{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T17:47:43Z","timestamp":1770140863130,"version":"3.49.0"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T00:00:00Z","timestamp":1632182400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Critical care survivors often experience symptoms of anxiety, depression, or post\u2010traumatic stress disorder (PTSD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the prevalence and severity of psychological symptoms during the first 6\u2009months after discharge from the intensive care unit (ICU) and to evaluate its association with patients who are difficult to sedate during admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Descriptive, prospective analysis of psychological symptoms in survivors from medicosurgical ICU over a 2\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All ICU survivors who required mechanical ventilation (MV) for more than 24\u2009hours were followed for 6\u2009months after their ICU discharge. ICU outcome and complications as well as the presence of psychological symptoms, 1 to 3 to 6\u00a0months after discharge were prospectively evaluated through phone interviews comparing the incidence and intensity of patients who were difficult to sedate during their ICU stay with those who were not. Descriptive analysis and multivariate logistic regression were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data were obtained for 195 patients, of whom 30% experienced difficult sedation (DS). Difficult\u2010to\u2010sedate patients were younger (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001), less critically ill (APACHE II score<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002), and more likely to engage in harmful use of alcohol (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001) and psychoactive\/psychotropic drug abuse. They also spent longer times on MV and in the ICU (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). Anxiety incidence at 1 to 3 to 6\u00a0months post\u2010discharge was significantly higher in DS patients than in those who were not (87.7% vs 45.4%, 75.5% vs 29.0%, and 70.8% vs 23.7%;<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01), respectively. Depression incidence was also significantly higher in the DS group (82.4% vs 43.1%, 66% vs 33.9%, and 60.4% vs 27.2%; [<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001]) at 1 to 3 to 6\u00a0months, respectively. A higher percentage of patients in the DS group reported symptoms of PTSD at 1\u00a0month (28.1% vs 11.5%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.007) when compared with non\u2010DS group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Critical care survivors who are difficult to sedate during their ICU stay are more likely to present psychological sequelae. Early identification of at\u2010risk patients is necessary to implement appropriate preventive strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>Patients who are difficult to sedate in the ICU may develop psychological disorders upon discharge, which may negatively affect their recovery. The prevention of DS and the early detection of psychological disorders are essential to minimize its subsequent impact.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nicc.12714","type":"journal-article","created":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T01:23:30Z","timestamp":1632273810000},"page":"679-688","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Psychological symptoms in difficult\u2010to\u2010sedate critical care survivors"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7416-5671","authenticated-orcid":false,"given":"Diana Gil","family":"Castillejos","sequence":"first","affiliation":[{"name":"Intensive Care Department University Hospital Joan XXIII Tarragona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3862-0462","authenticated-orcid":false,"given":"Mar\u00eda Lourdes","family":"Rubio","sequence":"additional","affiliation":[{"name":"Department of Nursing Rovira i Virgili University Tarragona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Ferre","sequence":"additional","affiliation":[{"name":"Department of Nursing Rovira i Virgili University Tarragona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00aa","family":"de los \u00c1ngeles de Gracia","sequence":"additional","affiliation":[{"name":"Intensive Care Department University Hospital Joan XXIII Tarragona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Bod\u00ed","sequence":"additional","affiliation":[{"name":"University Hospital Joan XXIII\/IISPV\/URV Tarragona\/CIBERES Tarragona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8838-3007","authenticated-orcid":false,"given":"Alberto","family":"Sandiumenge","sequence":"additional","affiliation":[{"name":"Medical Trasplant Coordinator University Hospital Vall d'Hebron Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,21]]},"reference":[{"issue":"2","key":"e_1_2_10_2_1","first-page":"129","article-title":"Afectaci\u00f3n emocional de los pacientes ingresados en una unidad de cuidados intensivos","volume":"18","author":"Gil B","year":"2013","journal-title":"Rev de Psicopatol y Psicol Clin"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.152.8.1228"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"47","article-title":"Contribuciones de la Psicolog\u00eda al manejo interdisciplinario del paciente en Unidad de Cuidados Intensivos (UCI)","volume":"46","author":"Contreras Moreno A","year":"2014","journal-title":"Rev Univ Ind Santander Salud"},{"issue":"1","key":"e_1_2_10_5_1","first-page":"1","article-title":"Anesthesia & intensive care medicine incidence and prevalence of anxiety, depression, and post\u2010traumatic stress disorder among critical care patients, families, and practitioners","volume":"1","author":"Jacka MJ","year":"2016","journal-title":"J Anaesth Intensive Care Med"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60575-2"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000882"},{"key":"e_1_2_10_8_1","first-page":"32","article-title":"Post\u2010intensive care syndrome: what to do and how to prevent it","volume":"8","author":"Davidson J","year":"2013","journal-title":"Am Nurse Today"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JAA.0000481401.21841.32"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001531"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201506-1158OC"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2016.12.005"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-024549"},{"key":"e_1_2_10_14_1","first-page":"31","article-title":"Estrategias de control de la sedaci\u00f3n dif\u00edcil","volume":"32","author":"Chamorro C","year":"2008","journal-title":"Med Intensiva"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12558"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2015.06.008"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(74)91639-0"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198510000-00009"},{"key":"e_1_2_10_19_1","first-page":"499","article-title":"Nomenclature et clasificacion des problemes li\u00e9s a la consommation de drogue et alcohol. 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