RESUMO
Anxiety during the chronic critical illness in the intensive care unit - an interpretive phenomenological study Abstract. BACKGROUND: Patients with a chronic critical illness (CCI) are persons who are dependent on life-sustaining therapies in the intensive care unit (ICU) for an extended period of time following a life-threatening, acute illness. In the ICU they are exposed to numerous physical and psychological stressors. Anxiety, one of the distressing symptoms, has received little attention. AIM: This study aims to examine anxiety in adult patients who have developed CCI while treated in an ICU to further understand this phenomenon. METHOD: An interpretive phenomenological approach was taken. Using an iterative process, data from guided interviews with seven participants were analysed. RESULTS: The anxiety experienced by the patients with CCI fluctuated with the level of consciousness: anxiety in another reality, anxiety caused by nightmares, anxiety at first awakening and anxiety during wakeful periods. Anxiety was often accompanied by feelings of powerlessness, being lost, insecurity, helplessness and uncertainty. CONCLUSIONS: The results of the study suggest that health care professionals caring for patients, especially nurses, may influence anxiety experienced by patients with CCI. Nurses who are able to recognize anxiety in patients with CCI have a better chance of caring for them in a sensitive manner.
Assuntos
Ansiedade/psicologia , Doença Crônica/psicologia , Estado Terminal/psicologia , Adulto , Ansiedade/prevenção & controle , Doença Crônica/terapia , Estado Terminal/terapia , Humanos , Unidades de Terapia Intensiva , Relações Enfermeiro-PacienteRESUMO
Retinal vessels are similar to cerebral vessels in their structure and function. Moderately low oscillation frequencies of around 0.1 Hz have been reported as the driving force for paravascular drainage in gray matter in mice and are known as the frequencies of lymphatic vessels in humans. We aimed to elucidate whether retinal vessel oscillations are altered in Alzheimer's disease (AD) at the stage of dementia or mild cognitive impairment (MCI). Seventeen patients with mild-to-moderate dementia due to AD (ADD); 23 patients with MCI due to AD, and 18 cognitively healthy controls (HC) were examined using Dynamic Retinal Vessel Analyzer. Oscillatory temporal changes of retinal vessel diameters were evaluated using mathematical signal analysis. Especially at moderately low frequencies around 0.1 Hz, arterial oscillations in ADD and MCI significantly prevailed over HC oscillations and correlated with disease severity. The pronounced retinal arterial vasomotion at moderately low frequencies in the ADD and MCI groups would be compatible with the view of a compensatory upregulation of paravascular drainage in AD and strengthen the amyloid clearance hypothesis.