目的

重症监护后综合症是一个用于描述由重症引起的并持续到出院后仍存在的新的或日益严重的身体，心理认知和社会状况多维障碍的术语。它与重症监护病房出院的患者高死亡率相关。然而，由于其包括身体，心理，认知和社会障碍的复杂性，该综合征的确切性质尚未完全概念化。因此，该分析的目的是定义重症监护后综合症的概念。这种概念上的清晰性为从业人员和研究人员提供了对综合症的全面了解和准确测量其发生率和患病率所必不可少的基本定义。

设计

Walker和Avant概念分析方法指导这项研究。

数据源

使用PubMed，CINHAL，PsycArticles，Academic search complete，Science Direct，MEDLINE和Health Source数据库对文献进行检索。纳入2010年至2020年之间以英语发布的与重症监护后综合症相关的定量和定性研究。

结果

在检索到的3948篇文章中，有24篇最终符合纳入标准。分析确定了重症监护后综合症的定义属性为：（1）新的或恶化的多维障碍；（2）身体机能障碍；（3）心理障碍；（4）认知障碍；（五）社会重建失败；（6）不仅限于重症监护和出院持续的多维症状受损。前因分为两类：既有病因和与重症监护病房有关的病因。结果被确定为积极的（例如，建立应对系统）和不利的（例如，生活质量下降和护理人员负担）。

结论

重症监护后综合症影响超过一半的重症监护病房出院患者。这种综合征的操作定义和概念性理解将有助于增进理解，并为预防策略的设计提供信息，以改善该综合征的长期后果。未来的研究和标准化工具的开发将有助于更好地了解该综合征的范围和特征，并为可能的预防干预措施的发展提供信息。

 

 

Objective

Post-intensive care syndrome is a term used to describe new or worsening multidimensional impairments in physical, psychological cognitive and social status arising from critical illness and persisting beyond hospital discharge. It is associated with high morbidity among patients discharged from intensive care units. However, due to its complexities, which encompass physical, psychological, cognitive and social impairments, the exact nature of this condition has not been fully conceptualized. The aim of this analysis therefore was to define the concept of post-intensive care syndrome. This conceptual clarity provides a general definition that is essential for practitioners and researchers to gain a comprehensive understanding of the syndrome and provide for accurate measurement of its incidence and prevalence.

Design

The Walker and Avant approach to concept analysis guided this investigation.

Data source

An electronic search of the literature using PubMed, CINHAL, PsycArticles, Academic search complete, Science Direct, MEDLINE and Health Source databases informed the analysis. The search included both quantitative and qualitative studies related to post-intensive care syndrome published in English between 2010 and 2020.

Results

Of the 3948 articles identified, 24 ultimately met the inclusion criteria. Analysis identified the defining attributes of post-intensive care syndrome as: (1) new or worsening multidimensional impairments; (2) physical dysfunction; (3) psychological disorder; (4) cognitive impairment; (5) failed social reconstruction; and (6) persistent impaired multidimensional symptoms extending beyond intensive care and hospital discharge. Antecedents were divided into two categories: pre-existing and those related to the intensive care admission. Consequences were identified as both positive (for example the establishment of coping processes) and adverse (for example decreased quality of life and caregiver burden).

Conclusion

Post-intensive care syndrome affects more than half of patients discharged from intensive care units. This operational definition and conceptual understanding of this syndrome will help improve understanding and inform the design of preventative strategies to improve long-term consequences of the syndrome. Future research and standardized instrument development will serve to better understand the scope and characteristics of this syndrome and inform the development of possible preventative interventions.

原文链接：

https://www.sciencedirect.com/science/article/pii/S002074892030300X?via%3Dihub