Tiels Laura M, Wintjens Marieke S J N, Waardenburg Sophie, van Rosmalen Frank, van Kuijk Sander M J, van der Horst Iwan C C, Luiten Regien, van Bussel Bas C T, van Mook Walther N K A, Hemmen Bea, van Santen Susanne
Department of Intensive Care Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre+, Maastricht, The Netherlands.
Nurs Crit Care. 2025 Jul;30(4):e13241. doi: 10.1111/nicc.13241. Epub 2025 Jan 13.
More self-efficacy leads to greater confidence in one's ability to perform actions to achieve treatment goals. Therefore, self-efficacy may affect patient recovery and health-related quality of life (HRQoL) after ICU discharge.
In a cohort of mechanically ventilated COVID-19 survivors, we examined the associations between self-efficacy at 3 months and HRQoL at 3, 12 and 24 months after discharge.
Mechanically ventilated survivors of the MaastrICCht cohort that completed a self-efficacy assessment with the General Self-Efficacy Scale (GSES) were included. HRQoL was measured using the EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), subdivided into a health utility score (EQ-HUS) and visual analogue scale (EQ-VAS). Linear regression models were used to investigate associations between self-efficacy and HRQoL and were adjusted for age, sex, body mass index (BMI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, ICU length of stay and hospital discharge location.
In 87 ICU survivors, more self-efficacy at 3 months after ICU discharge was associated with longitudinally higher EQ-HUS (β = 0.01; 95% CI: 0.01-0.02; p < 0.001) and higher EQ-VAS (β = 1.00; 95% CI: 0.66-1.35; p < 0.001) up to 2 years after ICU discharge. After adjustment for age, sex, BMI, APACHE II score, ICU length of stay, and hospital discharge location, associations were similar.
More self-efficacy at 3 months after ICU discharge was associated with longitudinally higher HRQoL up to 2 years after ICU discharge in mechanically ventilated COVID-19 survivors.
Screening for self-efficacy in patients post-ICU as well as developing interventions to improve self-efficacy are a target post-ICU to enhance HRQoL over the long term.
更强的自我效能会使人对自己采取行动实现治疗目标的能力更有信心。因此，自我效能可能会影响重症监护病房（ICU）出院后患者的康复及健康相关生活质量（HRQoL）。
在一组机械通气的新型冠状病毒肺炎（COVID-19）幸存者中，我们研究了出院后3个月时的自我效能与出院后3个月、12个月和24个月时的HRQoL之间的关联。
纳入了马斯特里赫特队列中完成一般自我效能量表（GSES）自我效能评估的机械通气幸存者。使用欧洲五维度健康量表（EQ-5D-5L）测量HRQoL，该量表细分为健康效用得分（EQ-HUS）和视觉模拟量表（EQ-VAS）。采用线性回归模型研究自我效能与HRQoL之间的关联，并对年龄、性别、体重指数（BMI）、急性生理与慢性健康状况评分系统II（APACHE II）评分、ICU住院时长及出院地点进行了校正。
在87名ICU幸存者中，ICU出院后3个月时自我效能越强，出院后长达2年的时间里，纵向EQ-HUS越高（β = 0.01；95%置信区间：0.01 - 0.02；p < 0.001），EQ-VAS也越高（β = 1.00；95%置信区间：0.66 - 1.35；p < 0.001）。在对年龄、性别、BMI、APACHE II评分、ICU住院时长及出院地点进行校正后，关联相似。
在机械通气的COVID-19幸存者中，ICU出院后3个月时自我效能越强，出院后长达2年的时间里，纵向HRQoL越高。
对ICU后患者进行自我效能筛查以及制定提高自我效能的干预措施，是长期提高HRQoL的ICU后目标。
