【原】#护理选题： “ICU日记”对ICU患者及其家属健康的影响

相关文献：

[1]李真,吴欣娟,杨慧,郭娜,李莉,徐梅,李奇,李尊柱,孙建华,罗红波.ICU日记对患者及家属心理健康干预效果的Meta分析[J].中华护理杂志,2020,55(07):1091-1096.

[2]林叶青,莫红平,冯永申,倪宏,张利峰.ICU日记对重症患者创伤后应激障碍影响的Meta分析[J].中国护理管理,2019,19(12):1810-1816.

[3]申苗苗,刘华平.国外ICU日记应用的研究进展[J].护理研究,2019,33(14):2443-2445.

[4]向韩,祝玲,姜曼.ICU后综合征的临床表现及干预措施的研究现状[J].护理研究,2019,33(04):599-604.

[5]罗利,傅凡,肖莎.日记法在ICU病人创伤后应激障碍早期干预的效果研究[J].护理研究,2019,33(01):145-148.

[6]韦秀霞,张秀伟,彭剑英,庄一渝.国外ICU后综合征的研究现状[J].中华护理杂志,2016,51(01):84-89.

[7]叶小健,庄一渝,陈香萍,叶志弘.ICU后综合征的干预研究现状[J].中华护理杂志,2015,50(11):1369-1374.

Garrouste-Orgeas M, Flahault C, Fasse L. The ICU-Diary study: prospective, multicenter comparative study of the impact of an ICU diary on the wellbeing of patients and families in French ICUs. Trials. 2017 Nov 15;18(1):542. doi: 10.1186/s13063-017-2283-y. PMID: 29141694; PMCID: PMC5688734.

ICU日记：对ICU患者及其家属健康的影响

Background研究背景

Post-intensive care syndrome includes the multiple consequences of an intensive care unit (ICU) stay for patients and families. It has become a new challenge for intensivists. Prevention programs have been disappointing, except for ICU diaries, which report the patient's story in the ICU. However, the effectiveness of ICU diaries for patients and families is still controversial, as the interpretation of the results of previous studies was open to criticism hampering an expanded use of the diary. The primary objective of the study is to evaluate the post-traumatic stress syndrome in patients. The secondary objectives are to evaluate the post-traumatic stress syndrome in families, anxiety and depression symptoms in patients and families, and the recollected memories of patients. Endpoints will be evaluated 3 months after ICU discharge or death.

ICU后综合征是指ICU患者在转出后，出现认知、心理和生理等方面功能障碍的综合征。这已经成为重症患者面临的新挑战。ICU日记是指医护人员或患者家属在患者ICU入住期间，通过文字或照片记录患者在ICU入住期间的关键事件，有助于填补患者记忆空白，促进信息的沟通交流以及患者出院后心理恢复。但ICU日记对患者和其家属的有效性仍然存在争议。本研究的主要目的是评估患者的ICU后创伤后应激综合征。次要目标是评估家庭的创伤后应激综合征、患者和家庭的焦虑和抑郁症状以及患者的回忆。在ICU出院或死亡后3个月进行评估。

Methods研究方法

 A prospective, multicenter, randomized, assessor-blind comparative study of the effect of an ICU diary on patients and families. We will compare two groups: one group with an ICU diary written by staff and family and given to the patient at ICU discharge or to the family in case of death, and a control group without any ICU diary. Each of the 35 participating centers will include 20 patients having at least one family member who will likely visit the patient during their ICU stay. Patients must be ventilated within 48 h after ICU admission and not have any previous chronic neurologic or acute condition responsible for cognitive impairments that would hamper their participation in a phone interview. Three months after ICU discharge or death of the patient, a psychologist will contact the patient and family by phone. Post-traumatic stress syndrome will be evaluated using the Impact of Events Scale-Revised questionnaire, anxiety and depression symptoms using the Hospital Anxiety and Depression Scale questionnaire, both in patients and families, and memory recollection using the ICU Memory Tool Questionnaire in patients. The content of a randomized sample of diaries of each center will be analyzed using a grid. An interview of the patients in the intervention arm will be conducted 6 months after ICU discharge to analyze in depth how they use the diary.

前瞻性、多中心、随机对照研究。我们将两组进行比较：其中一组是由工作人员和家属撰写ICU日记，并在患者出院或死亡时交给家属；另一组不进行ICU日记干预。每个研究中心（35个）分别纳入20名患者（他们至少有1名家庭成员可能在ICU住院期间探望他们；患者在ICU入院后48小时内必须进行通气，且既往无任何导致认知障碍的慢性神经系统或急性疾病，这将妨碍他们参与电话访谈）。在重症监护病房出院或患者死亡三个月后，心理医生将通过电话联系患者及其家人。

创伤后应激综合征将使用事件影响量表修订版进行评估；患者和家属将使用医院焦虑和抑郁量表进行焦虑和抑郁症状评估；患者将使用ICU记忆评估工具进行记忆回忆评估。

每个中心日记的随机样本的内容将使用网格进行分析。对ICU出院后6个月干预组患者进行访谈，深入分析他们使用日记的情况。

Discussion研究结论

This study will provide new insights on the impact of ICU diaries on post-traumatic stress disorders in patients and families after an ICU stay.

本研究将为ICU住院患者及其家庭创伤后应激障碍患者日记的影响提供新的见解。

（建议去看原文）

护理科研知识交流社群