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بررسی ارتباط دلیریوم بیمار با اضطراب در مراقبین خانوادگی بیماران بستری در بخش مراقبت‌های ویژه

نوع مقاله : علمی- پژوهشی

نویسندگان

1 کارشناسی ارشد، گروه پرستاری مراقبت‌های ویژه، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران.

2 دانشیار، گروه پرستاری مراقبت‌های ویژه، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران.

3 کارشناسی ارشد، گروه روانشناسی عمومی، دانشگاه آزاد اسلامی، واحد الکترونیکی، تهران، ایران.

4 دانشجوی کارشناسی ارشد، گروه پرستاری اورژانس، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران.

5 استادیار، گروه آمار زیستی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران.

6 استادیار، گروه پرستاری مراقبت‌های ویژه، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران.

چکیده

مقدمه: دلیریوم نوعی تخریب شناختی نوسان دار و یک مشکل حاد در بیماران بستری است که می‌تواند باعث ایجاد پاسخ های روانشناختی در مراقبین خانوادگی گردد. مطالعه حاضر با هدف تعیین ارتباط بین دلیریوم بیمار و اضطراب در مراقبین خانوادگی بیماران بستری در بخش مراقبت‌های ویژه انجام شده است.
روش: در این مطالعه مقطعی در سال 1402، تعداد 256 جفت از بیماران و مراقبین خانوادگی  بیماران بستری در بخش مراقبت‌های ویژه به روش نمونه‌گیری طبقه‌ای متناسب انتخاب شدند. جهت جمع‌آوری اطلاعات از سه پرسشنامه شامل اطلاعات جمعیت‌شناختی، پرسشنامه CAM-ICU و پرسشنامه GAD7 استفاده شد. داده‌ها با استفاده از نرم‌افزاز SPSS نسخه 16 تحلیل شدند.
یافته‌ها: نمره دلیریوم در 200 مورد از بیماران (1/78 %) مثبت گزارش شد. تعداد 240 نفر (8/93%) از مراقبین خانوادگی علائم اضطراب را گزارش کرده بودند که تعداد 43 نفر (8/16%) اضطراب خفیف، 84 نفر (8/32%) اضطراب متوسط و 113 نفر (2/44%) اضطراب شدید را تجربه کرده بودند. ارتباط آماری معنی‌داری بین دلیریوم بیمار و اختلال اضطراب فراگیر مراقبین خانوادگی گزارش شد (001/0 >P).
نتیجه‌گیری: وجود میزان بالای اضطراب در مراقبین خانوادگی لزوم توجه بیشتر کادر پرستاری به کاهش اضطراب را نمایان می‌کند. مراقبین خانوادگی نقش مهمی در حمایت از فرد بیمار برعهده دارند و حمایت از آنان به معنای تداوم مراقبت است. داشتن ارزیابی مناسب از نیازهای مراقبین خانوادگی و تلاش در جهت پاسخ به این نیازها می‌تواند موجب بهبود کیفیت مراقبت و افزایش رضایتمندی از دریافت خدمات مراقبتی گردد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The Relationship between Patient Delirium and Anxiety in Family Caregivers of Patients Admitted to the Intensive Care Unit

نویسندگان [English]

  • somaye shokri 1
  • elham nanab 2
  • shieva esmailie 3
  • yasaman jahed 4
  • Hamid Haghani 5
  • Mahboubeh shali 6

1 M.Sc, Department of Critical Care Nursing, Tehran School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

2 Associate Professor, Department of Critical Care Nursing, Tehran School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

3 M.Sc, Department of General Psychology, Islamic Azad University, Electronic branch, Tehran, Iran.

4 M.Sc. Student, Department of Emergency Nursing, Tehran School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

5 Assistant Professor, Department of Biostatistics, Iran University of Medical Sciences, Tehran, Iran

6 Assistant Professor, Department of Critical Care Nursing, Tehran School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

چکیده [English]

Objective: Mental and psychological problems of the patient's family, as an important issue, is presented in the special care section, which can be caused by the lack of awareness of the family regarding the diagnosis, prognosis and treatment of the patient. Anxiety caused by the hospitalization of a family member in the intensive care unit is one of the problems in the family of patients. The presence of anxiety in a patient's family member limits his ability to provide help and can exacerbate the patient's concerns. In addition to anxiety, delirium is another unpleasant experience for family caregivers. Delirium is a fluctuating cognitive impairment and an acute problem in hospitalized patients that can cause psychological responses in family caregivers. Having a proper assessment of the needs of the families of patients hospitalized in the intensive care unit and efforts to strengthen the care system in response to these needs can improve the quality of care and increase satisfaction with receiving care services. The present study was conducted with the aim of determining the relationship between patient delirium and anxiety in family caregivers of patients admitted to the intensive care unit. Method: In this cross-sectional study in 2024, 256 pairs of patients and family caregivers of patients admitted to the intensive care unit were selected using proportional stratified sampling. To collect information, three questionnaires including demographic information, CAM-ICU questionnaire and GAD7 questionnaire were used. Inclusion criteria for patients included age equal to 18 years or more, Richmond Sedation Scale score≥3 and stay more than 24 hours in the intensive care unit. Entry criteria for family caregivers of hospitalized patients included age 18 and older, having the duty of caring for the patient, and the ability to fill out questionnaires. In this study, family caregivers were considered to be people who take direct care of the patient without getting paid, who can be the patient's family, relatives, or friends. Exclusion criteria for the family included inability to cooperate with the research team (eg, hearing impairment, inability to communicate) and having a history of anxiety and depression. These criteria for patients included severe neurological injury (eg, severe traumatic brain injury), predicted length of stay in the intensive care unit of less than 24 hours, and Glasgow Coma Scale score <9. Data were analyzed using SPSS version 16 software. Results: The delirium score was reported positive in 200 cases of patients (78.1%). 240 people (93.8%) of family caregivers had reported symptoms of anxiety, 43 people (16.8%) had mild anxiety, 84 people (32.8%) had moderate anxiety and 113 people (44.2%) They had experienced severe anxiety. A statistically significant relationship was reported between the patient's delirium and the generalized anxiety disorder of the family caregivers (P<0.001). Conclusion: The presence of anxiety in family caregivers shows the need for nursing and medical staff to pay more attention to reducing anxiety and using appropriate interventions. Family caregivers play an important role in supporting the sick person, and this point highlights the need to pay attention and importance to them by the health care system and nurses; Because supporting them means continuing to care for the sick person. Having a proper assessment of the needs of the families of patients hospitalized in the intensive care unit and trying to strengthen the care system in response to these needs can improve the quality of care and increase satisfaction with receiving care services.

کلیدواژه‌ها [English]

  • Anxiety
  • Caregivers
  • Delirium
  • Intensive Care Units
  • Nurses
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روانشناسی سلامت
دوره 14، شماره 53
خرداد 1404
صفحه 7-18
فایل ها
هم رسانی
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