Academic unit of Anaesthesia, Critical Care, and Peri-operative Medicine, University of Glasgow, Glasgow, UK
Academic unit of Anaesthesia, Critical Care, and Peri-operative Medicine, University of Glasgow, Glasgow, UK.
Thorax. 2023 Feb;78(2):160-168. doi: 10.1136/thoraxjnl-2021-218428. Epub 2022 Mar 21.
At present, clinicians aiming to support patients through the challenges after critical care have limited evidence to base interventions.
Evaluate a multicentre integrated health and social care intervention for critical care survivors. A process evaluation assessed factors influencing the programme implementation.
This study evaluated the impact of the Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE) programme. We compared patients who attended this programme with a usual care cohort from the same time period across nine hospital sites in Scotland. The primary outcome was health-related quality of life (HRQoL) measured via the EuroQol 5-dimension 5-level instrument, at 12 months post hospital discharge. Secondary outcome measures included self-efficacy, depression, anxiety and pain.
137 patients who received the InS:PIRE intervention completed outcome measures at 12 months. In the usual care cohort, 115 patients completed the measures. The two cohorts had similar baseline demographics. After adjustment, there was a significant absolute increase in HRQoL in the intervention cohort in relation to the usual care cohort (0.12, 95% CI 0.04 to 0.20, 0.01). Patients in the InS:PIRE cohort also reported self-efficacy scores that were 7.7% higher (2.32 points higher, 95% CI 0.32 to 4.31, =0.02), fewer symptoms of depression (OR 0.38, 95% CI 0.19 to 0.76, p=0.01) and similar symptoms of anxiety (OR 0.58, 95% CI 0.30 to 1.13, =0.11). There was no significant difference in overall pain experience. Key facilitators for implementation were: integration with inpatient care, organisational engagement, flexibility to service inclusion; key barriers were: funding, staff availability and venue availability.
This multicentre evaluation of a health and social care programme designed for survivors of critical illness appears to show benefit at 12 months following hospital discharge.
目前，旨在帮助重症监护后患者应对挑战的临床医生在干预措施方面可获得的证据有限。
评估一项针对重症监护幸存者的多中心综合卫生和社会保健干预措施。一项过程评估评估了影响方案实施的因素。
本研究评估了重症监护综合征：促进独立和重返就业（InS：PIRE）方案的影响。我们将参加该方案的患者与同一时期苏格兰 9 家医院的常规护理队列进行了比较。主要结局是通过 EuroQol 5 维 5 级工具测量的健康相关生活质量（HRQoL），在出院后 12 个月进行测量。次要结局指标包括自我效能、抑郁、焦虑和疼痛。
接受 InS：PIRE 干预的 137 例患者在 12 个月时完成了结局测量。在常规护理队列中，有 115 例患者完成了测量。两个队列的基线人口统计学特征相似。调整后，干预组 HRQoL 较常规护理组有显著的绝对增加（0.12，95%CI 0.04 至 0.20，0.01）。InS：PIRE 组的患者报告的自我效能评分也高出 7.7%（2.32 分，95%CI 0.32 至 4.31，=0.02），抑郁症状较少（OR 0.38，95%CI 0.19 至 0.76，p=0.01），焦虑症状相似（OR 0.58，95%CI 0.30 至 1.13，=0.11）。整体疼痛体验无显著差异。实施的关键促进因素是：与住院治疗的整合、组织参与、服务纳入的灵活性；主要障碍是：资金、员工可用性和场地可用性。
本研究对一项针对重症疾病幸存者的卫生和社会保健方案进行了多中心评估，结果显示该方案在出院后 12 个月时具有获益。
Zotero 插件
