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American Journal of Critical Care. 2008;17: 534-543
Copyright © 2008 by the American Association of Critical-Care Nurses.
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CE Article

Symptoms of Acute Posttraumatic Stress Disorder After Intensive Care

By Karen Wallen, RN, MN (Hons), Wendy Chaboyer, RN, PhD, Lukman Thalib, BSc(H), MSC, PhD and Debra K. Creedy, RN, PhD. Karen Wallen is an associate lecturer at the Research Centre for Clinical Practice Innovation, Griffith University Gold Coast, Queensland, Australia. Wendy Chaboyer is foundation director of the Research Centre for Clinical Practice Innovation and an active acute and critical care nurse researcher. Lukman Thalib is an associate professor in the Faculty of Medicine at the University of Kuwait, Safat. Debra K. Creedy is a professor of nursing at the National University of Singapore. Both Thalib and Creedy are adjunct professors with the Research Centre for Clinical and Community Practice Innovation.

Corresponding author: Karen Wallen, RN, MN (Hons), Research Centre for Clinical Practice Innovation, Griffith University Gold Coast, PMB 50 Gold Coast Mail Centre, QLD 9726, Australia (e-mail: K.Wallen{at}griffith.edu.au).

Background Admission to intensive care is often a sudden and unexpected event precipitated by a life-threatening condition, 2 determinants thought to influence the development of posttraumatic stress disorder.

Objectives To identify the frequency of acute symptoms of posttraumatic stress disorder and to describe factors predictive of these symptoms in patients 1 month after discharge from intensive care.

Methods In this prospective cohort study, all patients meeting the inclusion criteria during the study period were invited to participate. Participants completed the Impact of Event Scale-Revised, and demographic and clinical data were accessed from an intensive care unit database.

Results During a 9-month period, 114 of 137 patients who met the inclusion criteria consented to participate in the study, and 100 (88%) completed it. The mean total score on the Impact of Event Scale-Revised was 17.8 (SD, 13.4; possible range, 0–88). A total of 13 participants (13%) scored higher than the cutoff score for clinical posttraumatic stress disorder. Neither sex nor length of stay was predictive of acute symptoms of post-traumatic stress disorder. In multivariate analysis, the only independent predictor of symptoms was age. Patients younger than 65 years were 5.6 times (95% confidence interval, 1.17–26.89) more likely than those 65 years and older to report symptoms.

Conclusion The rate of symptoms of posttraumatic stress disorder 1 month after discharge from intensive care was relatively low. Consistent with findings of previous research, being younger than 65 years was the only independent predictor of symptoms.

Notice to CE enrollees:
A closed-book, multiple-choice examination following this article tests your understanding of the following objectives:
  1. Describe the prevalence of and diagnostic criteria for posttraumatic stress disorder.
  2. Recognize the findings in this study as they relate to ICU patients.
  3. Understand the importance of recognizing the risk for PTSD in ICU patients.
To read this article and take the CE test online, visit www.ajcconline.org and click "CE Articles in This Issue." No CE test fee for AACN members.






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Copyright © 2008 by the American Association of Critical-Care Nurses.