Authors: Oystein Tronstad, Dylan Flaws, John Fraser, Sue Patterson
Event: 2019 TheMHS Conference
Subject: What are the short and long-term impacts of an ICU admission on the patient?
Type of resource: Conference Presentations and Papers
Stein is a physiotherapist with a special interest in patient-centred care, investigating how the multi-disciplinary team can maximise short and long-term recovery of ICU survivors. He is currently leading a project investigating how the ICU environment and design is affecting patient outcomes, aiming to redesign the ICU bed-space.
Dylan is a psychiatry registrar. The EDACS score, produced as part of his PhD, is standard practice throughout New Zealand. He was awarded a Junior Doctor Research Fellowship, and the Metro North “Rising Star” Junior Researcher of the Year. He is now collaborating with the CCRG to reduce ICU delirium.
'Your new heart is working fine'. I tried to explain that I wasn't fine, with flashbacks and nightmares, and struggles coming to terms with constraints on my life'. To the team, I’m a success; I’m extraordinarily grateful for their care but when my thoughts return to ICU, I relive the terror.
As ICU survival rates increase, attention focuses on the quality of the survival, recognising that ongoing cognitive and psych-emotional impairment (depression, anxiety and PTSD) are common, and collectively identified as 'Post ICU syndrome’. This syndrome is linked to delirium, experienced by approximately 80% of people admitted to ICU.
Drawing on literature and findings of a mixed-methods study, this presentation describes the deleterious effect of the ICU experience on mental wellbeing and shares the perspectives of 17 patients interviewed to inform design of the Intensive Care Cocoon. We highlight the profound impact on recovery of delirium, Post-ICU Syndrome and the impact on individuals, families and communities.
Our purpose is to encourage collaboration among services tasked with attending (separately) to mind and body and mount a compelling case for collaboration between mental health and all health sectors to address a growing need.
Learning Objective 1: Attendees will learn about the mental health complications most commonly experienced by patients admitted to ICU, and how this affects them in both the short and long term.
Learning Objective 2: Mental health complications during and after an ICU admission are often poorly assessed and diagnosed, and therefore many former ICU patients are not receiving adequate follow up and treatment for their condition. This will stimulate debate about the role Mental Health Services could have in ensuring these patients are treated holistically throughout their journey and ensuring that the recovery of both mind and body are considered for this patient cohort.
Darbyshire, J. L., et al. (2016). ""I Can Remember Sort of Vivid People...but to Me They Were Plasticine." Delusions on the Intensive Care Unit: What Do Patients Think Is Going On?" PLoS ONE 11(4): e0153775.
Dziadzko, V., et al. (2017). "Acute psychological trauma in the critically ill: Patient and family perspectives." Gen Hosp Psychiatry 47: 68-74.