- Patient monitoring shows that sadness is the most persistent emotion during the ICU stay, ahead of anxiety, and is closely related to clinical factors such as mechanical ventilation.
A study led by the Parc Taulí Research and Innovation Institute (I3PT), recently published in the journal Scientific Reports, provides a innovative look at how to analyze the evolution of the emotional and physical state of patients admitted to the Intensive Care Unit (ICU), from the moment they become conscious until they are discharged from the unit.
"This is one of the few studies that has been carried out by a Daily longitudinal monitoring of the emotional and physical state of critical patients throughout their stay in the ICU", highlighted neuropsychologist Elisabet Doña, principal investigator of the study. "This approach allows us to better understand not only the presence of anxiety, sadness, pain or dyspnea -difficulty breathing and shortness of breath-, but also how these symptoms evolve over time and how they interrelate with each other".
Measuring emotional state in the ICU: a clinical and methodological challenge
Assessing emotional state in critically ill patients is particularly complex. Factors such as heterogeneity in admission time, sedation, mechanical ventilation or communication difficulties make many common tools inapplicable in this context. Given this difficulty, the study used innovative analysis techniques and the visual analog scale ('VAS' for its acronym in English), an unconventional tool for emotional assessment but especially suitable for ICU patients, as it allows for simple and reliable assessment anxiety, sadness, pain and dyspnea, even in situations of limited communication.
Thanks to this methodology, the research team has been able to collect daily data on 62 critical patients —for respiratory diseases, sepsis or trauma— conscious and without delirium, a fact that brings great richness and precision to the analysis of the results.
Sadness, more present than anxiety during admission
The results show that the sadness is a particularly relevant component of the emotional suffering during the ICU stay, often with levels higher than those ofanxiety, and that both symptoms tend to remain relatively stable until the final phase of admission, when they decrease significantly.
The study also shows that the invasive mechanical ventilation is associated with higher levels of sadness and dyspnea, underscoring the emotional and physical impact of this type of life support. Furthermore, it highlights the dynamic relationship between physical discomfort (pain and difficulty breathing) and emotional state throughout the different phases of admission.
Towards a more comprehensive psychological assessment in ICUs
Although a high proportion of patients present cognitive alterations at the time of discharge from the ICU, the study has not found a direct relationship between these alterations and the evolution of emotional or physical discomfort during admission, suggesting that these impacts could have different underlying mechanisms.
The authors of the study highlight the importance of incorporating a multidimensional and continuous psychological assessment in ICUs, which goes beyond anxiety and includes aspects such as sadness or respiratory distress. This approach could facilitate detection of critical moments and allow interventions early and more personalized, with the aim of improve the experience and recovery of critically ill patients.
Leave a comment