The ICU patient , psychological aspects, UTI
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. [...]
[...] Faced with a stimulus evaluating the patient's response. In the normal state There are seven levels. The state of torpor is characterized by lentilifacação of thought, light latency responsiveness, both verbal and motor and mild difficulty in fine motor coordination, but showing no intellectual commitment. In the cloud, the latency response is greater; one begins to present difficulties to extend the stimuli (especially those requiring an interpretation), there is a greater commitment as the fine motor and with motor begins to change; greater stimulation to the patient presents behavioral responses is required. [...]
[...] As has been said, many feelings can populate an inpatient in ICU. These feelings can range from apathy, resignation, depression, anxiety, fear and even anger are always felt by the clinical team complicating the technical treatment that should be developed. However, the aggressiveness is often felt to be the most disturbing among all. The patient reacts with hostility or aggression to clinical care, resisting or rejecting treatment, is expressing his negativity, frustration or even morbid fantasies about their health status, and the therapeutic process that has to undergo (SEBASTIANI cited ANGERAMI, 1994). [...]
[...] Thus, in the ICU, patients are being treated diseases that may trigger psychiatric disorders, confirmed by other authors. Kornfeld (1979) reports that the ICU became essential in hospitals, already demonstrated its value to the seriously ill patient. However, as we become more efficient in the use of this technical environment, we become also more aware of the emotional impact of this experience. This concern should not be seen as a causal reflection, because the physiological and behavioral manifestations of emotional states may introduce serious and life threatening complications in these situations that are already difficult. [...]
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