الفهرس 
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Abstract
Summary
ICU patients often experience distorted memories, due to the effects of illness, medication, and sleep deprivation. This can result in confusing and frightening memories that are not based in reality. These memories can include hallucinations, delusions, and nightmares, as well as confusion about time and place. (Thomas et.al., 2020).
It is important for nurses to recognize and manage ICU distorted memory, as it can prolong hospital stays, increase the risk of long-term cognitive impairment, and have a negative impact on quality of life. To help prevent and manage ICU distorted memory, nurses can use a variety of strategies, such as maintaining a regular sleep-wake cycle, and promoting sensory stimulation. (Schou et al., 2022).
In some cases, patients may have memories of events or experiences that did not actually occur, or they may recall events in a different order or with a different meaning than was originally intended. In other cases, patients may have gaps in their memory or may not be able to recall events from their ICU stay at all. It’s important to note that this phenomenon is not limited to ICU patients and can occur in other medical settings as well. Additionally, some ICU survivors may experience long-term psychological effects, such as post-traumatic stress disorder (PTSD), as a result of their distorted memories. (Jos, 2022).
Significance of the study:
Studies have shown that the prevalence of ICU-related distorted memories varies widely, but it is estimated to affect 10-20% of patients who have been in the ICU for an extended period. These patients may experience persistent anxiety, depression, sleep disturbances, and avoidance behavior related to their ICU stay. Distorted memories can have significant impacts on patients and their families and can be long-lasting. It is important for nurses to be aware of the risk of these conditions and to take steps to prevent, recognize, and manage them when they occur. Providing support to patients and families. (Bruna , 2019).
Aim of the Study:
This study aims to assess distorted memory among the patients in intensive care unit and its related factors through the following.
1. Assess distorted memory among the patients in the intensive care unit.
2. Assess the factors associated with development of distorted memory among the patients in the intensive care unit.
Research questions:
This study aims to answer the following research questions:
1. What is the distorted memory among the patients in the intensive care unit?
2. What are the factors associated with development of distorted memory among the patients in intensive care unit?
Technical design:
It included research design, setting, subject and tools for data collection.
Research design:
A descriptive exploratory research design was utilized to achieve the aim of the present study.
Setting:
The study was conducted in medical ICU at El-Demerdash Hospitals affiliated to Ain-Shams University Hospitals
Subjects:
The purposive sample of (98) patients admitted to the previously mentioned setting was included in the study.
Tools of data collection:
I- patient structured interview questionnaire, (appendix I ).
Part (1): Patient demographic characteristic: it concerned with demographic characteristic of the studied patients.
Part(2): Patient medical data.
Part (3): Acute Physiology and chronic Health Evaluation (APACHE) tool: used to assess the severity of disease for adult patients admitted to intensive care units.
Part (4): Hospital Anxiety and Depression Scale (HADS) : used to assess the studied patients psychological status related factors HADS.
II - Distorted Memory related factors assessment sheet , (appendix II ) :
This tool was developed by the researcher to assess ICU related factors associated with development of distorted memory among the studied patients.
III – Distorted Memory tool , (appendix III) :
Used to assess presence or absence of memory loss or delusional memories among the studied patients
IV- Mini-Mental State Examination (MMSE), (appendix IV) : used to detect any cognitive disturbance; it includes tests of orientation, attention, memory, language and visual-spatial skills,
The main findings of this study revealed that:
An analysis of the studied patients total mean scores regarding disease severity, anxiety & depression, distorted memory affecting factors, distorted memory and cognitive disturbance were 11.495.40, 15.833.29, 16.923.13, 45.17±6.32, 12.263.66 and 21.674.21.
Conclusion:
Based on findings of the present study, it can be concluded that:
Majority of the studied patients had moderate level of disease severity, highest percentage of them had severe depression and anxiety level, more than three quarter of them reported high affecting factors on their distorted memory. As well, more than half of them had bad/distorted memory and severe cognitive disturbance. Additionally, there were a highly significant positive correlation between all the studied variables.
Recommendation:
Based on findings of the present study, the following can be recommended:
1. Emphasizing the ICU nurses about the importance to use the standardizing assessment tool for recognizing any patients at risk for developing distorted memory.
2. Planning and establishing health education program for patients in ICUs taking into consideration the studied distorted memory related factors to avoid its development among such group of patients.
3. Suggesting evidence-based strategies for avoiding development of distorted memory among the patients in ICUs.
4. The need for multidisciplinary ICU team to provides holistic care based on patients needs for enhancing quality of care & avoiding development of distorted memory.
5. Evaluating the effect of implementing suggested evidence-based strategies on the incidence of distorted memory among the patients in ICU and its impact on long run.
6. Developing a simplified illustrated and comprehensive Arabic booklet for distorted memory prevention strategies among the patients in ICUs.
7. Replication of the study on larger probability sample in ICUs at different geographical locations for data generalizability.