Psychology: Person-Centred Care a Key to Successful Recovery

Many patients find critical care admissions stressful, and subsequently survivors can experience psychological symptoms associated with depression, anxiety, posttraumatic stress disorder and cognitive impairment. Modifiable risk factors for these psychological difficulties? including sedation practices, delirious experiences and acute stress in critical care units, have been identified. The National Institute of Care and Health Excellence (NICE) now advocates psychological assessment and intervention for critically ill patients, and the UK’s Intensive Care Society supports the provision of senior practitioner psychologists in critical care to oversee acute and follow-up psychological services. High-quality evidence from randomised trials and systematic reviews is still lacking to support the precise form and mode of delivery of psychological interventions for critically ill patients. However, promising multimodal interventions in the acute setting include elements such as music therapy, multidisciplinary working to promote optimal rehabilitation, family psychoeducation programmes and evidence-based psychological approaches to managing delirium and symptoms of acute stress. Evidence-based psychological treatment programmes to address symptoms of psychological trauma, anxiety and depression can be provided by specialist practitioner psychologists based in critical care follow-up services. Cognitive interventions for critical care patients are being developed but are still in their infancy. A biopsychosocial approach to the experiences of critically ill patients is receiving increasing support within intensive care medicine, looking towards successful discharge.