Analgesia, sedation, and memory of intensive care

Capuzzo, Maurizia; Pinamonti, Anna; Cingolani, E; Grassi, Luigi; Bianconi, Margherita; P, Contu; Gritti, G; Alvisi, R

doi:10.1053/jcrc.2001.28789

Cited by 49 publications

(62 citation statements)

References 23 publications

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“…The way caregivers express themselves is of great importance (Franzén et al, 2006). Earlier studies have identified other factors than gender which may influence memories of the intensive care period such as length of stay (Rundshagen et al, 2002;Capuzzo et al, 2001), sedatives and analgesics and ventilator support (Bergbom-Engberg et al, 1988). We found that more women than men had memories of feelings/emotional memories from the time in the ICU, and also when comparing the 21 words one by one we saw that women experienced feelings of anxiety and fear to a higher degree than men.…”

Section: Discussionmentioning

confidence: 99%

“…Capuzzo et al (2001) found that more women than men reported at least one delusional memory (hallucinations, nightmares, feeling of panic or dreams) from the time in the ICU and argue that one of the reasons could be that women are more sensitive. As women seem to be at a higher risk of developing PTSD after a major trauma, and we know that PTSD is associated with different types of memories, it is of importance to investigate the differences between men and women's recollections and memories from their time in the ICU.…”

Section: Introductionmentioning

confidence: 99%

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Memories following physical trauma in patients treated in the ICU: Does gender and head injury make a difference?

Johansson

Ringdal

Bergbom

2008

International Emergency Nursing

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Memories following physical trauma in patients treated in the ICU: Does gender and head injury make a difference?

Johansson

Ringdal

Bergbom

2008

International Emergency Nursing

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“…Further studies are needed to determine the validity and reliability of this instrument. Jones and coworkers [15] have since proposed a similar tool (Intensive Care Unit Memory tool), which has been validated in a number of settings [4,16]. …”

Section: Discussionmentioning

confidence: 99%

“…Some patients report vivid recollections [1-3] whereas others have a poor or even no recollection at all of their stay on the ICU. No recollection at all of the ICU study ranges from 23% to 38% among postsurgical patients [4]. Various authors have reported that patients had unpleasant recollections after a stay on an ICU.…”

Section: Introductionmentioning

confidence: 99%

Discomfort and factual recollection in intensive care unit patients

Leur¹,

Schans

Loef³

et al. 2004

Crit Care

132

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IntroductionA stay in the intensive care unit (ICU), although potentially life-saving, may cause considerable discomfort to patients. However, retrospective assessment of discomfort is difficult because recollection of stressful events may be impaired by sedation and severe illness during the ICU stay. This study addresses the following questions. What is the incidence of discomfort reported by patients recently discharged from an ICU? What were the sources of discomfort reported? What was the degree of factual recollection during patients' stay in the ICU? Finally, was discomfort reported more often in patients with good factual recollection?MethodsAll ICU patients older than 18 years who had needed prolonged (>24 hour) admission with tracheal intubation and mechanical ventilation were consecutively included. Within three days after discharge from the ICU, a structured, in-person interview was conducted with each individual patient. All patients were asked to complete a questionnaire consisting of 14 questions specifically concerning the environment of the ICU they had stayed in. Furthermore, they were asked whether they remembered any discomfort during their stay; if they did then they were asked to specify which sources of discomfort they could recall. A reference group of surgical ward patients, matched by sex and age to the ICU group, was studied to validate the questionnaire.ResultsA total of 125 patients discharged from the ICU were included in this study. Data for 123 ICU patients and 48 surgical ward patients were analyzed. The prevalence of recollection of any type of discomfort in the ICU patients was 54% (n = 66). These 66 patients were asked to identify the sources of discomfort, and presence of an endotracheal tube, hallucinations and medical activities were identified as such sources. The median (min–max) score for factual recollection in the ICU patients was 15 (0–28). The median (min–max) score for factual recollection in the reference group was 25 (19–28). Analysis revealed that discomfort was positively related to factual recollection (odds ratio 1.1; P < 0.001), especially discomfort caused by the presence of an endotracheal tube, medical activities and noise. Hallucinations were reported more often with increasing age. Pain as a source of discomfort was predominantly reported by younger patients.ConclusionAmong postdischarge ICU patients, 54% recalled discomfort. However, memory was often impaired: the median factual recollection score of ICU patients was significantly lower than that of matched control patients. The presence of an endotracheal tube, hallucinations and medical activities were most frequently reported as sources of discomfort. Patients with a higher factual recollection score were at greater risk for remembering the stressful presence of an endotracheal tube, medical activities and noise. Younger patients were more likely to report pain as a source of discomfort.

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“…As experiências e as recordações relatadas por pacientes internados em Unidade de Terapia Intensiva (UTI), especialmente aqueles que se submeteram à ventilação artificial e à sedação, têm constituído foco de vários estudos [1][2][3] . Pacientes avaliados após a alta dessa unidade relatam experiências de fatos reais e também apresentam memórias ilusórias [4][5] .…”

Section: Introductionunclassified

Elaboração e avaliação de um instrumento para identificar memórias referentes à Unidade de Terapia Intensiva

Costa

Marcon

2009

J. bras. psiquiatr.

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resumo objetivo: Descrever o desenvolvimento de um instrumento para identificar as recordações de pacientes internados em Unidade de Terapia Intensiva (UTI) e verificar a validade de conteúdo e a aplicabilidade do instrumento. método: Estudo de desenvolvimento metodológico, fundamentado na teoria de elaboração de escalas psicológicas de Pasquali (1998). Para elaboração do instrumento, foram percorridas três etapas, a construção dos itens, a análise da validade de conteúdo e aparência por um painel de experts e, por fim, a realização de um estudo-piloto para verificar a aplicabilidade do instrumento na população-alvo. resultados: Houve pouca discordância entre os experts na análise das questões de acordo com os domínios do construto. Os itens foram avaliados positivamente, recebendo uma pontuação acima de 80%, valor este que obedece ao critério de validação do instrumento. Dessa forma, os itens foram considerados consistentes em relação aos domínios e ao construto, possibilitando identificar recordações das experiências vividas pelos pacientes durante sua permanência em UTI. conclusões: Os itens propostos mostraram-se compreensíveis, claros e com uma adequada estrutura de apresentação. O instrumento apresenta validade de conteúdo atestada por um painel de experts, demonstrando possuir características teóricas para identificar memórias de pacientes internados em UTI a curto e longo prazo.

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Analgesia, sedation, and memory of intensive care

Cited by 49 publications

References 23 publications

Memories following physical trauma in patients treated in the ICU: Does gender and head injury make a difference?

Memories following physical trauma in patients treated in the ICU: Does gender and head injury make a difference?

Discomfort and factual recollection in intensive care unit patients

Elaboração e avaliação de um instrumento para identificar memórias referentes à Unidade de Terapia Intensiva

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