Efectos de la terapia cognitivo conductual con mindfulness integrado en el manejo de la ansiedad en pacientes coronarios hospitalizados en una unidad de cuidados intensivos
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Fecha
2025
Autores
Aguilar Jiménez, Sara Milena
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias Jurídicas y Sociales
Facultad de Ciencias Jurídicas y Sociales
Resumen
El estudio de caso se centra en un paciente en UCI evaluado con el Inventario de Ansiedad de Beck, donde se identificaron síntomas físicos (palpitaciones, sudoración, dificultad para respirar), cognitivos (temor a la muerte, pensamientos intrusivos) y emocionales (inquietud, miedo), en un entorno crítico caracterizado por intervenciones invasivas, monitoreo constante y aislamiento. El estudio utiliza un diseño de caso clínico de línea de base múltiple A-B-A2, en el que la Fase A evalúa el nivel inicial de ansiedad en la UCI mediante el Inventario de Ansiedad de Beck (BAI); la Fase B implementa un programa de intervención psicológica con técnicas de relajación, reestructuración cognitiva y apoyo emocional, mientras que la Fase A2 consiste en una reevaluación para contrastar la evolución de la ansiedad. En la Fase A el evaluado registró un puntaje de 38 (ansiedad severa) con síntomas físicos intensos y pensamientos catastróficos en un entorno hospitalario estresante; en la Fase B se implementaron intervenciones psicológicas (relajación, mindfulness, apoyo emocional y mejora en la comunicación sobre el procedimiento) en momentos críticos, y en la Fase A2 se observó una reducción significativa de la ansiedad (puntaje entre 16 y 22) acompañada de una mejora en la adaptación al entorno y en la estabilidad de los síntomas físicos. Estos hallazgos confirman la eficacia de la integración de TCC y Mindfulness en el manejo de la ansiedad en contextos críticos y resaltan la importancia de incorporar estrategias psicológicas sistemáticas en el cuidado de pacientes en UCI para optimizar su recuperación y bienestar emocional.
The case study focuses on an ICU patient assessed with the Beck Anxiety Inventory, where physical symptoms (palpitations, sweating, difficulty breathing), cognitive symptoms (fear of death, intrusive thoughts), and emotional symptoms (restlessness, fear) were identified in a critical setting characterized by invasive interventions, constant monitoring, and isolation. The study employs a multiple baseline clinical case design (A-B-A2), in which Phase A evaluates the initial anxiety level in the ICU using the Beck Anxiety Inventory (BAI); Phase B implements a psychological intervention program with relaxation techniques, cognitive restructuring, and emotional support; and Phase A2 consists of a reevaluation to compare the evolution of anxiety. In Phase A, the patient recorded a score of 38 (severe anxiety) with intense physical symptoms and catastrophic thoughts in a stressful hospital environment; in Phase B, psychological interventions (relaxation, mindfulness, emotional support, and improved communication regarding the procedure) were implemented at critical moments; and in Phase A2, a significant reduction in anxiety (score between 16 and 22) was observed, accompanied by an improvement in adaptation to the environment and stability of physical symptoms. These findings confirm the efficacy of integrating CBT and Mindfulness in managing anxiety in critical contexts and underscore the importance of systematically incorporating psychological strategies in ICU patient care to optimize recovery and emotional well-being.
The case study focuses on an ICU patient assessed with the Beck Anxiety Inventory, where physical symptoms (palpitations, sweating, difficulty breathing), cognitive symptoms (fear of death, intrusive thoughts), and emotional symptoms (restlessness, fear) were identified in a critical setting characterized by invasive interventions, constant monitoring, and isolation. The study employs a multiple baseline clinical case design (A-B-A2), in which Phase A evaluates the initial anxiety level in the ICU using the Beck Anxiety Inventory (BAI); Phase B implements a psychological intervention program with relaxation techniques, cognitive restructuring, and emotional support; and Phase A2 consists of a reevaluation to compare the evolution of anxiety. In Phase A, the patient recorded a score of 38 (severe anxiety) with intense physical symptoms and catastrophic thoughts in a stressful hospital environment; in Phase B, psychological interventions (relaxation, mindfulness, emotional support, and improved communication regarding the procedure) were implemented at critical moments; and in Phase A2, a significant reduction in anxiety (score between 16 and 22) was observed, accompanied by an improvement in adaptation to the environment and stability of physical symptoms. These findings confirm the efficacy of integrating CBT and Mindfulness in managing anxiety in critical contexts and underscore the importance of systematically incorporating psychological strategies in ICU patient care to optimize recovery and emotional well-being.
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Palabras clave
Ansiedad, Terapia cognitivo conductual, Mindfulness, Cuidados intensivos, Hospitalización
