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Title: Developing a grounded theory model of post-traumatic stress disorder following an intensive care unit admission
Author: Sweetman, Isabel
ISNI:       0000 0004 8500 8924
Awarding Body: Royal Holloway, University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2019
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There are elevated rates of Post Traumatic Stress Disorder (PTSD) in survivors of intensive care units (ICU) and those who experience PTSD after an ICU admission (PTSD-ICU) are likely to experience worse outcomes, in relation to physical health-related quality of life and increased emergency admissions, comorbid anxiety and depression, and decreased ability to return to work. Existing research has investigated risk factors for PTSD-ICU. Systematic reviews of these studies have found that demographic factors (e.g. previous psychiatric history) and clinical factors (e.g. benzodiazepine administration, mechanical ventilation and delirium) are associated with developing later PTSD symptoms. These reviews have also found evidence for psychological risk factors for PTSD-ICU, including the presence of frightening and delusional memories of the ICU, and acute fear or stress during the ICU. However there are gaps in the psychological conceptualisation of PTSD-ICU, such as the role of cognitions, emotions and behaviour, as well as factors occurring after discharge from the ICU, such as social support and additional life stress. As there are high rates of PTSD in the ICU population, and this may have an adverse impact on wider outcomes, guidance recommends that individuals receive a psychological follow-up after discharge from the ICU, which would comprise of screening, assessment and treatment of PTSD. However, the research on psychological assessment and treatment of PTSD-ICU is limited to studies on peritraumatic interventions (e.g. music therapy, mind-body therapies and ICU diaries), and the evidence for these interventions is inconclusive. Furthermore, there is no research to indicate how applicable and effective evidence-based PTSD treatments are for an ICU-specific population. Known psychological factors, such as the role of delusional memories during ICU, may pose additional challenges and the need for adaptations to general PTSD treatment models. This thesis therefore aimed to address the gaps in the literature with regards to the psychological understanding of PTSD-ICU. The systematic review aimed to summarise the existing research on psychological variables associated with PTSDICU, and the empirical grounded theory study then aimed to develop a preliminary psychological model of PTSD-ICU, based on interview data from individuals suffering with PTSD symptoms after an ICU admission.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available