Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo, Japan.
Nursing Department Heart Center, Kanazawa Medical University Hospital, Uchinada, Japan.
PLoS One. 2022 Mar 18;17(3):e0263441. doi: 10.1371/journal.pone.0263441. eCollection 2022.
Returning to work is a serious issue that affects patients who are discharged from the intensive care unit (ICU). This study aimed to clarify the employment status and the perceived household financial status of ICU patients 12 months following ICU discharge. Additionally, we evaluated whether there exists an association between depressive symptoms and subsequent unemployment status.
This study was a subgroup analysis of the published Survey of Multicenter Assessment with Postal questionnaire for Post-Intensive Care Syndrome for Home Living Patients (the SMAP-HoPe study) in Japan. Eligible patients were those who were employed before ICU admission, stayed in the ICU for at least three nights between October 2019 and July 2020, and lived at home for 12 months after discharge. We assessed the employment status, subjective cognitive functions, household financial status, Hospital Anxiety and Depression Scale, and EuroQOL-5 dimensions of physical function at 12 months following intensive care.
This study included 328 patients, with a median age of 64 (interquartile range [IQR], 52-72) years. Of these, 79 (24%) were unemployed 12 months after ICU discharge. The number of patients who reported worsened financial status was significantly higher in the unemployed group (p<0.01) than in the employed group. Multivariable analysis showed that higher age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.03-1.08]) and greater severity of depressive symptoms (OR, 1.13 [95% CI, 1.05-1.23]) were independent factors for unemployment status at 12 months after ICU discharge.
We found that 24.1% of our patients who had been employed prior to ICU admission were subsequently unemployed following ICU discharge and that depressive symptoms were associated with unemployment status. The government and the local municipalities should provide medical and financial support to such patients. Additionally, community and workplace support for such patients are warranted.
重返工作岗位是一个严重的问题，影响着从重症监护病房（ICU）出院的患者。本研究旨在明确 ICU 出院后 12 个月患者的就业状况和家庭经济状况感知，并评估抑郁症状与随后失业状况之间是否存在关联。
本研究是日本多中心评估与邮政问卷对 ICU 后居家患者进行的 ICU 后综合征调查（SMAP-HoPe 研究）的亚组分析。纳入标准为 ICU 入院前有工作、2019 年 10 月至 2020 年 7 月期间 ICU 住院时间至少 3 晚、出院后在家居住 12 个月的患者。我们在 ICU 后 12 个月时评估了患者的就业状况、主观认知功能、家庭经济状况、医院焦虑抑郁量表和欧洲五维健康量表（EQ-5D）的物理功能维度。
本研究共纳入 328 例患者，中位年龄为 64 岁（四分位距 [IQR]，52-72 岁）。其中，79 例（24%）患者在 ICU 出院后 12 个月时失业。与在职组相比，失业组报告经济状况恶化的患者人数明显更多（p<0.01）。多变量分析显示，年龄较大（比值比 [OR]，1.06；95%置信区间 [CI]，1.03-1.08）和抑郁症状更严重（OR，1.13 [95% CI，1.05-1.23]）是 ICU 后 12 个月失业状态的独立因素。
我们发现，24.1%的 ICU 入院前有工作的患者在 ICU 出院后失业，抑郁症状与失业状况相关。政府和地方政府应为这些患者提供医疗和经济支持。此外，应为这些患者提供社区和工作场所的支持。
