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癌症幸存者入住重症监护病房后,其健康相关生活质量随时间推移如何变化?一项综合评价。

How Does Health-Related Quality of Life Change Over Time in Cancer Survivors Following an Admission to the Intensive Care Unit?: An Integrative Review.

机构信息

Author Affiliations: Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group (Ms Rourke, Dr Paterson) and School of Nursing, Midwifery and Public Health (Ms Rourke, Dr Paterson), University of Canberra, Bruce; and Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Garran (Ms Rourke, Dr Paterson), Canberra, Australian Capital Territory, Australia; and Robert Gordon University, Aberdeen, Scotland, United Kingdom (Ms Rourke, Dr Paterson).

出版信息

Cancer Nurs. 2024;47(2):100-111. doi: 10.1097/NCC.0000000000001157. Epub 2022 Dec 11.

Abstract

BACKGROUND

Cancer survivors account for 15% to 20% of all intensive care unit (ICU) admissions. In general ICU populations, patients are known to experience reduced health-related quality of life (HRQoL). However, little is known about HRQoL impacts among cancer survivors following a critical illness in ICU.

OBJECTIVE

The aim of this study was to critically synthesize the evidence to further understand the impact of a critical illness and ICU admission in cancer survivors.

METHODS

An integrative review was conducted and reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. Three electronic databases were searched (MEDLINE, CINAHL, and EMBASE) using keywords and Boolean logic. Quality appraisal, data extraction, and a narrative synthesis were completed for all included studies by 2 reviewers.

RESULTS

Eleven publications met inclusion criteria. Health-related quality-of-life domains most frequently reported in cancer survivors after discharge from ICU included the following: physical function limitations, physical symptoms, and anxiety/depression.

CONCLUSIONS

Health-related quality of life decreased immediately after the admission to ICU with a gradual increase in the 3 to 12 months following. Cancer survivors are vulnerable to physical limitations, pain, and social isolation after an admission to ICU.

IMPLICATIONS FOR PRACTICE

Cancer survivors who have been affected by a critical illness are at risk of reduced HRQoL after an admission to ICU. This integrative review will help clinicians and researchers to develop patient-centered models of care during the recovery of critical illness, which are currently lacking in service delivery.

摘要

背景

癌症幸存者占重症监护病房(ICU)入院人数的 15%至 20%。在一般的 ICU 人群中,已知患者的健康相关生活质量(HRQoL)会降低。然而,对于癌症幸存者在 ICU 经历重病后对 HRQoL 的影响知之甚少。

目的

本研究旨在批判性地综合证据,以进一步了解 ICU 中癌症幸存者重病和 ICU 入院对其的影响。

方法

进行了综合审查,并根据 PRISMA(系统评价和荟萃分析的首选报告项目)指南进行了报告。使用关键词和布尔逻辑在三个电子数据库(MEDLINE、CINAHL 和 EMBASE)中进行了搜索。两名审查员完成了所有纳入研究的质量评估、数据提取和叙述性综合。

结果

符合纳入标准的有 11 篇出版物。癌症幸存者在从 ICU 出院后报告的健康相关生活质量领域包括以下方面:身体功能受限、身体症状和焦虑/抑郁。

结论

在 ICU 入院后,健康相关生活质量立即下降,在 3 至 12 个月后逐渐增加。癌症幸存者在 ICU 入院后容易出现身体受限、疼痛和社会隔离。

对实践的影响

因重病而受影响的癌症幸存者在 ICU 入院后有降低 HRQoL 的风险。这一综合审查将帮助临床医生和研究人员在重症康复期间制定以患者为中心的护理模式,目前在服务提供方面还缺乏这些模式。

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