Tackling PTSD in ICU patients and their caregivers.

摘要

Recent studies confirm what many have observed about intensive care: it can be traumatic for patients and their loved ones. In a 2008 systematic review by Davy-dow and colleagues, for instance, 22% of ICU survivors reported clinically significant symptoms of posttraumatic stress disorder (PTSD). Dying in the hospital, rather than at home, stresses patients and caregivers alike, according to one recent prospective longitudinal study. Wright and colleagues recruited 666 subjects (333 dyads, each comprising a patient with advanced cancer and her or his informal care-giver) between 2002 and 2008, and assessed the quality of the patients' lives and the mental health of the caregivers. Two-thirds of the patients died at home; the rest died in the hospital (8% in an ICU). Compared with patients dying at home, those dying in an ICU had far lower scores on measures of quality of life, physical comfort, and well-being, and their caregivers had both "a heightened risk of developing PTSD" (21% versus 4% of those whose loved one died at home) and debilitating grief (22% versus 5%).