加護病房病人急性混亂發生率及相關因素之探討

Acute Confusion among Intensive Care Unit Patients

符芳蕙(Fang-Hui Fu) ； 徐淑芬(Shu-Feng Shi) ； 張玉坤(Yue-Cune Chang) ； 吳麗芬(Li-Fen Wu) ； 林健群(Jiann-Chyun Lin)

《源遠護理》 1卷2期 (2007/05) Pp. 52-63

https://doi.org/10.6530/YYN.2007.1(2).06

摘要

加護病房(intensive care unit; ICU)對重症病人是一個突來的壓力源，加上疾病嚴重度，及其他因素都可能造成病人急性混亂(acute confusion)。急性混亂可能延長病人脫離呼吸機的時間、增加再插管率、增加死亡率，而增加醫護的照顧需要。本研究的目的在探討加護病房重症病人急性混亂的發生率及相關因素。此研究為描述相關性之前瞻(prospective)調查研究，依方便取樣於某醫學中心之加護病房選取484位符合收案條件的病人，以加護病房混亂評估表CAM-ICU(Confusion Assessment Method for the Intensive Care Unit)來判斷病人急性混亂的發生狀況。結果發現急性混亂發生率為7.44%；「混亂經驗」、「年齡」、「鎮定劑分類」、「鉀離子」、「鎮定劑種類數」、「機器警示聲緊張」等因素對急性混亂的發生最具預測力。

關鍵字

急性混亂 ； 重症病人 ； 加護病房

並列摘要

The ICU environment is one of the acute stressors that may contribute to the acute confusion of critically ill patients. Acute confusion may delay a patient's weaning from ventilator, increase reintubation occurrence, mortality, and use of more medical and nursing manpower. The purpose of this study was to explore the incidence and related factors of acute confusion in critically ill patients in intensive care units. This descriptive, related, and prospective study used a convenient sampling of 484 patients from the intensive care unit in a teaching hospital in Taipei. The CAM-ICU was used to assess the patient's mental state. The incidence of acute confusion was 7.44 %. Predicable factors related to the occurrence of acute confusion included episode of confusion, age, sedative classification, blood potassium level, the types of sedatives used, and nervous response to equipment alarms.

並列關鍵字

acute confusion ； critically ill patients ； intensive care unit