중환자실에서 환자가 겪는 고통

Abstract

Intensive care unit (ICU) is an area which promotes feeling of high anxiety. And patients in ICU suffered from physical and psychological discomforts. These physical and psychological discomforts are varied according to patients themselves, age, character, illness and environment such as ICU structure, staff, operating system. Physical and psychological discomforts can affect treatment and prognosis of disease. Several reports have appeared of adverse psychological and psychiatric effects of intensive therapy. On the other hand, some patients may be reassuered by continuous surveillance and exhibit emotional reactions and increased cathecholamine production on returning to a general ward". It may be possible to have considerable influence on these effects by improving the environmental factors. We evaluated the recall of 300 patients after ICU discharge, and 609o of the patients had unpleasant experiences in ICU admission. The most frequently reported unpleasant experiences were pain(18.6%), family worries(15.6%), tracheal suction(5.0%), blood sampling(5.0%), sleep deprivation(4.6%), noise(3.3%), limit of motion and posture (3.0%), unkindness(2.6%) and others(1.0%). We asked about fear for dying in their ICU stay, and 106(35.3%) of 300 patients responded yes. There was no difference in APACHEII score between fear for death and not. Therefore we must try to reduce patient's various painful stimli by more careful and kind treatments. Medical staff should remember that their trivial behavior could stimulate patients and should try to control their patients by heartful experiencing about the prognosis.