探索重症监护病房康复环境下的患者目标。
Exploring Patients' Goals Within the Intensive Care Unit Rehabilitation Setting.
机构信息
Joanne M. McPeake is a nurse consultant, clinical research in innovation, National Health Service (NHS) Greater Glasgow and Clyde, and honorary senior clinical lecturer, University of Glasgow School of Medicine, Dentistry and Nursing, Glasgow, Scotland. Michael O. Harhay is an instructor, Department of Biostatistics, Epidemiology and Informatics, and Palliative and Advanced Illness Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Helen Devine is a senior physiotherapist and Pamela MacTavish is a highly specialized pharmacist in the intensive care unit, Glasgow Royal Infirmary, Glasgow, Scotland. Theodore J. Iwashyna is a professor, Department of Internal Medicine, Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor and a research scientist, Center for Clinical Management Research, Veterans Affairs Ann Arbor Health System, Ann Arbor, Michigan. Mark Mikkelsen is an associate professor of medicine and chief of the Section of Medical Critical Care, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania Health System, and director of the medical intensive care unit, Penn Presbyterian Medical Center, Perelman School of Medicine, University of Pennsylvania. Martin Shaw is an honorary lecturer, School of Medicine, Dentistry and Nursing, University of Glasgow and principal clinical physicist, NHS Greater Glasgow and Clyde. Tara Quasim is a senior clinical lecturer, University of Glasgow School of Medicine, Dentistry and Nursing and an intensive care unit consultant, NHS Greater Glasgow and Clyde.
出版信息
Am J Crit Care. 2019 Sep;28(5):393-400. doi: 10.4037/ajcc2019436.
BACKGROUND
The number of patients surviving critical care is increasing. Quality of life after critical care is known to be poor for some patients. The evidence base for effective rehabilitation interventions in the period following a stay in an intensive care unit is limited.
OBJECTIVES
To understand what rehabilitation goals are important to patients after critical care discharge.
METHODS
This prospective study, which was undertaken during an intensive care unit recovery program, explored the recovery goals of 43 patients. Framework analysis was used to extract prevalent themes and identify the important components of recovery from the patients' perspective.
RESULTS
Participants described diverse goals for their post-intensive care unit recovery. Most goals were about health-related quality of life, including physical goals and rehabilitation. Although health was central to many of the participants' individual recovery aims, themes of family and social engagement and adopting appropriate goal trajectories also emerged within patient goals. Individual strategies for reaching these goals varied, and patients had different aspirations about what they could achieve.
CONCLUSIONS
Patients' aspirations for their intensive care unit recovery are diverse. Design of postdischarge care can be informed by this greater understanding of the heterogeneous starting points and goal trajectories of survivors of critical illness.
背景
越来越多的危重病患者得以幸存。一些患者在重症监护后生活质量较差，这是已知的事实。重症监护后有效康复干预的证据基础有限。
目的
了解危重病患者出院后哪些康复目标对他们很重要。
方法
这项前瞻性研究是在重症监护病房康复计划期间进行的，共调查了 43 名患者的康复目标。采用框架分析法提取常见主题，并从患者的角度确定康复的重要组成部分。
结果
参与者描述了他们在重症监护病房康复后的各种目标。大多数目标与健康相关的生活质量有关，包括身体目标和康复。尽管健康是大多数参与者个人康复目标的核心，但家庭和社会参与以及采取适当的目标轨迹的主题也出现在患者的目标中。达到这些目标的个人策略各不相同，患者对自己能够实现的目标也有不同的期望。
结论
患者对重症监护病房康复的期望是多样化的。通过更好地了解危重病幸存者的异质起点和目标轨迹，可以为出院后的护理提供信息。
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