研究背景：病人因為嚴重疾病威脅到生命入住加護病房。病人在加護病房中除了疾病本身帶來的痛苦、加護病房陌生的環境及治療所引起的不舒服，對病人而言都是極大的壓力。病人轉出加護病房後的加護病房記憶根據加護病房記憶工具定義為事實記憶、情感記憶及妄想記憶。真實的記憶可以保護病人轉出加護病房後降低創傷後症後群的發生，而焦慮、害怕、恐慌或甚至不真實的可怕記憶則會影響病人在轉出加護病房後的心理及認知功能恢復。加護病房的照護策略隨著醫學的進步有顯著的改變，轉出加護病房病人的記憶現況為何仍不甚清楚，因此著實有必要探討轉出加護病房病人的加護病房記憶，以期了解在轉出後至出院前之記憶現況，以利往後早期的介入措施執行。
研究目的：探討外科病人轉出加護病房後之加護病房記憶現況及其影響因子。
研究方法：本研究為橫斷式的相關性研究，採方便取樣。研究場域為南部某區域教學醫院外科加護病房。藉由加護病房記憶工具，透過訪談方式評估轉出加護病房病人之記憶現況，運用卡方檢定、t 檢定探討人口學變項及疾病特徵（加護病房住院天數、疾病嚴重度、呼吸器使用、鎮靜止痛藥物使用）與加護病房記憶是否有相關；以邏輯斯迴歸探討影響加護病房記憶之影響因子。
研究結果：本研究納入112位轉出加護病房之外科病人。這112位病人以男性（n = 71；63.4%）為主，平均年齡64.9歲（SD = 12.8）。已婚佔多數（n = 81；72.3%）；教育程度國中以下佔多數（n = 82；73.2%）。大部分都是接受手術的病人（n = 94；83.9%），接受手術的病人中有69.6%（n = 82）為接受常規手術的病人。這112位病人加護病房住院天數平均4.2天。疾病嚴重度平均為15.8分。呼吸器使用人次86人（76.8 %），呼吸器平均使用天數1.4天。75 人（67%）使用連續鎮靜藥物（Propofol，20mg/ml），平均每人使用鎮靜藥物0.9天，使用劑量平均1.53 g/day。71 人（63.4%）使用連續止痛藥物（Morphine，10mg/ml），平均使用天數為 0.88天，使用劑量平均 33.72 mg/day。間歇止痛藥物Tramadol，藥物劑量100 mg/ml，200 mg 常規每六小時給予。95人（84.8%）的外科病人使用間歇止痛藥物，平均天數為 2.11天，使用劑量平均為441 mg/day。研究發現10位（8.9%）病人沒有加護病房記憶，72位（70.6%）病人有情感記憶，42（41.2%）位病人有妄想記憶。藉由卡方分析和t檢定發現：年齡和手術屬性與加護病房記憶相關；呼吸器、連續鎮靜止痛藥物使用及連續止痛藥物使用天數與加護病房情感記憶相關；加護病房住院天數、呼吸器使用天數、連續止痛藥物及間歇止痛藥物使用天數及劑量與加護病房妄想記憶相關。邏輯斯迴歸結果顯示：年齡是影響加護病房記憶有無的影響因子，OR = 1.113，95% CI [1.012, 1.224]，p = .027；妄想記憶有無之影響因子為加護病房住院天數，OR =1.624，95% CI [1.066, 2.473]，p = .024。
結論：本研究發現納入研究之個案平均年齡屬於中高年齡層。雖然有加護病房記憶的病人佔了多數，但這裡面絕大多數的人是沒有清楚的加護病房記憶，家人的會客在加護病房事實記憶為最多人記得的記憶，疼痛也是在病人情感記憶佔了多數。年齡越大有越高的的機會沒有加護病房記憶，住院天數越長則有越高的機率有妄想記憶。因此高齡和加護病房住院天數較長的病人為沒有加護病房記憶和有妄想記憶的高風險族群，讓家屬參與病人的照護，提高病人的現實感有清楚的加護病房記憶，並做好疼痛控制及鎮靜藥物使用維持晝夜節律，以減輕疼痛及妄想的發生，讓病人能有清楚的加護病房記憶。

SUMMARY
ICU memory can be categorized as factual memory, emotional memory and delusional memory. Lack of ICU memory or have delusional memory can cause PTSD, anxiety and depression after leaving ICU. The aim for this study is to explore ICU memory and investigate the influencing factors of ICU memory. This cross-sectional study included 112 adult patients with surgical problems who were discharged from ICU. Patient’s ICU memory was measured using the ICU memory tool. Chi square and t test were used to analyze the relationship between ICU memory and demographic data and disease character. We found age and surgery type were related to ICU memory. Mechanical ventilation, sedative and analgesic agents were related to emotional memory. ICU length of stay, days of mechanical ventilation, days and dose of sedative and analgesic agents were related to delusional memory. Logistic regression was used to analyze influencing factors of ICU memory. We found age is a predictor of lack of ICU memory. ICU length of stay is also a predictor of the occurrence of delusional memory. Therefore nurses should pay more attention to elderly patients, those who stay longer in ICU and provide proper care to avoid ICU amnesia and formation of delusional memory.

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