Thursday, 25 October 2012

HEALTH: Hospital stay leads to mental stress for half

HEALTH: Hospital stay leads to mental stress for half

Published: 25 October, 2012

MORE than half of patients who were discharged from hospital were suffering from mental health problems caused by their stay, a report has found.

University College Hospital is considering making “psychological interventions” in the Intensive Care Unit after their research revealed more than 50 per cent of 157 patients had suffered “adverse psychological problems”.

They were diagnosed with post traumatic stress, anxiety or depression despite being sent home as “well” by consultants.

The research is particularly important as major hospitals, like UCH, are no longer properly funded for patient “rehabilitation” and where bed space is at a premium.

It has led to concerns over a revolving door in hospital admissions with complaints that patients are sent home or handed over to council-run “community care” programmes before they have fully recovered, Dr Dorothy Wade, UCH health psychologist, said: “Our hypothesis is that patients suffer stress and delirium in the ICU due to invasive treatments and powerful drugs received, and those who suffer those stress reactions are more likely to have adverse psychological outcomes in the long-term.”

Three months after the patients had been discharged, they were assessed to see if they had any signs of post traumatic stress disorder (PTSD), depression and anxiety. It found patients who were on mechanical ventilation for more than 24 hours or who had had two or more organs supported suffered “considerable psychological distress”.

Three months after being discharged, 27 per cent had probable PTSD and 46 per cent had probable depression and 44 per cent had anxiety. The biggest risk factors were use of powerful sedative drugs.
The hospital is looking at modifying the way it uses drugs to avoid knock-on effect for patients. Eye masks and soft music are also being considered to “alleviate patients’ distress”.

Dr David Howell, clinical director of critical care, said: “The research showed associations between sedative drugs such as benzodiazepines, the length of time a patient was sedated and the likelihood of them feeling depressed, anxious and traumatised in future. However, we found that acute stress reactions felt by a patient in the ICU was an even stronger risk factor.

“As well as looking at modifying our drug treatments, we may need to invest more time in the psychological care of a patient and find ways to prevent psychological suffering in the ICU which can affect the quality of their life in years to come.”

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