Association Between Person-centered Care, Intensive Care Experience, and Post-intensive Care Syndrome in Critical Care Survivors: A Multi-center Prospective Cohort Study.

PURPOSE

This study aimed to investigate the association between patient-centered care, experiences in the intensive care unit (ICU), and post-intensive care syndrome among critical care survivors.

METHODS

This was a prospective, multicenter cohort study conducted in the second year, focusing on post-intensive care syndrome among ICU survivors. This study was conducted in 19 ICUs at four university hospitals located in Busan, South Korea. The participants were 618 adults who had been admitted to the ICU for more than 24 hours between May 2019 and July 2021. At the time of ICU discharge, participants completed a person-centered care and an intensive care experience questionnaire. We evaluated the post-intensive care syndrome of the participants at 3, 6, and 12 months after hospital discharge. Data analysis was performed using descriptive analysis, Pearson's correlations, multiple regression, and linear mixed model. The mediating effect of person-centered care was analyzed using hierarchical regression and path analysis.

RESULTS

Frightening experience in the ICU was significantly associated with a higher post-intensive care syndrome at 3 (β = .09, p = .021) and 6 (β = .09, p = .032) months after discharge. Person-centered care partially mediated the effect of the frightening experience on post-intensive care syndrome at 12 months after discharge (B = 0.05, 95% CI: 0.01-0.10). Female gender, older age, comorbidities, delirium, and discharge to an extended care facility were factors associated with increased post-intensive care syndrome at 3, 6, and 12 months. Furthermore, changes in post-intensive care syndrome during the one-year follow-up period were associated with comorbidities and the discharge place.

CONCLUSIONS

We observed that frightening experiences in the ICU are associated with an increased risk of post-intensive care syndrome in survivors. Person-centered care may be a potential factor in mediating the relationship between patients' frightening experiences and post-intensive care syndrome.

REGISTRATION NUMBER

This study is registered at the Korean Clinical Research Information Service (#KCT0004045).