重症病人與家屬的重症加護後症候群

隨著醫學的進步，重症疾病患者的數量逐年提升。然而重症病人出院後因重症住加護病房期間的疾病與治療產生的合併症與副作用，導致病人和家屬在出院後產生重症加護後症候群。病人的問題主要在於身體功能症狀、認知障礙、心理問題（包含焦慮、憂鬱和創傷壓力障礙等），此心理問題家屬也可能同時發生。本文藉由介紹病人與家屬的重症加護後症候群，並描述其症狀、危險因素與預防措施及其相關測量工具，期望能提供重症加護醫療人員在病患加護病房停留期間及早啟動預防措施，提升重症加護照護品質。

關鍵字

重症病人；加護病房；重症加護後症候群

並列摘要

The population of survivors of critical illness has increased with advancements in medicine and technology. However, many patients and their families experience post-intensive care syndromes after discharge from intensive care units (ICUs) due to the comorbidities and side-effects of severe illnesses and related treatments. The problems faced by these survivors are mainly physical symptoms, cognitive disorders, and psychological problems (including anxiety, depression, and traumatic stress disorder). Moreover, patient family members frequently experience psychological problems as well. This article introduces the post-intensive care syndromes (PICS) of survivors and their families; describe the physical symptoms, risk factors, and prevention strategies related to PICS; and primary instruments currently used to measure PICS. The authors hope to provide intensive care health staff with the knowledge necessary to implement preventive strategies for patients as early as possible during their ICU stay to improve the quality of intensive care.

並列關鍵字

critical illness patients ； Intensive care unit ； post intensive care syndrome

參考文獻

Altman, M. T., Knauert, M. P., & Pisani, M. A. (2017). Sleep disturbance after hospitalization and critical illness: A systematic review. Annals of the American Thoracic Society, 14(9), 1457–1468. https://doi.org/10.1513/AnnalsATS.201702-148SR

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. https://doi.org/10.1176/appi.books.9780890425596

Bagshaw, S. M., Thomas Stelfox, H., McDermid, R. C., Rolfson, D. B., Tsuyuki, R. T., Baig, N., ... Majumdar, S. R. (2014). Association between frailty and short- and long-term outcomes among critically ill patients: A multicenter prospective cohort study. CMAJ: Canadian Medical Association Journal, 186(2), E95–E102. https://doi.org/10.1503/cmaj.130639

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM‐5 (PCL‐5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498. https://doi.org/10.1002/jts.22059

Bryant, R. A., Moulds, M. L., & Guthrie, R. M. (2000). Acute stress disorder scale: A self-report measure of acute stress disorder. Psychological Assessment, 12(1), 61–68. https://doi.org/10.1037/1040-3590.12.1.61

被引用紀錄

王誱竩、張瀞文、林君黛（2021）。運用Watson關懷理論於一位突發缺氧性腦病變個案家屬之護理經驗。台灣健康照顧研究學刊，(24)，86-105。https://www.airitilibrary.com/Article/Detail?DocID=19946236-202107-202108260009-202108260009-86-105

汪欣潔、黃秀英、王麒嘉（2022）。一位肺泡蛋白質沉著症病人以體外維生循環系統行全肺灌洗術之加護護理經驗。志為護理-慈濟護理雜誌，21(5)，105-114。https://www.airitilibrary.com/Article/Detail?DocID=16831624-202210-202211220009-202211220009-105-114

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重症病人與家屬的重症加護後症候群

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