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    Literature review of post-traumatic stress disorder in the critical care population.

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    Authors
    Morrissey, Matthew
    Collier, Elizabeth
    Affiliation
    University of Salford
    Issue Date
    2016-04-24
    
    Metadata
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    Abstract
    Aim To determine which factors relate to the development of posttraumatic stress disorder, in adult patients who are admitted to critical care units. Background Patient survival rates from critical care areas are improving each year and this has led to interest in the long term outcomes for patients who have been discharged from such environments. Patients typically require invasive and extensive treatment, which places a stress on physical and mental health. Prevalence estimates of posttraumatic stress disorder in the critical care discharge population vary from 5-63%, yet it remains unclear what the predisposing factors are. Design. A systematised review Method Subject heading and keyword searches were conducted in MEDLINE, CINAHL, PsycINFO and ScienceDirect, with 23 articles identified that examined the relationship between critical care and the development of posttraumatic stress disorder. Results Three main themes were identified; Critical Care Factors, Patient Factors and Experience Factors. Eight key and 3 potential causative factors were found: younger age, female, previous psychiatric history, length of ICU stay, benzodiazepine sedation, use of stress hormones, delusional memory and traumatic memory, delirium, GCS score of ≤9 on admission & use of mechanical restraint Conclusions Posttraumatic stress reactions can be strongly related to the development and presence of traumatic and delusional memories. Younger patients may exclude themselves from research to avoid their traumatic thoughts. The role of prior psychiatric illness is unknown. Distinction between ‘factual’ and ‘false’ or delusional memory as occurs in the literature maybe unhelpful in understanding trauma reactions. Relevance to clinical practice There are around 38,000 occupied critical care beds each year in England. The scale of the issue is therefore substantial. Risk factors can be isolated from available evidence and provide a rudimentary risk assessment tool to inform practice development in this area.
    Citation
    Morrissey, M., and Collier, E. (2016) 'Literature review of post‐traumatic stress disorder in the critical care population', Journal of clinical nursing, 25(11-12), pp. 1501-1514.
    Publisher
    Wiley
    Journal
    Journal of Clinical Nursing
    URI
    http://hdl.handle.net/10545/623440
    DOI
    10.1111/jocn.13138
    Additional Links
    https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.13138
    Type
    Article
    Language
    en
    ISSN
    0962-1067
    EISSN
    1365-2702
    ae974a485f413a2113503eed53cd6c53
    10.1111/jocn.13138
    Scopus Count
    Collections
    School of Nursing and Professional Practice

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