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对脓毒症幸存者最重要的是什么:一项定性分析,以确定特定的与健康相关的生活质量领域。

What matters most to sepsis survivors: a qualitative analysis to identify specific health-related quality of life domains.

机构信息

Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.

Integrated Research and Treatment Center for Sepsis Control and Care (CSCC), Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.

出版信息

Qual Life Res. 2019 Mar;28(3):637-647. doi: 10.1007/s11136-018-2028-8. Epub 2018 Oct 22.

Abstract

PURPOSE

It is unknown how sepsis survivors conceptualize health-related quality of life (HRQL). We aimed to identify important HRQL domains for this population.

METHODS

A literature search was performed to inform an interview guide. Open-ended interviews were held with 15 purposefully sampled sepsis survivors. Interview transcripts were analyzed by interpretative phenomenological analysis to allow themes to develop organically. Resulting codes were reviewed by an independent expert. The preliminary list of domains was rated in a two-round Delphi consensus procedure with therapists and survivors.

RESULTS

Eleven domains emerged as critically important: Psychological impairment, Fatigue, Physical impairment, Coping with daily life, Return to normal living, Ability to walk, Cognitive impairment, Self-perception, Control over one's life, Family support, and Delivery of health care. Sepsis survivors want a "normal life," to walk again, and to regain control without cognitive impairment. Family support is essential to overcome sepsis aftermaths.

CONCLUSIONS

Survivors described many HRQL domains which are not captured by the QoL instruments that have traditionally been used to study ICU survivorship (i.e., SF-36 and EQ-5D). Future studies of QoL in ICU survivors should consider using both a traditional instrument so that results are comparable to previous research, as well as a more holistic QoL measurement instrument like the WHOQOL-BREF.

摘要

目的

目前尚不清楚脓毒症幸存者如何理解健康相关生活质量(HRQL)。我们旨在确定该人群重要的 HRQL 领域。

方法

进行文献检索,为访谈指南提供信息。对 15 名有针对性抽样的脓毒症幸存者进行了开放式访谈。通过解释性现象学分析对访谈记录进行分析,以便主题自然发展。由此产生的代码由独立专家进行审查。初步的领域清单在治疗师和幸存者的两轮 Delphi 共识程序中进行了评分。

结果

有 11 个领域被认为至关重要:心理障碍、疲劳、身体障碍、日常生活应对能力、恢复正常生活、行走能力、认知障碍、自我认知、对生活的控制、家庭支持以及医疗保健的提供。脓毒症幸存者希望过上“正常生活”,再次行走,并在没有认知障碍的情况下重新获得控制。家庭支持对于克服脓毒症后遗症至关重要。

结论

幸存者描述了许多 HRQL 领域,这些领域没有被传统上用于研究 ICU 幸存者的生活质量(即 SF-36 和 EQ-5D)工具所捕捉到。未来 ICU 幸存者生活质量的研究应同时考虑使用传统工具和更全面的生活质量测量工具,如 WHOQOL-BREF。

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