目的:对定性文献进行批判性总结,以了解患者在重症监护病房住院期间的妄想记忆经历。
方法:对具有荟萃合成和荟萃总结的定性研究进行系统综述。我们搜索了MEDLINE(通过PubMed),护理和相关健康文献累积指数(CINAHL),Scopus,和WebofScience至2022年7月。选择了所有对重症监护病房中具有妄想记忆的成年患者的主观体验提供定性见解的研究。关键评估技能计划清单用于质量评估。
结果:纳入14项研究。从归纳主题分析中得出的33个代码分为三个主题:\'危险感和死亡的可怕方面\'(危险中的感觉,被死亡包围,被周围的人迫害,感觉不安全),\'附近某人或某物的存在\'(感知亲人,感觉被可怕的生物淹没了,被我周围的人忽视),和“感官感知的世界背后的现实”(环游世界,刺激感官,感觉平静,并生活在幻想世界中)。研究中最常见的代码是“与家人在一起”,强度为35.7%。
结论:患者被描述为妄想的经历被认为是经历它的人的真实事件。需要进一步的研究来调查这些经历导致患者早期和晚期结局较差的程度。并测试防止这种情况的策略。
结论:对这种现象的更深入了解可能有助于医疗保健专业人员识别前兆,妄想记忆的症状和后果,并在适当的帮助下进行干预。一种策略是进一步人性化护理,并专注于家庭参与和与患者的沟通,以克服可能改变患者生活质量的事实事件。
OBJECTIVE: To critically summarise the qualitative literature to understand patients\' experiences of delusional memories during their Intensive Care Unit stay.
METHODS: A systematic review of qualitative studies with meta-synthesis and meta-summary. We searched MEDLINE (via PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Web of Science to July 2022. All studies that provided qualitative insights into the subjective experience of adult patients with delusional memories in the Intensive Care Unit were selected. The Critical Assessment Skills Programme checklist was used for the quality assessment.
RESULTS: Fourteen studies were included. The 33 codes that emerged from the inductive thematic analysis were grouped into three themes: \'The sense of danger and the terrifying aspect of death\' (feeling in danger, surrounded by death, persecuted by people around, and feeling unsafe), \'The presence of someone or something nearby\' (perceiving the loved ones, feeling overwhelmed by scary creatures, and being neglected by those around me), and \'The reality behind the world perceived by the senses\' (travelling the world, stimulating the senses, feeling peaceful, and living in a fantasy world). The most frequent code in the studies was \'Be with a family member\', with an intensity of 35.7%.
CONCLUSIONS: The patient\'s experience described as delusional is considered a real event by the person experiencing it. Further research is needed to investigate the extent to which these experiences lead to poorer early and late outcomes for patients, and to test strategies to prevent this.
CONCLUSIONS: A deeper understanding of the phenomenon may help healthcare professionals to recognise precursors, symptoms and consequences of delusional memories and intervene with appropriate help. One strategy would be to further humanise care and focus on family involvement and communication with patients to overcome the factual events that can potentially alter patients\' quality of life.