Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov 26;2(4):359-369.
doi: 10.1016/j.mayocpiqo.2018.10.001. eCollection 2018 Dec.

Improving Quality of Life in Patients at Risk for Post-Intensive Care Syndrome

Lisa M Daniels  1 , Andrea B Johnson  1 , Patrick J Cornelius  2 , Catherine Bowron  3 , Andrea Lehnertz  3 , Mitch Moore  4 , YongChun Shen  5 , Philip J Schulte  6 , Richard S Pendegraft  6 , Kristin R Hall  2 , Philippe R Bauer  1
Affiliations

Improving Quality of Life in Patients at Risk for Post-Intensive Care Syndrome

Lisa M Daniels et al. Mayo Clin Proc Innov Qual Outcomes. .

Abstract

Objective: To improve quality of life (QOL) in patients at risk for post-intensive care syndrome (PICS).

Patients and methods: We conducted a mixed-method, prospective, observational, pre-post interventional study in an adult medical and mixed medical/surgical/transplant intensive care unit (ICU) at a tertiary academic hospital. Preintervention included patients admitted from October 1 through October 31, 2016, and postintervention included patients admitted from January 15 through February 14, 2017. First, a multidisciplinary team of stakeholders identified barriers associated with decreased QOL in patients at risk for PICS. Next, interventions were designed and implemented. The effect of interventions was assessed using a mixed-method analysis. The qualitative analysis used a modified grounded theory approach. The quantitative analysis included assessment of preexisting symptoms and risk factors associated with PICS. The 36-Item Short-Form Health Status Survey (SF-36), which surveys physical and mental composite scores, was used to assess QOL.

Results: Barriers identified were lack of awareness and understanding of PICS. Interventions included educational videos, paper and online education and treatment materials, and online and in-person support groups for education and treatment. After interventions, the qualitative analysis found that patients who participated in the interventions after hospital discharge showed improved QOL, whereas education during hospitalization alone was not effective. The quantitative analysis did not find improvement in QOL, as defined by SF-36 physical or mental composite scores.

Conclusion: Interventions targeted to patients after hospitalization may offer subjective improvement in QOL for those at risk for PICS.

Keywords: ADL, activities of daily living; APACHE, Acute Physiology, Age, Chronic Health Evaluation; BMI, body mass index; ED, emergency department; ICU, intensive care unit; OT, occupational therapy; PICS, post–intensive care syndrome; PT, physical therapy; QOL, quality of life; SF-36, 36-Item Short-Form Health Status Survey.

PubMed Disclaimer

Figures

Figure
Figure
Flow diagram of included and excluded patients in the preintervention and postintervention phases. ICU = intensive care unit.
See this image and copyright information in PMC

References

    1. Kaukonen K.M., Bailey M., Suzuki S., et al. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA. 2014;311(13):1308–1316. - PubMed
    1. Wunsch H., Angus D.C., Harrison D.A., et al. Variation in critical care services across North America and Western Europe. Crit Care Med. 2008;36(10):2787–2793. e1-e9. - PubMed
    1. Vincent J.L., Marshall J.C., Namendys-Silva S.A., et al. Assessment of the worldwide burden of critical illness: the intensive care over nations (ICON) audit. Lancet Respir Med. 2014;2(5):380–386. - PubMed
    1. Adhikari N.K., Fowler R.A., Bhagwanjee S., et al. Critical care and the global burden of critical illness in adults. Lancet. 2010;376(9749):1339–1346. - PMC - PubMed
    1. Critical care statistics: critical care patients. http://www.sccm.org/Communications/Critical-Care-Statistics Society of Critical Care Medicine website.

LinkOut - more resources