ICU意識障礙患者家屬焦慮、抑郁情況及影響因素分析

蘇彩燕 何玲君 崔可

[摘要] 目的 調查ICU意識障礙（Doc）患者家屬焦慮、抑郁情況及影響因素。 方法 選擇2018年1～12月在我院ICU治療的意識障礙患者60例的家屬為調查對象。調查患者家屬焦慮及抑郁情緒，分析影響患者家屬焦慮抑郁的相關因素。 結果 （1）家屬抑郁評分（13.2±3.5）分，家屬焦慮評分平均（14.8±3.8）分。（2）單因素分析結果顯示，家屬年齡、職業、文化程度、與患者關系、月收入、工作狀態、患者病程、昏迷時間、醫療費用來源是影響家屬焦慮的相關因素（P<0.05）。多因素分析結果顯示，家屬年齡高、文化程度高、離退休、患者昏迷時間長是焦慮的保護因素（P<0.05）。（3）單因素分析結果顯示，家屬年齡、職業、文化程度、與患者關系、月收入、工作狀態、患者病程、昏迷時間、醫療費用來源是影響患者抑郁的相關因素（P<0.05）。多因素分析結果顯示，家屬年齡高、文化程度高、公費醫療、昏迷時間長、月收入是家屬抑郁的保護因素（P<0.05）。 結論 分析ICU意識障礙（Doc）患者家屬焦慮、抑郁情況，年齡、文化程度、職業、月收入、工作狀態、患者病程、昏迷時間、醫療費用來源等是影響家屬焦慮抑郁情緒的相關因素。

[關鍵詞] ICU;意識障礙;焦慮;抑郁

[中圖分類號] R395 ? ? ? ? ?[文獻標識碼] B ? ? ? ? ?[文章編號] 1673-9701（2020）12-0110-04

[Abstract] Objective To investigate the anxiety， depression and influencing factors of family members of ICU patients with disturbance of consciousness（Doc）. Methods A family of 60 patients with disturbance of consciousness who were treated in our hospital from January to December 2018 were selected as subjects. The anxiety and depression of the family members of the patients were investigated， and the related factors that affect the anxiety and depression of the family members were analyzed. Results （1） The family's depression score was（13.2±3.5） points， and anxiety score averaged（14.8±3.8） points. （2） Univariate analysis showed that family age， occupation， education level， relationship with patients， monthly income， working status， and patient duration， coma time and medical expenses were the factors affecting family anxiety（P<0.05）. Multivariate analysis showed that family members with older age， high level of education， retirement， and patients with coma for a long term were protective factors of anxiety（P<0.05）. （3） Univariate analysis showed that family age， occupation， education level， relationship with patients， monthly income， working status， patient duration， coma time， and medical expenses were the relevant factors affecting patients' depression（P<0.05）. Multivariate analysis showed that family members with older age， high level of education， public medical care， long coma， and monthly income were protective factors for family depression（P<0.05）. Conclusion Analysis of anxiety and depression of family members of Doc patients in ICU. Age， education level， occupation， monthly income， working status， course of disease， coma time， source of medical expenses and so on are the related factors that affect the anxiety and depression of family members.

[Key words] ICU; Disturbance of consciousness; Anxiety; Depression

意識是中樞神經系統對來自于內、外環境的各種刺激的應答能力，包括覺醒狀態和正常的意識內容，是雙層大腦皮層功能活動的綜合，取決于大腦皮層功能的完整性及意識開關系統的正常與否。ICU病房患者多病情危重，甚至意識障礙（Disorders of consiousness，Doc）[1，2]。意識障礙是因顱腦疾病或嚴重全身性疾病損傷大腦皮層及皮層下腦干網狀系統，導致這種應答能力減退或消失。……