Abstract
Purpose: To conduct a review of psychological problems experienced by patients following a critical illness necessitating an admission to an intensive care unit (ICU). Methods: Systematic literature review of computer databases - Medline, PsycLit and CINAHL - identified 30 relevant papers. In addition, other relevant articles were obtained, citation lists and associated articles retrieved. Due to the lack of research on patients' psychological reactions following a period in ICU, all articles that introduced a psychological construct into the paper were included in the review and a further 12 were found. Results: A number of findings were clearly identified. Many patients have no recall of their stay on ICU, including memory of their illness. A consequence of this amnesia is an over-optimistic view of recovery, which may also be in conflict with their relatives' perception. Physical recovery, due to muscle weakness, is often slow. Return to normal physical functioning may take six months. Psychological problems are common and include anxiety, depression, irritability and social withdrawal. Panic attacks and phobias associated with ICU experiences can produce an agoraphobic condition that complicates the recovery process. Conclusions: Research is required to strengthen psychological assessment procedures and design interventions to assist the overall care of ICU patients. Improvement in the speed and quality of recovery from the illness and its after-effects are possible, when adopting a psychological approach to care which complements concentrated physical interventions both during and following ICU.