Psychology Consultation Patterns in a Medical Intensive Care Unit: A Brief Report

Megan Hosey, Mana K. Ali, Earl C. Mantheiy, Kelsey Albert, Stephen T Wegener, Dale Needham

Research output: Contribution to journalArticle

Abstract

Purpose/Objective: Intensive care unit (ICU) survivors frequently experience long-lasting mental health, cognitive, and physiologic challenges. Psychologists have a role in providing interventions to reduce patient distress during critical illness and improve outcomes. There is limited data regarding psychology consultations in the ICU. This brief report characterizes psychology consultations in a medical intensive care unit (MICU) in an academic medical center. Method: Psychology consultations were prospectively tracked, with patient-related data retrospectively collected and analyzed. Results: A total of 79 consecutive psychology consultations occurred at mean of 8 ± 6 days after MICU admission. Reasons for consultation were patient emotional distress (56%), rehabilitation therapy engagement (24%), family engagement (13%), cognitive disturbance (4%), and pain (4%). Patient characteristics were: mean age 56 ± 15 years, 54% women, 53% White, and 34% with psychiatric comorbidity at MICU admission. Patients referred for consultation had a longer MICU length of stay than the total MICU population (12 ± 9 days vs. 4 ± 6 days, p < .01). For consultations for emotional distress compared with limited rehabilitation therapy engagement, patient demographic characteristics were similar, with the exception of women (vs. men) being more commonly consulted for emotional distress (64 vs. 26%, p = .01). Conclusions: Patients with a longer MICU stay more commonly had a rehabilitation psychology consultation request, typically to provide support for emotional distress or engagement in rehabilitation therapy. Future research should evaluate the effectiveness of psychology interventions in the ICU.

Original languageEnglish (US)
JournalRehabilitation Psychology
DOIs
StatePublished - Jan 1 2019

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Intensive Care Units
Referral and Consultation
Psychology
Rehabilitation
Patient Participation
Critical Illness
Psychiatry
Survivors
Comorbidity
Length of Stay
Mental Health
Therapeutics
Demography
Pain
Population

Keywords

  • Brief intervention
  • Critical care
  • Intensive care
  • Rehabilitation engagement

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Psychology Consultation Patterns in a Medical Intensive Care Unit : A Brief Report. / Hosey, Megan; Ali, Mana K.; Mantheiy, Earl C.; Albert, Kelsey; Wegener, Stephen T; Needham, Dale.

In: Rehabilitation Psychology, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Purpose/Objective: Intensive care unit (ICU) survivors frequently experience long-lasting mental health, cognitive, and physiologic challenges. Psychologists have a role in providing interventions to reduce patient distress during critical illness and improve outcomes. There is limited data regarding psychology consultations in the ICU. This brief report characterizes psychology consultations in a medical intensive care unit (MICU) in an academic medical center. Method: Psychology consultations were prospectively tracked, with patient-related data retrospectively collected and analyzed. Results: A total of 79 consecutive psychology consultations occurred at mean of 8 ± 6 days after MICU admission. Reasons for consultation were patient emotional distress (56{\%}), rehabilitation therapy engagement (24{\%}), family engagement (13{\%}), cognitive disturbance (4{\%}), and pain (4{\%}). Patient characteristics were: mean age 56 ± 15 years, 54{\%} women, 53{\%} White, and 34{\%} with psychiatric comorbidity at MICU admission. Patients referred for consultation had a longer MICU length of stay than the total MICU population (12 ± 9 days vs. 4 ± 6 days, p < .01). For consultations for emotional distress compared with limited rehabilitation therapy engagement, patient demographic characteristics were similar, with the exception of women (vs. men) being more commonly consulted for emotional distress (64 vs. 26{\%}, p = .01). Conclusions: Patients with a longer MICU stay more commonly had a rehabilitation psychology consultation request, typically to provide support for emotional distress or engagement in rehabilitation therapy. Future research should evaluate the effectiveness of psychology interventions in the ICU.",
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