重症病人及家屬創傷後壓力症之照護策略

Nursing Strategies for Post-Traumatic Stress Disorder of Critical Illness Patient and Family

歐羽珊(Yu-Shan Ou) ； 康豑云(Chih-Yun Kang) ； 蔣立琦(Li-Chi Chiang)

《源遠護理》 8卷3期 (2014/12) Pp. 75-80

https://doi.org/10.6530/YYN/2014.B.09

摘要

近年來重症病患與家屬的創傷後壓力症（post-traumatic stress disorder, PTSD）逐漸被重視，由於醫療科技進步，嚴重疾病的短期死亡率降低，接受重症照護而存活的病人因而增加。在重症單位治療期間，各種侵入性治療、肢體約束、疼痛感、密閉式空間與家屬分離等壓力源，導致病人產生極度焦慮及恐懼等心理反應，家屬同樣也面臨許多壓力源。當病人轉出重症單位後可能發展成慢性長期的創傷後壓力症，對其身、心造成極大衝擊，影響生活功能與適應。重症單位醫療團隊成員往往專注於病人急性期的身體照護，以穩定生命徵象為目標，可能忽略病人長期心理上的創傷經驗，因此本文整理創傷後壓力症之相關概念，進而提出預防重症病人及家屬發生PTSD之照護策略，希冀臨床醫療人員在面對照護此類病人及家屬時，能以家庭為單位主體，減輕重症醫療照護過程中可能的壓力衝擊，並提供現實感的連結，盡早提供相關預防、治療措施，達到病人家庭整體的身心靈安適狀態。

關鍵字

創傷後壓力症 ； 重症照護 ； 家庭 ； 衝擊 ； 加護病房

並列摘要

This article discusses concepts of post-traumatic stress disorder (PTSD) and provides strategies on the prevention of PTSD for patients and their families. PTSD experienced by critically ill patients and their families drew attention in recent years. Traditionally, the critical care medical team focused on patients' physical condition and stabilization of vital signs. The neglect of a patient's psychological needs may have contributed to development of chronic and long term PTSD. The advancement in medical technology reduced shortterm mortality of patients with a severe disease. However, anxiety and fear increased for those patients who received care in intensive care units resulting from invasive treatments, constraint, pain, closed space and separation from family. It is recommended that all ICU staff regard the patient and family as a unit and take substantial preventive and treatment measures to lower potential impact from the ICU care, and to protect the homeostasis of the complete family.

並列關鍵字

post-traumatic stress disorder ； critical care ； family ； impact ； intensive care unit