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Psychological sequelae following treatment in ICU at a level 1 Academic South African Hospital

Cindy Frances Hatchett, Gayle Langley, Shelley Scmollgruber

Abstract


Purpose: The purpose of this research was to determine the extent to which anxiety symptoms, depressive symptoms and post-traumatic stress (PTS) symptoms were experienced by a sample of patients following discharge from Intensive Care Units within a level 1 academic hospital in South Africa.

Design: A prospective, quantitative, cross-sectional, descriptive format was used to investigate these variables. The total sample number was 98 and the instruments used in the structured interview were the Hospital Anxiety and Depression Scale (HADS) developed by Zigmond and Snaith (1983) and the Experience After Treatment in ICU –7 (ETIC-7) developed by Scragg, Jones and Fauvel (2001).

Findings: Just under half the sample population (48%) had symptoms of anxiety, more than a quarter had symptoms of depression (28%), and 32% had symptoms of PTS. Furthermore it was elicited that 58% of the sample had combined anxiety and depressive symptoms severe enough to have a ‘possible clinical disorder’. An unexpected finding of this study was that patients who had memory of physical restraints in ICU were six times more likely to develop symptoms of PTS compared to those with no memory of physical restraint.

Conclusions: It was observed in this study that a significant number of ICU patients returning to the community develop psychological sequelae related to their admission and necessary treatments received in ICU. This psychological distress can affect the patients’ physical recovery (by an altered and decreased immune function), their quality of life and their functioning within the family and society.

Clinical relevance: The prevalence of psychological sequelae following treatment in ICU was found to be high. At present in South Africa, ICU staff have limited evidence on which to base decisions about improvements to critical care practice and the psychological sequelae following treatments in ICU. Critical illness and the recovery from it does not end at the ICU door and patients should be identified, followed up and offered the necessary support.

Authors' affiliations

Cindy Frances Hatchett, University of Witwatersrand, Department of nursing education

Gayle Langley,

Shelley Scmollgruber,

Keywords

Psychological sequelae following ICU treatment, anxiety, depression, posttraumatic stress

Cite this article

Southern African Journal of Critical Care 2010;26(2):.

Article History

Date submitted: 2010-05-07
Date published: 2011-05-30

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