Ensayos clínicos

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Información sobre este estudio

Over a third of those who survive critical illness suffer from symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD) after leaving the intensive care unit (ICU). This is twice as high as the rates of PTSD in combat veterans. The strongest risk factor is memories of frightening experiences and delusions (something that is very common during critical illness, when patients feel that something is real when it is actually not). Patients can hear speech even when sedated, yet there is no systematic communication with the critically ill while they receive life-saving medical treatments. We think that lack of real-time communication with patients contributes to their traumatic memories, because patients may not understand why they experience something painful, and what is happening to them. We therefore propose to modify an already existing intervention called ICU diaries to provide this real time communication. Currently it is one of the most commonly used interventions and consists of the treating team and family members writing down the daily events in a diary that the patient receives sometime after the hospital discharge. Unfortunately, ICU diaries have not shown consistent results, perhaps because when the patient reads about their ICU stay, they have already formed traumatic memories of that experience. Aloud reading of ICU diaries in real-time creates a method for systematically ensuring delivery of patient-orientated communication for ICU patients. This communication may therefore prevent negative psychological sequela in ICU survivors by orienting patients to their surroundings and situation; encouraging accurate memories and recall of the ICU experience. Prior to performing a larger study powered to evaluate the efficacy of this intervention on ICU survivor outcomes, we will perform an initial feasibility study to improve upon the current proposed protocol. We plan to assess feasibility via enrollment of 30 patients into a prospective cohort study where compliance with completing diary tasks can be measured and input from important stakeholders such as patients, patient families, room nurses, and physical/occupational therapists can be obtained and evaluated. This study is to determine the feasibility of providing psychological support to ICU patients through reading aloud standard of care daily diary entries by the care team which will be evaluated through feedback from patients and their family members

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