Evaluating the effectiveness of psychological care for intensive care unit patients at nutritional risk: A comparative study

Abstract

BACKGROUND

The intensive care unit (ICU) is a core hospital unit for critically ill patients. A high-intensity treatment environment, frequent invasive procedures, and isolation from family members often lead to severe psychological stress reactions in patients, including anxiety, depression, and posttraumatic stress disorder. Studies have reported that up to 50% of patients in the ICU experience varying degrees of psychological disorders, leading to reduced treatment compliance and exacerbated metabolic disorders through neuroendocrine pathways, thereby negatively affecting prognosis.

AIM

To investigate the influence of psychological nursing interventions on psychological status and all-cause mortality among patients admitted to the ICU.

METHODS

Data were obtained from 100 patients with nutritional risk in the ICU of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, admitted from June 2021 to June 2023. They were randomly divided into two groups (n = 50 each) based on nursing intervention: Control and study groups. At follow-up, the Zung Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used. All-cause mortality and time to death were compared between the two groups. The relationship between psychological status and all-cause mortality was assessed using the Cox proportional hazards regression model.

RESULTS

There were no statistically significant differences in SAS and SDS scores between the two groups before the nursing intervention (P > 0.05). However, after the psychological intervention, the SAS and SDS scores of the study group were significantly lower than those of the control group (P < 0.05). The all-cause mortality rates in the study and control groups were 20% and 40%, respectively (P < 0.05), indicating that psychological nursing interventions can significantly reduce all-cause mortality and improve clinical outcomes. Cox proportional hazards regression analysis revealed that a good psychological state reduced all-cause mortality (P < 0.05). Nursing satisfaction in the study group was significantly higher than that in the control group (P < 0.05), indicating a high level of recognition of the psychological intervention.

CONCLUSION

Psychological nursing interventions can effectively reduce the incidence of anxiety and depression in ICU patients with nutritional risk, improve their psychological state, reduce all-cause mortality, and improve their prognoses.

Keywords: Psychological nursing intervention; Nutritional risk; Intensive care unit; Psychological status; All-cause mortality

Core Tip: The presence of varying degrees of psychological disorders in patients in the intensive care unit not only reduces treatment compliance but may also exacerbate metabolic disturbances through neuroendocrine pathways, thus negatively affecting prognosis. This study is the first to focus on intensive care unit patients at nutritional risk and to innovatively reveal the clinical value of psychological interventions to improve their psychological status, reduce all-cause mortality, and improve their prognosis.