Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool

详细信息    查看全文

• 作者：Dorothy M Wade (1)
  Matthew Hankins (2)
  Deborah A Smyth (3)
  Elijah E Rhone (4)
  Michael G Mythen (5)
  David CJ Howell (6)
  John A Weinman (7)
  
  1. Chartered Health Psychologist ; Critical Care Department ; University College Hospital ; 235 Euston Rd ; London ; NW1 2BU ; UK
  2. Centre for Innovation and Leadership in Health Sciences ; Faculty of Health Sciences ; University of Southampton ; Southampton ; SO17 1BJ ; UK
  3. Critical Care Department ; University College Hospital ; 235 Euston Rd ; London ; NW1 2BU ; UK
  4. School of Medicine ; Henriette Raphael House ; King鈥檚 College London ; Guy鈥檚 Campus ; London ; SE1 1UL ; UK
  5. National Institute of Health Research University College London Hospitals Biomedical Research Centre ; Maple House ; 149 Tottenham Court Road ; London ; W1T 7DN ; UK
  6. Divisional Clinical Director ; Critical Care ; University College Hospital ; 235 Euston Rd ; London ; NW1 2BU ; UK
  7. Institute of Pharmaceutical Science ; Franklin-Wilkins Building ; King鈥檚 College London ; 150 Stamford Street ; London ; SE1 9NH ; UK
  
• 刊名：Critical Care
• 出版年：2014
• 出版时间：October 2014
• 年：2014
• 卷：18
• 期：5
• 全文大小：298 KB
• 参考文献：1. Samuelson, KA (2007) Stressful memories and psychological distress in adult mechanically ventilated intensive care patients - a 2-month follow-up study. Acta Anaesth Scand 51: pp. 671-678 CrossRef
  2. Wade DM, Howell DC, Weinman JA, Hardy RJ, Mythen MG, Brewin CR, Borja- Boluda S, Matejowsky CF, Raine RA: Investigating risk factors for psychological morbidity three months after intensive care: a prospective cohort study. / Crit Care 2012, 16:R192.
  3. Wade, D, Hardy, R, Howell, D, Mythen, M (2013) Identifying clinical and acute psychological risk factors for PTSD after Intensive Care: a systematic review. Minerva Anestesiol 79: pp. 944-963
  4. Davydow, DS, Gifford, JM, Desai, SV, Bienvenu, OJ, Needham, DM (2009) Depression in general intensive care unit survivors: a systematic review. Intens Care Med 35: pp. 796-809 CrossRef
  5. Pouwer, F, Beekman, ATF, Lubach, C, Snoek, FJ (2006) Nurses鈥?recognition and registration of depression, anxiety and diabetes-specific emotional problems in patients with diabetes mellitus. Patient Educ Coun 60: pp. 235-240 CrossRef
  6. Spronk, PE, Riekerk, B, Hofhuis, J, Rommes, JH (2009) Occurrence of delirium is severely underestimated in the ICU during daily care. Intens Care Med 35: pp. 1276-1280 CrossRef
  7. Tan T, Brett SJ, Stokes T, Guideline Development Group: Rehabilitation after critical illness: summary of NICE guidance. / BMJ 2009, 338:b822.
  8. Rattray, J, Johnston, M, Wildsmith, JAW (2004) The intensive care experience: development of the ICE questionnaire. J Adv Nurs 47: pp. 64-73 CrossRef
  9. Novaes, MA, Aronovich, A, Ferraz, MB, Knobel, E (1997) Stressors in ICU: patients' evaluation. Intens Care Med 23: pp. 1282-1285 CrossRef
  10. Granja, C, Lopes, A, Moreira, S, Dias, C, Costa-Pereira, A, Carneiro, A (2005) Patients' recollections of experiences in the intensive care unit may affect their quality of life. Crit Care 9: pp. R96-R109 CrossRef
  11. Schandl A, Bottai M, Hellgren E, Sundin O, Sackey PV: Developing an early screening instrument for predicting psychological morbidity after critical illness. / Crit Care 2013, 17:R210.
  12. Zigmond, AS, Snaith, RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67: pp. 361-370 CrossRef
  13. Wade D, Howell D, Hankins M, Mythen M, Welch J, Down J, Weinman J: Development of a new questionnaire to assess psychological stress in intensive care. / Am J Respir Crit Care Med 2012, 185:A2292.
  Levels of Critical Care for Adult Patients, Standards and Guidelines. ICS, London
  14. Chlan, L, Savik, K, Weinert, C (2003) Development of a shortened State Anxiety Scale from the Spielberger State-Trait Anxiety Inventory (STAI) for patients receiving mechanical ventilatory support. J Nurs Meas 11: pp. 283-293 CrossRef
  15. Kroenke, K, Spitzer, RL, Williams, JB (2003) The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Car 41: pp. 1284-1292 CrossRef
  16. Nelson, JE (2004) The symptom burden of chronic critical illness. Crit Care Med 32: pp. 1527-1534 CrossRef
  17. Foa, EB, Cashman, L, Jaycox, L, Perry, K (1997) The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psychol Assessment 9: pp. 445-451 CrossRef
  18. Radloff, LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1: pp. 385-401 CrossRef
  19. Spielberger, CD, Gorsuch, RL, Lushene, R, Vagg, PR, Jacobs, GA (1983) Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press, Palo Alto, CA
  20. Knaus, WA, Zimmerman, JE, Wagner, DP, Draper, EA, Lawrence, DE (1981) APACHE - Acute Physiology and Chronic Health Evaluation: a physiologically based classification system. Crit Care Med 9: pp. 591-597 CrossRef
  21. Ely, EW, Inouye, SK, Bernard, GR, Gordon, S, Francis, J, May, L (2001) Delirium in mechanically ventilated patients - Validity and reliability of the Confusion Assessment Method for the intensive care Unit (CAM-ICU). J Am Med Assoc 286: pp. 2703-2710 CrossRef
  22. Nunnally, JC, Berstein, IH (1994) Psychometric Theory. McGraw-Hill, New York
  
• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：BioMed Central
• ISSN：1364-8535

文摘

Introduction The psychological impact of critical illness on a patient can be severe, and frequently results in acute distress as well as psychological morbidity after leaving hospital. A UK guideline states that patients should be assessed in critical care units, both for acute distress and risk of future psychological morbidity; but no suitable method for carrying out this assessment exists. The Intensive care psychological assessment tool (IPAT) was developed as a simple, quick screening tool to be used routinely to detect acute distress, and the risk of future psychological morbidity, in critical care units. Methods A validation study of IPAT was conducted in the critical care unit of a London hospital. Once un-sedated, orientated and alert, critical care patients were assessed with the IPAT and validated tools for distress, to determine the IPAT鈥檚 concurrent validity. Fifty six patients took IPAT again to establish test-retest reliability. Finally, patients completed posttraumatic stress disorder (PTSD), depression and anxiety questionnaires at three months, to determine predictive validity of the IPAT. Results One hundred and sixty six patients completed the IPAT, and 106 completed follow-up questionnaires at 3聽months. Scale analysis showed IPAT was a reliable 10-item measure of critical care-related psychological distress. Test-retest reliability was good (r =0.8). There was good concurrent validity with measures of anxiety and depression (r =0.7, P P P P PTSD with days 1 and 2 data). The IPAT had 69% specificity and 57% sensitivity to predict future psychological morbidity (AUC =0.7). Conclusions The IPAT was found to have good reliability and validity. Sensitivity and specificity analysis suggest the IPAT could provide a way of allowing staff to assess psychological distress among critical care patients after further replication and validation. Further work is also needed to determine its utility in predicting future psychological morbidity.