Provision Of Psychological support to People in Intensive care

Status: Published

What is this study about?

Many critically ill patients suffer disturbing psychological symptoms, such as panic or hallucinations during their stay in the intensive care unit.  Doctors believe that these frightening experiences are caused by the effects of illness, drugs, stressful treatments such as being on a breathing machine (ventilator), and by the alien environment of the intensive care unit.

There is now strong evidence that these stressful experiences may trigger longer-term psychological problems for patients, such as post-traumatic stress disorder, severe depression and anxiety.

It can be difficult for intensive care nurses to recognise these symptoms. Most patients are unable to speak while they are on ventilators with a tube in their throat, while others may be withdrawn and unwilling to express how they feel. Many intensive care nurses also find it stressful to look after patients who are delirious or agitated, as they receive no special training in this type of care.

POPPI is a research study which aims to improve patients’ well-being after a stay in the intensive care unit by teaching nurses how to:

  • provide a calm, therapeutic environment for critically ill patients
  • detect psychological distress in critically ill patients
  • provide stress support sessions to their more distressed patients

The POPPI Study consists of two stages:

  1. Stage one included a feasibility study and a pilot study. The feasibility study developed and tested the training course for intensive care nurses in two NHS hospitals. The pilot study, conducted in two different NHS hospitals, ensured the necessary processes/procedures were in place to proceed to stage two.

  2. Stage two was a randomised clinical trial conducted at 24 NHS hospitals throughout the UK to find out if psychological training for nurses improves patients’ well-being after a stay in the intensive care unit. Psychological training was provided to nurses in 12 intensive care units. Patients in these units were be compared with patients in the other 12 intensive care units where nurses did not receive psychological training.

This study uses data from the Case Mix Programme.

When is it taking place?

Stage one of POPPI began in November 2013 and finished in June 2015. Stage two started in September 2015 and completed recruitment in February 2017.

Who is leading the study?

Professor Kathy Rowan, ICNARC

Dr Dorothy Wade, University College Hospital, London

This study is funded by the National Institute for Health Research (NIHR) – Health Services & Delivery Research (HS&DR) Programme (Project: 12/64/124)

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