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Published on: October 24, 2018
Psychology in an extracorporeal membrane oxygenation (ECMO) service in the North-West
Maleeha Butt1, Sarah Stirling2, Hannah Fitzmaurice2
1University of Manchester, Greater Manchester Mental Health Trust, UK.
Background:
Long-term psychological complications of ECMO have been reported and current national guidelines state that there should be access to psychologists for patients in intensive care; however, this is not available in all ICUs. This project was based in a cardiothoracic critical care unit (CTCCU) of a hospital in the north-west of England that does not currently have a psychologist. Therefore, the aim of this project was to identify the psychological needs of ECMO patients. A subsidiary aim was to develop and trial an ECMO-specific group intervention.
Methods:
The prevalence of mental health difficulties in ECMO patients was investigated using data from outcome measures completed 6 weeks post-discharge. Patients were interviewed about their experiences of ECMO, and themes were identified using a thematic analysis. Based on these themes, a pilot 6-week group was developed, and quantitative and qualitative outcomes were collected.
Results:
Analysis of post-discharge HADS found 50% of patients scored within the clinically significant range for anxiety and 37% for depression. Patient themes included feeling powerless, alone and fears around 'what is normal?'. The ECMO group was well-received by patients, with feedback that they felt 'seen and heard'. Despite the small sample size, the group demonstrated positive outcome data, with a 66% decrease in anxiety symptoms and a 78% decrease in depression symptoms.
Conclusions:
This project highlighted significant mental health distress for ECMO patients. Positive psychological outcomes were gained from the ECMO group and recommendations were made that embedding psychologists within CTCCU could promote post-traumatic growth for patients.
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