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Lobo-Valbuena B, Molina R, Castañeda-Vozmediano R, Lopez de la Oliva Calvo L, Abella A, Garcia-Arias MM, Salinas Gabiña I, Gordo F. Functional independence, frailty and perceived quality of life in patients who developed delirium during ICU stay: a prospective cohort study. Eur J Med Res 2023; 28:560. [PMID: 38049839 PMCID: PMC10696684 DOI: 10.1186/s40001-023-01530-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Survivors of critical illness are frequently left with a long-lasting disability. We hypothesised that patients who developed delirium during ICU stay, compared with patients who did not, would have worse health-related quality of life following a critical illness. METHODS Prospective longitudinal observational and analytical study assessing functional independence, frailty and perceived quality of life measured with the Barthel Index, the Clinical Frailty Scale, and the SF-36, comparing patients who developed delirium during ICU stay and patients who did not. The questionnaires were used at different times during the follow-up (upon ICU admission, at ICU discharge, at hospital discharge and 2 years after hospital discharge). RESULTS In a cohort of 1462 patients, we matched 93 patients who developed delirium (delirium group) with 93 patients who did not develop delirium (no-delirium group). Of 156 completed questionnaires (84.7%), we observed that (a) in each of the two groups of patients, the scores related to functional independence (Barthel Index) and frailty (Clinical Frailty Scale) tended to improve over time (p < 0.001), being consistently less favourable in the delirium group compared to the no-delirium group (p < 0.001); (b) the patients who developed delirium also presented lower scores on the SF-36 scale, these differences being statistically significant, and therefore evidencing a worse quality of life, with impact on both the psychological and social spheres (p < 0.001). CONCLUSIONS Patients who developed delirium had significantly lower scores 2 years after hospital discharge on the three used questionnaires, displaying a clear negative impact on the physical, psychological, and social dimensions. The study's results reinforce the need to support and strengthen the care of ICU survivors.
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Affiliation(s)
- Beatriz Lobo-Valbuena
- Intensivist - Intensive Care Unit, Hospital Universitario del Henares, Coslada, Madrid, Spain.
- Grupo de Investigación en Patología Crítica, Facultad de Ciencias de La Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain.
| | - Rosario Molina
- Intensivist - Intensive Care Unit, Hospital Universitario del Henares, Coslada, Madrid, Spain
- Grupo de Investigación en Patología Crítica, Facultad de Ciencias de La Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Raúl Castañeda-Vozmediano
- Research Support Unit, Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | | | - Ana Abella
- Intensivist - Intensive Care Unit, Hospital Universitario del Henares, Coslada, Madrid, Spain
- Grupo de Investigación en Patología Crítica, Facultad de Ciencias de La Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - María-Mercedes Garcia-Arias
- Intensivist - Intensive Care Unit, Hospital Universitario del Henares, Coslada, Madrid, Spain
- Grupo de Investigación en Patología Crítica, Facultad de Ciencias de La Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Irene Salinas Gabiña
- Intensivist - Intensive Care Unit, Hospital Universitario del Henares, Coslada, Madrid, Spain
- Grupo de Investigación en Patología Crítica, Facultad de Ciencias de La Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Federico Gordo
- Intensivist - Intensive Care Unit, Hospital Universitario del Henares, Coslada, Madrid, Spain
- Grupo de Investigación en Patología Crítica, Facultad de Ciencias de La Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
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Chan PY, Tay A, Chen D, De Freitas M, Millet C, Nguyen-Duc T, Duke G, Lyall J, Nguyen JT, McNeil J, Hopper I. Ambient intelligence-based monitoring of staff and patient activity in the intensive care unit. Aust Crit Care 2023; 36:92-98. [PMID: 36244918 DOI: 10.1016/j.aucc.2022.08.011] [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: 03/23/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Caregiver workload in the ICU setting is difficult to numerically quantify. Ambient Intelligence utilises computer vision-guided neural networks to continuously monitor multiple datapoints in video feeds, has become increasingly efficient at automatically tracking various aspects of human movement. OBJECTIVES To assess the feasibility of using Ambient Intelligence to track and quantify allpatient and caregiver activity within a bedspace over the course of an ICU admission and also to establish patient specific factors, and environmental factors such as time ofday, that might contribute to an increased workload in ICU workers. METHODS 5000 images were manually annotated and then used to train You Only LookOnce (YOLOv4), an open-source computer vision algorithm. Comparison of patientmotion and caregiver activity was then performed between these patients. RESULTS The algorithm was deployed on 14 patients comprising 1762800 framesof new, untrained data. There was a strong correlation between the number ofcaregivers in the room and the standardized movement of the patient (p < 0.0001) withmore caregivers associated with more movement. There was a significant difference incaregiver activity throughout the day (p < 0.05), HDU vs. ICU status (p < 0.05), delirious vs. non delirious patients (p < 0.05), and intubated vs. not intubated patients(p < 0.05). Caregiver activity was lowest between 0400 and 0800 (average .71 ± .026caregivers per hour) with statistically significant differences in activity compared to 0800-2400 (p < 0.05). Caregiver activity was highest between 1200 and 1600 (1.02 ± .031 caregivers per hour) with a statistically significant difference in activity comparedto activity from 1600 to 0800 (p < 0.05). The three most dominant predictors of workeractivity were patient motion (Standardized Dominance 78.6%), Mechanical Ventilation(Standardized Dominance 7.9%) and Delirium (Standardized Dominance 6.2%). CONCLUSION Ambient Intelligence could potentially be used to derive a single standardized metricthat could be applied to patients to illustrate their overall workload. This could be usedto predict workflow demands for better staff deployment, monitoring of caregiver workload, and potentially as a tool to predict burnout.
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Affiliation(s)
- Peter Y Chan
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Victoria, Australia; School of Public Health and Prevention Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Andrew Tay
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Victoria, Australia
| | - David Chen
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Victoria, Australia
| | - Maria De Freitas
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Victoria, Australia
| | - Coralie Millet
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Victoria, Australia
| | - Thanh Nguyen-Duc
- School of Public Health and Prevention Medicine, Monash University, Melbourne, Victoria, Australia
| | - Graeme Duke
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Victoria, Australia
| | - Jessica Lyall
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Victoria, Australia
| | - John T Nguyen
- School of Public Health and Prevention Medicine, Monash University, Melbourne, Victoria, Australia
| | - John McNeil
- School of Public Health and Prevention Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ingrid Hopper
- School of Public Health and Prevention Medicine, Monash University, Melbourne, Victoria, Australia
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Sathvik S, Krishnaraj L, Irfan M. Evaluation of sleep quality and duration using wearable sensors in shift laborers of construction industry: A public health perspective. Front Public Health 2022; 10:952901. [PMID: 36203668 PMCID: PMC9530656 DOI: 10.3389/fpubh.2022.952901] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/15/2022] [Indexed: 01/24/2023] Open
Abstract
Approximately 21% of the workers in developing and developed countries are shift laborers. The laborer's work shifts can affect personal life and sleep standards, adversely impacting laborers and their manage. This study assesses the impact of various shift plans (seven evenings/7 days, fixed-night or fixed-day, and backup shifts) on shift laborers, considering four shift schedules. Most laborers were on rotational shifts, whereas others were on a permanent day, permanent night, and standby shifts. In a cross-sectional study, 45 development laborers from the National Construction firm were enlisted. Bio-wearable sensors were provided to monitor sleep. Participants were approached and asked to complete a survey bundle comprising the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). Differences in sleep models were estimated using a Fitbit watch at various shift schedules. The average age of laborers who participated in the study was 37.5 years, and their average experience in the construction company was 6.5 years. The average total sleep time was 346 ± 46 min. The rotational shift laborers yielded the minimum total sleep time compared to the average PSQI and ESS scores of 7.66 ± 1.3 and 6.94 ± 3.4, respectively. Fifteen shift laborers (33.33%) were affected by a sleeping disorder in the present experimental investigation, and 30 participants had inadequate standards of sleep based on the PSQI scores. Poor sleep quality and duration among construction shift laborers decrease productivity at work. Additional studies are expected to assess sleep-related issues affecting construction shift laborers.
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Affiliation(s)
- S. Sathvik
- Department of Civil Engineering, Faculty of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - L. Krishnaraj
- Department of Civil Engineering, Faculty of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India,*Correspondence: L. Krishnaraj
| | - Muhammad Irfan
- Faculty of Management Science, Department of Business Administration, ILMA University, Karachi, Pakistan,Muhammad Irfan
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Bellon F, Beti-Abad A, Pastells-Peiró R, Casado-Ramirez E, Moreno-Casbas T, Gea-Sánchez M, Abad-Corpa E. Effects of nursing interventions to improve inpatients' sleep in intensive and non-intensive care units: Findings from an umbrella review. J Clin Nurs 2022; 32:1963-1978. [PMID: 35170142 DOI: 10.1111/jocn.16251] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/24/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
AIM This review aimed to synthesise the available reviews on the effects of nursing interventions on sleep quality among patients hospitalised in intensive care and non-intensive care units. BACKGROUND Poor sleep quality is a common fact in hospitalised patients. Nurses can contribute to the improvement of patients' sleep quality and duration. DESIGN A review of intervention reviews was carried out and reported following the PRISMA guidelines and checklist. METHODS We systematically searched for reviews published from January 2009 to December 2019 in PubMed, CINAHL Plus, Scopus, Institute for Scientific Information Web of Science, Joanna Briggs Database of Systematic Reviews and Cochrane Central Register of Controlled Trials databases. Searches were repeated at 24 November 2020 to include the most recent evidence. A narrative synthesis of the results was conducted. RESULTS Nine reviews (representing 109 original papers) met the selection criteria and were included for critical appraisal. Overall, nursing interventions and sleep quality were poorly defined. We grouped the interventions into 3 categories (environmental, barrier and internal interventions) to provide a more comprehensive overview and examine effects of nursing interventions on inpatients sleep quality. Inconsistent results were obtained and low quality of the original articles was reported, making it difficult to establish absolute conclusions. CONCLUSION The impact of environmental changes on patients' sleep was positive but inconclusive, while use of earplugs and eye masks, music and acupuncture generally showed positive results with moderate quality of evidence, and no harmful effects were reported.
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Affiliation(s)
- Filip Bellon
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain
| | - Aintzane Beti-Abad
- Department of Infectious Diseases, Basurto University Hospital, Bilbao, Spain
| | - Roland Pastells-Peiró
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain
| | | | - Teresa Moreno-Casbas
- Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain.,Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain.,Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Eva Abad-Corpa
- Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain.,University of Murcia-Murcia Health Service (IMIB-Arrixaca), Murcia, Spain
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