[Depressive, anxiety and posttraumatic stress disorders as long-term sequelae of intensive care treatment]

Prevalence of and risk factors for thirst in the intensive care unit: An observational study

AIM AND OBJECTIVES

This study investigated the incidence of thirst and contributing factors in intensive care unit (ICU) patients by analysing differences in physiologic, psychological, and disease- and environment-related parameters in ICU patients with vs without thirst.

BACKGROUND

Little is known about the factors that influence thirst, and there are no standardised methods for identifying at-risk patients in the ICU. Previous studies generalised the risk of thirst in ICU patients because of a lack of data on relevant variables. Here, we examined the factors contributing to thirst based on symptom management theory.

DESIGN

Prospective descriptive design.

METHODS

Physiologic, psychological, disease-related and environment-related data were collected for 301 patients from 4 ICUs (medical, surgical, cardiac and emergency ICUs) of a hospital from 15 December 2017-10 July 2019 through a screening interview, questionnaires and from electronic medical records. The data were analysed with descriptive statistics, the t-test and chi-squared test, and by logistic regression. Binary stepwise logistic regression was used to identify thirst-associated factors. The findings are reported according to the STROBE checklist for cross-sectional studies.

RESULTS

In total, 210/301 (69.8%) ICU patients experienced thirst. Risk factors were nil per os order (odds ratio [OR] = 4.10, 95% confidence interval [CI]: 1.44-11.69), surgery (OR = 2.96, 95% CI: 1.11-7.93), high glucose (OR = 3.36, 95% CI: 1.01-11.17) and greater disease severity (OR = 1.13, 95% CI: 1.02-1.24).

CONCLUSION

Thirst is common in ICU patients. Timely detection of patients' thirst and identification of those at high risk by ICU nurses can ensure the implementation of effective and safe interventions.

RELEVANCE TO CLINICAL PRACTICE

The results of this study highlight the need to evaluate thirst symptoms in patients with severe disease and develop relief strategies for fasting, perioperative, and hyperglycaemic patients and others who are at high risk of thirst.

Comparison of prevalence and risk factors of somatization between Chinese health care workers and non-health care workers during COVID-19 outbreak

BACKGROUND

This study aimed to compare prevalence and risk factors of somatization (SOM) between health care workers and non-health care workers during COVID-19 outbreak in China.

METHODS

From 14 February to 29 March 2020, an online survey was performed in both 605 health care workers and 1151 non-health care workers. Based on the somatization dimension score of the Symptom Checklist-90, participants were divided into non-SOM group and SOM group.

RESULTS

Health care workers had higher prevalence rate of SOM (p < 0.001) than non-health care workers, with an OR of 1.70 (95% CI, 1.22-2.36, p = 0.002). Multiple logistic regression analysis revealed that in non-health care workers, the risk factors of SOM included other ethnicities, insomnia, and suicide, while in health care workers, the risk factors included working 6-8 h per day, and working ≥10 h per day during COVID-19 outbreak.

CONCLUSIONS

Our research suggests that both non-health care workers and health care workers have a relatively high prevalence of somatization. However, the related factors for somatization in both groups are significantly different, showing that medical service-related factors are associated with somatization in health care workers, while demographic and clinical factors are associated with somatization in non-health care workers.

[Care differences in a consultation and liaison service]

BACKGROUND

The investigation of the real density of care by a consultation-liaison service (CLS) as a function of patient groups, settings and diagnoses makes sense with respect to a better allocation of resources.

OBJECTIVE

Are there differences concerning the density of care by a CLS in a general hospital depending on patient groups and on the psychiatric diagnosis?

METHOD

A retrospective (2012-2015) survey of all consultations (n = 7081 corresponding to 4080 patients) was carried out based on the CLS documentation for quality assurance. Bivariate tests (i.e. χ²-test and ANOVA) and multivariate linear and logistic models were used to investigate group differences and associations.

RESULTS

The number of consultations achieved corresponded to 3.2 % of the total admissions to hospital, especially internal medicine (22.3 %), surgery (26.1 %) as well as gynecology and obstetrics (21.1 %). A suicide attempt was the reason for treatment in 3.3 %. Each patient received on average 1.7 consultations lasting 75 min but only 25 % received 2 or more consultations. Patients with psychiatric comorbidities, non-oncology patients as well as female and young patients received a more intensive care by CLS. Patients with depressive and somatoform disorders received a higher density of treatment.

DISCUSSION

The psychotherapeutic interventions performed did not follow the expected diagnostic patterns in other settings. Systemic interventions with indirect treatment should be given priority in older patients and especially in patients with organic mental disorders.