I read theCase Study，，，，by van Mol et al.Journal of Compassionate Health Care（（2016) 3.5, with great interest. The article concerned person-centered care in the intensive care unit (ICU) in the Netherlands. I think it may be useful to relate my own personal experience of critical care in the UK.
I was admitted to hospital in February 2013, aged 57, with an advanced Type III abdominothorasic aortic aneurism. During the week before I was to undergo major surgery to perform an “open repair” of the aorta, I was informed in detail of the severity and potential negative outcomes of the procedure, including kidney failure and paraplegia.
我从顾问外科医生那里收到的信息是明确而坦率的，因此毫无疑问，我对潜在危害。但是，没有提及术后不良心理影响的可能性。
没有提及术后不良心理影响的可能性。
该过程成功了，在诱发昏迷中大约48小时后，我在ICU中恢复了意识。我记得自己幸存下来感到很高兴，但是我对周围环境感到非常困惑，经历了几天，尤其是令人恐惧的精神功能障碍的夜晚，其中包括许多令人不安的妄想和幻觉，我绝对确定是现实。我确信自己处于极大的危险，并且护理人员打算杀死我。
During this period, friends and relatives were very concerned and surprised by my state of mind. I recognized and trusted them, however during their visits I described my terrible experiences as if they were fact, which I totally believed them to be. My wife tried to obtain information regarding my condition, enquiring as to why I was acting and speaking in such a strange manner, and fearing that I might have permanent brain injuries. However, the care staff were unable to offer a possible explanation. Thus, my wife remained deeply concerned by my condition.
范·莫尔（Van Mol）指出：“专业人士可以支持有关一般信息讨论的亲戚，谈论可能的情感和认知后果，从较差异或亲人的重新验证过程中恢复过来”。这个单词deliertranslates from Dutch into English as delirium.
皇家Psychiatr学院发布的一份传单y describes delirium very well, offering advice for the patient and carer. It contains a list of what you might experience in a delirious state. “You may: Be less aware of what is going on around you. Be unsure about where you are or what you are doing there. Be unable to follow a conversation or to speak clearly. Have vivid dreams, which are often frightening and may carry on when you wake up. See people or things which aren’t there. Worry that other people are trying to harm you. Be more confused at some times than at others – often in the evening or at night”.
在ICU期间，我经历了所有这些，但是没有关于我在护理人员和我自己或亲戚之间的心理状况的讨论。实际上，在我康复足够恢复到一般病房之后，我确实与神经科医生进行了磋商，但是我们仍然没有解释我的经历的讨论。从技术角度来看，我得到的护理非常出色，但是我觉得护理人员普遍缺乏意识和不愿意接受我在ICU度过了一个可怕的夜晚。
FCIC对专业人士与患者及其家人之间沟通的任何鼓励和建议都将受到欢迎。
On the subject of communication, Van Mol states “The importance of clear communication in a timely and understandable manner to the person being treated and their relatives might support the coping mechanism managing the stressful surroundings and critically unstable situation”.
关于我手术的物理方面的沟通在手术前后都是出色的，但是在任何阶段都没有关于我经历心理副作用的可能性的讨论，事实证明，在我康复的早期阶段，这很痛苦。我同意范·莫尔（Van Mol）的观点，即在操作之前与我和我的亲戚进行了一些沟通，这可能使之后更容易应对压力状况。
在讨论中，范莫尔指出，家庭和患者以重症监护（FCIC）为中心是专业人士与患者及其亲戚之间的联系。我个人认为，在提供整体以患者为中心的治疗方案时，这是一个关键功能。
我了解同情疲劳和倦怠的概念，我目睹了各级护理人员经常经历的极大压力条件下的大量工作量。出于这个原因，我认为，FCIC对专业人士与患者及其家人之间沟通的任何鼓励和建议都将受到欢迎。
Personally, I am sure that I would have benefitted from a more patient-centered approach to my care in ICU, specifically regarding communication of information to enable me and my relatives to understand and cope with the symptoms experienced during my highly unpleasant period of delirium.
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