Impact of spirituality on patient memories of intensive care unit stays: A nationwide cross-sectional study

BACKGROUND: Absent or delusional memories are experienced by many patients following an intensive care unit (ICU) stay. Up to 70% may have delusional or hallucinatory intrusive memories, which may persist long term. This study aims to investigate how spiritual health (SH) impacts ICU patients’ memories and quality of communication (QoC) between patients and physicians (PP) or nurses (PN). METHODS: This cross-sectional study was conducted across the country on ICU patients discharged from 45 medical centers in 31 provinces of Iran, to evaluate the direct and indirect effects of SH and ICU characteristics on patients’ memory. Two valid and standard ICU memory tools (ICU-MT) and SH questionnaires were administered to patients 1 day post-ICU discharge used. RESULTS: No significant direct effect of SH scores on ICU-MT items was observed. No significant correlation was observed between PP-QoC and PN-QoC variables and primary items of the ICU-MT. Female sex positively correlated with the development of delusional memories (odds ratio [OR]: 1.730, 95% confidence interval [CI]: 1.025–2.915, P < 0.05). Subjects admitted to the medical ICU were less likely to remember being in the ICU (OR: 0.398, 95% CI: 0.159–0.996, P < 0.05), and were less likely to report intrusive memories from their time in the hospital or events that led to their admission (OR: 0.19, 95% CI: 0.086–0.419, P < 0.001). CONCLUSIONS: The results of this study indicate that the spiritual health indirectly increased coping with intrusive memories, however, no direct effect was observed on ICU-MT items. The quality of communication between patients and physicians and nurses significantly mediated development of intrusive memories.