Quality of life of critically ill patients in a developing country: a prospective longitudinal study

Abstract

[Purpose] To evaluate the quality of life of critical illness survivors in a developing country over the time after hospital discharge and to assess the influence of clinical variables on quality of life. [Subjects and Methods] A prospective longitudinal study was conducted in a large, tertiary, public hospital in Sao Paulo, Brazil. We included patients ≥18 years old, hospitalized in the intensive care unit with ≥24 hours of invasive mechanical ventilation. Quality of life was assessed using the Medical Outcomes Study 36-Item Short Form Health Survey, which was applied by telephone interview at the first, third and sixth months after hospital discharge. [Results] 75 patients were included in the study. Quality of life improved progressively after hospital discharge; role-physical was the most compromised domain. The physical component was influenced by the age. Quality of life was not influenced by Apache II categorization, length of invasive mechanical ventilation, intensive care unit stay or hospital stay. [Conclusion] Survivors of critical illness in a developing country present poor quality of life, which improves over time. Age influenced the physical component of quality of life.

Are the instruments for quality of life assessment comparable between cultures? No

“…These were areas where we had faced issues during the CCA process, but did not have an option of replacing with culture-specific terms. When the posttraumatic stress disorder and anxiety/ depression domain results of our ICU patients emerged to be lower than those from western data (even though factors associated with higher psychiatric morbidity were similar) and eerily similar to a study from another developing country [12], we were left pondering. Is this difference true or a chink in the cultural adaptation?…”

Health-related Quality of Life Evaluated by MOS SF-36 in the Elderly Patients 1 Month before ICU Admission and 3 Months after ICU Discharge

“… 17 , 31 One of the other influential factors cited by different studies, we find the physical capacities of the HRQoL, the age, the admission diagnosis, the severity of the acute disease, the length of stay, and the readmission in the hospital. 3 , 32 , 33 …”

“…The HRQoL of the severely sick EP after ICU and hospital discharge has been mainly taken into consideration in the developed countries but never specifically in the few studies conducted in the developing countries. 3 , 37 – 39 …”

“… 1 Thus, the identification of the factors that affect this HRQoL is crucial to guide health professionals and policy makers to the intervention strategies that are geared toward the most efficient use of intensive cares for the EP. 2 , 3 …”

Avaliação da independência funcional e da qualidade de vida após a alta da unidade de terapia intensiva: um estudo do coorte prospectivo

“…2,3 Além de todas as mudanças relacionadas à permanência na UTI, o aumento da sobrevida é acompanhado por impacto na qualidade de vida (QV) em curto e longo prazo após a alta. 4 A aplicação de escalas de funcionalidade para avaliação de pacientes críticos é de extrema importância para o fisioterapeuta, pois tem como principal objetivo minimizar a perda funcional adquirida, além de preservar a capacidade de manter as habilidades necessárias para a realização das atividades de vida diária (AVDs), com ênfase na transferência e locomoção. 5 A avaliação do desempenho funcional é cada vez mais vista como uma medida valiosa de resultados de testes clínicos e é comumente utilizada com a finalidade de identificar o diagnóstico, prognóstico e comparar a resposta ao tratamento dos pacientes, bem como verificar e monitorar o desempenho da funcionalidade para orientar o terapeuta na elaboração de tratamentos e prevenção de deficiências físicas.…”