1 Outcomes After Critical Illness and Surgery Group, and.
2 Division of Pulmonary and Critical Care Medicine.
Ann Am Thorac Soc. 2019 Jun;16(6):731-737. doi: 10.1513/AnnalsATS.201812-851OC.
Increasingly, patients are surviving acute respiratory failure (ARF), prompting the need to better understand standardized outcome measures commonly used during ARF follow-up studies. Investigate standardized outcome measures (patient-reported physical and mental health measures, and cognitive testing) compared with findings from semistructured, qualitative interviews. As part of two ARF multicenter follow-up studies, standardized outcome measures were obtained, followed by qualitative evaluation via an in-depth, semistructured interview conducted and coded by two independent researchers. Qualitative interviews revealed the following post-ARF survivorship themes: physical impairment; anxiety, depression, and post-traumatic stress disorder symptoms; and cognitive impairment. Scores from standardized measures related to these themes were compared for ARF survivors reporting versus not reporting these themes in their qualitative interviews. Of 59 invited ARF survivors, 48 (81%) completed both standardized outcome measures and qualitative interviews. Participants' median (interquartile range) age was 53 (43-64) years; 54% were female, and 88% were living independently before hospitalization. The two independent reviewers classifying the presence or absence of themes from the qualitative interviews had excellent agreement (κ = 0.80). There were significantly worse scores on standardized outcome measures for survivors reporting (vs. not reporting) physical and mental health impairments in their qualitative interviews. However, standardized cognitive test scores did not differ between patients reporting versus not reporting cognitive impairments in their qualitative interviews. These findings support the use of recommended, commonly used standardized outcome measures for physical and mental health impairments in ARF survivorship research. However, caution is needed in interpreting self-reported cognitive function compared with standardized cognitive testing.
越来越多的急性呼吸衰竭(ARF)患者存活下来,这促使我们需要更好地了解 ARF 随访研究中常用的标准化结局指标。调查标准化结局指标(患者报告的身体和心理健康指标,以及认知测试)与半结构化定性访谈的结果相比。作为两项 ARF 多中心随访研究的一部分,我们获得了标准化结局指标,然后通过由两名独立研究人员进行和编码的深入半结构化定性访谈进行定性评估。定性访谈揭示了 ARF 幸存者的以下生存主题:身体功能障碍;焦虑、抑郁和创伤后应激障碍症状;以及认知障碍。对报告这些主题的 ARF 幸存者与未报告这些主题的幸存者进行比较,对标准化测量结果进行评分。在邀请的 59 名 ARF 幸存者中,有 48 名(81%)完成了标准化结局指标和定性访谈。参与者的中位(四分位间距)年龄为 53(43-64)岁;54%为女性,88%在住院前独立生活。两名独立的评分者对定性访谈中主题的存在或不存在进行分类的一致性非常好(κ=0.80)。在定性访谈中报告身体和心理健康障碍的幸存者的标准化结局指标评分明显更差(与未报告者相比)。然而,在定性访谈中报告认知障碍的患者与未报告者的标准化认知测试评分无差异。这些发现支持在 ARF 生存研究中使用推荐的常用标准化身体和心理健康结局指标。然而,与标准化认知测试相比,在解释自我报告的认知功能时需要谨慎。
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