Investigation And Influencing Factors Of Post Intensive Care Syndrome In Family Members Of Patients With Hemorrhagic Stroke

Objective: The occurrence status of post intensive care syndrome in the family members of patients with hemorrhagic stroke was investigated,and the related influencing factors of post intensive care syndrome in the family members of patients with hemorrhagic stroke were analyzed.The occurrence status of post intensive care syndrome in the family members of patients with hemorrhagic stroke in different periods was compared,so as to provide evidence support for clinical targeted nursing measures,and ultimately to improve the nursing quality of family members of patients in ICU and improve the satisfaction of family members of patients,so as to promote the rehabilitation of patients.Methods: This study used descriptive cross-sectional survey and convenient sampling method to select 205 family members of patients with hemorrhagic stroke admitted to the intensive care unit of a tertiary hospital in Shiyan City,Hubei Province from October 2020 to July 2021.The family members of ICU patients were investigated on the day of patient transfer to ICU and two weeks after transfer to the general ward.The post intensive care syndrome of family members was diagnosed mainly from physiological and psychological aspects.Pittsburgh sleep quality index（PSQI）and fatigue assessment instrument（FAI）were used to evaluate the physiological dysfunction of family members.The Hospital Anxiety and Depression Scale（HADS）and the Impact of Event Scale-Revised（IES-R）were used to assess the psychological dysfunction of family members of patients.The influencing factors of post intensive care syndrome in family members were investigated by self-designed questionnaire.Results: In this study,220 family members were distributed questionnaires,the first survey recovered 220 cases,the recovery rate was 100%.Among all the returned questionnaires,205 were valid,accounting for 93.18%of the total questionnaires.The incidence and influencing factors of post intensive care syndrome in 205 families of patients with hemorrhagic stroke were studied.In addition,180 valid questionnaires（25 family members lost due to death,transfer/discharge）were collected for the second time,and the recovery rate was 87.80%.The incidence of post intensive care syndrome in 180 families of patients with hemorrhagic stroke at different stages was compared.1.As for physiological dysfunction,69.76% of family members of 205 patients had sleep dysfunction;45.37% of the family members had fatigue symptoms（26.83%were mild fatigue symptoms,12.20% were moderate fatigue symptoms,6.34% were severe fatigue symptoms）.2.Regarding psychological dysfunction,47.80% of family members of 205 patients had anxiety symptoms,32.68% had depression symptoms,and 50.73% had PTSD symptoms.3.In terms of physiological dysfunction,the related factors of sleep dysfunction in patients’ families may be:gender,age,education level,relationship with patients,previous ICU care experience,family monthly income（yuan）,payment method,residence,APACHEII score,ICU hospitalization time（day）.The related factors of fatigue are:age,family income（yuan）,payment method,place of residence,APACHEII score,ICU stay（days）.4.In terms of psychological dysfunction,anxiety scores in different gender,age,education level,relationship with patients,previous ICU care experience,family monthly income（yuan）,payment method,residence,APACHEII score of patients,ICU length of stay（days）were statistically significant.Depression scores were statistically significant in different age,educational level,relationship with patients,previous ICU care experience,family monthly income（yuan）,payment method,residence,APACHEII score and ICU hospitalization time（days）.Age,education level,family monthly income（yuan）,payment method,residence,APACHEII score and ICU stay（days）were the influencing factors of PTSD in family members.5.Logistic regression analysis of influencing factors of post intensive care syndrome in family members of patients with hemorrhagic stroke showed that gender（P<0.05）,age（P<0.01）,monthly family income（P<0.01）and APACHEII score（P< 0.01）were independent risk factors for post intensive care syndrome in family members.6.Pearson correlation analysis of the main outcome variables showed that ICU length of stay was significantly positively correlated with APACHEII score,total sleep score,fatigue score,anxiety score,depression score and total IES-R score.APACHEII score was positively correlated with sleep score,fatigue score,anxiety score,depression score and IES-R score.The total sleep score was significantly positively correlated with fatigue score,anxiety score,depression score and IES-R score.Fatigue score was significantly positively correlated with anxiety score,depression score and IES-R total score;anxiety score was significantly positively correlated with depression score and IES-R total score;depression score was positively correlated with IES-R score.7.The results of the occurrence of post intensive care syndrome in the family members of patients with hemorrhagic stroke in different periods were as follows:a total of 180 family members of patients completed the investigation on the day of transfer from the ICU and two weeks after transfer to the ward.In this group,the positive rate of sleep disorder was 71.67% on the day when the patients were transferred out of ICU,and 56.11% after two weeks of transfer to the ward.The positive rate of fatigue score on the day of transfer from ICU was 45.56%,and the positive rate of fatigue score after two weeks of transfer from ICU was 43.33%.The incidence of anxiety was 51.11%on the day of transfer from ICU,the positive rate of anxiety was 30.56%after 2 weeks of transfer from ICU,the positive rate of depression was 36.11%on the day of transfer from ICU,and the positive rate of depression was 20.56%after 2 weeks of transfer from ICU.The positive rate of post-traumatic stress disorder on the day of transfer from ICU was 53.33%,and the positive rate of post-traumatic stress disorder after two weeks of transfer from ICU was 41.11%.8.The results of physiological and psychological dysfunction of family members after ICU in different periods were as follows:the scores of sleep disorder,anxiety,depression and IES-R in different periods were significantly different（P<0.05）.Conclusion:1.The incidence of post intensive care syndrome in family members of patients with hemorrhagic stroke is high,mainly manifested in physiological and psychological dysfunction.2.The incidence of post intensive care syndrome in family members was related to their gender,age,educational level,relationship with patients,previous ICU care experience,monthly family income（yuan）,payment method,residence,APACHEII score of patients and ICU hospitalization time（day）Gender,age,monthly family income and APACHEII score of patients were independent risk factors for post intensive care syndrome in family members.3.The incidence of sleep disorders,fatigue,anxiety,depression and trauma of family members in the general ward after 2 weeks was lower than that in the ICU,but the incidence was still at a high level.There were significant differences in the total score of sleep,anxiety,depression and trauma between the families transferred from ICU on the day and those transferred from general ward after 2 weeks（P<0.01）.