memories and the psychological distress of ICU survivors has been mainly attributed to the strong vividness with long duration and high emotional content of these memories when compared with memories of real events [13].…”

Section: Recovery From Critical Illnessmentioning

confidence: 99%

“…Delusional memories have been associated with anxiety, depression, post-traumatic stress symptomatology [9,12] and poor health-related quality of life [16].The aim of a diary is to provide a coherent narrative of the illness period, clarifying gaps in memory and diminishing the impact or dominance of imagined occurrences and hallucinations [18]. It has also been suggested that diaries can be used by relatives to encourage the healing process, after their own vicarious traumatic experience or as a basis for discussion about the patient's illness experience [10].…”

Section: Icu Diaries To Improve Recovery From Critical Illnessmentioning

confidence: 99%

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Intensive care diaries to promote recovery for patients and families after critical illness: A Cochrane Systematic Review

Ullman

Aitken

Rattray

et al. 2015

International Journal of Nursing Studies

104

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Review methods: Studies evaluated the effectiveness of patient diaries, when compared to no ICU diary, for patients or family members to promote recovery after admission to ICU were included. Outcome measures for describing recovery from ICU included the risk of post-traumatic stress disorder (PTSD), anxiety, depression and post-traumatic stress symptomatology, health-related quality of life and costs. We used standard methodological approaches as expected by The Cochrane Collaboration. Two review authors independently reviewed titles for inclusion, extracted data and undertook risk of bias according to pre-specified criteria. Permanent repository link Results:We identified three eligible studies; two describing ICU patients (N = 358), and one describing relatives of ICU patients (N = 30). No study adequately reported on risk of PTSD as described using a clinical interview, family or caregiver anxiety or depression, health-related quality of life or costs. Within a single study there was no clear evidence of a difference in risk for developing anxiety (RR 0.29, 95% CI 0.07 to 1.19) or depression (RR 0.38, 95% CI 0.12 to 1.19) in participants who received ICU diaries, in comparison to those that did not receive a patient diary. Within a single study there was no evidence of difference in median post-traumatic stress symptomatology scores (diaries 24, SD 11.6; no diary 24, SD 11.6) and delusional ICU memory recall (RR 1.04, 95% CI 0.84 to 1.28) between the patients recovering from ICU admission who received patient diaries, and those who did not. One study reported reduced post-traumatic stress symptomatology in family members of patients recovering from admission to ICU who received patient diaries (median 19; range 14 to 28), in comparison to no diary (median 28; range 14 to 38). Conclusions:Currently there is minimal evidence from RCTs of the benefits or harms of patient diaries for patients and their caregivers or family members. A small study has described their potential to reduce post-traumatic stress symptomatology in family members. However, there is currently inadequate evidence to support their effectiveness in improving psychological recovery after critical illness for patients and their family members.

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Stressful memories and psychological distress in adult mechanically ventilated intensive care patients – a 2‐month follow‐up study

Abstract: Extremely stressful experiences of the ICU are associated with subsequent psychological distress. Female sex, agitation and extreme fear during the ICU stay seem to increase the risk of developing high levels of acute PTSD-related symptoms.

Cited by 196 publications

References 27 publications

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

Communication Difficulties and Psychoemotional Distress in Patients Receiving Mechanical Ventilation

Intensive care diaries to promote recovery for patients and families after critical illness: A Cochrane Systematic Review

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