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The ICU patient - psychological aspects

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  1. Introduction
  2. The patient and the changes of thought and sense-perception
  3. Psychological aspects
  4. Conclusion

The ICU sets, for their intrinsic characteristics in an environment that requires great mental and emotional adjustments of the patient. It is an unknown and threatening environment, and coincide with the disease and its likely physical discomfort, and fear the possibility of death that some people when the need for ICU admission - real factor as a possibility, and ghostly due the very stigma that UTI mean imminent death.

Still it should be considered that a critical illness in most cases can occur suddenly and unexpectedly, involving a threatening one's life structure, requiring the immediate need of upgrading to a new environment and often scary. All equipment, sounds and people may seem terrifying, in addition to the concepts that the person may have already than would a UTI, compete to increase feelings of fear, loneliness and helplessness.
The accumulation of environmental and situation factors affect all patients admitted to an intensive care unit in varying degrees depending on their personality traits, physical status, extent of interventional needs and length of stay in the ICU.

Among the most common emotional manifestations are anxiety, intense fear, denial, regression, guilt and depression. The growing dependence and paranoid state caused by the characteristics mentioned above can lead to ICU psychosis. This is characterized by intense agitation ranging from a mild confusion to a state of advanced delirium. Organic reactions of this framework as mental confusion, difficulty in attention, spatial disorientation and time, loss of memory, perception changes and effective instability occur more frequently in patients who have suffered severe trauma, prolonged surgical and anesthetic interventions, cerebral oxygenation deficit, with large metabolic changes, other entity (Wallace-Barnhill cited Shoemaker, 1992).

[...] This phenomenon tends to exacerbate when patients lose their ability to speak, see, hear, move or understand. When the patient is sequelado or is in a state of coma becomes easier for the health team to ignore the patient's value system (SEBASTIANI and CHIATTONI, 1991). Despessoalizados patients experience strong feelings of abandonment and dichotomy, and may even genuinely experience a feeling of unreality surrounding his person or the outside world, reaching to feel separated from your body. Anger becomes a common response to despessoalização, but feelings of resentment, death anxiety, denial and alienation may also occur. [...]


[...] Patients present predictable psychological responses which, if not treated, can be life threatening and recovery. All ICUs mainly deal with anxiety, depression and delirium in an extremely stressful environment. They describe medical problems, that is, diseases that can present with psychiatric symptoms that may be encountered in the ICU, according to the table. This table was based on Kaplan and Sadock table (1993, p.547) Thus, despite the ICU focus, that is, treat diseases and threatening pictures to life, there are important psychological aspects to be considered in patient care. [...]


[...] 10-19. ROSSER R. Quality of life assessment. In: BAUM S NEWMAN, Weinman J. Cambridge handbook of psychology, health and medicine. Cambridge: Cambridge University Press; 1997. p.310-13. SANTOS, C.T., SEBASTIANI, R. W. Psychological monitoring the person with chronic disease. [...]


[...] Ana Mercy Bahia Bock at PUC-MG on 13/05/02. CAMPOS, T.C.P. Hospital Psychology: the psychology practice in hospitals. Sao Paulo, E.P.U CECCARELLI, PR, "oedipal Settings of contemporaneity: thoughts on the new forms of membership," in Journal of Psychoanalysis Pulsional, Sao Paulo, year XV 88-98, mar FERRAZ, MB Quality of life: concept and a brief history. Young Physician, 1998; 219 -22. FERREIRA, V. M. Fantasies of death in patients with chronic renal failure. Interdisciplinary graduate work, Mackenzie Presbyterian University, São Paulo FOULKES SH, editor. [...]


[...] Freud S. (1913 {1912-1913}). Totem and Taboo. In: Standard Ed of the Complete Psychological Works, vol. XIII. [Translated by Jayme Solomon]. Rio de Janeiro: Imago; 1969. p. 13-192. MAURER LANE, ST, "Social psychology and a new conception of man for psychology," in social psychology: the man in motion, São Paulo, Brasiliense pp. [...]

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