ENTRAR            

Artículo de investigación

Avances en Enfermería [av.enferm. -Col-] 2015 ene-jul; 33(1): 047-054   Recibido: 23/08/2012 Aprobado: 15/12/2014

Anxiety and depression symptoms in family members of ICU patients   Maria Kourti,* Efstathia Christofilou,** George Kallergis*** *RN, BSc, MSc, PhD. Faculty of Nursing, University of Athens, Intensive Care Unit, �Laiko� General Hospital of Athens. Athens, Greece. **RN, BSc, MSc. Head Nurse of Intensive Care Unit, �Laiko� General Hospital of Athens. Athens, Greece. ***MD, PhD. Assistant Professor, Faculty of Nursing, University of Athens. Athens, Greece

Abstract

Objective: This study investigated symptoms of anxiety and depression in relatives of patients admitted in the Intensive Care Unit and determined whether these symptoms were associated to the seriousness of the patients� condition. Metodology: A total of 102 patients� relatives were surveyed during the study. They were given a self-report questionnaire in order to assess demographic data, anxiety and depression symptoms. The symptoms of anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale (hads). Patient�s condition was evaluated with a.p.a.ch.e ii Score. Results: More than 60% of patients� relatives presented severe symptoms of anxiety and depression. No relation was found between symptoms of anxiety and depression of the relatives of patients and patients� condition of health. On the contrary, these feelings used to exist regardless of the seriousness of patient�s condition. Conclusions: The assessment of these patients is recommended in order serious problems of anxiety and depression to be prevented.
Key-words: Anxiety/ Depressive Disorder/ Intensive Care Units/ Visitors to Patients.

Resumen
Síntomas de ansiedad y depresión en familiares de pacientes en la UCI

Objetivo: El presente estudio se propuso investigar los síntomas de ansiedad y depresión en familiares de pacientes que fueron admitidos en la Unidad de Cuidados Intensivos y se determinó si estos síntomas se asociaron con la gravedad de la condición del paciente. Metodología: Durante este estudio se encuestó un total de 102 familiares de pacientes, a quienes se les solicitó diligenciar un cuestionario auto-administrado para estimar aspectos sociodemográficos y síntomas de ansiedad y depresión. Los síntomas de ansiedad y depresión fueron evaluados con la Hospital Anxiety and Depression Scale (hads). La condición del paciente fue evaluada con el a.p.a.ch.e ii Score. Resultados: Más del 60% de los familiares encuestados presentaron síntomas severos de ansiedad y depresión. No se encontró relación entre los síntomas de ansiedad y depresión de los familiares de los pacientes y el estado de salud de éstos. Por el contrario, aquellas sensaciones solían darse con independencia de la gravedad de la condición del paciente. Conclusiones: Se recomienda la evaluación de estos pacientes para evitar problemas serios de ansiedad y depresión.
Palabras clave: Ansiedad/ Trastorno Depresivo/ Unidades de Cuidados Intensivos/ Visitas a Pacientes.

Resumo
Sintomas de ansiedade e depressão em familiares de pacientes na UCI

Objetivo: O presente estudo pesquisou os sintomas de ansiedade e depressão em familiares de pacientes que foram admitidos na Unidade de Terapia Intensiva e se determinou se esses sintomas se associaram com a gravidade da condição do paciente. Metodologia: Durante este estudo se inquiriu um total de 102 familiares de pacientes, a quem se solicitou diligenciar um questionário auto- administrado, para estimar aspectos sociodemográficos e sintomas de ansiedade e depressão. Os dados sobre sintomas de ansiedade e depressão foram processados usando a Hospital Anxiety and Depression Scale (hads). A condição do paciente foi avaliada com o a.p.a.ch.e ii Score. Resultados: Mais de 60% dos familiares questionados apresentaram sintomas severos de ansiedade e depressão. Não se encontrou relação entre os sintomas de ansiedade e depressão dos familiares dos pacientes e o estado de saúde deles. Pelo contrário, essas sensações com frequência se apresentavam com independência da gravidade da condição do paciente. Conclusões: Recomenda-se a avaliação destes pacientes para evitar problemas sérios de ansiedade e depressão.
Palavras chave: Ansiedade/ Transtorno Depressivo/ Unidades de Terapia Intensiva/ Visitas a Pacientes.
 

Bibliografía

(1) Carlet J, Garrouste M, Dumay MF, Diaw F, Guidet B, Timsit JF et al. Managing intensive care units: make love, not war! J Crit Care. 2010 Jun;25(2):359.e9-359.e12.

(2) Davidson JE. Family-centered care: meeting the needs of patients� families and helping families adapt to critical illness. Crit Care Nurse. 2009 Jun;29(3):28-34.

(3) Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E et al. Clinical practice guidelines for support of the family in the patient- centered intensive care unit: American College of Critical Care Medicine Task Force 2004- 2005. Crit Care Med. 2007 Feb;35(2):605-622.

(4) Gries CJ, Engelberg RA, Kross EK, Zatzick D, Nielsen EL, Downey L et al. Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the icu. Chest. 2010 Feb;137(2):280-287.

(5) Siegel MD, Hayes E, Vanderwerker LC, Loseth DB, Prigerson HG. Psychiatric illness in the next of kin of patients who die in the intensive care unit. Crit Care Med. 2008 Jun;36(6):1722-1728.

(6) Schmidt M, Azoulay E. Having a loved one in the icu: the forgotten family. Curr Opin Crit Care. 2012 Oct;18(5):540-547.

(7) Stricker KH, Kimberger O, Schmidlin K, Zwahlen M, Mohr U, Rothen HU. Family satisfaction in the intensive care unit: what makes the difference? Intens Care Med. 2009 Dec;35(12):2051-2059.

(8) Rothen HU, Stricker KH, Heyland DK. Family satisfaction with critical care: measurements and messages. Curr Opin Crit Care. 2010 Dec;16(6):623-631.

(9) Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-370.

(10) Pillai L, Aigalikar S, Vishwasrao SM, Husainy SM. Can we predict intensive care relatives at risk for posttraumatic stress disorder? Indian J Crit Care Med. 2010;14(2):83-87.

(11) Anderson WG, Arnold RM, Angus DC, Bryce CL. Posttraumatic stress and complicated grief in family members of patients in the intensive care unit. J Gen Intern Med. 2008 Nov;23(11):1871-1876.

(12) Pillai LV, Ambike D, Husainy S, Vaidya N, Kulkarni SD, Aigolikar S. The prevalence of post-traumatic stress disorder symptoms in relatives of severe trauma patients admitted to the intensive care unit. Indian J Crit Care Med. 2006;10(3):181-186.

(13) Michopoulos I, Douzenis A, Kalkavoura C, Christodoulou C, Michalopoulou P, Kalemi G et al. Hospital Anxiety and Depression Scale (hads): validation in a Greek general hospital sample. Ann Gen Psychiatry. 2008 Mar;7:4.

(14) Mystakidou K, Tsilika E, Parpa E, Galanos A, Vlahos L. Psychometric properties of the Impact of Event Scale in Greek cancer patients. J Pain Symptom Manage. 2007 Apr;33(4):455-461.

(15) Maruiti MR, Galdenao LE, Dias OGF. Anxiety and depressions in relatives of patients admitted in intensive care units. Acta Paul Enferm. 2008;21(4):636-642.

(16) Bian Y, Zhang P, Xiong Y, Xu F, Zhu S, Tang Z, Xue Z. Application of the apache ii score to assess the condition of patients with critical neurological diseases. Acta Neurol Belg. 2015 Jan;[Epub ahead of print].

(17) Azoulay E, Pochard F, Chevret S, Adrie C, Annane D, Bleichner G et al. Half the family members of intensive care unit patients do not want to share in the decision-making process: a study in 78 French intensive care units. Crit Care Med. 2004 Sep;32(9):1832-1838.

(18) Azoulay E, Chaize M, Kentish-Barnes N. Involvement of icu families in decisions: fine-tuning the partnership. Ann Intensive Care. 2014 Nov;4:37.

(19) Pochard F, Darmon M, Fassier T, Bollaert PE, Cheval C, Coloigner M et al. Symptoms of anxiety and depression in family members of intensive care unit patients before discharge or death. A prospective multicenter study. J Crit Care. 2005 Mar;20(1):90-96.

(20) Paparrigopoulos T, Melissaki A, Efthymiou A, Tsekou H, Vadala C, Pavlou E et al. Short-term psychological impact on family members of intensive care unit patients. J Psychosom Res. 2006 Nov;61(5):719-722.

(21) Brand A, Leor S, Apter A, Fennig S. The impact of comorbid depressive and anxiety disorders on severity of anorexia nervosa in adolescent girls. J Nerv Ment Dis. 2014 Oct;202(10):759-762.

(22) Plaszewska L, Gazda D. Emotional reactions and needs of family members of icu patients. Anaesthesiol Intensive Ther. 2012;44(3):145-149.

(23) Carlet J, Garrouste M. Welcome to our intensive care unit, make yourself at home! Crit Care Med. 2009 Jul;37(7):2313-2314.

(24) Carson SS, Vu M, Danis M, Camhi SL, Scheunemann LP, Cox CE et al. Development and validation of a printed information brochure for families of chronically ill patients. Crit Care Med. 2012 Jan;40(1):73-78.

(25) Goethals S, Dierckx de Casterlé B, Gastmans C. Nurses� decision-making in cases of physical restraint: a synthesis of qualitative evidence. J Adv Nurs. 2012 Jun;68(6):1198-1210.

(26) Peigne V, Chaize M, Falissard B, Kentish N, Rusinova K, Megarbane B et al. Important questions asked by family members of intensive care unit patients. Crit Care Med. 2011 Jun;39(6):1365-1371.

(27) Lautrette A, Darmon M, Megarbane B, Joly LM, Chevret S, Adrie C et al. A communication strategy and brochure for relatives of patients dying in the icu. N Engl J Med. 2007 Feb;356(5):469-478.

(28) Adams A, Mannix T, Harrington A. Nurses� communication with families in the intensive care unit: a literature review. Nurs Crit Care. 2015 Jan;[Epub ahead of print].

(29) Kross EK, Engelberg RA, Gries CJ, Nielsen EL, Zatzick D, Curtis JR. icu care associated with symptoms of depression and posttraumatic stress disorder among family members of patients who die in the icu. Chest. 2011;139(4):795-801.