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在 ICU 临床实践中使用长期预测的 ICU 后生活质量来使患者为 ICU 后生活做好准备:一项可行性研究。

Using long-term predicted Quality of Life in ICU clinical practice to prepare patients for life post-ICU: A feasibility study.

机构信息

Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Intensive Care, Nijmegen, the Netherlands.

出版信息

J Crit Care. 2022 Apr;68:121-128. doi: 10.1016/j.jcrc.2021.12.014. Epub 2022 Jan 7.

Abstract

PURPOSE

To examine the feasibility of using the PREdicting PAtients' long-term outcome for Recovery (PREPARE) prediction model for Quality of Life (QoL) 1 year after ICU admission in ICU practice to prepare expected ICU survivors and their relatives for life post-ICU.

MATERIALS AND METHODS

Between June 2020 and February 2021, the predicted change in QoL after 1 year was discussed in 25 family conferences in the ICU. 13 physicians, 10 nurses and 19 patients and/or family members were interviewed to evaluate intervention feasibility in ICU practice. Interviews were analysed qualitatively using thematic coding.

RESULTS

Patients' median age was 68.0 years, five patients (20.0%) were female and seven patients (28.0%) died during ICU stay. Generally, study participants thought the intervention, which clarified the concept of QoL through visualization and served as a reminder to discuss QoL and expectations for life post-ICU, had merit. However, some participants, especially physicians, thought the prediction model needed more data on more severely ill ICU patients to curb uncertainty.

CONCLUSIONS

Using predicted QoL scores in ICU practice to prepare patients and family members for life after ICU discharge is feasible. After optimising the model and implementation strategy, its effectiveness can be evaluated in a larger trial.

摘要

目的

检验在 ICU 实践中使用预测患者长期康复结局(PREPARE)预测模型预测 ICU 入住 1 年后生活质量(QoL),从而使预期 ICU 幸存者及其家属为 ICU 后生活做好准备的可行性。

材料和方法

2020 年 6 月至 2021 年 2 月,在 ICU 中进行了 25 次家庭会议,讨论了 1 年后 QoL 的预计变化。采访了 13 名医生、10 名护士和 19 名患者和/或家属,以评估 ICU 实践中干预措施的可行性。使用主题编码对访谈进行定性分析。

结果

患者的中位年龄为 68.0 岁,5 名患者(20.0%)为女性,7 名患者(28.0%)在 ICU 期间死亡。一般来说,研究参与者认为该干预措施通过可视化澄清了 QoL 的概念,并作为讨论 QoL 和对 ICU 后生活的期望的提醒,具有一定的价值。然而,一些参与者,尤其是医生,认为该预测模型需要更多来自更严重的 ICU 患者的数据来遏制不确定性。

结论

在 ICU 实践中使用预测的 QoL 评分来为 ICU 出院后的生活做好患者和家属的准备是可行的。在优化模型和实施策略后,可以在更大规模的试验中评估其有效性。

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