Psychology consultation patterns in a medical intensive care unit: A brief report

Rehabil Psychol. 2019 Aug;64(3):360-365. doi: 10.1037/rep0000264. Epub 2019 Feb 25.

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. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

MeSH terms

  • Academic Medical Centers
  • Cognitive Dysfunction / psychology
  • Cognitive Dysfunction / therapy
  • Critical Care / methods*
  • Critical Care / psychology*
  • Critical Illness / psychology*
  • Critical Illness / rehabilitation*
  • Family / psychology
  • Female
  • Humans
  • Intensive Care Units
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pain / psychology
  • Patient Compliance / psychology
  • Psychological Distress
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • Sex Factors