Medicii cred că delirul este cauzat de modificări ale modului în care funcționează creierul.

Acest lucru se poate întâmpla atunci când: • Creierul tău primește mai puțin oxigen. • Există
schimbări în modul în care creierul tău folosește oxigenul și când există schimbări chimice în
acesta. • Iei anumite medicamente, sau te afli sub anestezie sau sedare. • Ai o infecție severă
sau suferi de anumite boli. • Ai dureri severe. • Văzul sau auzul sunt reduse. • Ai o vârstă
înaintată.

Tratamente psihologice pentru PTSD Există tratamente psihologice excelente, bazate pe

dovezi, pentru PTSD. Unele dintre cele mai cercetate sunt: • Terapiile cognitiv-
comportamentale (CBT), inclusiv Terapia Cognitivă pentru PTSD (CT-PTSD) și Terapia de
Procesare Cognitivă (CPT) • Desensibilizarea și reprocesarea prin mișcări oculare (EMDR)
Deși aceste tratamente pot diferi prin specificul lor, ceea ce toate implică este: • O anumită
expunere la memoria traumei. Amintirile PTSD pot fi puțin amestecate (amintirile de la
terapie intensivă chiar mai mult). A vorbi și a scrie despre ceea ce ți s-a întâmplat poate ajuta
la „procesarea” acestor amintiri pentru a deveni mai puțin intruzive și înfricoșătoare. •
Crearea înțelesului. Înțelegerea a ceea ce ți s-a întâmplat, înțelegerea sensului pe care l-ai dat
acestor experiențe la momentul respectiv și ajutorul în privința reevaluării acestor idei în
lumina a ceea ce știi acum. • Învățarea diferitelor strategii de coping. Depășirea evitării,
învățarea unor modalități mai sănătoase de coping și reluarea vieții.

Unele componente ale tratamentului care pot fi deosebit de utile pentru persoanele care au
experimentat UCI includ: • Învățarea despre modalitățile prin care bolile fizice, delirul și
aspecte privind mediul medical te pot afecta din punct de vedere psihologic. • Învățarea
despre halucinații și flashback-uri și de ce se întâmplă. Este important să înțelegi că doar
pentru că ai experimentat halucinații în timpul internării la terapie intensivă sau flashback-uri
după aceea, nu înseamnă că ești pe cale să înnebunești sau că ești în pericol.

amintirile din această perioadă). Dacă trauma ta a continuat mult timp, psihologii te vor ajuta
să creezi o „cronologie” a evenimentelor pentru a-ți întregi povestea. • Vizualizarea unor site-
uri dacă este posibil. Revizitarea secției de terapie intensivă (sau privirea unor imagini sau
videoclipuri) te poate ajuta în vederea „procesării” amintirilor legate de traumă și corectării
convingerilor nefolositoare. Mulți oameni consideră că este util să întâlnească personalul care
i-a îngrijit. • Acceptarea faptului că ar putea exista lacune în memoria ta, deoarece nu ai fost
conștient pe toată perioada internării. • Înțelegerea faptului că ai putea avea „amintiri
corporale” puternice despre ceea ce ți s-a întâmplat. Acestea pot fi experimentate ca
flashback-uri sau pot fi retrăite în timpul tratamentului traumei
Informații pentru profesioniștii din domeniul sănătății mintale care lucrează cu pacienți care
au PTSD în urma internării la terapie intensivă Chiar și terapeuții obișnuiți să lucreze cu
supraviețuitori ai traumei pot fi „scuturați” de anumite aspecte ale traumei UCI. În mod
fundamental, tratamentele psihologice pentru traume UCI utilizează aceleași elemente ca și
atunci când tratează alte tipuri de traume. Cu toate acestea, terapeuților le-ar putea fi de ajutor
familiarizarea cu detaliile de mai jos și solicitarea unei supervizări adecvate atunci când
lucrează cu această populație. Dacă ai experimentat o traumă medicală și intenționezi să
soliciți terapie, ar putea fi util să discuți această pagină cu terapeutul tău. Amintiri ale
traumei: durată, fragmentare, conținut Internarea la terapie intensivă poate varia de la zile la
săptămâni. Durata șederii poate însemna faptul că pacienții au prezentat un nivel mai ridicat
al traumei decât alți supraviețuitori și că pot exista mai multe amintiri ale traumei care pot fi
procesate ulterior. Este puțin probabil ca pacienții să fi fost conștienți întreaga perioadă
petrecută la terapie intensivă. Este posibil să fi avut conștiința afectată, codificarea memoriei
se poate să fi fost afectată, iar recuperarea va fi ulterior afectată. Este de așteptat ca pacienții
să aibă lacune la nivelul memoriei, iar acestea pot fi recunoscute. În timpul procesării
memoriei puteți utiliza promptul „Și care este următorul lucru pe care vi-l puteți aminti?”.
Terapeuții ar trebui să se aștepte ca amintirile traumatice ale experiențelor de îngrijire critică
să fie fragmentate și să conțină un amestec de conținut „real” și „halucinat”. Adesea este util
să construiți o cronologie a experiențelor spitalicești ale persoanei, care să includă informații
din memoria lor, din fișele medicale și din jurnalul UCI, dacă există, precum și descrieri din
partea familiei și prietenilor. Construirea unei narațiuni ilustrate sau scrise este adesea utilă.
Boli Critice, Terapie Intensivă și Tulburare de Stres Post-Traumatic (PTSD) 25 © 2020
Psychology Tools Limited This resource is designed for everyone, and is free to share.
Translated versions are available from psychologytools.com Experimentarea iluziilor sau a
halucinațiilor în UCI pot părea să persiste după externare Delirul este extrem de frecvent la
pacienții care au avut nevoie de terapie intensivă și poate provoca halucinații și credințe
delirante. Dacă aceste experiențe par a fi persistente după ICU, poate fi util să le
conceptualizăm ca amintiri involuntare ale experiențelor lor de a încerca activ să creeze
sensuri, care au fost codificate în timpul stărilor fiziologice de delir. Pentru a da un exemplu
clinic. „Mark” a fost ventilat și sedat în timpul internării sale la terapie intensivă și a avut
delir. Una dintre asistentele sale era de origine asiatică și în această perioadă a crezut că a fost
persecutat de gangsteri asiatici. După ce și-a revenit din punct de vedere fizic, tot a simțit
frică în jurul oamenilor cu aspect asiatic, a experimentat amintiri neplăcute în preajma fețelor
asiatice și susținea (ceva mai puțin puternic decât în timpul internării la UCI) faptul că a fost
urmărit de o gașcă de bărbați asiatici. Conceptualizarea pe care el a găsit-o ca fiind cea mai
utilă a fost că sistemul său de amenințare a fost ușor declanșat de similarități cu amintirile
traumei (fețele asiatice), iar amintirile sale nedorite au fost flashback-uri din perioada
internării sale la terapie intensivă. Ambele au redus intensitatea, cu expunerea terapeutică la
amintirile sale traumatice. Ulterior, el a efectuat câteva experimente comportamentale pentru
a-și testa convingerile cu privire la faptul de a fi urmărit și a reevaluat credința sa „nimeni nu
îmi acordă o atenție deosebită” ca fiind cel mai puțin amenințătoare. Odată ce amintirile sale
au fost „procesate” și credințele sale reevaluate, nu a mai simțit atâta suferință în legătură cu
amintirile sale de la terapie intensivă. Pacienții pot descrie „amintiri corporale” deosebit de
puternice în timpul reprocesării memoriei traumatice Pacienții ar putea descrie aceste
experiențe în mod spontan în timpul evaluării sau procesării memoriei, dar ar putea, de
asemenea, să fie utilă solicitarea acestor experiențe în mod direct și subtil de către terapeut.
De exemplu, pacienții pot raporta senzații neplăcute în zona gâtului legate de experiența
intubației sau disconfort la nivelul zonei inghinale legat de cateterism. La fel ca în cazul
amintirilor obișnuite ale traumelor din experiențe vizuale sau auditive, reprocesarea memoriei
(adică expunerea la) acestor amintiri somatosenzoriale este o formă eficientă de tratament.
Dacă pacienții au petrecut Boli Critice, Terapie Intensivă și Tulburare de Stres Post-
Traumatic (PTSD) 26 © 2020 Psychology Tools Limited This resource is designed for
everyone, and is free to share. Translated versions are available from psychologytools.com
timp la terapie intensivă întinși pe spate sau într-o poziție înclinată, poate fi util să efectuați
anumite părți ale procesării memoriei cu pacientul într-o poziție similară cu cea în care s-a
aflat. „Flashback-urile de durere” sunt un fenomen real și merită explorate Flashback-urile
sunt forme de memorie involuntară. Ele sunt adesea experimentate în modalități vizuale și
auditive, însă amintirile olfactive (miros) și somatosenzoriale (atingere) sunt, de asemenea,
frecvent raportate. Cercetările indică faptul că persoanele care suferă de durere fizică în
timpul traumei lor pot re-experimenta această durere sub formă de flashback-uri, dar că mulți
nu vor raporta spontan aceste experiențe. Experiența clinică indică faptul că aceste amintiri
pot fi procesate în același mod ca și alte amintiri traumatice. Trebuie abordate evaluările
consecințelor traumei Evaluările realizate în urma experiențelor de îngrijire critică ar putea
atinge o serie de domenii importante și pot fi abordate folosind intervenții cognitive și
comportamentale. Pentru mai multe informații, clinicienii sunt direcționați către Murray și
colab. (2020) [4] care discută abordările clinice ale acestora mai detaliat. • Credințe despre
boli mentale sau integritate mentală datorate experiențelor de delir. Credințele ar putea
include teme precum „Înnebunesc”, „Nu pot avea încredere în propria mea minte” sau „Nu
dețin controlul”. Pacienții s-ar putea simți rușinați de modul în care s-au comportat în timpul
tratamentului. • Convingeri despre pierderi. Acestea pot include convingeri privind pierderea
unei funcții fizice sau pierderea modului de viață anterior. • Credințe despre imaginea
corporală. Acestea pot include convingeri despre schimbarea permanentă, cum ar fi „Nu voi
mai fi niciodată același” sau alte convingeri despre cicatrici sau alte modificări ale imaginii
corporale, cum ar fi „Sunt dezgustător”. • Probleme de sănătate. Este frecvent ca pacienții
care au avut experiențe medicale grave să se teamă de reapariția bolii respective sau de o altă
boală care ar putea duce la reinternare în spital. O astfel de anxietate legată de sănătate poate,
de asemenea, să Boli Critice, Terapie Intensivă și Tulburare de Stres Post-Traumatic (PTSD)
27 © 2020 Psychology Tools Limited This resource is designed for everyone, and is free to
share. Translated versions are available from psychologytools.com se extindă cu îngrijorarea
pentru cei dragi. • Credințe privind tratamentul medical și personalul medical. Să te simți
furios pentru aspectele tratamentului medical nu este neobișnuit, iar unii pacienți se pot simți
neîncrezători față de personalul medical.

A National Institute for Health and Care Excellence (NICE) guideline (Tan et al. 2009) stated that
patients should be assessed during their critical care stay for acute symptoms such as anxiety,
depression, panic episodes, nightmares, delusions, hallucinations, intrusive memories, flashback
episodes and underlying psychological disorders, to determine their risk of future psychological
morbidity. Furthermore, psychological support should be provided to aid rehabilitation and
recovery in critical care units, on general wards, and in the community. However, it is not known
to what extent psychological assessment and support are really carried out in ICUs.

Research suggests that acute stress in the ICU may be one of the strongest patient risk factors
for poor psychological and cognitive outcomes after intensive care (Wade et al. 2012; Davydow
et al. 2013). Therefore it is important to detect and minimise acute tress where possible. 

Families of critical care patients also frequently need support to deal with anxiety and fatigue, to
comfort them when they learn that a loved one is dying, or after a death. Conflict may arise
between family members who have different views on a patient’s care, or between families and
staff, particularly around withdrawal of support or non-resuscitation orders.
 
Staff in critical care have much higher than average rates of stress and burnout than other
hospital staff (Moss et al. 2016). This may be related to the responsibility of maintaining lives
through sophisticated technological interventions; difficult emotions created by caring for patients
who are dying or who die, and a culture in which staff may be perfectionist, driving themselves to
provide high standards of care, without utilising appropriate self-care strategies. Conflict between
patients’ families who are upset, angry or grieving, and staff who are not trained to deal with
these emotions, can also escalate. Excessive stress can lead to staff going on long-term sick
leave or eventually leaving the service. The United States critical care societies’ collaborative has
recently issued a call to action on burnout syndrome (Moss et al. 2016).

In the acute setting, psychologists should supervise the psychological and cognitive assessment
of all patients, both in the critical care unit, and after transfer to other wards, as well as providing
or supervising psychological support to patients and relatives who are highly stressed or
traumatised. They can also help staff manage communications with distressed families.
Psychologists can provide training to increase staff knowledge and understanding of
psychological reactions, delirium, stressors in the critical care environment, and psychological
and cognitive outcomes of critical illness. They may also deliver training to increase staff
competency in providing psychological support to patients who are distressed, agitated, or
delirious.

Psychologists should play a key role in the multidisciplinary team (MDT), attending ward rounds,
and being available for consultation on matters such as communication, sleep, effects of
sedation, anxiety, stress, mood, delirium, and family issues. They should be involved in
developing holistic care plans for long-stay patient.
 

Finally, psychologists should play a role in addressing stress and burnout among critical care
staff. This could include advising senior management at an organisational level on systemic
issues influencing patient and staff wellbeing, as well as organising a wellbeing programme for
staff (individual and group sessions as well as teaching and proactive work) and coaching or
reflective sessions with senior management. (M Smithies & J Highfield, University Hospital
Wales, Cardiff, personal communication).

The Intensive Care Unit (ICU) is the place where attention is given to patients
with a vital crisis, that is, compromise of one or more vital organs and thus
requiring continued intervention and permanent monitoring by health caregivers.
It is undeniable that such circumstances become a source of stress for the ill
person, his or her family, and for the health personnel. It is therefore a field
where the psychologist has multiple functions and levels of intervention that
deserve to be clearly defined. The importance of considering the role of the
psychologist in an ICU is supported by Scragg, Jones and Fauvel (2001), who
confirm that treatment in an ICU can generate psychological problems in
patients that interfere with quality of life, specially anxiety and depression (47%
of patients) and posttraumatic stress indicators (38% of patients). The Health
Psychologist, specially in the ICU, needs to have personal and professional skills
that enable him to interact with people in special conditions, different to those
commonly found in other professional fields. Likewise, he must integrate
knowledge that transcend those of his own discipline into his professional skills,
in order to complement his explanations with knowledge coming from biomedical
sciences and other social sciences.

Results allowed to define psychologist’s role in three fundamental

areas: attention to patients at the ICU, attention to family members or
caregivers, and work with health personnel. These three areas are related to the
objective of improving this people quality of life.

In view of its characteristics, the ICU is one of the hospital places that has a
deeper impact on patients and family members, specially because of the use of
high technology devices such as monitors displaying cardiac activity, blood
pressure and other important data that reveal the patient’s condition.

 The aforementioned means physical conditions that include noises emitted by

the monitoring devices and permanent artificial illumination, which favours the
loss of day-night cycles; constant presence of healthcare professionals,
frequently watching the patients and performing procedures on them. Besides,
the use of devices establish conditions such as dependence of them, immobility
and nakedness in order to ease performing of the procedures and cleaning and
care. Likewise, both having an endotracheal tube and the effect of certain
medications cause difficulties for communication (Caro, Grimaldos, Novoa &
Serrano, 1995; Paredes, Parra, Urueña & Serrano, 1997; Bermúdez, Sanz,
Novoa & Serrano, 1999; Aldana, Morales, Novoa & Rodríguez, 2000). A review of
studies performed by Cook, Meade and Perry (2001) summarises the
psychological impact of being in the ICU and Fontaine (1994) describes in detail
the most common conditions of discomfort and distress for patients in an ICU,
i.e., thirst, insomnia, pain, restraint, inability to speak, immobility, noise, trouble
breathing, confusion, inability to determine current time and day, hopelessness,
loneliness, seeing other patients and have doctors and nurses saying more than
what the patient can understand.

Generally speaking, different studies agree in considering the physical conditions

of the ICU as generators of psychological distress

have pointed out that the conditions of stress that critical patients are exposed
to often have a detrimental effect on their responses to disease, because they
favour an increase in cardiovascular effort and oxygen consumption, which is
reflected in a longer stay in the ICU and a progressive decrease of their
biological and psychological stability.

This situation of stress is shown in several ways, as described by Blanco (1986): at the
somato-physiological level there is an increase of neurological reticular activity,
catecholamine secretion and steroid production, which has effects on bodily functions,
specially on the endocrine system. Secondly, at the motor level there often is some
direct action performed by the patient in order to change the aversive conditions
(aggression, removal of tubes, resisting procedures, etc.) and finally emotional
responses appear, such as anxiety, rage, sadness, depression and delusions.

On the other hand, within the context of critical disease there are many degrees of
severity of the patient admitted to the ICU. A measure that has shown to be effective to
determine the severity of the patient and the probability of death is the APACHE II
(Knaus, Draper, Wagner & Zimmerman, 1985) and APACHE III (Pappachan, Millar,
Bennett & Smith, 1999). Both scales have been used in the ICU and its records have
supported the psychological role, as they allow for prediction of the prognosis and
adjustment of actions accordingly

The scientific literature also reveals the necessity of taking into account
the diverse psychological profiles, in order to be able to respond to
patient demands in the ICU, since they determine the response of the
patient to the situation of being hospitalised and being in the ICU.

Even patients with well structured psychological profiles may present with very childlike
behaviours during their long stay in the ICU (Horta, Plazas & Serrano, 1998). In the
same way, it is possible to find, in ICU patients, psychological disturbances such as
anxiety (Epstein & Breslow, 1999; Hansen-Flaschen, 1994; McCartney & Bolan, 1994;
Tesar & Stern, 1995) and depression (Paredes, Parra, Urueña & Serrano, 1997) and the
term ICU psychosis or ICU Syndrome has been specifically coined to refer to affective,
behavioural and cognitive abnormalities in ICU patients, related to sleep deprivation,
exposure to sensory overload, environmental restriction and medication (Durbin, 1995;
Fontaine, 1994; Sivark, Higgins & Seiver, 1995). Besides, the different experiences in
the ICU (intubation or extubation, feelings of loss of control, among others), together
with vulnerability factors can trigger the development of a Posttraumatic Stress Disorder
(PTSD) in some patients (Horta, Plazas & Serrano, 1998).

It is also important to pay attention to the collateral effects of medications frequently

used in the ICUs (Tekeres, 2000; Tung & Rosenthal, 1995) and conditions of immune
suppression associated with the conditions of the ICU patient (DeKeyser, 2003; Krueger,
Thoth, Floyd & cols., 1994; Schrader, 1996).
Regarding interventions, some studies have shown that behavioural and environmental
interventions are beneficial, combined with pharmacologic treatment (Blacher 1987;
Chlan, 1998; Fontaine, 1994; Granber, Engberg & Lundberg, 1999; McGuire, Baste,
Ryan & Gallagher, 2000; Posen; 1995; Sivak, Higgins & Seiver, 1995). Music as a valid
alternative has been suggested and applied by several authors, with different goals,
including the control of the noisy environment that inhibits sleeping and promotes
anxious reactions, helping promote relaxation and handling pain (Biley, 2000; Fontaine,
1994; Horta, Jaimes, Rodríguez & Serrano, 2000; Magill, 1993), easing medical
procedures and decreasing use of medication (Bonebreak, 1996).

Another mode of intervention related to environmental design includes that described by

Costello (2000) as a model of intervention for preoperative Augmentative Alternative
Communication (AAC), for patients programmed to stay in the ICU after surgery. Even
though reported data are anecdotic in nature, they show beneficial effects of the
intervention, as described by patients, family and healthcare professionals.

In regard to the problem of delirium in the ICU, Roberts (2001) states that it continues
to be a problem and its clinical handling focuses on procedures designed to save the life;
nevertheless, healthcare professionals require skills to prevent it, which means to be
able to identify it on time and have a thorough understanding of how the brain, the most
important organ in these cases, works, as well as being aware of the features of the
physical environment in order to be able to help patients cope with those conditions,
specially when they cannot be modified or eliminated (for instance, immobility and
devices). This author suggest the reduction of noise, specially at night, using music and
familiar voices, speaking in a calm tone, looking at the patient, without using medical
jargon that may disturb even more or induce irrational ideas; reorientation to time and
space is also a factor to take into account in these cases, in order to alleviate the
sensory deprivation; thereby the importance of the presence of close people, such as
family members, that support or directly help with actions of communication and sensory
stimulation in order to relieve the anxiety caused by the foreign environment of the ICU.
In opinion of this author, it is imperative to provide an appropriate handling of pain,
because of its relationship with irritability and its sleepdisrupting effect, both associated
with the presentation of delusional syndrome. In cases of delusion, it is necessary to
calm family members and warn them about the syndrome; it is important to offer
support to both the patient and them by explaining the nature of the syndrome, the
visual course followed by the disease and the possible treatments.

With regard to that, DeKeyser (2003) states that both psychologists and nurses are able
to carry out several actions that allow patients to increase their feelings of security and
comfort. In the study by Laitinen (1996), patients emphasised the importance of having
a closer relationship with the professionals in charge, because they believe that
perceived calmness and feelings of security and acceptance will depend on the quality of
this presence.

Also related to the aforementioned, it is worth to mention the contributions of

environmental psychology in hospital environments and specifically in the ICUs (Trites,
Galbraith, Sturdavant & Leckwart, 1970; Bell, Fisher & Loomis, 1978; Carlopio, 1996).

 the role of the psychologist in an ICU, which consists of individual

attention to patients, attention to family members and companions, work
with the medical and paramedic personnel and environmental design. 
From the methodological viewpoint, it is important to bring to notice that this research
evidences the need to clearly separate the effects of biomedical conditions from those of
the pharmacological treatment and the particular conditions of the ICU on the patients’
psychological state during their stay at the ICU. In this line, Fontaine (1994) includes
conditions derived from the pharmacological treatment into the category of biomedical
conditions, which have important side effects such as cognitive and behavioural
alterations – changes in state of consciousness, orientation, memory, attention,
sensoperception and thought among them, some in the category of ICU psychiatric
abnormalities. In pragmatic terms, controlling these alterations as good as possible
becomes necessary, because, as this author points out and as evidenced by this
research, they may imply potential damages to the patients themselves or to the
healthcare team in charge of them. When possible, the intervention should pose as little
restrictions as possible and should appeal in minimum amounts to sedatives. As found
by this research, knowledge of the patients’ characteristics provided information to guide
the medical intervention in the noted direction.

Results are also consistent with what was described by authors such as Epstein and
Breslow (1999) regarding anxiety in ICU patients and their families, so that it becomes
important to pay attention to indications, both verbal and physiological, susceptible of
being monitored by people that have contact with the patient. Interventions directed
towards managing anxiety showed significant effects, but the important thing is to bear
in mind that such interventions must be continued, because the conditions of an ICU,
already described, may be thought of as favouring or feeding anxiety, as found in 17%
of the 71 cases evaluated during and after their stay at the ICU, who showed problems
such as anxiety and depression related to their ICU stay.

Taking into account the importance of psychological variables in the quality of life of ICU
patients, this research allowed for a reaffirmation of the need to know those variables as
soon as possible, in order to be able to determine whether they are previous conditions
or they are brought about by the stay at the ICU and the medical conditions. For
example, the work at the HUCSR with patients described as being in «low spirits» or
conflictive families allowed us to give direction to the interventions performed on them
during visits and during the periods of communication with the healthcare personnel.

Coincidences were found among what was stated by DeKeyser (2003), Granberg,
Engberg and Lundberg (1999), Krueger et al. (1994), Simini (1999) and Thomas (2003)
regarding factors that were more worrying and distressing for patients during their ICU
stay, such as noise levels, permanent illumination, conversations by unknown people,
mobility restriction and social loneliness. As said, the patients’ experience of stress is not
only related to sepsis and trauma, but is also heavily affected by environmental
conditions; hence the importance of work based on environmental design. From the set
of complaints and reports of distresses it can be concluded that the most frequent
psychological stressors were pain, sleep deprivation, fear or anxiety and nudity.

It is important to observe how opportunity and effectiveness of psychological

interventions may allow to break feedback cycle existing between environmental
conditions and psychological conditions and the physiological

The results of intervention with family and companions of the patient are also consistent
with the literature reviewed, as it is regarded that family has a double function, the first
one as supporters of the patient and the second as agents that ease the work of the
healthcare personnel. The role of psychological intervention with the family in handling
information and reducing the negative impact of ICU on the family was evident in this
research, by enhancing communication with the patient and the healthcare team. A
general conclusion worth noting of this is the change in beliefs held by family and
companions about the psychological conditions of their hospitalized family members,
going from considering them as completely biological entities, incapable of contact and
influence by the environment, to understanding that despite their physiological condition
they continue to be psychologically active beings.

It was evidenced that family members want to be informed about the medical evolution
of their patient and about the way that they can help with the patient’s recovery. In this
way, the Psychological Preparation for ICU programme and the presence of the
Psychologist during the visits were activities that should be highlighted.

The results of intervention with family and companions of the patient are also consistent
with the literature reviewed, as it is regarded that family has a double function, the first
one as supporters of the patient and the second as agents that ease the work of the
healthcare personnel. The role of psychological intervention with the family in handling
information and reducing the negative impact of ICU on the family was evident in this
research, by enhancing communication with the patient and the healthcare team. A
general conclusion worth noting of this is the change in beliefs held by family and
companions about the psychological conditions of their hospitalized family members,
going from considering them as completely biological entities, incapable of contact and
influence by the environment, to understanding that despite their physiological condition
they continue to be psychologically active beings.

It was evidenced that family members want to be informed about the medical evolution
of their patient and about the way that they can help with the patient’s recovery. In this
way, the Psychological Preparation for ICU programme and the presence of the
Psychologist during the visits were activities that should be highlighted.

 Conduct scientific studies of behavior and brain function.

 Observe, interview, and survey individuals.
 Identify psychological, emotional, behavioral, or organizational issues and
diagnose disorders.
 Research and identify behavioral or emotional patterns.
Psychologists study cognitive, emotional, and social processes and behavior by observing,
interpreting, and recording how people relate to one another and to their environments. They
use their findings to help improve processes and behaviors.

Duties
Psychologists typically do the following:

 Conduct scientific studies of behavior and brain function

 Observe, interview, and survey individuals
 Identify psychological, emotional, behavioral, or organizational issues and diagnose
disorders
 Research and identify behavioral or emotional patterns
 Test for patterns that will help them better understand and predict behavior
 Discuss the treatment of problems with clients
 Write articles, research papers, and reports to share findings and educate others
 Supervise interns, clinicians, and counseling professionals

Descrierea postului de psiholog ar trebui să înceapă cu câteva declarații introductive despre

companie. Oferiți potențialilor solicitanți o privire asupra culturii, astfel încât să aibă o idee despre
ceea ce este unic la organizație; sperăm că acest lucru îi va face să vrea să se alăture echipei.

Responsabilitatile postului de psiholog:

Vorbește cu indivizii și le stimulează sănătatea mintală pozitivă și creșterea personală.

Evaluează nevoile pacienților și le acomodează în consecință.

Studiază factorii care afectează comportamentul uman.

Elaborează planuri de tratament.

Administreaza teste psihologice si determina rezultate.

Consiliere: Oferă consiliere prin conducerea unor sesiuni de grup sau individuale.

Comportamental: Cercetează variațiile tiparelor comportamentale de-a lungul vieții unei persoane,
examinează tendințele societale și încearcă să corecteze tulburările cauzate de dezvoltarea
necorespunzătoare.

Criminalistică: Lucrează cu agenții de aplicare a legii și acționează ca experți în diverse cazuri juridice,
evaluează competența, lucrează cu martori și efectuează evaluări psihologice.

Clinic: Lucrează pentru a preveni, diagnostica și trata tulburările mintale și lucrează cu medicii pentru
a determina cel mai bun curs de tratament pentru pacienți.