O'Neill Brenda, Linden Mark A, Ramsay Pam, Darweish Medniuk Alia, Outtrim Joanne, King Judy, Blackwood Bronagh
Centre for Health and Rehabilitation Technologies, Ulster University, Belfast, Northern Ireland.
School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
J Intensive Care Soc. 2025 Jan 3;26(1):38-46. doi: 10.1177/17511437241305266. eCollection 2025 Feb.
Understanding the degree to which patients are actively involved, confident and capable of engaging with self-management and rehabilitation could be an initial step in guiding individualised supportive strategies for people after critical illness.
To assess the levels of active involvement with self management among ICU survivors using the Patient Activation Measure (PAM), explore associations between patient characteristics and PAM results, and investigate its relationship with patients' support needs at key transition points during the recovery process.
Eligible participants received both the PAM and Support Needs After Critical care (SNAC) questionnaires by post. The return of the completed questionnaires was considered as consent to participate. Ethical approval was obtained (17/NI/0236). Descriptive statistics were used to summarise the data and Pearson's coefficient for correlations between variables.
There were 200 completed PAM and SNAC questionnaires. PAM scores showed that levels of active involvement with self management fell into level 1 ( = 64; disengaged and overwhelmed, low confidence to self manage) and 2 ( = 70; still struggling), with considerably less participants achieving scores in level 3 ( = 51; taking action) and 4 ( = 15; pushing further). Lower patient activation levels were associated with higher support needs (r = -0.16, p = 0.02).
We found that patient activation levels are low implying low knowledge, skills and confidence to self-manage after critical illness, and also that patients have support needs at various timepoints during recovery. Future research should focus on a longitudinal study to track changes in activation and support needs in the same patients over time and identify effective strategies to optimise recovery after critical illness.
了解患者积极参与、自信并能够进行自我管理和康复的程度，可能是为危重症患者制定个性化支持策略的第一步。
使用患者激活量表（PAM）评估重症监护病房幸存者自我管理的积极参与程度，探讨患者特征与PAM结果之间的关联，并调查其与康复过程中关键过渡点患者支持需求的关系。
符合条件的参与者通过邮寄方式同时收到PAM和重症监护后支持需求（SNAC）问卷。完成问卷的返回被视为同意参与。获得了伦理批准（17/NI/0236）。使用描述性统计来汇总数据，并使用Pearson系数来分析变量之间的相关性。
共收到200份完整的PAM和SNAC问卷。PAM评分显示，自我管理的积极参与水平分为1级（n = 64；不参与且不堪重负，自我管理信心低）和2级（n = 70；仍在挣扎），达到3级（n = 51；采取行动）和4级（n = 15；进一步推进）的参与者较少。较低的患者激活水平与较高的支持需求相关（r = -0.16，p = 0.02）。
我们发现患者激活水平较低，这意味着危重症后自我管理的知识、技能和信心较低，而且患者在康复过程中的各个时间点都有支持需求。未来的研究应侧重于纵向研究，以跟踪同一患者激活和支持需求随时间的变化，并确定优化危重症后康复的有效策略。
