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Cardiothoracic Surgery ICU adverse psychological reactions of patients and nursing


Key words Cardiothoracic Surgery [Abstract] Objective: To analyze the cardiothoracic surgery ICU patients with adverse psychological reactions, and explore related care measures. Methods: 68 patients, adverse psychological reactions and nursing data were analyzed retrospectively. Results: When transferred to general ward, 66 patients and basic elimination of adverse psychological reactions after cardiothoracic surgery in 2005 after the occurrence of ICU syndrome has dropped to 13.5%. Conclusion: The nurses know the patients before surgery, postoperative psychological characteristics based on different patients, to give psychological support and counseling, can fully mobilize the patient's own defense mechanisms to prevent the occurrence of ICU syndrome. Chinese papers League finishing. [Key words] Cardiothoracic Surgery; intensive care unit; adverse psychological reactions; nursing severe chest trauma and heart, lung, esophageal surgery, patients are generally transferred to ICU ward, Although the ICU has improved the facilities, comprehensive medical care, because of its critical condition, coupled with the environment and to set specific, there are still 50% of patients during the monitoring of adverse psychological reactions. Mainly as disorientation, impaired memory and common sense, anxiety, fear and depression, and even to refuse treatment, the disease caused by deterioration of prognosis [1]. Nurses to detect changes in patients with abnormal psychology, psychological assistance to give good, for the sober and rehabilitation of patients surviving more important. This hospital cardiothoracic surgery in recent years, especially for ICU patients 68 cases of adverse psychological reactions that occurred were analyzed to reduce patient stress factors of nursing. 1 clinical data 1.1 General information from June 2002 to January 2006, our hospital ICU ward patients were treated in 124 patients with severe cardio-thoracic surgery, male 75 cases, 49 females; age of 17 years to 68 years, mean (36.19 ± 16.15) years. Among them, 62 cases of heart disease, 29 cases of esophageal cancer, lung cancer in 22 cases, cardiac in 8 cases, 3 cases of mediastinal tumor. After all, 68 patients had varying degrees of adverse psychological reactions, ICU stay accounted for 54.84% of the total number of patients wards. 1.2 symptoms of adverse psychological reactions, extent and impact factors through observation and investigation,[link widoczny dla zalogowanych], the comprehensive collection of information, 68 cases of adverse psychological reactions that occur include the following 4. 1.2.1 delirium cognitive function in patients with the suspicion, common sense is low, there cognitive impairment places on time and can not correctly understand the relevant medical treatment, care, interpretation of suspicion to conceal their own health care condition, does not provide medical history, there is not not tell doctors, nurses listen to, transferred to general wards, the lack of trust in the medical staff, fear of disease recurrence, have over the care of ICU psychological dependence. Mainly due to anesthesia just awakening disorientation, impaired memory and common sense. 1.2.2 conscious patients with anxiety and fear after the horror show, eyes closed, eyes open, after complaining of vertigo, some kind of vague uneasiness, and some concerns for their own illness, tension and fear, which is when the night falls, the surrounding silence, this time of fear and fear in patients with sudden rise in the see or hear other people's suffering and death, anxiety, fear is further exacerbated, said the environment was mainly due to abnormal tension coupled with the rapid physiological changes in patients, making them feel nervous, anxiety, fear. ICU is the advanced medical equipment in hospitals are concentrated in the area, ICU variety of advanced equipment and staff have been conducting a series of complex operations, in addition to ease of care and treatment, ICU there is no day and night, can not say anything, and is not in such an environment is easy for patients with anxiety, psychological stress [2]. 1.2.3 lonely and depressed patients with a clear mind after intense struggle, the resulting low cardiac symptoms, after the spirit is in malaise, paralysis, indifferent reaction, severe insomnia, pessimistic, mainly due to surgery patients After waking up a kind of They want their loved ones from the recent, access to spiritual comfort, and ICU patients with multiple family members not allowed to accompany the patient, feeling alone, there is a sense of isolation, drug ineffective. Patients with a variety of monitoring pipeline forced the limited mobility, communication barriers caused by mechanical ventilation. Mechanical equipment noise, and tracheal suctioning sound the alarm sound to bring to patients the abnormal mental stimulation, the patient can not sleep. 1.2.4 of patients with depression and low self-esteem showed sadness, apathy, depression, frequent crying, lack of confidence in treatment, and health care do not match, especially the introverted character of the patients showed more prominent. Mainly due to the special circumstances of ICU patients a sense of oppression; patient loss of ability to a life of boredom; is an emergency treatment when loss of confidence. In addition, for ease of operation, indwelling catheter, and observation of disease, ICU ward, most of the body were exposed, the patient felt personal space is violated, deprived of privacy, resulting in inferiority complex. in nursing diagnosis, we used analysis system symptom checklist (SCL-90), 68 patients were further psychological assessment of objective and quantitative, comprehensive assessment of the psychological state of patients and grade detailed in Table 1. Table 1 Cardiothoracic Surgery ICU patients with adverse psychological reaction degree statistics (abbreviated) Note: The table includes the same person have several adverse psychological reactions