scholarly journals Critical Care Recovery Center: a model of agile implementation in intensive care unit (ICU) survivors

2019 ◽  
Vol 32 (12) ◽  
pp. 1409-1418 ◽  
Author(s):  
Sophia Wang ◽  
Philip Hanneman ◽  
Chenjia Xu ◽  
Sujuan Gao ◽  
Duane Allen ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Cognitive Impairment ◽  
Focus Group ◽  
The United States ◽  
Mental Health Symptoms ◽  
Health Symptoms

ABSTRACTBackground:As many as 70% of intensive care unit (ICU) survivors suffer from long-term physical, cognitive, and psychological impairments known as post-intensive care syndrome (PICS). We describe how the first ICU survivor clinic in the United States, the Critical Care Recovery Center (CCRC), was designed to address PICS using the principles of Agile Implementation (AI).Methods:The CCRC was designed using an eight-step process known as the AI Science Playbook. Patients who required mechanical ventilation or were delirious ≥48 hours during their ICU stay were enrolled in the CCRC. One hundred twenty subjects who completed baseline HABC-M CG assessments and had demographics collected were included in the analysis to identify baseline characteristics that correlated with higher HABC-M CG scores. A subset of patients and caregivers also participated in focus group interviews to describe their perceptions of PICS.Results:Quantitative analyses showed that the cognitive impairment was a major concern of caregivers. Focus group data also confirmed that caregivers of ICU survivors (n = 8) were more likely to perceive cognitive and mental health symptoms than ICU survivors (n = 10). Caregivers also described a need for ongoing psychoeducation about PICS, particularly cognitive and mental health symptoms, and for ongoing support from other caregivers with similar experiences.Conclusions:Our study demonstrated how the AI Science Playbook was used to build the first ICU survivor clinic in the United States. Caregivers of ICU survivors continue to struggle with PICS, particularly cognitive impairment, months to years after discharge. Future studies will need to examine whether the CCRC model of care can be adapted to other complex patient populations seen by health-care professionals.

scholarly journals Advances in the Management of Sepsis and the Understanding of Key Immunologic Defects

2011 ◽  
Vol 115 (6) ◽  
pp. 1349-1362 ◽  
Author(s):  
Lee P. Skrupky ◽  
Paul W. Kerby ◽  
Richard S. Hotchkiss
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Operating Room ◽  
The United States ◽  
Difficult Problem ◽  
Treatment Algorithms ◽  
New Treatment ◽  
Overall Mortality

Anesthesiologists are increasingly confronting the difficult problem of caring for patients with sepsis in the operating room and in the intensive care unit. Sepsis occurs in more than 750,000 patients in the United States annually and is responsible for more than 210,000 deaths. Approximately 40% of all intensive care unit patients have sepsis on admission to the intensive care unit or experience sepsis during their stay in the intensive care unit. There have been significant advances in the understanding of the pathophysiology of the disorder and its treatment. Although deaths attributable to sepsis remain stubbornly high, new treatment algorithms have led to a reduction in overall mortality. Thus, it is important for anesthesiologists and critical care practitioners to be aware of these new therapeutic regimens. The goal of this review is to include practical points on important advances in the treatment of sepsis and provide a vision of future immunotherapeutic approaches.

scholarly journals Critical Care Nurses’ Experiences During the COVID-19 Pandemic: A US National Survey

2021 ◽  
pp. e1-e7
Author(s):  
Jill L. Guttormson ◽  
Kelly Calkins ◽  
Natalie McAndrew ◽  
Jacklynn Fitzgerald ◽  
Holly Losurdo ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Moral Distress ◽  
Community Support ◽  
Well Being ◽  
The United States ◽  
Critical Care Nurses ◽  
Emotional Symptoms

Background Given critical care nurses’ high prepandemic levels of moral distress and burnout, the COVID-19 pandemic will most likely have a tremendous influence on intensive care unit (ICU) nurses’ mental health and continuation in the ICU workforce. Objective To describe the experiences of ICU nurses during the COVID-19 pandemic in the United States. Methods Nurses who worked in ICUs in the United States during the COVID-19 pandemic were recruited to complete a survey from October 2020 through early January 2021 through social media and the American Association of Critical-Care Nurses. Three open-ended questions focused on the experiences of ICU nurses during the pandemic. Results Of 498 nurses who completed the survey, 285 answered the open-ended questions. Nurses reported stress related to a lack of evidence-based treatment, poor patient prognosis, and lack of family presence in the ICU. Nurses perceived inadequate leadership support and inequity within the health care team. Lack of consistent community support to slow the spread of COVID-19 or recognition that COVID-19 was real increased nurses’ feelings of isolation. Nurses reported physical and emotional symptoms including exhaustion, anxiety, sleeplessness, and moral distress. Fear of contracting COVID-19 or of infecting family and friends was also prevalent. Conclusions Intensive care unit nurses in the United States experienced unprecedented and immense burden during the COVID-19 pandemic. Understanding these experiences provides insights into areas that must be addressed to build and sustain an ICU nurse workforce. Studies are needed to further describe nurses’ experiences during the COVID-19 pandemic and identify effective resources that support ICU nurse well-being.

scholarly journals Flattening the Mental Health Curve: COVID-19 Stay-at-Home Orders Are Associated With Alterations in Mental Health Search Behavior in the United States

10.2196/19347 ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. e19347 ◽  
Author(s):  
Nicholas C Jacobson ◽  
Damien Lekkas ◽  
George Price ◽  
Michael V Heinz ◽  
Minkeun Song ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Suicidal Ideation ◽  
The United States ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Search Queries ◽  
Negative Thoughts ◽  
The Impact ◽  
At Home

Background The coronavirus disease (COVID-19) has led to dramatic changes worldwide in people’s everyday lives. To combat the pandemic, many governments have implemented social distancing, quarantine, and stay-at-home orders. There is limited research on the impact of such extreme measures on mental health. Objective The goal of this study was to examine whether stay-at-home orders produced differential changes in mental health symptoms using internet search queries on a national scale. Methods In the United States, individual states vary in their adoption of measures to reduce the spread of COVID-19; as of March 23, 2020, 11 of the 50 states had issued stay-at-home orders. The staggered rollout of stay-at-home measures across the United States allows us to investigate whether these measures impact mental health by exploring variations in mental health search queries across the states. This paper examines the changes in mental health search queries on Google between March 16-23, 2020, across each state and Washington, DC. Specifically, this paper examines differential changes in mental health searches based on patterns of search activity following issuance of stay-at-home orders in these states compared to all other states. The participants were all the people who searched mental health terms in Google between March 16-23. Between March 16-23, 11 states underwent stay-at-home orders to prevent the transmission of COVID-19. Outcomes included search terms measuring anxiety, depression, obsessive-compulsive, negative thoughts, irritability, fatigue, anhedonia, concentration, insomnia, and suicidal ideation. Results Analyzing over 10 million search queries using generalized additive mixed models, the results suggested that the implementation of stay-at-home orders are associated with a significant flattening of the curve for searches for suicidal ideation, anxiety, negative thoughts, and sleep disturbances, with the most prominent flattening associated with suicidal ideation and anxiety. Conclusions These results suggest that, despite decreased social contact, mental health search queries increased rapidly prior to the issuance of stay-at-home orders, and these changes dissipated following the announcement and enactment of these orders. Although more research is needed to examine sustained effects, these results suggest mental health symptoms were associated with an immediate leveling off following the issuance of stay-at-home orders.

scholarly journals Flattening the Mental Health Curve: COVID-19 Stay-at-Home Orders Are Associated With Alterations in Mental Health Search Behavior in the United States (Preprint)

2020 ◽  
Author(s):  
Nicholas C Jacobson ◽  
Damien Lekkas ◽  
George Price ◽  
Michael V Heinz ◽  
Minkeun Song ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Suicidal Ideation ◽  
The United States ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Search Queries ◽  
Negative Thoughts ◽  
The Impact ◽  
At Home

BACKGROUND The coronavirus disease (COVID-19) has led to dramatic changes worldwide in people’s everyday lives. To combat the pandemic, many governments have implemented social distancing, quarantine, and stay-at-home orders. There is limited research on the impact of such extreme measures on mental health. OBJECTIVE The goal of this study was to examine whether stay-at-home orders produced differential changes in mental health symptoms using internet search queries on a national scale. METHODS In the United States, individual states vary in their adoption of measures to reduce the spread of COVID-19; as of March 23, 2020, 11 of the 50 states had issued stay-at-home orders. The staggered rollout of stay-at-home measures across the United States allows us to investigate whether these measures impact mental health by exploring variations in mental health search queries across the states. This paper examines the changes in mental health search queries on Google between March 16-23, 2020, across each state and Washington, DC. Specifically, this paper examines differential changes in mental health searches based on patterns of search activity following issuance of stay-at-home orders in these states compared to all other states. The participants were all the people who searched mental health terms in Google between March 16-23. Between March 16-23, 11 states underwent stay-at-home orders to prevent the transmission of COVID-19. Outcomes included search terms measuring anxiety, depression, obsessive-compulsive, negative thoughts, irritability, fatigue, anhedonia, concentration, insomnia, and suicidal ideation. RESULTS Analyzing over 10 million search queries using generalized additive mixed models, the results suggested that the implementation of stay-at-home orders are associated with a significant flattening of the curve for searches for suicidal ideation, anxiety, negative thoughts, and sleep disturbances, with the most prominent flattening associated with suicidal ideation and anxiety. CONCLUSIONS These results suggest that, despite decreased social contact, mental health search queries increased rapidly prior to the issuance of stay-at-home orders, and these changes dissipated following the announcement and enactment of these orders. Although more research is needed to examine sustained effects, these results suggest mental health symptoms were associated with an immediate leveling off following the issuance of stay-at-home orders.

scholarly journals Report on the Third International Intensive Care Unit Diary Conference

2020 ◽  
Vol 40 (5) ◽  
pp. e18-e25 ◽  
Author(s):  
Peter Nydahl ◽  
Ingrid Egerod ◽  
Megan M. Hosey ◽  
Dale M. Needham ◽  
Christina Jones ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Psychiatric Morbidity ◽  
Implementation Strategies ◽  
The United States ◽  
Staff Members ◽  
The Third ◽  
Post Intensive Care Syndrome

Topic Many patients in intensive care units have frightening experiences and memories and subsequent post–intensive care syndrome, with psychiatric morbidity including depression, anxiety, and posttraumatic stress disorder. Intensive care unit diaries, written by staff members and families, support patients’ understanding of what occurred and may alleviate their psychological suffering. Clinical Relevance An increasing number of critical care nurses in the United States and elsewhere are implementing intensive care unit diaries, but implementation remains challenging. Purpose To address emerging questions and support implementation in the United States, we held the Third International Intensive Care Unit Diary Conference as a 1-day preconference during the Seventh Annual Johns Hopkins Critical Care Rehabilitation Conference on November 1, 2018, in Baltimore, Maryland. This article summarizes the conference. Content Covered Conference presentations included intensive care unit–related experiences of patients and families, psychosocial aspects of post–intensive care syndrome, the evolution of diaries, implementation strategies for intensive care unit diaries, special topics (eg, legal issues, electronic vs handwritten diaries, pediatric diaries, and time of handover), and psychosocial recovery.

scholarly journals Evaluating Mental Health–Related Symptoms Among Cancer Survivors During the COVID-19 Pandemic: An Analysis of the COVID Impact Survey

2021 ◽  
pp. OP.20.00752
Author(s):  
Jessica Yasmine Islam ◽  
Denise C. Vidot ◽  
Marlene Camacho-Rivera
Keyword(s):  
Mental Health ◽  
United States ◽  
High School ◽  
Cancer Survivors ◽  
Multinomial Logistic Regression ◽  
The United States ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
High School Degree ◽  
Health Related

PURPOSE: The COVID-19 pandemic has affected the mental health of adults in the United States because of recommended preventive behaviors such as physical distancing. Our objective was to evaluate mental health symptoms and identify associated determinants among cancer survivors during the COVID-19 pandemic in the United States. METHODS: We used nationally representative data of 10,760 US adults from the COVID-19 Impact Survey. We defined cancer survivors as adults with a self-reported diagnosis of cancer (n = 854, 7.6%). We estimated associations of mental health symptoms among cancer survivors using multinomial logistic regression. We estimated determinants of reporting at least one mental health symptom 3-7 times in the 7 days before survey administration among cancer survivors using multivariable Poisson regression. RESULTS: Cancer survivors were more likely to report feeling nervous, anxious, or on edge (adjusted odds ratio [aOR], 1.42; 95% CI, 1.07 to 1.90); depressed (aOR, 1.57; 95% CI, 1.18 to 2.09); lonely (aOR, 1.42; 95% CI, 1.05 to 1.91); and hopeless (aOR, 1.51; 95% CI, 1.11 to 2.06) 3-7 days per week in the last 7 days when compared with adults without cancer. Among cancer survivors, adults of age 30-44 years (adjusted prevalence ratio [aPR], 1.87; 95% CI, 1.18 to 2.95), females (aPR, 1.55, 95% CI, 1.12 to 2.13), adults without a high school degree (aPR, 1.79; 95% CI, 1.05 to 3.04), and adults with limited social interaction (aPR, 1.40, 95% CI, 1.01 to 1.95) were more likely to report at least one mental health–related symptom in the last 7 days (3-7 days/week). CONCLUSION: Cancer survivors are reporting mental health symptoms during the COVID-19 pandemic, particularly young adults, adults without a high school degree, women, and survivors with limited social support.

scholarly journals Flattening the Mental Health Curve: COVID-19 Stay-at-Home Orders are Associated with Alterations in Mental Health Search Behavior in the United States

2020 ◽  
Author(s):  
Nicholas C. Jacobson ◽  
Damien Lekkas ◽  
George Price ◽  
Michael V. Heinz ◽  
Minkeun Song ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Suicidal Ideation ◽  
The United States ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Search Queries ◽  
Negative Thoughts ◽  
The Impact ◽  
At Home

Background: COVID-19 has led to dramatic changes globally in persons’ everyday lives. To combat the pandemic, many governments have implemented social distancing, quarantine, and stay-at-home orders. There is limited research on the impact of such extreme measures on mental health. Objective: The goal of the present study was to examine whether stay-at-home orders produced differential changes in mental health symptoms using internet search queries at a national scale. Methods: In the United States, individual states vary in their adoption of measures to reduce the spread of COVID-19; as of March 23, 2020, eleven of the fifty states had issued stay-at-home orders. The staggered rollout of stay-at-home measures across the U.S. allows us to investigate whether these measures impact mental health by exploring variations in mental health search queries across the states. The current manuscript examines the changes in mental health search queries on Google between March 16-23, 2020 across each state and Washington D.C. Specifically, the current manuscript examines differential change in mental health searches based on patterns of search activity following issuance of stay-at-home orders in these states compared to all other states. Participants included all persons who searched mental health terms in Google between March 16-23. Between March 16-23, eleven states underwent stay-at-home orders to prevent the transmission of COVID-19. Outcomes included search terms measuring anxiety, depression, obsessive-compulsive, negative thoughts, irritability, fatigue, anhedonia, concentration, insomnia, and suicidal ideation. Results: Analyzing over 10 million search queries using generalized additive mixed models, the results suggested that the implementation of stay-at-home orders are associated with a significant flattening of the curve for searches for suicidal ideation, anxiety, negative thoughts, and sleep disturbances with the most prominent flattening associated with suicidal ideation and anxiety. Conclusions: These results suggest that, despite decreased social contact, mental health search queries increased rapidly prior to the issuance of stay-at-home orders, and these changes dissipated following the announcement and enactment of these orders. Although more research is needed to examine sustained effects, these results suggest mental health symptoms were associated with an immediately leveling off following the issuance of stay-at-home orders.

scholarly journals Association of Exposure to Police Violence With Prevalence of Mental Health Symptoms Among Urban Residents in the United States

2018 ◽  
Vol 1 (7) ◽  
pp. e184945 ◽  
Author(s):  
Jordan E. DeVylder ◽  
Hyun-Jin Jun ◽  
Lisa Fedina ◽  
Daniel Coleman ◽  
Deidre Anglin ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
The United States ◽  
Urban Residents ◽  
Mental Health Symptoms ◽  
Police Violence ◽  
Health Symptoms

The Relationship Among Trauma, Acculturation, and Mental Health Symptoms in Somali Refugees

2021 ◽  
Vol 49 (2) ◽  
pp. 196-232
Author(s):  
Katherine C. Jorgenson ◽  
Johanna E. Nilsson
Keyword(s):  
Mental Health ◽  
United States ◽  
English Language ◽  
The United States ◽  
Traumatic Experiences ◽  
Future Research ◽  
Mental Health Symptoms ◽  
Somali Refugees ◽  
Health Symptoms ◽  
The Relationship

More than 100,000 Somali refugees have resettled in the United States, creating a need for additional research about mental health needs and premigration experiences that precede resettlement. The purpose of this study was to learn more about premigration traumatic experiences, the process of acculturation following resettlement, and the relationship between premigration trauma, acculturation, and mental health. Eighty Somali refugees from two mid-sized Midwestern cities participated. It was hypothesized that acculturation would mediate the relationship between premigration trauma and mental health symptoms. The results partially supported this hypothesis, dependent upon the dimension of acculturation included in the path analysis. Unexpected relationships among the various acculturation dimensions in the model (American cultural identity, English language competency, and American cultural competency) occurred with traumatic experiences, mental health symptoms, and time in the United States. We discuss implications and directions for future research, practice, advocacy, and training.

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