长期重症监护后的健康相关生活质量和疾病负担：患者报告结局测量工具的开发。

Long-term health-related quality of life and burden of disease after intensive care: development of a patient-reported outcome measure.

机构信息

Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, 413 45, Gothenburg, Sweden.

Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, 413 45, Gothenburg, Sweden.

出版信息

Crit Care. 2021 Feb 25;25(1):82. doi: 10.1186/s13054-021-03496-7.

DOI:10.1186/s13054-021-03496-7

PMID:33632271

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7905420/

Abstract

BACKGROUND

ICU survivorship includes a diverse burden of disease. Current questionnaires used for collecting information about health-related problems and their relation to quality of life lack detailed questions in several areas relevant to ICU survivors. Our aim was to construct a provisional questionnaire on health-related issues based on interviews with ICU survivors and to test if this questionnaire was able to show differences between ICU survivors and a control group.

METHODS

Thirty-two ICU survivors were identified at a post-ICU clinic and interviewed at least six months after ICU discharge. Using an established qualitative methodology from oncology, all dysfunctions and disabilities were extracted, rephrased as questions and compiled into a provisional questionnaire. In a second part, this questionnaire was tested on ICU survivors and controls. Inclusion criteria for the ICU survivors were ICU stay at least 72 h with ICU discharge six months to three years prior to the study. A non-ICU-treated control group was obtained from the Swedish Population Register, matched for age and sex. Eligible participants received an invitation letter and were contacted by phone. If willing to participate, they were sent the questionnaire. Descriptive statistics were applied.

RESULTS

Analysis of the interviews yielded 238 questions in 13 domains: cognition, fatigue, physical health, pain, psychological health, activities of daily living, sleep, appetite and alcohol, sexual health, sensory functions, gastrointestinal functions, urinary functions and work life. In the second part, 395 of 518 ICU survivors and 197 of 231 controls returned a completed questionnaire, the response rates being 76.2% and 85.3%, respectively. The two groups differed significantly in 13 of 22 comorbidities. ICU survivors differed in a majority of questions (p ≤ 0.05) distributed over all 13 domains compared with controls.

CONCLUSIONS

This study describes the development of a provisional questionnaire to identify health-related quality of life issues and long-term burden of disease after intensive care. The questionnaire was answered by 395 ICU survivors. The questionnaire could identify that they experience severe difficulties in a wide range of domains compared with a control group. Trial registry ClinicalTrials.gov Ref# NCT02767180.

摘要

背景

重症监护病房（ICU）幸存者存在多种疾病负担。目前用于收集与健康相关问题及其与生活质量关系信息的问卷在几个与 ICU 幸存者相关的领域缺乏详细问题。我们的目的是根据 ICU 幸存者的访谈构建一个与健康相关问题的暂定问卷，并测试该问卷是否能够显示 ICU 幸存者与对照组之间的差异。

方法

在 ICU 后诊所确定了 32 名 ICU 幸存者，并在 ICU 出院后至少 6 个月进行访谈。使用肿瘤学中已建立的定性方法，提取所有功能障碍和残疾，将其重新表述为问题，并编入暂定问卷。在第二部分，将该问卷用于 ICU 幸存者和对照组。ICU 幸存者的纳入标准为 ICU 住院时间至少 72 小时，ICU 出院时间为研究前 6 个月至 3 年。从瑞典人口登记处获得未接受 ICU 治疗的对照组，按年龄和性别匹配。合格的参与者收到邀请信，并通过电话联系。如果愿意参加，他们会收到问卷。应用描述性统计。

结果

访谈分析产生了 238 个问题，涉及 13 个领域：认知、疲劳、身体健康、疼痛、心理健康、日常生活活动、睡眠、食欲和酒精、性功能、感觉功能、胃肠道功能、泌尿系统功能和工作生活。在第二部分，518 名 ICU 幸存者中有 395 名和 231 名对照组中有 197 名完成了问卷，回复率分别为 76.2%和 85.3%。两组在 22 种合并症中的 13 种有显著差异。与对照组相比，ICU 幸存者在 13 个问题中存在差异（p≤0.05），分布在所有 13 个领域。