PSYCHOLOGICAL EFFECTS OF SEDATIVE ON CRITICALLY ILL PATIENTS

A GUL; R GUL; M HAROON; J KHAN; F AJMAL; HS KHAN; S KHAN

doi:10.54112/bcsrj.v2023i1.623

Authors

A GUL Internal Medicine/ Critical Care (FCPS II), Senior Clinical Fellow, Russell’s Hall Hospital, Dudley, UK
R GUL Internal Medicine (FCPS II), Junior Clinical Fellow, Heartlands Hospital, Birmingham, UK
M HAROON Internal Medicine/ Critical Care (FCPS II), Khyber Teaching Hospital, Peshawar, Pakistan
J KHAN Pulmonology/ Critical Care (FCPS II), Bahria International Hospital, Rawalpindi, Pakistan
F AJMAL Internal Medicine/ Critical Care (FCPS II), Lady Reading Hospital, Peshawar, Pakistan
HS KHAN MRCP (UK), MRCP (Ireland), Registrar, Aintree Hospital, Liverpool, UK
S KHAN Dow International Medical College Karachi, Sindh, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.623

Keywords:

Critical Care, Intensive Care Unit, Psychological Effect, Anxiety, Depression, Post-Traumatic Stress Disorder

Abstract

This study aimed to assess the psychological effects experienced by patients admitted to the intensive care unit (ICU). Following ethical approval, the study was conducted as a cross-sectional survey at Bahria International Hospital ICU between January 2022 and December 2022. The inclusion criteria required patients to be over 18 years of age, have stayed in the ICU for at least 24 hours, be aware during the assessment, and provide informed consent for research participation. Patients who failed to complete the assessment or were transferred out of the ICU were excluded from the study. The data was analyzed using a non-probability sampling technique and the SPSS-24 version. A chi-square value of less than 0.5 was considered significant. The data from a total of 161 patients was evaluated. Of these, 72 patients (44%) were diagnosed with depression, while 89 patients (55.2%) had medical cases. Males outnumbered females, with 94 (58%) male patients and 67 (42%) female patients. 26 patients (17%) had a hospital stay of over 2 weeks, compared to 135 (83%) who were discharged within 2 weeks. One hundred fifty-one patients (93%) did not show signs of anxiety, while 10 (6%) tested positive. Nine patients tested positive for amnesia, while 152 did not. One hundred fifty-five patients (96%) reported no hallucinations, while 6 patients (4%) believed they had experienced hallucinations. Seventy-four patients (46%) tested negative for post-traumatic stress disorder (PTSD), while 87 patients (54%) claimed to experience PTSD. Of the ICU admissions, 89 (55%) were due to medical cases, while 27 (16.7%) were surgical. The study highlights the need for implementing a bedside screening instrument and physician approval to improve the identification and early detection of psychological effects in critically ill ICU patients. The first step towards preventing and developing a future ICU free from psychological effects is identifying the incidence and risk factors associated with such impacts. The complex psychosocial impacts experienced by critically ill ICU patients require more attention and research.

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References

Aljarameez, F., Saha, C., Sinan, M., Rajan, L., Ahmed, G. Y., and Mutair, A. A. (2023). Sociodemographic determinants of structural empowerment and organisational commitment among critical care nurses in Saudi Arabia: a comparative cross-sectional study. British Journal of Healthcare Management 29, 1-12.

Choo, M. S., and Lee, D. S. (2020). Does deep sedation with analgesia have positive effects on anxiety, pain and compliance in patients before and after prostate biopsy? International Journal of Clinical Practice 74, e13517.

Devlin, J. W., Skrobik, Y., Gélinas, C., Needham, D. M., Slooter, A. J., Pandharipande, P. P., Watson, P. L., Weinhouse, G. L., Nunnally, M. E., and Rochwerg, B. (2018). Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical care medicine 46, e825-e873.

Eikermann, M., Needham, D. M., and Devlin, J. W. (2023). Multimodal, patient-centred symptom control: a strategy to replace sedation in the ICU. The Lancet Respiratory Medicine 11, 506-509.

Gamwell, K. L., Roberts, C. M., Kraft, J. D., Edwards, C. S., Baudino, M. N., Grunow, J. E., Jacobs, N. J., Tung, J., Mullins, L. L., and Chaney, J. M. (2023). Factor analysis of the stigma scale-child in pediatric inflammatory bowel disease. Journal of Psychosomatic Research 164, 111095.

Hanifa, A. L. B., Alrø, A. B., Holm, A., and Dreyer, P. (2023). Nurses’ experiences of managing cognitive problems in intensive care unit patients: A qualitative study. Intensive and Critical Care Nursing 79, 103508.

Hida, S., Takemoto, M., Masumoto, A., Mito, T., Nagaoka, K., Kumeda, H., Kawano, Y., Aoki, R., Kang, H., and Tanaka, A. (2017). Clinical benefits of deep sedation with a supraglottic airway while monitoring the bispectral index during catheter ablation of atrial fibrillation. Journal of Arrhythmia 33, 283-288.

Hirshberg, E. L., Butler, J., Francis, M., Davis, F. A., Lee, D., Tavake-Pasi, F., Napia, E., Villalta, J., Mukundente, V., and Coulter, H. (2020). Persistence of patient and family experiences of critical illness. BMJ open 10.

Ho, J. Q., Nguyen, C. D., Lopes, R., Ezeji-Okoye, S. C., and Kuschner, W. G. (2018). Spiritual care in the intensive care unit: a narrative review. Journal of intensive care medicine 33, 279-287.

Jean, R., Shah, P., Yudelevich, E., Genese, F., Gershner, K., Levendowski, D., Martillo, M., Ventura, I., Basu, A., and Ochieng, P. (2020). Effects of deep sedation on sleep in critically ill medical patients on mechanical ventilation. Journal of sleep research 29, e12894.

Leong, E.-L., Chew, C.-C., Ang, J.-Y., Lojikip, S.-L., Devesahayam, P.-R., and Foong, K.-W. (2023). The needs and experiences of critically ill patients and family members in intensive care unit of a tertiary hospital in Malaysia: a qualitative study. BMC Health Services Research 23, 1-11.

Liang, S., Chau, J. P. C., Lo, S. H. S., Choi, K. C., Bai, L., and Cai, W. (2023). The effects of a sensory stimulation intervention on psychosocial and clinical outcomes of critically ill patients and their families: A randomised controlled trial. Intensive and Critical Care Nursing 75, 103369.

Martinho, C. I. F., and Rodrigues, I. T. R. M. (2016). Communication of mechanically ventilated patients in intensive care units. Revista Brasileira de terapia intensiva 28, 132-140.

Papautsky, E. L., and Abdulbaseer, U. (2024). Capturing the Work of Patients' Family Members in the Medical Intensive Care Unit Using Naturalistic Observations. HERD: Health Environments Research & Design Journal 17, 84-91.

Su, L., Liu, C., Chang, F., Tang, B., Han, L., Jiang, H., Zhu, W., Hong, N., Zhou, X., and Long, Y. (2021). Selection strategy for sedation depth in critically ill patients on mechanical ventilation. BMC Medical Informatics and Decision Making 21, 1-12.

Topçu, S., Ecevit Alpar, Ş., Gülseven, B., and Kebapçı, A. (2017). Patient experiences in intensive care units: a systematic review. Patient Experience Journal 4, 115-127.

Yoo, H. J., Lim, O. B., and Shim, J. L. (2020). Critical care nurses’ communication experiences with patients and families in an intensive care unit: A qualitative study. Plos one 15, e0235694.

Zainah, M., Sasikala, M., Nurfarieza, M., and Ho, S. (2016). Needs of family members of critically ill patients in a critical care unit at Universiti Kebangsaan Malaysia Medical Centre. Med & Health 11, 11-21.