The Intensive Care Experience Of Patients In ICU

ObjectiveExplore the intensive care experience of patients in ICU; formulate a standardscale (Intensive Care Experience Scale, ICES) which is suitable to Chinese patients to quantify and evaluate the intensive care experience of them; evaluate the reliability and validity of the scale; and explore the impact of patients' intensive care experienceon their anxiety and depression during hospital time.Methods1. Sample of 104 patients in ICU of QiLu Hospital and ShengLi Hospital were studied.Data collection was conducted from Jan2006 to Jan2007. Patients have to fulfill the following criteria: the patients must be admitted to ICU for more than 48h, conscious, alert and willing to cooperate. The patients will be excluded if they are younger than 18 years old, have the history of Alzheimer's Disease, have difficulty to communicate in Chinese, or are transferred from ICU of other hospitals.2. (1) Formulate the original scale through combining the translation of scale from abroad and the interview to 10 nurses and 10 patients in ICU. (2) On the first 24hours that patients were admitted to ICU, the investigator evaluated them, chose those who fulfilled the criteria, and completed the General Condition Form and APACHE II Form. (3)After getting out of ICU and before getting out of the hospital, patients completed ICES and HADS according to their real experience in ICU. The forms were completed mainly through face-to-face guidance.3. Data analysis T-test, ANOVA, Principle Component Analysis and Multiple Linear Regressions were used to analyze all data by SPSS11.5.Results1. Formulation of the ICES Through item-analysis and filtration, exploratory factor analysis, we got the standard ICES with 7 principle components and 27 items.2. Estimate of the ICES The Cronbach's a coefficient of the ICES was 0.7763, and the relation coefficients of the 7 principle components were between 0.4776 and 0.7726, which shows that the ICES has better reliability. The relation coefficients between all items and the principle, components and the whole scale have statistical meanings or significant statistical meanings(P<0.05, P<0.01), which shows that the ICES has better construct validity. The 7 principle components explain 60.42% of the scale, and the items chosen have charges above the average, which shows that contents of the items and the principle components have high consistence and the ICES has better construct validity.3. Estimate of the intensive care experience The 7 principle components abstracted from ICES explain the 7 aspects of patients' intensive care experience: treatment, mentality, environment, feeling, awareness, memories, and diseases. Patients in different age group have different disease experience (P<0.05). Patients with different marriage conditions have different feeling and memory experience (P<0.05). Patients with different ICU time have different disease experience (P<0.05). The impacts of other personal conditions on the intensive care experience of patients have no statistical meanings (P>0.05).4. Estimate of anxiety and depression of patients in ICU Of 104 patients, 59 patients (56.70%) have the score of anxiety>9; 84 patients (80.80%) have the score of depression>9. The anxiety and depression of patients with different education backgrounds, different ICU time and different APACHE II scores have no difference (P>0.05). Patients with different gentle have different depression score (P<0.05), but the anxiety score of them has no difference (P>0.05). Patients in different age group have significant different anxiety and depression score (P<0.01). Patients with different careers have significant different anxiety score (P<0.01), but the depression score has no difference (P>0.05). Patients with different marriage conditions have different anxiety score (P<0.05), but the depression score has no difference (P> 0.05). Patients with different expense origins and different mechanical ventilation time have significant different anxiety score (P<0.01), and different depression score (P<0.05).5. The impact of intensive care experience on anxiety and depression of patients in ICU The anxiety of patients in ICU is related to the mentality experience of patients in ICU (P<0.01). The depression of patients in ICU is not related to the intensive care experience of patients (P>0.05).Conclusions1. The ICES was formulated with 7 principle components and 27 items.2. The ICES has better reliability and validity and is suitable to patients in China.3. The main experience of patients in ICU includes: treatment, mentality, environment, feeling, awareness, memories, and diseases.4. The age, marriage condition and ICU time have impact on patients' intensive care experience.5. Patients have evident anxiety and depression during the time in ICU.6. The anxiety of patients in ICU is mainly related to their age, career, marriage condition, expense origin and mechanical ventilation time; the depression of patients in ICU is mainly related to their age, gentle, expense origin and mechanical ventilation time.7. The anxiety of patients in ICU is related to the mentality experience of patients in ICU. The depression of patients in ICU is not related to the intensive care experience of patients.