Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis

Critical Care, Journal Year: 2019, Volume and Issue: 23(1)

Published: June 11, 2019

As more patients are surviving intensive care, mental health concerns in survivors have become a research priority. Among these, post-traumatic stress disorder (PTSD) can an important impact on the quality of life critical care survivors. However, data its burden conflicting. Therefore, this systematic review and meta-analysis aimed to evaluate prevalence PTSD symptoms adult after unit (ICU) discharge. We searched MEDLINE, EMBASE, LILACS, Web Science, PsycNET, Scopus databases from inception September 2018. included observational studies assessing Two reviewers independently screened extracted data. Studies were meta-analyzed using random-effects model estimate symptom at different time points, also estimating confidence prediction intervals. Subgroup meta-regression analyses performed explore heterogeneity. Risk bias was assessed Joanna Briggs Institute tool GRADE approach. Of 13,267 retrieved, 48 review. Overall 19.83% (95% interval [CI], 16.72–23.13; I2 = 90%, low evidence). Prevalence varied widely across studies, with wide range expected (from 3.70 43.73% 95% settings). Point estimates 15.93% CI, 11.15–21.35; 90%; 17 studies), 16.80% 13.74–20.09; 66%; 13 18.96% 14.28–24.12; 92%; 20.21% 13.79–27.44; 58%; 7 studies) 3, 6, 12, > 12 months discharge, respectively. may affect 1 every 5 survivors, high ICU should be for cared accordingly, given potential negative life. In addition, action taken further causal relationship between stay PTSD, as well propose early measures prevent population. PROSPERO, CRD42017075124 , Registered 6 December 2017.

Language: Английский

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Sleep Disturbance after Hospitalization and Critical Illness: A Systematic Review

Annals of the American Thoracic Society, Journal Year: 2017, Volume and Issue: 14(9), P. 1457 - 1468

Published: June 23, 2017

Rationale: Sleep disturbance during intensive care unit (ICU) admission is common and severe.Sleep has been observed in survivors of critical illness even after transfer out the ICU.Not only sleep important to overall health well being, but patients are also a physiologically vulnerable state.Understanding how impacts recovery from hospital discharge therefore clinically meaningful.Objectives: This Systematic Review aimed summarize studies that identify prevalence risk factors for survivors.

Language: Английский

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2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility

Pediatric Critical Care Medicine, Journal Year: 2022, Volume and Issue: 23(2), P. e74 - e110

Published: Feb. 1, 2022

A guideline that both evaluates current practice and provides recommendations to address sedation, pain, delirium management with regard for neuromuscular blockade withdrawal is not currently available.To develop comprehensive clinical guidelines critically ill infants children, specific attention seven domains of care including sedation/agitation, iatrogenic withdrawal, blockade, delirium, PICU environment, early mobility.The Society Critical Care Medicine Pediatric Pain, Agitation, Neuromuscular Blockade, Delirium in pediatric patients consideration the Environment Early Mobility Guideline Taskforce was comprised 29 national experts who collaborated from 2009 2021 via teleconference and/or e-mail at least monthly planning, literature review, development, revision, approval. The full taskforce gathered annually in-person during Congress progress reports further strategizing final face-to-face meeting occurring February 2020. Throughout this process, standard operating procedures Manual Guidelines development adhered to.Taskforce content separated into subgroups addressing pain/analgesia, tolerance/iatrogenic environment (family presence sleep hygiene), mobility. Subgroups created descriptive actionable Population, Intervention, Comparison, Outcome questions. An experienced medical information specialist developed search strategies identify relevant between January 1990 reviewed literature, determined quality evidence, formulated classified as "strong" "we recommend" or "conditional" suggest." Good statements were used when indirect evidence supported benefit no minimal risk. Evidence gaps noted. Initial by each subgroup revised deemed necessary prior being disseminated voting taskforce. Individuals had an overt potential conflict interest abstained votes. Expert opinion alone substitution a lack evidence.The issued 44 (14 strong 30 conditional) five good statements.The represent list practical assessment, prevention, key aspects critical children. Main areas focus included 1) need routine monitoring agitation, using validated tools, 2) enhanced use protocolized sedation analgesia, 3) recognition importance nonpharmacologic interventions enhancing patient comfort provision.

Language: Английский

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Patient outcomes after critical illness: a systematic review of qualitative studies following hospital discharge

Critical Care, Journal Year: 2016, Volume and Issue: 20(1)

Published: Oct. 24, 2016

There is growing interest in patient outcomes following critical illness, with an increasing number and different types of studies conducted, a need for synthesis existing findings to help inform the field. For this purpose we conducted systematic review qualitative evaluating after hospital discharge survivors illness. We searched PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL databases from inception June 2015. Studies were eligible inclusion if study population was >50 % adults discharged ICU, evaluation outcomes. excluded they focused on specific ICU populations or specialty ICUs. Citations screened duplicate, two reviewers extracted data sequentially each article. Themes related outcome domains coded categorized based main Patient Reported Outcomes Measurement Information System (PROMIS) framework. A total 2735 citations screened, 22 full-text articles eligible, year publication ranging 1995 All themes then using PROMIS descriptors: satisfaction life (16 studies), including positive outlook, acceptance, gratitude, independence, boredom, loneliness, wishing had not lived; mental health (15 articles), symptoms post-traumatic stress disorder, anxiety, depression, irritability/anger; physical (14 mobility, activities daily living, fatigue, appetite, sensory changes, muscle weakness, sleep disturbances; social (seven changes friends/family relationships; ability participate roles (six hobbies disability. may experience emotions satisfaction; however, wide range mental, physical, social, functional sequelae occur discharge. These are important understanding patient-centered care providing focus future interventional aimed at improving importance survivors.

Language: Английский

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Effect of virtual reality meditation on sleep quality of intensive care unit patients: A randomised controlled trial

Intensive and Critical Care Nursing, Journal Year: 2020, Volume and Issue: 59, P. 102849 - 102849

Published: March 31, 2020

Language: Английский

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Identifying patients’ support needs following critical illness: a scoping review of the qualitative literature

Critical Care, Journal Year: 2019, Volume and Issue: 23(1)

Published: May 24, 2019

Intensive care survivors suffer chronic and potentially life-changing physical, psychosocial cognitive sequelae, supporting recovery is an international priority. As survivors' transition from the intensive unit to home, their support needs develop change. In this scoping review, we categorised patients' using House's Social Support Needs framework (informational, emotional, instrumental, appraisal) mapped these against Timing it Right reflecting patient's (event/diagnosis) ward (stabilisation/preparation) discharge home (implementation/adaptation). We searched electronic databases 2000 2017 for qualitative research studies reporting adult critical experiences of care. Two reviewers independently screened, extracted coded data. Data were analysed a thematic approach. From 3035 references, included 32 involving 702 patients. Studies conducted in UK Europe (n = 17, 53%), Canada USA 6, 19%), Australasia Hong Kong 1, 3%), Jordan 3%) multi-country 3%). Across trajectory, informational, appraisal spiritual evident, nature intensity need differed when framework. Informational changed needing basic facts about admission, detail progress treatments coping with long-term sequelae. The emotional cope confusion, anxiety comfort, security family presence, flashbacks, counselling community support. Early instrumental ranged managing sleep, fatigue, pain nursing transitioned physical ability support, strength training personal hygiene; at regaining independence, return work. Appraisal related obtaining feedback on progress, after discharge, reassurance others who had been through ICU experience. This review first identify change social among as they environment. An understanding different periods would help inform health service provision survivors.

Language: Английский

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Quarantine experience of close contacts of COVID-19 patients in China: A qualitative descriptive study

General Hospital Psychiatry, Journal Year: 2020, Volume and Issue: 66, P. 81 - 88

Published: July 22, 2020

Language: Английский

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Sleep in the intensive care unit

Jornal Brasileiro de Pneumologia, Journal Year: 2015, Volume and Issue: 41(6), P. 539 - 546

Published: Dec. 1, 2015

ABSTRACT Poor sleep quality is a consistently reported by patients in the ICU. In such potentially hostile environment, extremely fragmented and architecture unconventional, with predominance of superficial stages limited amount time spent restorative stages. Among causes disruption ICU are factors intrinsic to acute nature their condition, as well related environment treatments administered, mechanical ventilation drug therapy. Although consequences poor for recovery remain unknown, it seems influence immune, metabolic, cardiovascular, respiratory, neurological systems. There evidence that multifaceted interventions focused on minimizing nocturnal disruptions improve patients. this article, we review literature regarding normal We also analyze assessment methods; its potential implications process critically ill patients; strategies promotion.

Language: Английский

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Impact of an Active Music Therapy Intervention on Intensive Care Patients

American Journal of Critical Care, Journal Year: 2019, Volume and Issue: 28(1), P. 48 - 55

Published: Jan. 1, 2019

Nonpharmacological interventions appear to benefit many patients and do not have the side effects commonly associated with medications. Music-based experiences may critical care patients.To examine effect of an active music therapy intervention on physiological parameters self-reported pain anxiety levels in intensive unit.A study was conducted using a pretest-posttest, within-subject, single-group design. The population consisted convenience sample 52 patients. Study participants received 30-minute session consisting either relaxation or "song choice" intervention. therapist recorded patients' vital signs before after intervention, completed self-assessments their intervention.After significant decreases (all P < .001) were found respiratory rate (mean difference, 3.7 [95% CI, 2.6-4.7] breaths per minute), heart (5.9 [4.0-7.8] beats (1.2 [0.8-1.6] points) (2.7 [2.2-3.3] points). No change oxygen saturation level observed. Outcomes differed between 2 groups: receiving often fell asleep.The results this support as nonpharmacological units. This lay groundwork for future research units larger, more diverse samples.

Language: Английский

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Animal-assisted intervention in the ICU: a tool for humanization

Critical Care, Journal Year: 2018, Volume and Issue: 22(1)

Published: Jan. 29, 2018

The combination of an aging population and advances in critical care medicine is resulting a growing number survivors illness [1].Survivors' descriptions their stay intensive unit (ICU) are frequently filled with traumatic events, include experiences confusion, anxiety, sleeplessness, pain, loneliness [2,3].Sedative anxiolytic medications administered to manage patient symptoms associated delirium worse physical mental health outcomes [4].Therefore, there interest the use non-pharmacologic interventions creating more humanized environment ICU for patients families [5].Such efforts have included focus on understanding critically ill as individual providing comprehensive medical, psychological, rehabilitation [6][7][8].This publication aims to: 1) suggest conceptual model reduce suffering promote recovery environment; 2) describe animalassisted intervention (AAI) exemplar nonpharmacologic provide utility this intervention; 3) discuss basic principles introducing program ICU.

Language: Английский

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