[Psychophysiologic reaction patterns in coping with events by intensive care patients]

The aim of this study was to demonstrate the clear relations between psychological and physiological parameters determined in intensive care patients. For this purpose, heart rate, salivary-cortisol secretion and blood pressure were measured as physiological stress indicators; psychological parameters were covered by examining the patients' way of coping, that is to contrast emotional with rational coping. By comparison, the equivalent parameters were determined in a group of healthy patients. When comparing both groups, we found a higher salivary-cortisol secretion and an increased heart rate in the group of intensive care patients, with the circadian rhythm of the cortisol-secretion remaining almost stable. When examining the patients' group according to the way of coping, we found a higher activation of the sympathetic nervous system in those patients who coped with their situation emotionally than in those who faced their problems rationally. The level of physiological excitation significantly decreased after the patients had been transferred from the ICU to the normal ward. The increased physiological excitation of ICU patients serves to release energies that help them to cope with their situation and can likewise be associated with emotional reactions such as being extremely watchful and in a state of mobilization as well as feeling particularly helpless. The extent of physiological irritation is modified by the way of intrapsychical coping.