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Fear and anxiety are ever present within ICUs, and their absence may indicate a potential withdrawn or depressed state. The danger of death, the psychological trauma of the illness/injury, the surrender to professional care, and the reaction of relatives are all familiar to staff working within these environments.... 顯示更多 Fear and anxiety are ever present within ICUs, and their absence may indicate a potential withdrawn or depressed state. The danger of death, the psychological trauma of the illness/injury, the surrender to professional care, and the reaction of relatives are all familiar to staff working within these environments. A stressful and agitated response may also be observed in patients who are unable to express their needs. Many of them will be ventilated compromising communication, which is frustrating to patients, relatives, and staff. Not being able to synchronize one’s own breathing has been found to be one of the most discomforting aspects of the ICU stay. Panic in these situations is not uncommon and can be accompanied by insecurity, agony and anxiety.
Depression, withdrawal and despondency are all elements of the ICU situation, and anxiety within these units is frequently seen as a prodromal symptom of other disorders such as depression. Given that some patients will be receiving benzodiazepines, there are reports of this agent unmasking depression.
Hallucinations and delusions are often reported by patients within ICUs or immediately after transfer and have been associated with some of the environmental factors contributing to the stressors. Many patients are sedated for long periods and, on waking, will be naturally disorientated in time and space, will possibly have dreams the they can recollect, will have heard the voices of their relatives and staff, and will possibly have significant alterations to their body and capacities. Sleep deprivation, loss of day-night orientation, noise levels, isolation, and depersonalization as patients place their physical integrity in the hands of others have all been considered as potential causes of these altered states of consciousness.
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