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危重症患者气管切开相关生活质量评分的制定。

Development of the Tracheostomy Well-Being Score in critically ill patients.

机构信息

Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum (North Rhine-Westphalia), Germany.

Faculty of Psychology, FernUniversität of Hagen, Universitätsstraße 47, 58097, Hagen, Germany.

出版信息

Eur J Trauma Emerg Surg. 2023 Apr;49(2):981-990. doi: 10.1007/s00068-022-02120-9. Epub 2022 Oct 13.

Abstract

PURPOSE

Little attention has been given to understanding the experiences and perceptions of tracheostomized patients. This study aimed to measure the impact of tracheostomy on well-being in critically ill patients with the development of the Tracheostomy Well-Being Score (TWBS).

METHODS

This is a prospective, monocentric, observational study including critically ill patients with a tracheostomy without delirium. A 25-item questionnaire with items from six categories (respiration, coughing, pain, speaking, swallowing, and comfort) was used to select the 12 best items (two per category) to form the TWBS score after testing on two consecutive days. Item selection secured (1) that there were no skewed response distributions, (2) high stability from day 1 to day 2, and (3) high prototypicality for the category in terms of item-total correlation.

RESULTS

A total of 63 patients with a mean age of 56 years were included. The 12 items of the TWBS were characterized by a high retest reliability (τ = 0.67-0.93) and acceptable internal consistency. The overlap with the clinician rating was low, suggesting that acquiring self-report data is strongly warranted.

CONCLUSION

With the TWBS, an instrument is available for the assessment of the subjective effects a tracheostomy has on in critically ill patients. The score potentially offers a chance to increase well-being of these patients. Additionally, this score could also increase their quality of life by improving tracheostomy and weaning management.

CLINICAL TRIAL REGISTRATION

German Clinical Trials Register Identifier DRKS00022073 (2020/06/02).

摘要

目的

人们对气管切开患者的体验和感受关注甚少。本研究旨在通过开发气管切开幸福评分(TWBS)来衡量气管切开对危重症患者幸福感的影响。

方法

这是一项前瞻性、单中心、观察性研究,纳入了无谵妄的气管切开危重症患者。使用包含六个类别的 25 项问卷(呼吸、咳嗽、疼痛、说话、吞咽和舒适度),对连续两天的测试后选择 12 个最佳项目(每个类别两个),形成 TWBS 评分。项目选择要确保:(1)不存在偏态反应分布;(2)从第 1 天到第 2 天的稳定性高;(3)就项目总分相关性而言,对类别具有高典型性。

结果

共纳入 63 例患者,平均年龄为 56 岁。TWBS 的 12 个项目具有较高的重测可靠性(τ=0.67-0.93)和可接受的内部一致性。与临床医生评分的重叠度较低,表明强烈需要获取自我报告数据。

结论

TWBS 是一种用于评估气管切开对危重症患者主观影响的工具。该评分可能有机会提高这些患者的幸福感。此外,通过改善气管切开和撤机管理,该评分还有可能提高他们的生活质量。

临床试验注册

德国临床试验注册中心标识符 DRKS00022073(2020/06/02)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbd/10175326/4bd0ff647345/68_2022_2120_Fig1_HTML.jpg

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