Yoğun Bakımda Ağrılı Hastaya Psikiyatrik Yaklaşım
Özet
Yoğun bakım ünitelerinde (YBÜ) ağrılı hastalar, hem fiziksel hem de psikososyal stres faktörleri ile karşılaşmaktadır. Bu hastalarda ağrı başlı başına fiziksel bir stres kaynağı olmakla birlikte, invaziv prosedürler, uyku bozuklukları, iletişim zorlukları gibi çeşitli stresörler nedeniyle posttravmatik stres bozukluğu (PTSB), deliryum, depresyon ve anksiyete gibi psikolojik bozukluklar geliştirebilirler. YBÜ'deki hastaların yaklaşık yarısında psikolojik semptomlar gözlemlenir ve bu semptomlar hastaların iyileşme süreçlerini olumsuz yönde etkileyebilir. Ağrılı hastalar daha az sedasyon aldıklarında daha fazla ağrı hissedebilir ve bu durum, psikolojik travmalara yol açabilir. Psikiyatrik değerlendirme, PICS (Yoğun Bakım Sonrası Sendromu) tanısının konulmasında da kritik rol oynar. Psikiyatrik yaklaşımlar depresyon, anksiyete, PTSB ve deliryum gibi hastalıkların yönetilmesinde önemli bir yere sahiptir. Bu bozuklukların erken tanı ve tedavisi, hastaların iyileşme süreçlerinde ve genel yaşam kalitelerinde büyük iyileşmeler sağlar. Bu başlık altında YBÜ’de ağrılı hastaya psikiyatrik yaklaşım hakkında bilgi verilmiştir.
In intensive care units (ICUs), patients experiencing pain are confronted with both physical and psychosocial stressors. Pain itself is a primary source of physical stress; however, patients may also develop psychological disorders such as post-traumatic stress disorder (PTSD), delirium, depression, and anxiety due to various other stressors, including invasive procedures, sleep disturbances and communication difficulties. Psychological symptoms are observed in approximately half of ICU patients, and these symptoms can negatively impact their recovery process. Painful patients may experience more intense pain when less sedation is administered, which can lead to psychological trauma. Psychiatric evaluation also plays a critical role in diagnosing Post-Intensive Care Syndrome (PICS). Psychiatric approaches are essential in managing conditions such as depression, anxiety, PTSD and delirium. Early diagnosis and treatment of these disorders lead to significant improvements in patients' recovery processes and overall quality of life. Under this heading, information is given about the psychiatric approach to patients with pain in the ICU.
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