Kang Jiyeon, Yun Seonyoung
College of Nursing, Dong-A University, Republic of Korea.
Department of Nursing, Youngsan University, Republic of Korea.
Asian Nurs Res (Korean Soc Nurs Sci). 2025 Aug;19(3):274-283. doi: 10.1016/j.anr.2025.03.009. Epub 2025 May 20.
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.
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.
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.
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.
This study is registered at the Korean Clinical Research Information Service (#KCT0004045).
本研究旨在调查以患者为中心的护理、重症监护病房（ICU）的经历与危重症幸存者的重症监护后综合征之间的关联。
这是一项前瞻性、多中心队列研究，于第二年开展，重点关注ICU幸存者的重症监护后综合征。本研究在韩国釜山的四家大学医院的19个ICU中进行。参与者为2019年5月至2021年7月期间入住ICU超过24小时的618名成年人。在ICU出院时，参与者完成了一份以患者为中心的护理和一份重症监护经历问卷。我们在出院后3个月、6个月和12个月评估了参与者的重症监护后综合征。数据分析采用描述性分析、Pearson相关性分析、多元回归分析和线性混合模型。使用分层回归和路径分析分析以患者为中心的护理的中介作用。
ICU中的可怕经历与出院后3个月（β = 0.09，p = 0.021）和6个月（β = 0.09，p = 0.032）时较高的重症监护后综合征显著相关。以患者为中心的护理部分介导了出院后12个月时可怕经历对重症监护后综合征的影响（B = 0.05，95%CI：0.01 - 0.10）。女性、年龄较大、合并症、谵妄以及转至长期护理机构是与出院后3个月、6个月和12个月时重症监护后综合征增加相关的因素。此外，在一年随访期内重症监护后综合征的变化与合并症和出院地点有关。
我们观察到ICU中的可怕经历与幸存者重症监护后综合征风险增加有关。以患者为中心的护理可能是介导患者可怕经历与重症监护后综合征之间关系的一个潜在因素。
本研究已在韩国临床研究信息服务中心注册（#KCT0004045）。
