Page 85 - ACCCN's Critical Care Nursing

62 S C O P E O F C R I T I C A L C A R E

TABLE 4.4 Summary of studies examining anxiety and depression in survivors of a critical illness

First
a
author/ Acuity /ICU Instrument/
Country Design n/Male Cohort LOS days Age cut-off score Main findings
b
Eddleston Cross-sectional 143/52% Follow-up clinic 15/3.7 51 HADS ≥11 7% met the criteria for anxiety,
(2000) / 3 months and 3% depression
83
UK post- Females more likely to have
discharge higher anxiety scores
c
Nelson Cross-sectional, 24/58% 19 months 58 /27 40 GDS /16 Positive correlation r = 0.30
d
(2000) / postal survey (mean) after between depression scores
90
UK acute lung and days of sedation; 69% of
injury patients not depressed prior
to ICU scored >16
Scragg Cross-sectional 80/52% Survival from –/– 57 HADS >8 43% scored above 8 for anxiety
(2001) / postal survey ICU over 2 and 30% for depression.
88
UK years
Jones Cohort 30/67% 2 and 8 weeks 17/8 57 HADS ≥11 Patients with no factual but
57
(2001) / after ICU some delusional memories
UK discharge were more likely to be
anxious and depressed at
2 weeks
Jones RCT 116/61% General ICU 17/14 58 HADS >11 No statistically significant
91
(2003) / patients – 3 differences between the two
UK hospitals; 8 groups; there was a trend to
weeks and 6 reduced depression scores
months after for those with scores >11 at
discharge 8 weeks
Jackson Prospective 34/53% Medical and 24.9/– 53.2 GDS-SF ≥6 Patients with
92
(2003) / cohort coronary ICU; neuropsychological
USA 6 month impairment were more like to
follow-up score above the threshold at
6 months (36% v 17%).
Hopkins Prospective 66/50% ARDS; 12 18.1/34 46 BDI >30 9% severe levels of anxiety and
87
(2004) / longitudinal month BAI >30 6% severe levels of depression
USA follow-up at 12 months
Hopkins 2 year Anxiety and depression
(2005) / follow-up persisted up to 2 years with
93
USA 23% reporting moderate to
severe levels
Rattray Prospective 80/64% General ICU; 17.7/4.9 54.7 HADS ≥11 Anxiety and depression
85
(2005) / longitudinal Hosp significantly reduced between
UK discharge, 6 6 & 12 months; 18%
& 12 months demonstrated probable
anxiety, 11% probable
depression
Sukantarat Prospective 51/43% ICU patients ≥3 15.3/16.9 57.4 HADS: anxiety 24% had anxiety scores
184
(2007) / days; 3 & 9 ≥10 ≥10 at both 3 & 9 months
UK months HADS: 35% had depression scores
depression ≥8 at 3 months and 45% at six
≥8 months
Dowdy Prospective 161/55% Acute Lung ≤20 = 80%/ 49 HADS ≥11 11% scored above threshold at
(2009) / cohort Injury; 6 ≤10 = 51% 6 months
82
USA months
Myhren Cross-sectional 255/63% 4–6 weeks SAPS 37/12 48 HADS ≥11 Mean anxiety (5.6 v 4.2) and
e
84
(2009) / post-ICU depression (4.8 v 3.5) scores
Norway discharge higher than general
population norms
Myhren Longitudinal As above and 3 Unemployment and optimism
(2010) 86 & 12 months were predictors of anxiety
scores; surgery and optimism
predicted depression
a APACHE II score, Hospital Anxiety and Depression Scale, Geriatric Depression Scale – Short Form, APACHE III score, Simplified Acute Physiology Score
e
b
d
c