When a person is sick, the body will produce different psychological reactions and mental symptoms, especially when the condition is aggravated and needs to be transferred to ICU for further treatment, sober patients will produce anxiety, fear, insecurity and irritability and other adverse emotions, and serious and even lead to deterioration of the condition, so it is very necessary to do a good job of psychological care of the critically ill patients. The following is the psychological care of icu patients paper I organized for you, for your reference.
icu patient's psychological care essay Sample 1: ICU psychological care of critically ill patientsAbstract ICU critically ill patients need to be isolated custody treatment, closed environment, unfamiliar monitor, therapeutic instrument, easy to let the patient to produce psychological barriers to the process of treatment, especially need to cooperate with psychological care, and the face of different conditions, in the treatment of different phases of the psychological care of the way and the contents of the way should be different. Different. Comprehensive and reasonable holistic care is an effective measure to promote the mental health of patients, especially the more serious patients must further strengthen the psychological guidance intervention.
Keywords ICU; critically ill patients; psychological care
The condition of patients in the intensive care unit (ICU) is severe, with rapid progression and large changes, and the ICU is usually a closed unit, which does not allow family members to accompany the patients. There is also a big difference in the psychological response of different patients. Although ICUs are well-equipped with comprehensive medical care, some patients still have adverse psychological reactions during the period of supervision. The incidence of psychological disorders in ICU patients has been reported to range from 14% to 72% [1]. How to carry out effective psychological care for different types of patients with multiple diseases, reduce adverse psychological reactions, so that patients actively cooperate with the treatment until the physical and mental recovery as soon as possible, has become an urgent problem to be solved. Now combined with clinical work will be nursing summarized as follows:
1 patients appear adverse emotional reasons
1.1 the influence of the ward environment: the ICU is a concentration of the whole hospital of various departments and specialties of the critically ill place, the patients are awake after showing panic, some are a vague uneasiness, some for their own disease worry, nervousness and fear, and its is when the night falls. The surrounding is silent, at this time the patient fear and fear rises suddenly, in seeing or hearing the pain and death of others, anxiety, fear is further aggravated.ICU a variety of advanced instruments and staff constantly carry out a series of complex operations, coupled with in order to facilitate the monitoring and treatment, ICU does not have a ? Time-based? , the lights are always on, do not know the day and night, can not make a sound, can not move, this environment is easy to make the patient uneasy, resulting in psychological stress [2].
1.2 Loneliness and frustration: the patient is awake and struggling violently, the spirit is in a state of depression, paralysis, indifferent response, severe insomnia, pessimism, mainly because the patient wakes up after surgery with a kind of ? regeneration? s feeling. They want to be closer to their loved ones and get spiritual comfort, while ICU patients are mostly not allowed to be accompanied by their loved ones, and the patients feel doubly lonely and frustrated.
1.3 Lack of trust and suspicion: In addition to limited visiting hours and communication with medical staff in the ICU, the visual stimulation of ICU patients is limited to the ceiling above their heads and the white walls around them. Sound stimulation is limited to the monotonous sound of the monitor, ventilator, nutrition pump and oxygen tubing. Therefore, all kinds of sound and visual stimulation in ICU can induce adverse psychological reactions in patients, causing low cognition and judgment, and cognitive disorders of time and place, inability to correctly understand the explanations of the medical staff about treatment and nursing care, and suspicion that the medical staff hides the condition of the patient from him/herself, does not provide the history of his/her illness, does not tell the doctors and nurses about his/her discomfort, and does not tell the doctors and nurses about his/her discomfort. They don't tell doctors and nurses about their illnesses and lack trust in them.
1.4 Impact of sleep: The ICU ward is an environment where patients are constantly receiving monotonous sensory inputs due to frequent assessment and treatment, as well as monitoring of their hemodynamic and respiratory status, which tends to have an adverse impact on sleep. In addition to this, nursing activities at night as well as the treatment of the patient's underlying disease and the mechanical sounds of instruments, alarms, and endotracheal suctioning sounds bring abnormal mental stimulation to the patient, all of which can cause poor sleep.
1.5 Economic concerns: ICU wards not only high hospitalization fees, in addition to the basic amount of hospitalization, general treatment and care costs, there are also charges for special tests and expensive materials, bringing a heavy economic burden to the patient and the burden of thought, so that the patient can not feel at ease with the treatment.
2 psychological care measures
2.1 Attention to nurse-patient exchanges, improve communication: nurses are important regulators in the custody environment, regulating the patient's mood, reducing the patient's pain plays an important role. Nurses should take the initiative to introduce patients to the ICU ward, pay attention to communication with patients, in order to help reduce the fear of patients, nervousness, at any time to provide patients with high-quality and efficient service, so that the reasonable needs of patients to maximize the satisfaction. 2.2 Meet the needs of patients: according to the psychological characteristics of patients, try to meet the wishes of patients, ICU indoor layout as close as possible to life, increase the flavor of life, the temperature and humidity and light can be adjusted, there is a good sound insulation or sound-deadening devices, try to keep the environment relatively quiet; in addition, you can also prepare newspapers and magazines for the patients, allow patients to use headphones to listen to the radio, put their own familiar objects or family photos, maximize the change of wither and fall. In addition, you can also prepare newspapers and magazines for the patients, allow them to use headphones to listen to the radio, display their familiar objects or photos of their family members, and maximize the change of the boring ICU life [3].
2.3 Do a good job of psychological guidance: ICU critically ill patients during hospitalization has a large number of psychological changes, with the change of condition, mood fluctuations, so it is extremely important to do a good job of psychological guidance of the patient. Psychological guidance is through the nurse's analysis and guidance, gradually alleviate or reduce the patient's psychological problems and pressure, so that it is not willing to cooperate, unwilling to accept treatment to the active and urgent request for treatment, from the wrong understanding to the correct understanding, from the avoidance of reality to the active face of reality, from the bad psychological state transformation.
2.4 Ensure that the patient's sleep environment: sleep not only ensures the recovery of the patient's physical strength, but also allows the patient to relax the tension, which is particularly important for the patient's recovery. Such as the provision of soft, flat, clean beds, the height of the appropriate pillow and moderate thickness of the bedding, to assist the patient to take a comfortable lying posture, to maintain indoor air circulation, turn off fluorescent lamps at night, the use of soft light wall lamps, as far as possible to make the sound of machinery and talk, walk and other man-made noise is reduced to a minimum, focus on the treatment and care, to reduce the interference of the patient's sleep, for the patients to create a good sleeping environment. The patient's sleep is reduced, and a good sleep environment is created for the patient.
2.5 All nursing measures and operations should seek the cooperation of patients: in the case of patients awake, nurses should obtain the understanding and cooperation of patients, and explain the purpose and steps to the patient before taking any measures and operations, so that the patient can take the initiative to cooperate with the treatment, to avoid directly affecting the patient's mood.
3 Discussion
The psychological care of critically ill patients mainly refers to the care of patients in the waking state, due to the critical condition, conscious, most patients produce anxiety, fear, depression, dependence and other adverse psychological reactions. We address the patient's adverse emotions, timely guidance, patient explanation, in order to increase the patient's self-esteem and self-confidence. Timely communication and exchange with patients, giving comfort and meeting patients' psychological needs play an important role in patients' recovery. Especially in the tense environment of ICU, we use music therapy, which can ease the excessive tension of patients, reduce the ideological pressure, and play a due effect on reducing and preventing the emergence of ICU syndrome. It is believed that the development and implementation of appropriate nursing interventions for the psychological problems of tracheal intubation patients during intubation can reduce the occurrence of tracheal intubation complications, greatly improve the mental health of patients, and play a positive role in the successful extubation and recovery of the disease.
References
[1] Yu Senyang. Theory and practice of modern mechanical ventilation. Beijing. Peking Union Medical College Press,2000,844
[2] Ao Haiqing. Research on psychological stress-related diseases[J]. Journal of Chinese Medicine,2004,22(8):1414
[3]Ma M. Research and thinking on the influence of ICU environment on patients' body and mind[J]. Chinese Journal of Nursing, 2004, 39(4):306
Psychological care of icu patients essay sample 2: Analysis of psychological characteristics of critically ill patients in ICU and nursing interventionsAbstractWith the development of medical and nursing sciences, more and more critically ill patients are being admitted to intensive care units. For a long time, people tend to pay too much attention to the causative role of somatic and pathological factors for the cause, treatment and recovery of the disease, but neglect the influence of the psychological aspects, especially for the awake patients in ICU wards, the special ward environment causes different degrees of psychological barriers to the patients. It has been reported that the incidence of psychological disorders in ICU patients is 14%~72%, therefore, in clinical nursing, nursing staff should not only do a good job of monitoring the condition, basic nursing, but also actively do a good job of psychological care to reduce the psychological barriers of the patients, and implement the appropriate nursing measures for the different psychological characteristics of different patients to cooperate with the doctor's treatment. The author reviews the psychological problems, causes and nursing interventions of ICU critically ill patients.
Keywords ICU, nursing, psychological support
1 Psychological Problems of ICU Patients
1.1 Extreme Tension, Fear and Anxiety Tension, anxiety and fear are the most common kind of emotional reaction among ICU patients, and the sudden change of the disease, change of environment, and the death of other patients in the surrounding area will make the patients have tension and anxiety. Coupled with the fact that ICU wards do not allow family members to accompany them, patients can't help but feel fearful in an unfamiliar environment.
1.2 Loneliness and depression Patients change to a new and unfamiliar environment, isolated from the outside world, family members can not be accompanied by the medical staff to communicate with very little, coupled with a variety of monitoring instruments in the ward, respiratory machines issued by the sound interference, so that the patient touched the scene, resulting in loneliness and depression of the mind.
1.3 ICU syndrome ICU syndrome refers to a group of syndromes that occur in the process of ICU supervision, mainly mental disorders, with other manifestations. The clinical manifestations of patients are diversified, with varying degrees of severity, mainly mental disorders, with other accompanying symptoms, including delirium, thought disorder, emotional disorders, headache and insomnia.
1.4 Ineffective denial Ineffective denial is an attempt to alleviate the fear and anxiety caused by health problems by consciously or unconsciously adopting some ineffective denial behaviors, which are mainly manifested in the denial of the disease and the resistance to the environment, believing that one's condition is very mild and does not need all kinds of supervision, and requesting to be discharged from the hospital as soon as possible, and so on.
1.5 Self-image disorders refers to the health problems of patients on the physical appearance, structure, and functional changes in feelings, cognition, beliefs, values, etc., such as post-traumatic amputation of patients feel physically mutilated, confused about the future, and feel pain.
1.6 Sleep pattern disorder Sleep pattern disorder is a pathological change in the physiological mechanism of sleep caused by the difficulty in falling asleep, easy to wake up, dreamy, insomnia and other varying degrees of sleep quality and quantity of the damage to the patient's physical and mental health, mostly related to the patient's own disease, environmental factors, the impact of drugs.
1.7 Dependence on the ventilator and the ICU ward Patients on long-term mechanical ventilation in the ICU are used to passive ventilation, and once they are off the ventilator, they feel like they can't breathe. Due to the difference in staffing and technology between the ICU ward and the general ward, patients are worried about relapse of their illnesses when they are transferred to the general ward, and so they often display childish childish behaviors and are reluctant to leave the ICU ward, hoping to receive comprehensive care. They want to receive comprehensive care.
2 Causes of various psychological problems in ICU patients
2.1 Disease-related factors Many diseases not only affect patients in terms of physical function, but also affect the mental aspect of patients. For example, patients with respiratory failure, due to pulmonary ventilation and gas exchange dysfunction, resulting in impaired gas exchange, hypoxemia and carbon dioxide retention; shock patients due to a sudden decrease in the effective circulating blood volume, insufficient blood perfusion to tissues and organs resulting in cerebral ischemia and hypoxia, these diseases not only lead to patients with varying degrees of delirium, but also make the patient appear irritable, anxiety, fear and a series of negative emotions.
2.2 Cognitive factors of the patient Due to the sudden change of the disease, resulting in the patient's body function is impaired or limited, coupled with the patient's lack of understanding of the disease, the patient believes that the change of the condition will lead to their own death, resulting in restlessness and fear of the mind. The experience and level of understanding of the disease can also lead to very different reactions and consequences for different patients with equally severe conditions.
2.3 The impact of the environment The structure of the ICU ward, staffing and equipment are not the same as ordinary wards, the first ICU patients, family members can not be accompanied by the side of the daily work of the medical staff will be more energy in the treatment of the patient's condition and monitoring, and ignored the patient's communication, coupled with ICU wards are generally required to 24 hours of illumination, a variety of lights and a variety of instruments, the impact of alarms, resulting in the patient's condition. The impact of the alarm sound has caused an auditory and visual burden on the patients, leading to anxiety and insomnia.
2.4 Therapeutic factors Because of the disease, patients are often given sedative drugs, such as Lixi, which can cause a certain degree of dependence on drugs, affecting the patient's sleep state. In the process of treatment, all kinds of tubes that directly intervene in the patient's vital organs, such as all kinds of drainage tubes, endotracheal tubes, deep vein catheters, etc., will cause psychological disturbances to the patients, resulting in anxiety and fear and disorders of self-image. In addition, because the medical staff's inquiries and records will involve some of the patient's privacy which is usually not spoken to people, it will make the patient anxious and uneasy, fearing that his information will be disclosed. 3 Nursing interventions
3.1 Stabilizing the patient's mood In clinical work, medical staff should be calm, composed and serious, not discussing the condition in front of the patient, and in the face of the patient's inquiries, do not answer ? I don't know? or? You don't need to know? etc. Do not panic about sudden illnesses to avoid aggravating patients' fear. Due to the changes of the disease on the body's function and the unpredictability of the disease prognosis, will lead to the patient's psychological imbalance, we have to carry out effective and reasonable psychological guidance, do not force the patient to control their emotions, but to carry out a gradual and orderly stabilization and guidance. The patient's condition is stable, do not discuss the patient's condition, at the same time to tell the patient's family to pay attention to the patient's confidentiality, do a good job of protective medical work.
3.2 Psychological and social support ICU patients often have low self-esteem due to physical and environmental influences. In clinical work, healthcare workers should strengthen communication with patients, and make patients' minds peaceful through language expression and emotional infections, and at the same time feedback positive information about patients, such as the improvement of some laboratory indicators, the normalization of vital signs, etc., to make the patient feel better. The ICU ward does not allow family members to stay with the patient, so the visiting system can be appropriately liberalized to mobilize the patient's family and friends to strengthen the patient's encouragement and support, so that the patient can feel the warmth.
3.3 Improve the patients' cognitive ability of the disease The lack of disease-related knowledge can easily make the patients fear and anxiety, therefore, in the clinical work, in the supervision and treatment of patients at the same time, to explain to the patients the relevant medical knowledge, so that the patients deepen their understanding of their own diseases, know the latest medical level of the development of the disease, and to help the patients objectively look at their own condition to help patients naturally decompression. The first step is to make sure that you have a good understanding of what is happening in the world and what is happening in the world.
3.4 Creating a good environment A strange environment can easily make patients feel uneasy and lonely. In their daily work, healthcare workers should minimize noise, speak gently, and do not make a lot of noise. Various instruments and respirators in the ICU ward will have a variety of alarms, which will increase the patients' sense of uneasiness while also affecting the patients' sleep. The alarm volume is adjusted to the appropriate level, and the cause of the alarm should be eliminated at the first time when the alarm sounds, and at the same time, the function of the various instruments should be explained to the patient to ease the patient's uneasiness.
3.5 Elimination of the psychology of dependence On the use of the ventilator has a dependence on the patient, to explain to the patient the use of the ventilator and the reasons for the withdrawal of the ventilator, so that the patient can understand their own condition has been restored to the situation of not using the ventilator, and at the same time, tell him that the ventilator will be placed at the bedside, such as the discomfort but can be worn at any time, to alleviate the nervousness of the patient. For patients to be transferred out of the ICU, to do a good job of explaining the work, while explaining that his condition has greatly improved, to the general ward to continue the follow-up treatment, so that the patient to establish confidence in overcoming the disease, to enhance their ability to resist disease.
4 Summary
ICU hospitalized patients, due to the critical condition, conscious, most patients produce anxiety, fear, depression, dependence and other adverse psychological reactions. In response to the patient's adverse emotions, timely guidance, patient explanation, in order to increase the patient's self-esteem and self-confidence. Timely communication and exchange with patients, give comfort, to meet the psychological needs of patients, while creating a good environment for patients, ? Thinking of the patient's thoughts, anxious patient's urgency?
These are the first time I've ever seen a patient in a hospital, and I've never seen one.
References
[1]Ma Min. Research and thinking on the influence of ICU environment on patients' body and mind[J]. Chinese Journal of Nursing,2004,39(4):306.
[2]DU Peng,YAO Meifang.Prevention and Nursing of ICU Syndrome[J]. PLA Nursing Journal,2002.19(1):27-29.
[3]Wen Xinyan,Liao Liru. Psychological response and care of traumatic paraplegic patients[J]. Modern Journal of Integrative Chinese and Western Medicine.2005,14(2):262.
[4]WANG Zhihong,ZHOU Lanshu. Critical care nursing[M]. People's Military Medical Press,2003.166.
[5]Liu R. ICU nurses and the care of ventilator-dependent patients[J]. Journal of Practical Nursing,2003.19.72
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