ICU日记在ICU患者急性应激障碍中的干预效果研究

Intervention effects of ICU diaries in patients with acute stress disorder in ICU

摘要:

目的 探讨ICU日记在ICU患者急性应激障碍中的干预效果。方法 选取52例ICU患者，随机分为试验组和对照组，对照组采用常规护理方法，试验组在对照组基础上书写ICU日记干预，比较2组患者干预后第3天、第7天和第21天的斯坦福急性应激反应问卷评分，急性应激障碍发生率，斯坦福急性应激反应问卷各维度评分。结果 试验组与对照组干预后第3天的斯坦福急性应激反应问卷评分和急性应激障碍症状阳性表现无统计学意义（P=0.075、P=0.471）；在分离、功能损害2个维度上，2组患者差异有统计学意义（P=0.035、P=0.016），试验组评分显著低于对照组；在再体验、回避、激惹3个维度上，2组患者评分差异无统计学意义（P=0.320、P=0.140、P=0.137）。干预后第7天的斯坦福急性应激反应问卷评分比较（49.77±12.16 vs. 76.88±17.56），差异有统计学意义（P=0.000）；急性应激障碍症状阳性表现比较（69.23% vs. 96.15%），差异有统计学意义（P=0.028）；在急性应激反应变量各维度上2组患者评分差异有统计学意义（P=0.000）。干预后第21天的斯坦福急性应激反应问卷评分比较（35.92±5.54 vs. 75.23±17.28），差异有统计学意义（P=0.000）；急性应激障碍症状阳性表现比较（38.46% vs. 76.92%），差异有统计学意义（P=0.005）；在急性应激反应变量各维度上2组患者评分差异有统计学意义（P=0.000）。干预后第7天、第21天试验组斯坦福急性应激反应问卷评分、急性应激障碍阳性率、急性应激反应变量各维度评分显著低于对照组。结论 ICU日记有利于降低ICU患者急性应激障碍症状和发生率。

Abstract:

Objective To explore the intervention effects of intensive care unit（ICU） diaries in patients with acute stress disorder（ASD） in ICU.Methods Fifty-two patients in ICU were selected and randomly divided into experimental group and control group. The control group received conventional nursing approaches，while the experimental group had ICU diary intervention in addition to the nursing approaches of the control group. The two groups were compared in the incidence of ASD，the Stanford Acute Stress Reaction Questionnaire（SASRQ） score，and the scores of SASRQ dimensions on day 3，7，and 21 after intervention.Results On day 3，there were no significant differences between the experimental group and the control group in the SASRQ score and the incidence of ASD（P=0.075，P=0.471）；the experimental group showed significantly lower scores of dissociation and functional impairment dimensions than the control group（P=0.035，P=0.016），with no significant differences in the three dimensions of re-experience，avoidance，and irritation（P=0.320，P=0.140，P=0.137）. On day 7，significant differences were observed between the two groups in the SASRQ score（49.77±12.16 vs. 76.88±17.56），the incidence of ASD（69.23% vs. 96.15%），and the score of each SASRQ dimension（P=0.000，P=0.028，P=0.000）. On day 21，the two groups also showed significant differences in the SASRQ score（35.92±5.54 vs. 75.23±17.28），the incidence of ASD（38.46% vs. 76.92%），and each SASRQ dimension score（P=0.000，P=0.005，P=0.000）. On days 7 and 21，the SASRQ score，the incidence of ASD，and SASRQ dimension scores were all significantly lower in the experimental group than in the control group.Conclusion ICU diaries can help reduce the symptoms and incidence of ASD in ICU patients.