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- Southern African Journal of Critical Care
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- Volume 26, Issue 2, 2010
Southern African Journal of Critical Care - Volume 26, Issue 2, 2010
Volume 26, Issue 2, 2010
Author Nicki FoucheSource: Southern African Journal of Critical Care 26, pp 36 –40 (2010)More Less
In keeping with the theme of psychological and psychosocial issues, I thought it appropriate to touch on a subject that is becoming more prevalent in the critical care nursing literature - PTSD or post-traumatic stress disorder, a psychiatric disorder caused by exposure to a traumatic event or extreme stressor that is responded to with fear, helplessness or horror.
The experiences of nurses in providing psychosocial support to families of critically ill trauma patients in intensive care units - a study in the Durban metropolitan areaSource: Southern African Journal of Critical Care 26, pp 42 –51 (2010)More Less
Background. Critically injured trauma patients are often admitted to an intensive care unit (ICU), which can be a very unfamiliar and intimidating environment for their families. Health organisations have a responsibility to foster an environment that protects the physical and emotional health of the severely stressed family members who assemble in their facilities.
Purpose. The purpose of the research was to explore the experiences of ICU nurses in providing psychosocial support to families of critically ill trauma patients.
Research approach. Using an interpretive hermeneutic phenomenological approach, two semi-structured interviews were conducted with each participant to explore their experiences of providing psychological support to families of ICU patients. The study was conducted in the surgical ICUs of two private hospitals and one public hospital in the Durban metropolitan area.
Findings. Four main themes emerged from the data: cultural awareness, communication challenges, providing assistance, and lack of training.
Conclusion. These findings provide implications for practice that, if applied, would improve the ICU experience for both the nursing staff and the families they support.
Source: Southern African Journal of Critical Care 26, pp 52 –58 (2010)More Less
Purpose. The purpose of this research was to determine the extent to which anxiety symptoms, depressive symptoms and post-traumatic stress (PTS) symptoms were experienced by a sample of patients after discharge from intensive care units (ICUs). The participants had a mean stay of 3 days in ICUs in a level 1 academic hospital in Gauteng, South Africa.
Methods. A prospective, quantitative, cross-sectional, descriptive design was used to investigate these variables. A preliminary record review of the hospital's ICU bed occupancy for the previous year was 1 596. The total study sample was 98 (N=98) to ensure that a power of at least 95% accuracy was acquired for the 0.05 level of significance testing. The instruments used in the structured interview were the Hospital Anxiety and Depression Scale (HADS) developed by Zigmond and Snaith (1983) and the Experience after Treatment in Intensive Care 7-Item scale (ETIC-7) developed by Scragg, Jones and Fauvel (2001). Data were analysed using STATA 10.
Findings. Just under half the sample population (48%) had symptoms of anxiety, more than a quarter had symptoms of depression (28%), and 32% had symptoms of PTS. Furthermore, it was elicited that 58% of the sample had combined anxiety and depressive symptoms severe enough to have a 'possible clinical disorder'. An unexpected finding of this study was that patients who had memory of physical restraints in the ICU were six times more likely to develop symptoms of PTS than those with no memory of physical restraint.
Conclusions. It was observed in this study that a significant number of ICU patients returning to the community develop psychological sequelae related to their admission and the treatments necessary, e.g. mechanical ventilation. This psychological distress can affect patients' physical recovery (by an altered and decreased immune function), their quality of life and their functioning in the family and in society.
Clinical relevance. The prevalence of psychological sequelae after treatment in an ICU was found to be high. At present ICU staff in South Africa have limited evidence on which to base decisions about improvements to critical care practice and the psychological sequelae following treatments in an ICU. Critical illness and the recovery from it do not end at the ICU door, and patients should be identified, followed up and offered the necessary support.
Source: Southern African Journal of Critical Care 26, pp 59 –64 (2010)More Less
The use of small-group bedside teaching to promote critical thinking in clinical problem solving among critical care nursing students
Communicating family-friendly practice : starting by saying what we do
Validation of therapeutic intervention scoring system in a South African intensive care unit
Journal Club : restoring the links between education and PICU clinical practice
ICU hand hygiene audit
SBAR : is this a critical communication tool between doctor and nurse?
The trials and tribulations of clinical research : the first trial
Knowledge of intensive care nurses on evidence-based guidelines for prevention of ventilator-associated pneumonia
Implementing sepsis care bundles trust-wide
End-of-life issues : supporting a critical care patient home to die
The expected role of the critical care clinical nurse specialist in private hospitals
The impact of outreach
The views of intensive care nurses on end-of-life care in public hospital intensive care units
Effect of small-group bedside teaching on clinical problem-solving skills among critical care nursing students
A collaborative programme between the private sector and a nursing agency for the upgrading / training of enrolled nurses
Impact of an educational programme on ventilation and ventilation graphics for nursing staff working in intensive care
The establishment of an integrated national data collection service for intensive care units in South Africa