Departments of Intensive Care, Linköping University, County Council of Östergötland, Sweden; Clinical and Experimental Medicine, Linköping University, County Council of Östergötland, Sweden.
Medicine and Health Sciences, Linköping University, County Council of Östergötland, Sweden.
J Crit Care. 2017 Oct;41:58-63. doi: 10.1016/j.jcrc.2017.04.044. Epub 2017 Apr 28.
To assess the independent associations between ability to cope and hopelessness with measures of health-related quality of life (HRQoL) and their effects on mortality up to 3 years after discharge in patients who have been treated in an intensive care unit (ICU).
A prospective, cross-sectional multicenter study of 980 patients. Ability to cope, hopelessness, and HRQoL were evaluated using validated scales. Questionnaires were sent to patients 6, 12, 24, and 36 months after discharge from ICU.
After adjustment, low scores for ability to cope and high scores for hopelessness were both related to poorer HRQoL for all subscales (except for coping with bodily pain). Effects were in the same range as coexisting disease for physical subscales, and stronger for social and mental subscales. High scores for hopelessness also predicted mortality up to 3 years after discharge from ICU (p<0.001).
The psychological factors ability to cope and hopelessness both strongly affected HRQoL after ICU care, and this effect was stronger than the effects of coexisting disease. Hopelessness also predicted mortality after critical illness. Awareness of the psychological state of patients after a stay in ICU is important to identify which of them are at risk.
评估在重症监护病房（ICU）接受治疗的患者出院后 3 年内，应对能力和绝望感与健康相关生活质量（HRQoL）测量之间的独立关联及其对死亡率的影响。
这是一项前瞻性、横断面多中心研究，共纳入了 980 名患者。使用经过验证的量表评估应对能力、绝望感和 HRQoL。在 ICU 出院后 6、12、24 和 36 个月时向患者发送问卷。
调整后，应对能力评分低和绝望感评分高均与所有子量表（除应对身体疼痛外）的 HRQoL 较差相关。其影响与共存疾病对身体子量表的影响相当，对社会和心理子量表的影响更强。绝望感评分高也预测了 ICU 出院后 3 年内的死亡率（p<0.001）。
心理因素应对能力和绝望感均强烈影响 ICU 治疗后的 HRQoL，其影响强于共存疾病的影响。绝望感也预测了危重病后的死亡率。了解 ICU 后患者的心理状态对于识别处于危险中的患者非常重要。
