Embracing the new vulnerable self: A grounded theory approach on critical care survivors’ post-intensive care syndrome

Kang, Jiyeon; Jeong, Yeon Jin

doi:10.1016/j.iccn.2018.08.004

Cited by 39 publications

(60 citation statements)

References 33 publications

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“…Nurses facilitate patient mobility at all hours of the day and night and, therefore, could contribute to improving patient functional ability. The recovery process from PICS is a continuum . Functional reconciliation requires continuous and consistent care even after ICU discharge.…”

Section: Introductionmentioning

confidence: 99%

Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

Inoue

Hatakeyama

Kondo

et al. 2019

Acute Medicine & Surgery

402

365

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Expanding elderly populations are a major social challenge in advanced countries worldwide and have led to a rapid increase in the number of elderly patients in intensive care units (ICUs). Innovative advances in medical technology have enabled lifesaving of patients in ICUs, but there remain various problems to improve their long‐term prognoses. Post‐intensive care syndrome (PICS) refers to physical, cognition, and mental impairments that occur during ICU stay, after ICU discharge or hospital discharge, as well as the long‐term prognosis of ICU patients. Its concept also applies to pediatric patients (PICS‐p) and the mental status of their family (PICS‐F). Intensive care unit‐acquired weakness, a syndrome characterized by acute symmetrical limb muscle weakness after ICU admission, belongs to physical impairments in three domains of PICS. Prevention of PICS requires performance of the ABCDEFGH bundle, which incorporates the prevention of delirium, early rehabilitation, family intervention, and follow‐up from the time of ICU admission to the time of discharge. Diary, nutrition, nursing care, and environmental management for healing are also important in the prevention of PICS. This review outlines the pathophysiology, prevention, and future directions of PICS.

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Section: Introductionmentioning

confidence: 99%

Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

Inoue

Hatakeyama

Kondo

et al. 2019

Acute Medicine & Surgery

402

365

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“…Qualitative findings support fatigue as a commonly experienced symptom post ICU discharge, with people describing it as a complex symptom rather than simple muscle weakness. (59) Fatigue was particularly prevalent in the early period after ICU discharge, (22,34,82) and for many people, fatigue symptoms and vitality improved over time. (43,63) Fatigue was generally viewed as an expected and integral part of recovery: “I just think of it as getting over what I’ve been through ”.…”

Section: Resultsmentioning

confidence: 99%

Prevalence and experience of fatigue in survivors of critical illness: A mixed-methods systematic review

Bench

Stayt

Shah

et al. 2020

Preprint

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Objective To investigate the prevalence, experience and management of fatigue in adult survivors of critical illness. Data sources An electronic search was performed on seven databases: CINAHL, Medline, EMBASE, PsycINFO, Emcare, British Nursing Index, and Web of Science. Study selection and data extraction Seventy-six peer-reviewed, English language studies that investigated fatigue or vitality in adult patients admitted to an Intensive Care Unit (ICU) and followed up for any period were included. Extracted data were split into three datasets for analysis: data from vitality domain of SF-36 (dataset A), other quantitative data (dataset B), and qualitative data (dataset C). Methodological quality was assessed using the critical appraisal skills programme (CASP) tools. Data synthesis We adopted a segregated approach to mixed-methods synthesis. We merged all datasets, attributing all results to one of four qualitative themes. These were prevalence and severity, contributing factors, impacts on quality of life, assessment and management. Results The prevalence of fatigue ranged from 13.8 to 80.9 %. Fatigue severity reached its nadir at approximately one month post ICU discharge, improved over time but seldom reached reference population scores. Various biological, disease related and psychological factors associated with fatigue were identified including age, poor pre-morbid status and sleep disturbance. No critical illness specific tool to assess fatigue in ICU survivors was identified. A paucity of evidence based interventions for management of fatigue in ICU survivors were identified despite fatigue negatively impacting on survivors quality of life. Conclusions This mixed method review shows that fatigue is highly prevalent in ICU survivors, negatively impacting their recovery. To date, no ICU specific fatigue assessment tool or targeted intervention has been designed to manage this symptom. Our review has identified factors, which may increase or mitigate against fatigue, along with potential management strategies, which should be used to inform future research and practice.

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“…Until 12 months post-discharge, ICU survivors' physical and mental health is at low levels and recovers slowly [35]. According to a relevant qualitative study [36], readmission breaks the trajectory of post-ICU recovery.…”

Section: Hads Measures Of Activities Of Daily Living [Adl]mentioning

confidence: 99%

Cut-Off Values of the Post-Intensive Care Syndrome Questionnaire for the Screening of Unplanned Hospital Readmission within One Year

Kang

Jeong²,

Hong

2020

J Korean Acad Nurs

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This study aimed to assign weights for subscales and items of the Post-Intensive Care Syndrome questionnaire and suggest optimal cutoff values for screening unplanned hospital readmissions of critical care survivors. Methods: Seventeen experts participated in an analytic hierarchy process for weight assignment. Participants for cutoff analysis were 240 survivors who had been admitted to intensive care units for more than 48 hours in three cities in Korea. We assessed participants using the 18-item Post-Intensive Care Syndrome questionnaire, generated receiver operating characteristic curves, and analysed cutoff values for unplanned readmission based on sensitivity, specificity, and positive likelihood ratios. Results: Cognitive, physical, and mental subscale weights were 1.13, 0.95, and 0.92, respectively. Incidence of unplanned readmission was 25.4%. Optimal cutoff values were 23.00 for raw scores and 23.73 for weighted scores (total score 54.00), with an area of under the curve (AUC) of .933 and .929, respectively. There was no significant difference in accuracy for original and weighted scores. Conclusion: The optimal cutoff value accuracy is excellent for screening of unplanned readmissions. We recommend that nurses use the Post-Intensive Care Syndrome Questionnaire to screen for readmission risk or evaluating relevant interventions for critical care survivors.

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Embracing the new vulnerable self: A grounded theory approach on critical care survivors’ post-intensive care syndrome

Cited by 39 publications

References 33 publications

Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

Prevalence and experience of fatigue in survivors of critical illness: A mixed-methods systematic review

Cut-Off Values of the Post-Intensive Care Syndrome Questionnaire for the Screening of Unplanned Hospital Readmission within One Year

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