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Peng MM, Liang Z, Wang P. Lifestyle factors, physical health, and life satisfaction under different changes in depressive symptoms among Chinese community-dwelling older adults: A longitudinal analysis. Int J Soc Psychiatry 2024:207640241255573. [PMID: 38824394 DOI: 10.1177/00207640241255573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
BACKGROUND The study aims to investigate the long-term impact of lifestyle-related factors and physical health on life satisfaction and depressive symptoms among Chinese community-dwelling older adults. METHODS Using data from the China Health and Retirement Longitudinal Study (CHARLS), the analytic sample of this study included 1,068 older adults who had participated in the surveys in both 2011 and 2018. Multivariate regression was employed to analyze both cross-sectional and longitudinal relationships between lifestyle-related factors, physical health, and subjective well-being - specifically depressive symptoms and life satisfaction. Additionally, the model tested how these factors correlate with life satisfaction across different groups of depressive symptom changes among older adults, categorized as not at risk of depression, intermittent depression, and chronic depression. RESULTS Multimorbidity was significantly related to baseline and follow-up depressive risk in older adults. Shorter sleep duration was associated with baseline depression risk. Current alcohol drinkers reported significantly more severe depressive symptoms than non-drinkers. At baseline, current smokers were more likely to have a lower degree of life satisfaction than nonsmokers. Among older adults with chronic depression at the 7-year follow-up, former smokers tended to have lower life satisfaction than nonsmokers. CONCLUSIONS Our findings identified drinking alcohol and having a shorter sleep duration as modifiable lifestyle-related risk factors for late-life depression and smoking as a detrimental factor for life satisfaction in older Chinese adults. Multimorbidity was a significant predictor of more depressive symptoms. Our findings have implications for future psychosocial interventions that target the alleviation of depressive symptoms and the promotion of life satisfaction in older Chinese people based on their different long-term mental and physical health conditions.
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Affiliation(s)
- Man-Man Peng
- Department of Social Work, The Chinese University of Hong Kong, Shatin, NT, China
| | - Zurong Liang
- Department of Sociology, Zhejiang University, Hangzhou, China
| | - Pengfei Wang
- School of Public Health, Fudan University, Shanghai, China
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Ageel M, Shbeer A, Tawhari M, Darraj H, Baiti M, Mobaraki R, Hakami A, Bakri N, Almahdi RH, Ageeli R, Mustafa M. Prevalence of Depression, Anxiety, and Post-traumatic Stress Syndrome Among Intensive Care Unit Survivors in Jazan, Saudi Arabia. Cureus 2024; 16:e60523. [PMID: 38883092 PMCID: PMC11180542 DOI: 10.7759/cureus.60523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2024] [Indexed: 06/18/2024] Open
Abstract
Objective To quantify the prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) among ICU survivors in the Jazan region, Saudi Arabia, and explore the correlational relationships among these conditions to inform targeted mental health interventions in this unique regional context. Methods The study employed a cross-sectional observational design to assess ICU survivors from two major hospitals in the Jazan Region: Prince Mohammed Bin Nasser Hospital and King Fahad Central Hospital. One hundred participants were interviewed face-to-face to gather detailed insights into their post-ICU experiences. We employed the hospital anxiety and depression scale (HADS) and the post-trauma symptom scale (PTSS-10) to systematically assess the psychological impacts of anxiety, depression, and PTSD among participants. Results The demographic breakdown of participants showed a youthful skew, with 37% under 35 years, 49% aged between 36-60 years, and only 14% over 60 years, contrasting with typical ICU demographics, which generally skew older. This younger distribution may influence the psychological outcomes observed. The sample was fairly gender-balanced, with 53% male and 47% female, closely reflecting the regional gender ratio of ICU admissions. Among the participants, 24% were classified as 'abnormal' and 20% as 'borderline abnormal' for anxiety, while 25% were 'borderline abnormal' and 21% 'abnormal' for depression. About 8% of participants were diagnosed with severe PTSD. Anxiety was more strongly correlated with PTSD than depression. The analysis demonstrated significant associations between demographic factors and psychological distress among ICU survivors. Females reported higher anxiety, while lower education and unemployment were associated with increased depression. Additionally, lower household income was associated with higher PTSS scores, and marital status was linked to depression, suggesting that socioeconomic factors play a critical role in post-ICU psychological recovery. Conclusion The findings emphasize the imperative need for comprehensive mental health evaluations and tailored interventions for ICU survivors in the Jazan region.
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Affiliation(s)
- Mohammed Ageel
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Abdullah Shbeer
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Mariam Tawhari
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Hussam Darraj
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Maisa Baiti
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Raghad Mobaraki
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Areej Hakami
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Nawaf Bakri
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Rahf H Almahdi
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Raghd Ageeli
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Mawada Mustafa
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
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3
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Mesina RS, Rustøen T, Hagen M, Laake JH, Hofsø K. Long-term functional disabilities in intensive care unit survivors: A prospective cohort study. Aust Crit Care 2024:S1036-7314(23)00197-2. [PMID: 38171986 DOI: 10.1016/j.aucc.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/16/2023] [Accepted: 11/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Functional disabilities are common in intensive care unit (ICU) survivors and may affect their ability to live independently. Few previous studies have investigated long-term functional outcomes with health status before ICU admission (pre-ICU health), and they are limited to specific patient groups. OBJECTIVES The objective of this study was to investigate the prevalence of functional disabilities and examine pre-ICU health variables as possible predictive factors of functional disabilities 12 months after ICU admission in a mixed population of ICU survivors. METHODS This prospective cohort study was conducted in six ICUs in Norway. Data on pre-ICU health were collected as soon as possible after ICU admission using patients, proxies, and patient electronic health records and at 12 months after ICU admission. Self-reported functional status was assessed using the Katz Index of independence in personal activities of daily living (P-ADL) and the Lawton instrumental activities of daily living scale (I-ADL). RESULTS A total of 220 of 343 (64%) ICU survivors with data on pre-ICU health completed the questionnaires at 12 months and reported the following functional disabilities at 12 months: 31 patients (14.4%) reported P-ADL dependencies (new in 16 and persisting in 15), and 80 patients (36.4%) reported I-ADL dependencies (new in 41 and persisting in 39). In a multivariate analysis, worse baseline P-ADL and I-ADL scores were associated with dependencies in P-ADLs (odds ratio [OR]: 1.87; 95% confidence interval [CI]: 1.14-3.06) and I-ADLs (OR: 1.52; 95% CI: 1.03-2.23), respectively, at 12 months. Patients who were employed were less likely to report I-ADL dependencies at 12 months (OR: 0.34; 95% CI: 0.12-0.95). CONCLUSION In a subsample of ICU survivors, patients reported functional disabilities 12 months after ICU admission, which was significantly associated with their pre-ICU functional status. Early screening of pre-ICU functional status may help identify patients at risk of long-term functional disabilities. ICU survivors with pre-ICU functional disabilities may find it difficult to improve their functional status.
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Affiliation(s)
- Renato S Mesina
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1078, Blindern NO-0316, Oslo, Norway.
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1078, Blindern NO-0316, Oslo, Norway
| | - Milada Hagen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Public Health, Faculty of Nursing Science, Oslo Metropolitan University, P.O. Box 4, St. Olavs Plass N-0130, Oslo, Norway
| | - Jon Henrik Laake
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Anaesthesiology and Intensive Care Medicine, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway
| | - Kristin Hofsø
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, P. O. Box 4950, Nydalen N-0424, Oslo, Norway; Lovisenberg Diaconal University College, Lovisenberggt. 15b, 0456, Oslo, Norway
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Bjørnøy I, Rustøen T, Mesina RJS, Hofsø K. Anxiety and depression in intensive care patients six months after admission to an intensive care unit: A cohort study. Intensive Crit Care Nurs 2023; 78:103473. [PMID: 37354695 DOI: 10.1016/j.iccn.2023.103473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES To measure the prevalence of anxiety and depression in intensive care patients six months after admission to an intensive care unit and to investigate which variables are associated with anxiety and depression at six months. RESEARCH METHODOLOGY In this cohort study, patient-reported outcome measures were collected as soon as possible upon admission and at six months. Two logistic regression models were performed to examine variables associated with reporting anxiety and depression above ≥8 at six months. SETTING Patients were recruited from six intensive care units in two Norwegian hospitals between 2018 and 2020. MAIN OUTCOME MEASURES The Hospital Anxiety and Depression Scale. RESULTS A total of 145 patients was included in the study. The patients reported a prevalence of 18.6% (n = 27) and 12.4% (n = 18) of anxiety and depression, respectively. Higher baseline anxiety scores were associated with both higher odds of reporting anxiety and depression above ≥8. Younger age was associated with higher odds of reporting anxiety, and being female was associated with lower odds of reporting depression. CONCLUSION Several intensive care survivors reported having symptoms of anxiety and depression six months after admission to the intensive care unit. Younger age, and higher anxiety scores at baseline were variables associated with higher odds of reporting symptoms of either anxiety or depression, while being female was associated with a lower odds of reporting depression. IMPLICATIONS FOR CLINICAL PRACTICE Screening patients for anxiety and depression may help to identify vulnerable patients. Structured follow-ups with intensive care nurses in an outpatient setting may be useful to help patients to work through some of the experiences from the intensive care unit.
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Affiliation(s)
- Ingrid Bjørnøy
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Lovisenberg gt 15b, N-0456 Oslo, Norway; Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1078 Blindern, NO-0316 Oslo, Norway.
| | - Renato Jr Santiago Mesina
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.
| | - Kristin Hofsø
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Lovisenberg gt 15b, N-0456 Oslo, Norway; Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.
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5
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Yuan C, Xiao Y, Wang F, Wang Y, Wang Y, Lin F. The effect of video visitation on intensive care unit patients and family members outcomes during the COVID-19 pandemic: A randomised controlled trial. Intensive Crit Care Nurs 2023; 76:103394. [PMID: 36731263 PMCID: PMC9852363 DOI: 10.1016/j.iccn.2023.103394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/19/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate the effect of video visitation on intensive care patients' and family members' outcomes during the COVID-19 pandemic. DESIGN This is a randomised controlled trial. SETTING An adult intensive care unit in a tertiary hospital in Beijing, China. METHODS A total of 121 adults, who were >18 years of age, conscious, able to communicate verbally, and admitted to the intensive care unit for over 24 hours were randomised into the intervention (video visitation) (n = 65) and control (n = 56) Groups. A total of 98 family members participated. Patient primary outcomes included anxiety and depression, measured using the Hospital Anxiety and Depression Scale. Secondary outcomes included patient delirium and family anxiety assessed using the Confusion Assessment Method scale and Self-Rating Anxiety Scale, respectively; and patient and family satisfaction, measured using a questionnaire routinely used in the hospital. RESULTS There were no statistically significant differences between the groups in patients' anxiety (t = 1.328, p = 0.187) and depression scores (t = 1.569, p = 0.119); and no statistically significant differences in delirium incidence between the groups (7.7 % vs 7.1 %, p > 0.05). There were no significant differences in changes in family members' anxiety scores (t = 0.496, p = 0.621). A statistically significant difference in satisfaction was found between the two group patients (86.1 % vs 57.2 % of patients were satisfied with using video visitation, p < 0.05), and the result of family members' satisfaction was also statistically significant (88 % vs 62.5 % of family members were satisfied with using video visitation, p < 0.05). CONCLUSION Video visitation did not seem to influence anxiety, but the use of video visitation can improve the patient and their family members' satisfaction. Future research is needed to determine the feasibility of embedding video visitation into routine practice, and the optimal frequency and length of video visitation in relation to patients' and family members' outcomes. IMPLICATIONS FOR CLINICAL PRACTICE Video visitation improved patient and family members' satisfaction. Therefore, clinicians should consider using video visitation when face to face visit is restricted. Video visVitation did not reduce patient anxiety significantly in this study maybe because the average length of intensive care stay was too short. Future research is needed on its effect on long term intensive care patients.
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Affiliation(s)
- Cui Yuan
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China,Corresponding authors
| | - Yanyan Xiao
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Fang Wang
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yi Wang
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yaqing Wang
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Frances Lin
- School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia,Corresponding authors
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6
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Knauert MP, Ayas NT, Bosma KJ, Drouot X, Heavner MS, Owens RL, Watson PL, Wilcox ME, Anderson BJ, Cordoza ML, Devlin JW, Elliott R, Gehlbach BK, Girard TD, Kamdar BB, Korwin AS, Lusczek ER, Parthasarathy S, Spies C, Sunderram J, Telias I, Weinhouse GL, Zee PC. Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2023; 207:e49-e68. [PMID: 36999950 PMCID: PMC10111990 DOI: 10.1164/rccm.202301-0184st] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Background: Sleep and circadian disruption (SCD) is common and severe in the ICU. On the basis of rigorous evidence in non-ICU populations and emerging evidence in ICU populations, SCD is likely to have a profound negative impact on patient outcomes. Thus, it is urgent that we establish research priorities to advance understanding of ICU SCD. Methods: We convened a multidisciplinary group with relevant expertise to participate in an American Thoracic Society Workshop. Workshop objectives included identifying ICU SCD subtopics of interest, key knowledge gaps, and research priorities. Members attended remote sessions from March to November 2021. Recorded presentations were prepared and viewed by members before Workshop sessions. Workshop discussion focused on key gaps and related research priorities. The priorities listed herein were selected on the basis of rank as established by a series of anonymous surveys. Results: We identified the following research priorities: establish an ICU SCD definition, further develop rigorous and feasible ICU SCD measures, test associations between ICU SCD domains and outcomes, promote the inclusion of mechanistic and patient-centered outcomes within large clinical studies, leverage implementation science strategies to maximize intervention fidelity and sustainability, and collaborate among investigators to harmonize methods and promote multisite investigation. Conclusions: ICU SCD is a complex and compelling potential target for improving ICU outcomes. Given the influence on all other research priorities, further development of rigorous, feasible ICU SCD measurement is a key next step in advancing the field.
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Survivorship After Critical Illness and Post-Intensive Care Syndrome. Clin Chest Med 2022; 43:551-561. [PMID: 36116822 DOI: 10.1016/j.ccm.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Improvements in critical care medicine have led to a marked increase in survivors of the intensive care unit (ICU). These survivors encounter many difficulties following ICU discharge. The term post -intensive care syndrome (PICS) provides a framework for identifying the most common symptoms which fall into three domains: cognitive, physical, and mental health. There are numerous risk factors for the development of PICS including premorbid conditions and specific elements of ICU hospitalizations. Management is complex and should take an individualized approach with interdisciplinary care. Future research should focus on prevention, identification, and treatment of this unique population.
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8
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Tingey JL, Dasher NA, Bunnell AE, Starosta AJ. Intensive Care-Related Cognitive Impairment: A Biopsychosocial Overview. PM R 2022; 14:259-272. [PMID: 35077003 DOI: 10.1002/pmrj.12773] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/21/2022] [Accepted: 01/21/2022] [Indexed: 11/10/2022]
Abstract
Advancements in critical care medicine have improved survival rates for patients experiencing critical illness in intensive care units (ICUs). While mortality has declined, more than half of ICU survivors experience functional impairments that persist beyond discharge. Of particular concern is ICU-related cognitive impairment, which can extend across the care continuum, ranging from acute and transient presentations in the ICU (eg, delirium) to long-term impairments years after discharge. ICU-related cognitive impairment has received increased attention in the literature, particularly as it relates to ICU survivors who have received and survived critical care in the context of SARS-CoV-2 pandemic and are now experiencing post-acute sequelae of SARS-CoV-2 infection. The medical complexity and heterogeneity of ICU survivors, coupled with the multifactorial etiology of ICU-related cognitive impairments, lead to challenges in how to optimize care for ICU survivors at various stages of recovery. This review aims to provide an overview of cognitive outcomes associated with critical illness by integrating recent literature focused on etiology, assessment, and interventions in the context of ICU-related cognitive impairments. The narrative review employs a biopsychosocial framework to comprehensively evaluate the multifactorial nature of ICU-related cognitive outcomes. Authors also highlight multidisciplinary teams composed of key rehabilitation providers are likely best suited for optimizing recovery trajectories of ICU survivors. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jamie L Tingey
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Nickolas A Dasher
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Aaron E Bunnell
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Amy J Starosta
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, United States
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9
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Tugnoli S, Spadaro S, Corte FD, Valpiani G, Volta CA, Caracciolo S. Health Related Quality of Life and Mental Health in ICU Survivors: Post-Intensive Care Syndrome Follow-Up and Correlations between the 36-Item Short Form Health Survey (SF-36) and the General Health Questionnaire (GHQ-28). Health (London) 2022. [DOI: 10.4236/health.2022.145037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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10
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Hill JE, Twamley J, Breed H, Kenyon R, Casey R, Zhang J, Clegg A. Scoping review of the use of virtual reality in intensive care units. Nurs Crit Care 2021; 27:756-771. [PMID: 34783134 DOI: 10.1111/nicc.12732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND A wide range of reviews have demonstrated the effectiveness and tolerability of Virtual Reality (VR) in a range of clinical areas and subpopulations. However, no previous review has explored the current maturity, acceptability, tolerability, and effectiveness of VR with intensive care patients. AIMS To identify the range of uses of VR for intensive care patients, classify their current phase of development, effectiveness, acceptability, and tolerability. METHODS A scoping review was conducted. A multi-database search was undertaken (inception to January 2021). Any type of study which examined the use of VR with the target application population of intensive care patients were included. Screening, data extraction, and assessment of quality were undertaken by a single reviewer. A meta-analysis and a descriptive synthesis were undertaken. RESULTS Six hundred and forty-seven records were identified, after duplicate removal and screening 21 studies were included (weak quality). The majority of studies for relaxation, delirium, and Post Traumatic Stress Disorder (PTSD) were at the early stages of assessing acceptability, tolerability, and initial clinical efficacy. Virtual Reality for relaxation and delirium were well-tolerated with completion rates of target treatment of 73.6%, (95% CI:51.1%-96%, I2 = 98.52%) 52.7% (95% CI:52.7%-100%, I2 = 96.8%). The majority of reasons for non-completion were due to external clinical factors. There were some potential benefits demonstrated for the use of VR for relaxation, delirium, and sleep. CONCLUSION Virtual Reality for intensive care is a new domain of research with the majority of areas of application being in the early stages of development. There is great potential for the use of VR in this clinical environment. Further robust assessment of effectiveness is required before any clinical recommendations can be made.
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Affiliation(s)
- James Edward Hill
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - Jacqueline Twamley
- Intensive Care Nurse/Academic Research and Innovation Manager, Centre for Health Research and Innovation, NIHR Lancashire Clinical Research Facility, UK
| | - Hetty Breed
- Faculty of Biology, Medicine and Health, Manchester University, Manchester, UK
| | - Roger Kenyon
- Community Engagement & Service User Support, University of Central Lancashire, Preston, UK
| | - Rob Casey
- Digital Therapy Solutions to Empower Stroke, Dementia, Parkinson's Rehabilitation, DancingMind Pte Ltd, Singapore
| | | | - Andrew Clegg
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
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Higgins AM, Neto AS, Bailey M, Barrett J, Bellomo R, Cooper DJ, Gabbe BJ, Linke N, Myles PS, Paton M, Philpot S, Shulman M, Young M, Hodgson CL. Predictors of death and new disability after critical illness: a multicentre prospective cohort study. Intensive Care Med 2021; 47:772-781. [PMID: 34089063 DOI: 10.1007/s00134-021-06438-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/15/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to determine the prevalence and predictors of death or new disability following critical illness. METHODS Prospective, multicentre cohort study conducted in six metropolitan intensive care units (ICU). Participants were adults admitted to the ICU who received more than 24 h of mechanical ventilation. The primary outcome was death or new disability at 6 months, with new disability defined by a 10% increase in the WHODAS 2.0. RESULTS Of 628 patients with the primary outcome available (median age of 62 [49-71] years, 379 [61.0%] had a medical admission and 370 (58.9%) died or developed new disability by 6 months. Independent predictors of death or new disability included age [OR 1.02 (1.01-1.03), P = 0.001], higher severity of illness (APACHE III) [OR 1.02 (1.01-1.03), P < 0.001] and admission diagnosis. Compared to patients with a surgical admission diagnosis, patients with a cardiac arrest [OR (95% CI) 4.06 (1.89-8.68), P < 0.001], sepsis [OR (95% CI) 2.43 (1.32-4.47), P = 0.004], or trauma [OR (95% CI) 6.24 (3.07-12.71), P < 0.001] diagnosis had higher odds of death or new disability, while patients with a lung transplant [OR (95% CI) 0.21 (0.07-0.58), P = 0.003] diagnosis had lower odds. A model including these three variables had good calibration (Brier score 0.20) and acceptable discriminative power with an area under the receiver operating characteristic curve of 0.76 (95% CI 0.72-0.80). CONCLUSION Less than half of all patients mechanically ventilated for more than 24 h were alive and free of new disability at 6 months after admission to ICU. A model including age, illness severity and admission diagnosis has acceptable discriminative ability to predict death or new disability at 6 months.
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Affiliation(s)
- A M Higgins
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - A Serpa Neto
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia.,Department of Intensive Care, Austin Health, Melbourne, VIC, Australia.,Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - M Bailey
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
| | - J Barrett
- Intensive Care Unit, Epworth Healthcare, Melbourne, VIC, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - R Bellomo
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia.,Department of Intensive Care, Austin Health, Melbourne, VIC, Australia
| | - D J Cooper
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia
| | - B J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - N Linke
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - P S Myles
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Anaesthesiology and Perioperative Medicine, The Alfred, Melbourne, VIC, Australia
| | - M Paton
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Physiotherapy, Monash Health, Melbourne, VIC, Australia
| | - S Philpot
- Intensive Care Unit, Cabrini Health, Melbourne, VIC, Australia
| | - M Shulman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Anaesthesiology and Perioperative Medicine, The Alfred, Melbourne, VIC, Australia
| | - M Young
- Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia
| | - C L Hodgson
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia. .,Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia.
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12
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Xu T, Wang Y, Wang R, Lamb KV, Ren D, Dai G, Wang L, Yue P. Predictors of caring ability and its dimensions among nurses in China: A cross-sectional study. Scand J Caring Sci 2020; 35:1226-1239. [PMID: 33615516 DOI: 10.1111/scs.12941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2020] [Accepted: 11/15/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Caring is an essential component of professional nursing practice, which directly affects the quality of patient care. Nurses' caring ability may not meet patients' demands for high-quality care. There are challenges in designing and implementing interventions to improve nurses' caring ability, especially in China. Understanding Chinese nurses' caring ability and related influential factors serves as the basis for effective interventions to improve their ability to care for patients. AIM To describe the caring ability of nurses and its potential predictors in China. METHODS From January to February 2018, a cross-sectional survey was conducted among 2304 Registered Nurses working at different levels of hospitals across 29 provinces in China. The structured online survey included socio-demographic information, Caring Ability Inventory, Caring Efficacy Scale and Professional Quality of Life. Descriptive statistics, univariate analyses and multivariate analyses were conducted. RESULTS Overall caring ability and its three dimensions of the participants were all significantly lower than the Nkongho' norm, an international scoring standard of nurse's caring ability. Age, employment type, workplace, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were predictors of knowing, explaining 41.8% of the variance. Predictors of courage were educational level, bereavement experience, caring efficacy, compassion satisfaction and burnout (31.7% of the variance). Educational level, workplace, exposure to critically ill patients, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were influencing factors of patience, accounting for 19.5% of the variance. CONCLUSIONS Chinese nurses' caring ability, with patience, knowing, and courage in descending order. Particular attention needs to be paid to the courage dimension of the nurses' caring ability. Further, the predictors of overall caring ability and each dimension were diverse. These results indicate that nurse educators and administrators need to identify training priorities and design targeted interventions based on the influencing factors.
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Affiliation(s)
- Tianmeng Xu
- School of Nursing, Capital Medical University, Beijing, China
| | - Yongli Wang
- Yuetan Community Health Service Center, Fuxing Hospital of Capital Medical University, Beijing, China
| | - Rongjin Wang
- School of Nursing, Capital Medical University, Beijing, China
| | - Karen V Lamb
- College of Nursing, Rush University, Chicago, IL, USA
| | - Dianxu Ren
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Guizhi Dai
- Community Health Care Service Center of Dongcheng District, Beijing, China
| | - Li Wang
- Fangzhuang Community Health Care Service Center of Fengtai District, Beijing, China
| | - Peng Yue
- School of Nursing, Capital Medical University, Beijing, China
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ICU Recovery Clinic Attendance, Attrition, and Patient Outcomes: The Impact of Severity of Illness, Gender, and Rurality. Crit Care Explor 2020; 2:e0206. [PMID: 33063022 PMCID: PMC7523871 DOI: 10.1097/cce.0000000000000206] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Supplemental Digital Content is available in the text. Objectives: The primary purpose is to characterize patients attending ICU recovery clinic and then describe their trajectory of cognitive and emotional health in 1 year. Design: Retrospective observational study to assess attendance, attrition, and patient outcomes. Setting: ICU Recovery Clinic. Patients: Adult patients recently admitted to ICU for sepsis or acute respiratory failure and who were referred to clinic. Interventions: None. Measurements and Main Results: Thirty-eight patients (63%) attended ICU recovery clinic with a mean age of 53.2 ± 16 years (range, 20–82 yr), 42% female and mean Sequential Organ Failure Assessment scores at an ICU admission of 9.4 ± 2.9 participated in outcomes. Twelve patients (32%) were lost to follow up and 12 patients (32%) were transferred to different providers before the end of 1 year. Sequential Organ Failure Assessment scores were negatively associated with health-related quality of life at baseline (r = –0.41; p = 0.033; n = 28) and short term (r = –0.40; p = 0.037; n = 27). Male patients had higher Sequential Organ Failure Assessment scores (mean difference = 2.4; t = 2.779; p = 0.008) and longer hospital length of stay (mean difference = 9.3; t = 2.27; p = 0.029). Female patients had higher scores on Hospital Anxiety and Depression Scale (mean difference = 7.2; t = 2.74; p = 0.01) and Impact of Events Scale-Revised (mean difference = 18.9; t = 2.74; p = 0.011) at the initial follow-up visit. Patients never attending clinic were more likely to live further away, have a tracheotomy, and spent longer time in the ICU. Conclusions: Attendance and attrition in ICU recovery clinic are related to patient factors (living in rural area) and ICU factors. Data suggest different recovery trajectories exist based on gender, severity of illness, and self-reported outcomes.
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14
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Evans AC, Bufka LF. The Critical Need for a Population Health Approach: Addressing the Nation's Behavioral Health During the COVID-19 Pandemic and Beyond. Prev Chronic Dis 2020; 17:E79. [PMID: 32762806 PMCID: PMC7417017 DOI: 10.5888/pcd17.200261] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The COVID-19 global pandemic highlights the necessity for a population health approach to identify and implement strategies across systems to improve behavioral health. Adopting a population health approach helps to address the needs of the total population, including at-risk subgroups, through multiple levels of intervention and to promote the public’s behavioral health and psychological well-being.
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Affiliation(s)
- Arthur C Evans
- American Psychological Association, Washington, District of Columbia
| | - Lynn F Bufka
- American Psychological Association, 750 First St, NE, Washington, DC 20002.
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15
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Miranda-Ackerman RC, Lira-Trujillo M, Gollaz-Cervantez AC, Cortés-Flores AO, Zuloaga-Fernández Del Valle CJ, García-González LA, Morgan-Villela G, Barbosa-Camacho FJ, Pintor-Belmontes KJ, Guzmán-Ramírez BG, Bernal-Hernández A, Fuentes-Orozco C, González-Ojeda A. Associations between stressors and difficulty sleeping in critically ill patients admitted to the intensive care unit: a cohort study. BMC Health Serv Res 2020; 20:631. [PMID: 32646516 PMCID: PMC7346515 DOI: 10.1186/s12913-020-05497-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/01/2020] [Indexed: 01/14/2023] Open
Abstract
Background Patients admitted to the intensive care unit (ICU) experience sleep disruption caused by a variety of conditions, such as staff activities, alarms on monitors, and overall noise. In this study, we explored the relationship between noise and other factors associated with poor sleep quality in patients. Methods This was a prospective cohort study. We used the Richards–Campbell Sleep Questionnaire to explore sleep quality in a sample of patients admitted to the ICU of a private hospital. We measured the noise levels within each ICU three times a day. After each night during their ICU stay, patients were asked to complete a survey about sleep disturbances. These disturbances were classified as biological (such as anxiety or pain) and environmental factors (such as lighting and ICU noise). Results We interviewed 71 patients; 62% were men (mean age 54.46 years) and the mean length of stay was 8 days. Biological factors affected 36% and environmental factors affected 20% of the patients. The most common biological factor was anxiety symptoms, which affected 28% of the patients, and the most common environmental factor was noise, which affected 32.4%. The overall mean recorded noise level was 62.45 dB. Based on the patients’ responses, the environmental factors had a larger effect on patients’ sleep quality than biological factors. Patients who stayed more than 5 days reported less sleep disturbance. Patients younger than 55 years were more affected by environmental and biological factors than were those older than 55 years. Conclusions Patient quality of sleep in the ICU is associated with environmental factors such as noise and artificial lighting, as well as biological factors related to anxiety and pain. The noise level in the ICU is twice that recommended by international guides. Given the stronger influence of environmental factors, the use of earplugs or sleeping masks is recommended. The longer the hospital stay, the less these factors seem to affect patients’ sleep quality.
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Affiliation(s)
| | | | | | | | | | | | | | - Francisco José Barbosa-Camacho
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Avenida Belisario Domínguez # 1000 Col. Independencia, 44340, Guadalajara, Jalisco, Mexico
| | - Kevin Josue Pintor-Belmontes
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Avenida Belisario Domínguez # 1000 Col. Independencia, 44340, Guadalajara, Jalisco, Mexico
| | - Bertha Georgina Guzmán-Ramírez
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Avenida Belisario Domínguez # 1000 Col. Independencia, 44340, Guadalajara, Jalisco, Mexico
| | - Aldo Bernal-Hernández
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Avenida Belisario Domínguez # 1000 Col. Independencia, 44340, Guadalajara, Jalisco, Mexico
| | - Clotilde Fuentes-Orozco
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Avenida Belisario Domínguez # 1000 Col. Independencia, 44340, Guadalajara, Jalisco, Mexico
| | - Alejandro González-Ojeda
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Avenida Belisario Domínguez # 1000 Col. Independencia, 44340, Guadalajara, Jalisco, Mexico.
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Zucato da Silva C, José Gomes Campos C, Ferraz Martins Jamarim M, Marcondes pimentel de abreu lima G. Experiencias de pacientes con discapacidades funcionales posteriores al tratamiento en la Unidad de Cuidados Intensivos. REVISTA CUIDARTE 2020. [DOI: 10.15649/cuidarte.1018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: Comprender las experiencias de los pacientes con discapacidades funcionales después del tratamiento en la Unidad de Cuidados Intensivos a su regreso a casa. Materiales y métodos: Se trata de un estudio de enfoque cualitativo que utilizó el estudio de caso como método de investigación. La muestra de ocho participantes fue compuesta intencionalmente y cerrada por saturación teórica. La recolección de datos se realizó a través de entrevistas domiciliarias semiestructuradas complementadas con notas y diarios de campo. Los datos fueron analizados mediante el análisis de contenido temático propuesto por Minayo. Resultados: La atención primaria, a través de la atención domiciliaria, fue la principal responsable del seguimiento posterior al alta de los participantes. Del material empírico, surgieron las categorías "sufrimiento emocional y sus repercusiones en la recuperación funcional" y "la pérdida del rol familiar y los conflictos con los cuidadores". Discusión y conclusiones: La recuperación funcional de pacientes con discapacidades funcionales después de pasar por cuidados intensivos puede ser compleja y requiere, además de rehabilitación física, monitoreo psicoemocional adecuado, aclaración de los recuerdos de hospitalización y apoyo profesional a la familia. Se sugiere que la atención primaria reciba capacitación sobre la complejidad de estos pacientes y la creación de estrategias que lo acerquen a la atención hospitalaria, lo que permite una atención compartida y continua.
Como citar este artículo: Silva, Camila Zucato; Campos, Claudinei José Gomes; Jamarim, Michelle Ferraz Martins; Lima, Gerusa Marcondes Pimentel de Abreu. Vivências de pacientes diante de incapacidades funcionais pós-tratamento em Unidade de Terapia Intensiva. Revista Cuidarte. 2020; 11(2): e1018. http://dx.doi.org/10.15649/cuidarte.1018
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Jeong YJ, Kang J. Development and validation of a questionnaire to measure post-intensive care syndrome. Intensive Crit Care Nurs 2019; 55:102756. [PMID: 31522829 DOI: 10.1016/j.iccn.2019.102756] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/09/2019] [Accepted: 08/26/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study aimed to develop a Post-Intensive Care Syndrome Questionnaire (PICSQ) and assess the psychometric properties of PICSQ in intensive care unit survivors. METHODS PICSQ items were generated through relevant literature reviews, qualitative interviews among survivors, and multiple rounds of content validity evaluations by experts. Data were collected from 536 survivors at seven health care facilities in three cities of Korea from June to August 2018. The validity and reliability of PICSQ were assessed using exploratory factor analysis, confirmatory factor analysis, internal consistency and correlation coefficients. RESULTS The final PICSQ consisted of 18 items. Through exploratory factor analysis, three factors (mental, cognitive and physical) were derived. The reliability of PICSQ was represented by a Cronbach's α of 0.93, while the internal consistency of each factor was good (Cronbach's α = 0.84 to 0.90). The model fit of PICSQ was satisfactory and confirmatory factor analysis demonstrated good convergent and discriminant validity of the questionnaire. CONCLUSION Because PICSQ is valid and reliable, it is recommended for use in clinical practice and research to assess post-intensive care syndrome in intensive care survivors.
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Affiliation(s)
- Yeon Jin Jeong
- Department of Nursing, Dongju College, Busan, South Korea
| | - Jiyeon Kang
- College of Nursing, Dong-A University, Busan, South Korea.
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18
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Balczon R, Pittet JF, Wagener BM, Moser SA, Voth S, Vorhees CV, Williams MT, Bridges JP, Alvarez DF, Koloteva A, Xu Y, Zha XM, Audia JP, Stevens T, Lin MT. Infection-induced endothelial amyloids impair memory. FASEB J 2019; 33:10300-10314. [PMID: 31211919 PMCID: PMC6704457 DOI: 10.1096/fj.201900322r] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/21/2019] [Indexed: 01/14/2023]
Abstract
Patients with nosocomial pneumonia exhibit elevated levels of neurotoxic amyloid and tau proteins in the cerebrospinal fluid (CSF). In vitro studies indicate that pulmonary endothelium infected with clinical isolates of either Pseudomonas aeruginosa, Klebsiella pneumoniae, or Staphylococcus aureus produces and releases cytotoxic amyloid and tau proteins. However, the effects of the pulmonary endothelium-derived amyloid and tau proteins on brain function have not been elucidated. Here, we show that P. aeruginosa infection elicits accumulation of detergent insoluble tau protein in the mouse brain and inhibits synaptic plasticity. Mice receiving endothelium-derived amyloid and tau proteins via intracerebroventricular injection exhibit a learning and memory deficit in object recognition, fear conditioning, and Morris water maze studies. We compared endothelial supernatants obtained after the endothelia were infected with P. aeruginosa possessing an intact [P. aeruginosa isolated from patient 103 (PA103) supernatant] or defective [mutant strain of P. aeruginosa lacking a functional type 3 secretion system needle tip complex (ΔPcrV) supernatant] type 3 secretion system. Whereas the PA103 supernatant impaired working memory, the ΔPcrV supernatant had no effect. Immunodepleting amyloid or tau proteins from the PA103 supernatant with the A11 or T22 antibodies, respectively, overtly rescued working memory. Recordings from hippocampal slices treated with endothelial supernatants or CSF from patients with or without nosocomial pneumonia indicated that endothelium-derived neurotoxins disrupted the postsynaptic synaptic response. Taken together, these results establish a plausible mechanism for the neurologic sequelae consequent to nosocomial bacterial pneumonia.-Balczon, R., Pittet, J.-F., Wagener, B. M., Moser, S. A., Voth, S., Vorhees, C. V., Williams, M. T., Bridges, J. P., Alvarez, D. F., Koloteva, A., Xu, Y., Zha, X.-M., Audia, J. P., Stevens, T., Lin, M. T. Infection-induced endothelial amyloids impair memory.
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Affiliation(s)
- Ron Balczon
- Department of Biochemistry and Molecular Biology, University of South Alabama, Mobile, Alabama, USA
- Center for Lung Biology, University of South Alabama, Mobile, Alabama, USA
| | - Jean-Francois Pittet
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Brant M. Wagener
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Stephen A. Moser
- Department of Pathology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Sarah Voth
- Center for Lung Biology, University of South Alabama, Mobile, Alabama, USA
- Department of Physiology and Cell Biology, University of South Alabama, Mobile, Alabama, USA
| | - Charles V. Vorhees
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio, USA
| | | | - James P. Bridges
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Diego F. Alvarez
- Center for Lung Biology, University of South Alabama, Mobile, Alabama, USA
- Department of Physiology and Cell Biology, University of South Alabama, Mobile, Alabama, USA
| | - Anna Koloteva
- Department of Physiology and Cell Biology, University of South Alabama, Mobile, Alabama, USA
| | - Yuanyuan Xu
- Department of Physiology and Cell Biology, University of South Alabama, Mobile, Alabama, USA
| | - Xiang-Ming Zha
- Department of Physiology and Cell Biology, University of South Alabama, Mobile, Alabama, USA
| | - Jonathon P. Audia
- Center for Lung Biology, University of South Alabama, Mobile, Alabama, USA
- Department of Microbiology and Immunology, University of South Alabama, Mobile, Alabama, USA
| | - Troy Stevens
- Center for Lung Biology, University of South Alabama, Mobile, Alabama, USA
- Department of Physiology and Cell Biology, University of South Alabama, Mobile, Alabama, USA
- Department of Internal Medicine, University of South Alabama, Mobile, Alabama, USA
| | - Mike T. Lin
- Center for Lung Biology, University of South Alabama, Mobile, Alabama, USA
- Department of Physiology and Cell Biology, University of South Alabama, Mobile, Alabama, USA
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Zengin N, Ören B, Üstündag H. The relationship between stressors and intensive care unit experiences. Nurs Crit Care 2019; 25:109-116. [PMID: 31407452 DOI: 10.1111/nicc.12465] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 06/12/2019] [Accepted: 06/20/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patients in intensive care units (ICUs) face many physical and psychological stressors because of the environment of these units and their own critical conditions and experience stress in various degrees. Each stressor may affect patients' experiences in ICUs differently. AIM AND OBJECTIVES This study aimed to examine the relationship between stressors and patients' experiences in an ICU. METHODS This descriptive, cross-sectional study was conducted between September 2014 and June 2015 in a university hospital and included 116 patients who were admitted to the general ICU for at least 24 hours. Data were collected using the Intensive Care Experience Scale and a questionnaire that included questions about socio-demographic and disease-related characteristics of patients and their stressors. RESULTS The mean age of the patients was 57.81 ± 13.81 years, and the mean duration of ICU stay was 2.28 ± 3.88 days. There was a moderate positive relation between the stressors noise (r = .534; P < .01), thirst (r = .438; P < .01), loneliness (r = .410; P < .01), and pain (r = .404; P < .01) and the subscale frightening experiences. However, there was a moderate, negative relation between the stressors inability to speak (r = -.444; P < .01), surrounding speeches (r = -.458; P < .01), equipment noise (r = -.490; P < .01), and physical exercise (r = -.546; P < .01) and the subscale satisfaction with care. CONCLUSIONS The patients associated stressors with satisfaction and frightening experiences in the early period of their discharge from the ICU. As stressors increases, so do frightening experiences, and satisfaction with care is affected negatively. RELEVANCE TO CLINICAL PRACTICE Currently, stressors to which patients discharged from ICU are exposed during their admission to wards are not evaluated in practice. This study is important in that it can help health professionals be aware of effects of stressors on patients in the early period of their discharge.
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Affiliation(s)
- Neriman Zengin
- Faculty of Health Sciences, Department of Midwifery, University of Health Science, Istanbul, Turkey
| | - Besey Ören
- Faculty of Health Sciences, Department of Midwifery, University of Health Science, Istanbul, Turkey
| | - Hülya Üstündag
- Faculty of Health Sciences, Department of Nursing, İstanbul Bilgi University, Istanbul, Turkey
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Proffitt T, Menzies V. Relationship of symptoms associated with ICU-survivorship: An integrative literature review. Intensive Crit Care Nurs 2019; 53:60-67. [PMID: 30878537 DOI: 10.1016/j.iccn.2019.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/23/2019] [Accepted: 02/23/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The number of adults who survive a critical illness involving admission to an intensive care unit is increasing. These survivors have an increased risk of developing impairments in cognition, physical function and psychological health. OBJECTIVE This integrative literature review examined the literature for studies exploring the relationships among two or more of the variables of interest, i.e. cognitive, physical, and psychological symptoms (depressive, anxiety, or posttraumatic stress) in intensive care unit survivors post-hospital discharge. METHODS A literature search was conducted using PubMed, CINHAL and PsycINFO databases. FINDINGS While all 13 studies included in the review explored some aspect of a relationship among the variables of interest, none explored associations among all three variables. Five studies explored physical function and psychological symptoms, four studies explored cognitive impairment and psychological symptoms and five studies explored the association among different psychological symptoms. Inconsistencies were found in the study designs, follow-up time frames, patient populations and measures used. CONCLUSIONS Further research using well-designed methodologies and standardized instruments is warranted. Gaining a better understanding of the relationships among these impairments has the potential to contribute to the development of screening guidelines, preventative strategies, and treatments.
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Affiliation(s)
- Tracye Proffitt
- Virginia Commonwealth University School of Nursing, 1100 East Leigh Street, Box 980567, Richmond, VA 23298-0567, United States.
| | - Victoria Menzies
- Virginia Commonwealth University School of Nursing, 1100 East Leigh Street, Box 980567, Richmond, VA 23298-0567, United States
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Kang J, Jeong YJ. Embracing the new vulnerable self: A grounded theory approach on critical care survivors’ post-intensive care syndrome. Intensive Crit Care Nurs 2018; 49:44-50. [DOI: 10.1016/j.iccn.2018.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/25/2018] [Accepted: 08/10/2018] [Indexed: 11/29/2022]
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Ohtake PJ, Lee AC, Scott JC, Hinman RS, Ali NA, Hinkson CR, Needham DM, Shutter L, Smith-Gabai H, Spires MC, Thiele A, Wiencek C, Smith JM. Physical Impairments Associated With Post-Intensive Care Syndrome: Systematic Review Based on the World Health Organization's International Classification of Functioning, Disability and Health Framework. Phys Ther 2018; 98:631-645. [PMID: 29961847 DOI: 10.1093/ptj/pzy059] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 03/29/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND Post-intensive care syndrome (PICS) is a constellation of new or worsening impairments in physical, mental, or cognitive abilities or a combination of these in individuals who have survived critical illness requiring intensive care. PURPOSE The 2 purposes of this systematic review were to identify the scope and magnitude of physical problems associated with PICS during the first year after critical illness and to use the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to elucidate impairments of body functions and structures, activity limitations, and participation restrictions associated with PICS. DATA SOURCES Ovid MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CINAHL Plus with Full Text (EBSCO), Web of Science, and Embase were searched from inception until March 7, 2017. STUDY SELECTION Two reviewers screened titles, abstracts, and full text to independently determine study eligibility based on inclusion and exclusion criteria. DATA EXTRACTION Study methodological quality was assessed using the Newcastle-Ottawa Scale. Data describing study methods, design, and participant outcomes were extracted. DATA SYNTHESIS Fifteen studies were eligible for review. Within the first year following critical illness, people who had received intensive care experienced impairments in all 3 domains of the ICF (body functions and structures, activity limitations, and participation restrictions). These impairments included decreased pulmonary function, reduced strength of respiratory and limb muscles, reduced 6-minute walk test distance, reduced ability to perform activities of daily living and instrumental activities of daily living, and reduced ability to return to driving and paid employment. LIMITATIONS The inclusion of only 15 observational studies in this review may limit the generalizability of the findings. CONCLUSIONS During the first year following critical illness, individuals with PICS experienced physical impairments in all 3 domains of the ICF.
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Affiliation(s)
- Patricia J Ohtake
- Department of Rehabilitation Science, University at Buffalo, 515 Kimball Tower, Buffalo, NY 14214 (USA)
| | - Alan C Lee
- Department of Physical Therapy, Mount St Mary's University, Los Angeles, California
| | | | - Rana S Hinman
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Naeem A Ali
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Carl R Hinkson
- Respiratory Care, Providence Regional Medical Center Everett, Everett, Washington
| | - Dale M Needham
- Pulmonary & Critical Care Medicine and Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, Maryland
| | - Lori Shutter
- Critical Care Medicine, UPMC/University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Helene Smith-Gabai
- Program in Occupational Therapy, Brenau University, Gainesville, Georgia
| | - Mary C Spires
- Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan
| | | | - Clareen Wiencek
- School of Nursing, University of Virginia, Charlottesville, Virginia
| | - James M Smith
- Physical Therapy Department, Utica College, Utica, New York
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Choi J, Lingler JH, Donahoe MP, Happ MB, Hoffman LA, Tate JA. Home discharge following critical illness: A qualitative analysis of family caregiver experience. Heart Lung 2018; 47:401-407. [PMID: 29731146 PMCID: PMC6026552 DOI: 10.1016/j.hrtlng.2018.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 04/08/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Few studies have longitudinally explored the experience and needs of family caregivers of ICU survivors after patients' home discharge. METHODS Qualitative content analysis of interviews drawn from a parent study that followed family caregivers of adults ICU survivors for 4 months post-ICU discharge. RESULTS Family caregivers (n = 20, all white, 80% woman) viewed home discharge as positive progress, but reported having insufficient time to transition from family visitor to the active caregiver role. Caregivers expressed feelings of relief during the steady recovery of family members' physical and cognitive function. However, the slow pace of improvement conflicted with their expectations. Even after patients achieved independent physical function, emotional needs persisted and these issues contributed to caregivers' anxiety, worry, and view that recovery was incomplete. CONCLUSION Family caregivers of ICU survivors need information and skills to help managing patients' care needs, pacing expectations with actual patients' progress, and caregivers' health needs.
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Affiliation(s)
- JiYeon Choi
- Department of Acute and Tertiary Care, University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA; Yonsei University College of Nursing, Seoul, Republic of Korea.
| | - Jennifer H Lingler
- Department of Health and Community Systems, University of Pittsburg, School of Nursing, Pittsburgh, PA, USA
| | - Michael P Donahoe
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Mary Beth Happ
- Center of Excellence in Critical and Complex Care, The Ohio State University College of Nursing, Columbus, OH, USA
| | - Leslie A Hoffman
- Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Judith A Tate
- The Ohio State University College of Nursing, Columbus, OH, USA
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24
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Parsons EC, Hough CL, Vitiello MV, Palen B, Zatzick D, Davydow DS. Validity of a single PTSD checklist item to screen for insomnia in survivors of critical illness. Heart Lung 2018; 47:87-92. [PMID: 29449026 DOI: 10.1016/j.hrtlng.2017.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 12/26/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND There is no insomnia screening tool validated in intensive care unit (ICU) survivors. OBJECTIVES To examine the validity of a single item from the PTSD checklist-Civilian version (PCL-C) to detect insomnia by Insomnia Severity Index (ISI) METHODS: We performed a secondary analysis of data from a longitudinal investigation in 120 medical-surgical ICU survivors. At 1 year post-ICU, patients completed ISI, PCL-C, and Medical Short-Form 12 (SF-12) by telephone. A single PCL-C item rates difficulty initiating or maintaining sleep over the past month. We compared performance characteristics of this PCL-C item to ISI-defined insomnia (ISI ≥15). RESULTS A score of ≥3 on the PCL-C sleep item exhibited 91% sensitivity and 67% specificity for ISI-defined insomnia (ISI ≥ 15), and it demonstrated construct validity by correlation to related QOL indices. CONCLUSIONS A single PCL-C sleep item score ≥ 3 is a reasonable screen to identify insomnia symptoms in ICU survivors.
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Affiliation(s)
- Elizabeth C Parsons
- VA Puget Sound Health Care System, Seattle, WA; Division of Pulmonary, Critical Care, Sleep Medicine, University of Washington, Seattle, WA.
| | - Catherine L Hough
- Division of Pulmonary, Critical Care, Sleep Medicine, University of Washington, Seattle, WA
| | - Michael V Vitiello
- Department of Psychiatry & Behavioral Sciences, University of Washington, Harborview Medical Center, Seattle, WA
| | - Brian Palen
- VA Puget Sound Health Care System, Seattle, WA; Division of Pulmonary, Critical Care, Sleep Medicine, University of Washington, Seattle, WA
| | - Douglas Zatzick
- Department of Psychiatry & Behavioral Sciences, University of Washington, Harborview Medical Center, Seattle, WA
| | - Dimitry S Davydow
- Division of Behavioral Health, CHI Franciscan Health System, Tacoma, WA
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25
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Langerud AK, Rustøen T, Småstuen MC, Kongsgaard U, Stubhaug A. Intensive care survivor-reported symptoms: a longitudinal study of survivors' symptoms. Nurs Crit Care 2017; 23:48-54. [PMID: 29243344 DOI: 10.1111/nicc.12330] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/30/2017] [Accepted: 11/06/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is growing interest in potential long-term outcomes following intensive care, but few researchers have studied the prevalence of multiple symptoms or the association between pain and other symptoms. AIMS To investigate the prevalence of anxiety, depression, fatigue, sleep disturbance and post-traumatic stress symptoms (PTSS) among intensive care survivors 3 months and 1 year after being discharged from an intensive care unit (ICU) and to determine whether pain is associated with higher prevalence of these symptoms 3 months and 1 year after ICU stay. STUDY DESIGN Exploratory, longitudinal cohort of intensive care survivors from two mixed ICUs in a tertiary referral hospital in Norway. METHODS Intensive care survivors completed surveys at 3 months (n = 118) and 1 year (n = 89) after ICU discharge. Clinical Trials: NCT02279212. RESULTS Prevalence rates of intensive care survivors' symptoms were pain 58 (49·2%), anxiety/depression 24/118 (20·8%), fatigue 18/118(15·3%), PTSS 15 (12·8%) and sleep disturbance 58/118 (49·2%) at 3 months after ICU discharge (n = 118). Prevalence rates at 1 year (n = 89) changed only slightly to pain 34 (38·2%), anxiety/depression 17 (20·0%), fatigue 12 (13·8%), PTSS 13 (15·1%) and sleep disturbance 40/89 (46·5%). Associations were strong between pain and presence of sleep disturbance, anxiety/depression, PTSS and fatigue. CONCLUSIONS Intensive care survivors have multiple symptoms and the prevalence rates of these symptoms remained almost unchanged from 3 months to 1 year after ICU discharge. The presence of pain was associated with high odds for the presence of sleep disturbance, anxiety/depression, PTSS and fatigue, compared to a no-pain group. ICU survivors may benefit from targeted interventions designed to alleviate the symptom burden. RELEVANCE TO CLINICAL PRACTICE Knowledge about ICU survivor's prevalence and risk for having multiple symptoms may help health care professionals to give better care, if needed, to the ICU survivors.
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Affiliation(s)
- Anne Kathrine Langerud
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Department of Post-operative and Critical Care, Division of Emergencies and Critical Care Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Ullevål, Oslo, Norway.,Institute of Health and Society, Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Ulf Kongsgaard
- Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Audun Stubhaug
- Department of Pain Management and Reserch, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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26
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Quality of Life and Related Factors Among Patients Discharged from Critical Care Units. ACTA ACUST UNITED AC 2017. [DOI: 10.5812/ccn.62148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ohtake PJ, Coffey Scott J, Hinman RS, Lee AC, Smith JM. Impairments, activity limitations and participation restrictions experienced in the first year following a critical illness: protocol for a systematic review. BMJ Open 2017; 7:e013847. [PMID: 28119388 PMCID: PMC5278234 DOI: 10.1136/bmjopen-2016-013847] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Critical illness requiring intensive care unit (ICU) management is a life-altering event with ∼25% of ICU survivors experiencing persistent reductions in physical functioning, impairments in mental health, cognitive dysfunction and decreased quality of life. This constellation of problems is known as 'postintensive care syndrome' (PICS) and may persist for months and/or years. The purpose of this systematic review is to identify the scope and magnitude of physical problems associated with PICS during the first year after discharge from ICU, using the International Classification of Functioning, Disability and Health framework to elucidate the impairments of body functions and structures, activity limitations and participation restrictions. METHODS AND ANALYSIS Medline (Ovid), Cochrane Database of Systematic Reviews (Ovid), Cochrane Central Register of Controlled Trials (Ovid), PubMed, CINAHL (EBSCO), Web of Science and EMBASE will be systematically searched for observational studies reporting the physical impairments of body functions and structures, activity limitations and participation restrictions associated with PICS. Two reviewers will assess the articles for eligibility according to prespecified selection criteria, after which an independent reviewer will perform data extraction which will be validated by a second independent reviewer. Quality appraisal will be performed by two independent reviewers. Outcomes of the included studies will be summarised in tables and in narrative format and meta-analyses will be conducted where appropriate. ETHICS AND DISSEMINATION Formal ethical approval is not required as no primary data is collected. This systematic review will identify the scope and magnitude of physical problems associated with PICS during the first year after discharge from ICU and will be disseminated through a peer-reviewed publication and at conference meetings, to inform practice and future research on the physical problems associated with PICS. TRIAL REGISTRATION NUMBER CRD42015023520.
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Affiliation(s)
- Patricia J Ohtake
- Department of Rehabilitation Science, University at Buffalo, Buffalo, New York, USA
| | | | - Rana S Hinman
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alan Chong Lee
- Department of Physical Therapy, Mount Saint Mary's University, Los Angeles, California, USA
| | - James M Smith
- Physical Therapy Department, Utica College, Utica, New York, USA
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