Journal of Korean Critical Care Nursing (중환자간호학회지)

Korean Society of Critical Care Nursing (한국중환자간호학회)
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Impact of Environmental Stressors on the Risk for Posttraumatic Stress Disorder and Quality of Life in Intensive Care Unit Survivors

중환자실 환자의 환경적 스트레스 요인이 외상후 스트레스장애 위험도와 삶의 질에 미치는 영향

  • Cha, Hyo-Jung (Chungnam National University Hospital) ;
  • Ahn, Sukhee (College of Nursing, Chungnam National University)
  • 차효정 (충남대학교병원 중환자실) ;
  • 안숙희 (충남대학교 간호대학)
  • Received : 2018.10.13
  • Accepted : 2018.12.31
  • Published : 2019.02.28
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Abstract

Purpose : This study was to determine the levels of environmental stressor, posttraumatic stress disorder, and quality of life in intensive care units (ICU) survivors after intensive care, and to explore the factors affecting posttraumatic stress disorder and quality of life. Methods: With a longitudinal survey design, data were collected from 116 patients who were discharged from the ICU of a university hospital. The environmental stressor, posttraumatic stress disorder, and quality of life were measured immediately following and 1 month after the ICU discharge. Results: Of all the subjects, 16.4% experienced posttraumatic stress disorder after discharge. Multiple regression analysis revealed that ICU environmental stressors, experience of ICU readmission, using psychotropic drugs and narcotic analgesics, and ICU admission after surgery or cardiac intervention accounted for 22.2% of posttraumatic stress disorder. Posttraumatic stress disorder and sedation status when entering ICU accounted for 28.3% of the quality of life 1 month after ICU discharge. Conclusion: Nursing interventions focused on ICU environmental stressors would not only reduce environmental stress but also contribute to the reduction of posttraumatic stress disorder and later improvement of quality of life.

Keywords

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington DC: American Psychiatric Publishing.
  2. Baldwin, F. J., Hinge, D., Dorsett, J., & Boyd, O. F. (2009). Quality of life and persisting symptoms in intensive care unit survivors: Implication for care after discharge. BMC Research Notes, 12 (2), 160.
  3. Ballard, K. (1981). Identification of environmental stressor for patients in a surgical intensive care unit. Issues in Mental Health Nursing, 3(1-2), 89-108. https://doi.org/10.3109/01612848109140863
  4. Bok, H. (1999). A study of patients' and nurses' perception of intensive care Unit environmental stressor (Unpublished master's thesis). Ewha Womans University, Seoul, Korea.
  5. Breslau, N. (2002). Posttraumatic stress disorder. The New England Journal of Medicine, 346(19), 1495-1498. https://doi.org/10.1056/NEJM200205093461913
  6. Christian, S., Gustav, S., Alwin, E. G., Erich, K., Andreas, B., Hans, P. K., . . . Klaus, P. (2000). Health-related quality of life and post-traumatic stress disorder in patients after cardiac surgery and intensive care treatment. Journal of Thoracic and Cardiovascular Surgery, 120(3), 505-512. https://doi.org/10.1067/mtc.2000.108162
  7. Cochran, J., & Ganong, L. H. (1989). A comparison of nurses and patients perception of intensive care unit stressors. Journal of Advanced Nursing, 14(12), 1038-1043. https://doi.org/10.1111/j.1365-2648.1989.tb01515.x
  8. Davydow, D. S., Gifford, J. M., Desai, S. V., Needham, D. M., & Bienvenu, O. J. (2008). Posttraumatic stress disorder in general intensive care unit survivors: A systematic review. General Hospital Psychiatry, 30(5), 421-434. https://doi.org/10.1016/j.genhosppsych.2008.05.006
  9. Davydow, D. S., Gifford, J. M., Desai, S. V., Bienvenu, O. J., & Needham, D. M. (2009). Depression in general intensive care unit survivors: A systematic review. Journal of Intensive Care Medicine, 35(5), 796-809. https://doi.org/10.1007/s00134-009-1396-5
  10. Eun, H. J., Kwon, T. A., Lee, S. M., Kim, T. H., Choi, M. R., & Jo, S. J. (2005). A study on reliability and validity of the Korean version of impact of event scale-revised. Journal of the Korean Neuropsychiatric Association, 44(3), 303-310.
  11. Field, A. (2013). Discovering statistics using IBM SPSS statistics. London: Sage Publication.
  12. Garrouste, O. M., Coquet, I., Perier, A., Timsit, J. F., Pochard, F., Lancrin, F., . . . Misset, B. (2012). Impact of an intensive care unit diary on psychological distress in patients and relatives. Critical Care Medicine, 40(7), 2033-2040. https://doi.org/10.1097/CCM.0b013e31824e1b43
  13. Go, J. G. (2007). Patients' anxiety in intensive care units and its related factors. Journal of Korean Academy of Nursing, 37 (4), 586-593. https://doi.org/10.4040/jkan.2007.37.4.586
  14. Heydon, G., Vander, R. P., & Maguire, J. (2016). Survivors' quality of life after cardiopulmonary resuscitation: An integrative review of the literature. Scandinavian Journal of Caring Sciences, 31(1), 6-26. https://doi.org/10.1111/scs.12323
  15. Jackson, J. C., Mitchell, N., & Hopkins, R. O. (2009). Cognitive functioning mental health, and quality of life in ICU survivors: An overview. Critical Care Clinics, 25 (3), 615-628. https://doi.org/10.1016/j.ccc.2009.04.005
  16. Jeon, J. H. (2017). A study on the prevalence and related factors of Post-Intensive Care Syndrome (PICS) of intensive care survivors (Unpublished master's thesis). Seoul University, Seoul, Korea.
  17. Jones, C., Griffiths, R. D., Humphris, G., & Skirrow, P. M. (2001). Memory, delusions, and the development of acute posttraumatic stress disorder related symptoms after intensive care. Critical Care Medicine, 29 (3), 573-580. https://doi.org/10.1097/00003246-200103000-00019
  18. Jones, C., Backman, C., Capuzzo, M., Egerod, I., Flaaten, H., Granja, C., . . . Griffiths, R. D. (2010). Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: A randomised, controlled trial. Critical Care Medicine, 14(5), R168.
  19. Kim, M. Y., Lee, Y. G., Park, S. L., Hwang, I. S., Lee, S. J., & Shin, J. S. (2005). A study on the health-related quality of life after ICU care. Acute and Critical Care, 20 (2), 144-151.
  20. Kim, S. G., & Kang, J. Y. (2016). Post-intensive care syndrome and quality of life in survivors of critical illness. Journal of Korean Critical Care Nursing, 9(1), 1-14.
  21. Kim, Y. J. (2006). Nurses' and patients' perception of environmental stressors in a surgical intensive care unit (Unpublished master's thesis). Ulsan University, Ulsan, Korea.
  22. Lee, Y. H., Choi, J. S., Lee, J. A., Ryu, S. Y., Shin, M. H., & Kim, J. H. (2009). A study on the application of the Korean valuation weights for EuroQoL-5 Dimension. Korean Journal of Health Education and Promotion, 26 (1), 1-13.
  23. Needham, D., Davidson, J., Cohen, H., Hopkins, R., Weinert, C., Wunsch, H., & Harvey, M. (2012). Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders' conference. Critical Care Medicine, 40 (2), 502-509. https://doi.org/10.1097/CCM.0b013e318232da75
  24. Parker, A. M., Sricharoenchai, T., Raparla, S., Schneck, K. W., Bienvenu, O. J., & Needham, D. M. (2015). Posttraumatic stress disorder in critical illness survivor: A metaanalysis. Journal of Critical Care Medicine, 43 (5), 1121-1129. https://doi.org/10.1097/CCM.0000000000000882
  25. Scragg, P., Jones, A., & Fauvel, N. (2001). Psychological problems following ICU treatment. Anaesthesia, 56(1), 9-14. https://doi.org/10.1046/j.1365-2044.2001.01714.x
  26. Song, H. S. (2012). Changes in symptom experience, functional status and health related quality of life of survivors after intensive care units discharge: A 6 month-longitudinal study (Unpublished doctoral dissertation). Soonchunhyang University, Chungnam, Korea.
  27. Vest, M. T., Murphy, T. E., Araujo, K. L., & Pisani, M. A. (2011). Disability in activities of daily living, depression, and quality of life among older medical ICU survivors: A prospective cohort study. Health and Quality of Life Outcomes, 9 (1), 9. https://doi.org/10.1186/1477-7525-9-9
  28. Weiss, D., & Marmar, C. (1997). The impact of event scale, revised. In J. Wilson & T. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399-411). New York, USA: Guilford Press.
  29. Yoo, Y. S., Bong, S. O., Kim, G. L., Choi, G. O., & Jeong, H. S. (2007). The stress of patients in the coronary care unit. Journal of Korean Biological Nursing Science, 9 (2), 135-142.