scholarly journals The Characteristics of Post-Intensive Care Syndrome to Inform Occupational Therapy Practice During the Post-Intensive Care Period: A Systematic Scoping Review.

Author(s):  
Zoe Heiniger ◽  
Susan Brandis

Abstract Background: As the demand for intensive care treatment increases, so too does the number of people surviving critical illness. Since 2010, the term “post-intensive care syndrome” has been used to describe the constellation of new or worsening physical, cognitive, and psychological impairments that persist after intensive care discharge. This review aimed determine the characteristics of PICS present during the first year following discharge from the ICU to inform occupational therapists working with this population during the post-intensive care period. Methods: A systematic scoping review has been conducted according to the PRISMA-ScR Checklist. Seven key databases were searched from inception to 2020. A single reviewer screened available literature against eligibility criteria then cross-checked by a second reviewer. Data were abstracted from relevant publications and results were narratively synthesised through application of a biopsychosocial model.Results: Twenty-five studies were identified for inclusion. Characteristics were categorised as biological, psychological, or social and contextual. Overarching outcomes were also considered. Results demonstrated that characteristics were complex and interwoven between domains. Results were grouped into four key themes: 1) An increased worldwide demand for intensive care, 2) ADL performance, 3) HRQOL, and 4) Consideration of social and contextual characteristics. No studies were found to detail the role of occupational therapists working with post-intensive care survivors.Conclusions: The complex and interwoven nature of post-intensive care syndrome highlights the need to consider a holistic rehabilitation approach. Considering the COVID-19 pandemic, occupational therapists have the potential to play an increased role during the post-intensive care period to reduce the global healthcare burden and improve patient outcomes. Future research is needed to determine the best model of care to support occupational therapists working with survivors of critical illness.Trial Registration: NA

2021 ◽  
Author(s):  
David J Zorko ◽  
James Dayre McNally ◽  
Bram Rochwerg ◽  
Neethi Pinto ◽  
Rachel Couban ◽  
...  

Due to improvements in the delivery of intensive care, survival of even the most critically ill of children has increased, leading to a growing proportion of children with chronic and/or complex medical conditions in the pediatric intensive care unit (PICU). Some of these children are at significant risk of recurrent critical illness and persistent long-term morbidity, and become ‘superusers’ of PICU resources. These children are increasingly recognized as a unique high-risk population in the PICU referred to as children with chronic critical illness (CCI). To date, this population has been understudied, in part due to pediatric CCI being a novel concept without an accepted definition to consistently identify these children. This scoping review is the first step in the development of a consensus case definition for pediatric CCI. This comprehensive literature review will seek to first evaluate existing or suggested definitions of pediatric CCI, and in their absence, identify key terms and constructs to inform the development of a working definition of pediatric CCI for future research.


Pain Medicine ◽  
2021 ◽  
Author(s):  
Daly Geagea ◽  
Zephanie Tyack ◽  
Roy Kimble ◽  
Lars Eriksson ◽  
Vince Polito ◽  
...  

Abstract Objective Inadequately treated pain and distress elicited by medical procedures can put children at higher risks of acute and chronic biopsychosocial sequelae. Children can benefit from hypnotherapy, a psychological tailored intervention, as an adjunct to pharmacological agents to address the multiple components of pain and distress. Despite providing evidence on the effectiveness and potential superiority of hypnotherapy to other psychological interventions, research on hypnotherapy for paediatric procedural pain and distress has been predominantly limited to oncology and needle procedures. Plus, there is a lack of reporting of intervention manuals, factors influencing hypnotic responding, pain unpleasantness outcomes, theoretical frameworks, adverse events, as well as barriers and facilitators to the feasibility of delivering the intervention and study procedures. The proposed review aims to map the range and nature of the evidence on hypnotherapy for procedural pain and distress in children to identify gaps in literature and areas requiring further investigation. Methods This review will follow the Arksey and O'Malley (2005) methodology and incorporate additional scoping review recommendations by The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses. Relevant studies will be identified through searching published literature databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus and Web of Science) and grey literature in addition to hand-searching of reference lists and key journals. Two authors will independently screen titles and abstracts of search results followed by full-texts review against eligibility criteria. Conclusion Findings are anticipated to guide future research and inform the development of tailored hypnotic interventions in children.


2021 ◽  
pp. 175114372098870
Author(s):  
Zudin Puthucheary ◽  
Craig Brown ◽  
Evelyn Corner ◽  
Sarah Wallace ◽  
Julie Highfield ◽  
...  

Background Many Intensive Care Unit (ICU) survivors suffer from a multi- system disability, termed the post-intensive care syndrome. There is no current national coordination of either rehabilitation pathways or related data collection for them. In the last year, the need for tools to systematically identify the multidisciplinary rehabilitation needs of severely affected COVID-19 survivors has become clear. Such tools offer the opportunity to improve rehabilitation for all critical illness survivors through provision of a personalised Rehabilitation Prescription (RP). The initial development and secondary refinement of such an assessment and data tools is described in the linked paper. We report here the clinical and workforce data that was generated as a result. Methods Prospective service evaluation of 26 acute hospitals in England using the Post-ICU Presentation Screen (PICUPS) tool and the RP. The PICUPS tool comprised items in domains of a) Medical and essential care, b) Breathing and nutrition; c) Physical movement and d) Communication, cognition and behaviour. Results No difference was seen in total PICUPS scores between patients with or without COVID-19 (77 (IQR 60-92) vs. 84 (IQR 68-97); Mann-Whitney z = −1.46, p = 0.144. A network analysis demonstrated that requirements for physiotherapy, occupational therapy, speech and language therapy, dietetics and clinical psychology were closely related and unaffected by COVID-19 infection status. A greater proportion of COVID-19 patients were referred for inpatient rehabilitation (13% vs. 7%) and community-based rehabilitation (36% vs.15%). The RP informed by the PICUPS tool generally specified a greater need for multi-professional input when compared to rehabilitation plans instituted. Conclusions The PICUPS tool is feasible to implement as a screening mechanism for post-intensive care syndrome. No differences are seen in the rehabilitation needs of patients with and without COVID-19 infection. The RP could be the vehicle that drives the professional interventions across the transitions from acute to community care. No single discipline dominates the rehabilitation requirements of these patients, reinforcing the need for a personalised RP for critical illness survivors.


2016 ◽  
Vol 44 (12) ◽  
pp. 198-198
Author(s):  
Christopher Schneller ◽  
Briseyda Morales ◽  
Laura Campbell ◽  
Meredith Bone

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055823
Author(s):  
Enza Leone ◽  
Nicola Eddison ◽  
Aoife Healy ◽  
Carolyn Royse ◽  
Nachiappan Chockalingam

ObjectivesThe COVID-19 pandemic has resulted in a shift to remote consultations, but telehealth consultation guidelines are lacking or inconsistent. Therefore, a scoping review was performed to chart the information in the articles exploring telehealth for the UK allied health professionals (AHPs) and compare them with the UK AHP professional bodies’ guidelines.DesignScoping review following Aksey and O’ Malley methodological framework.Data sourcesCINHAL and MEDLINE were searched from inception to March 2021 using terms related to ‘telehealth’, ‘guidelines’ and ‘AHPs’. Additionally, the UK AHP professional bodies were contacted requesting their guidelines.Study selectionArticles exploring telehealth for patient consultations, written in English and published in peer-reviewed journal or guidelines available from UK AHP professional bodies/their websites were considered eligible for review.Data extractionOne reviewer extracted data concerning three overarching domains: implementation, financial and technological considerations.Results2632 articles were identified through database searches with 21 articles eligible for review. Eight guidelines were obtained from the UK AHP professional bodies with a total of 29 included articles/guidelines. Most articles were published in the last two years; there was variety in telehealth terminology, and most were developed for occupational therapists, physiotherapists and speech and language therapists. Information was lacking about the assessment of telehealth use and effectiveness, barriers and limitations, the logistical management, the family’s and caregiver’s roles and the costs. There was lack of clarity on the AHPs’ registration requirements, costs and coverage, and legal aspects.ConclusionThis study identified gaps in current guidelines, which showed similarities as well as discrepancies with the guidance for non-AHP healthcare professionals and revealed that the existing guidelines do not adequately support AHPs delivering telehealth consultations. Future research and collaborative work across AHP groups and the world’s leading health institutions are suggested to establish common guidelines that will improve AHP telehealth services.


2018 ◽  
Vol 198 ◽  
pp. 16-24 ◽  
Author(s):  
R. Scott Watson ◽  
Karen Choong ◽  
Gillian Colville ◽  
Sheri Crow ◽  
Leslie A. Dervan ◽  
...  

2019 ◽  
Vol 59 (6) ◽  
pp. e764-e781 ◽  
Author(s):  
Pallavi Sood ◽  
Sandra L Kletzel ◽  
Shilpa Krishnan ◽  
Hannes Devos ◽  
Ahmed Negm ◽  
...  

Abstract Background Technological advances have allowed a variety of computerized cognitive training tools to be engineered in ways that are fun and entertaining yet challenging at a level that can maintain motivation and engagement. This revolution has created an opportunity for gerontological scientists to evaluate brain gaming approaches to improve cognitive and everyday function. The purpose of this scoping review is to provide a critical overview of the existing literature on nonimmersive, electronic brain gaming interventions in older adults with mild cognitive impairment or dementia. Research Design and Methods Systematic search was conducted using 7 electronic databases from inception through July 2017. A comprehensive 2-level eligibility process was used to identify studies for inclusion based on PRISMA guidelines. Results Seventeen studies met eligibility criteria. Majority of the studies were randomized controlled trials (n = 13) and incorporated an active control (n = 9). Intervention doses ranged from 4 to 24 weeks in duration with an average of 8.4 (±5.1 standard deviation [SD]) weeks. Session durations ranged from 30 to 100 min with an average of 54 (±25 SD) minutes. Nearly half of studies included a follow-up, ranging from 3 months to 5 years (n = 8). For most studies, brain gaming improved at least one cognitive outcome (n = 12); only one study reported improvement in activities of daily living. Discussion and Implications This scoping review conveys the breadth of an emerging research field, which will help guide future research to develop standards and recommendations for brain gaming interventions which are currently lacking.


Author(s):  
Christina Jones ◽  
Peter Gibb ◽  
Ramona O. Hopkins

Millions of patients are treated in intensive care units (ICUs) each year, and the number of survivors is growing as a result of advances in critical care medicine. Unfortunately, many survivors of critical illness have substantial morbidity. Physical, psychological, and cognitive impairments are particularly common—so much so that a group of clinicians coined the term “post-intensive care syndrome” (PICS) to help raise awareness. Patients surviving critical illnesses are often quite weak, and physical therapy, hopefully starting in the ICU, is vital. But weakness is only one of the problems critical-illness survivors and their loved ones face. Unfortunately, many survivors are left with cognitive impairment (e.g., impaired memory, attention, and executive functioning), as well as distress-related psychiatric phenomena such as posttraumatic stress and depression. Importantly, these problems are not limited to adult patients, and loved ones also suffer. In this chapter the authors describe their personal journeys in coming to understand the suffering and issues that critical-illness survivors and their families face.


2020 ◽  
Author(s):  
Camille Guinemer ◽  
Martin Boeker ◽  
Bjoern Weiss ◽  
Daniel Fuerstenau ◽  
Felix Balzer ◽  
...  

BACKGROUND Telemedicine has been deployed to address issues in intensive care delivery, as well as to improve outcome and quality of care. Implementation of this technology has been characterized by high variability. Tele-intensive care unit (ICU) interventions involve the combination of multiple technological and organizational components, as well as interconnections of key stakeholders inside the hospital organization. The extensive literature on the benefits of tele-ICUs has been characterized as heterogeneous. On one hand, positive clinical and economical outcomes have been shown in multiple studies. On the other hand, no tangible benefits could be detected in several cases. This could be due to the diverse forms of organizations and the fact that tele-ICU interventions are complex to evaluate. The implementation context of tele-ICUs has been shown to play an important role in the success of the technology. The benefits derived from tele-ICUs depend on the organization where it is deployed and how the telemedicine systems are applied. There is therefore value in analyzing the benefits of tele-ICUs in relation to the characteristics of the organization where it is deployed. To date, research on the topic has not provided a comprehensive overview of literature taking both the technology setup and implementation context into account. OBJECTIVE We present a protocol for a scoping review of the literature on telemedicine in the ICU and its benefits in intensive care. The purpose of this review is to map out evidence about telemedicine in critical care in light of the implementation context. This review could represent a valuable contribution to support the development of tele-ICU technologies and offer perspectives on possible configurations, based on the implementation context and use case. METHODS We have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and the recommendations of the Joanna Briggs Institute methodology for scoping reviews. The scoping review and subsequent systematic review will be completed by spring 2021. RESULTS The preliminary search has been conducted. After removing all duplicates, we found 2530 results. The review can now be advanced to the next steps of the methodology, including literature database queries with appropriate keywords, retrieval of the results in a reference management tool, and screening of titles and abstracts. CONCLUSIONS The results of the search indicate that there is sufficient literature to complete the scoping review. Upon completion, the scoping review will provide a map of existing evidence on tele-ICU systems given the implementation context. Findings of this research could be used by researchers, clinicians, and implementation teams as they determine the appropriate setup of new or existing tele-ICU systems. The need for future research contributions and systematic reviews will be identified. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/19695


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