scholarly journals Implementation of a Follow-Up Program for Intensive Care Unit Survivors

2021 ◽  
Vol 18 (19) ◽  
pp. 10122
Author(s):  
Marta Villa ◽  
Silvia Villa ◽  
Simona Vimercati ◽  
Mara Andreossi ◽  
Fabrizia Mauri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Symptom Scale ◽  
Icu Stay ◽  
Icu Discharge ◽  
Length Of Icu Stay

In Intensive Care Unit (ICU) survivors, critical illness has an impact on an individual’s long-term health status and quality of life. Adults who have recovered from intensive care management could develop muscle weakness, neurocognitive impairment, difficulties in managing activities of daily living and to returning to work, and psychological problems such as depression and anxiety. A prospective, observational study was designed. Data were collected from January to December 2018 from a structured follow-up program, at 3 time points after ICU discharge: at seven days, a visit in the general ward, a phone interview at three months and an ambulatory visit at six months. A total of 95 patients were enrolled, 36% female, with a median age of 65 (55–73) years and a median ICU length of stay of 13 (8–20) days. At the seven days follow-up, patients who had a positive Hospital Anxiety and Depression Scale showed a significantly longer time of intubation (p = 0.048) and length of ICU stay (p = 0.023). At three months, we observed a significant relationship between a positive Hospital Anxiety and Depression Scale and a median value of EuroQol-5D (p = 0.048). At six months, we observed that patients who had a positive Post-Traumatic Symptom Scale were significantly younger than the other group. Findings from the present study suggest that a longer time of intubation and length of ICU stay are associated with a higher level of anxiety and depression immediately after ICU discharge. Follow-up programs are recommended to assess and rehabilitate cognitive function at ICU discharge.

scholarly journals Anxiety and depression symptoms in family members of icu patients

2015 ◽  
Vol 33 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Maria Kourti ◽  
Efstathia Christofilou ◽  
George Kallergis
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Demographic Data ◽  
Family Members ◽  
Depression Scale ◽  
Self Report ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Hospital Anxiety ◽  
Icu Patients

<p><strong>Objective:</strong> This study investigated symptoms of anxiety and depression in relatives of patients admitted in the Intensive Care Unit and determined whether these symptoms were associated to the seriousness of the patients’ condition.</p><p><strong>Metodology:</strong> A total of 102 patients’ relatives were surveyed<br />during the study. They were given a self-report questionnaire in order to assess demographic data, anxiety and depression symptoms. The symptoms of anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale (hads). Patient’s condition was evaluated with a.p.a.ch.e ii Score.</p><p><strong>Results:</strong> More than 60% of patients’ relatives presented severe symptoms of anxiety and depression. No relation was found between symptoms of anxiety and depression of the relatives of patients and patients’ condition of health. On the<br />contrary, these feelings used to exist regardless of the seriousness of patient’s condition.</p><p><strong>Conclusions:</strong> The assessment of these patients is recommended in order serious problems of anxiety<br />and depression to be prevented. </p>

Benefit to Family Members of Delivering Hand Massage With Essential Oils to Critically Ill Patients

2015 ◽  
Vol 24 (5) ◽  
pp. 446-449 ◽  
Author(s):  
Charlsea Prichard ◽  
Patricia Newcomb
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Essential Oils ◽  
Family Members ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Control Group ◽  
Hospital Anxiety ◽  
Quasi Experimental ◽  
Hand Massage

BackgroundIn intensive care environments, patients’ families are often encouraged to participate in their loved one’s care; however, many family members feel anxious, depressed, and unsure about how to help patients.ObjectivesTo determine (1) the feasibility of teaching family members a simple intervention combining hand massage with essential oils in a trauma intensive care unit and (2) an effect size for use in designing a more powerful trial.MethodA quasi-experimental pilot study of the effect of a family-delivered touch treatment on anxiety and depression of family members of patients. Fifteen family members were assigned to a treatment group, and 15 family members were assigned to a control group. The treatment consisted of the application of hand massage with essential oils for 6 sessions. Each session lasted 5 minutes and was presented twice a day for 3 days.ResultsThe 5-minute intervention was associated with positive change in anxiety and depression scores on the Hospital Anxiety and Depression Scale (HADS) among family members visiting patients. The magnitude of change (improvement) in anxiety scores within the group of treated family members was significantly greater than within family members in the control group.ConclusionAdministering a brief hand massage using pleasant-smelling oils to patients in an intensive care unit may reduce anxiety of family members who administer the treatment.

scholarly journals Changes in insomnia as a risk factor for the incidence and persistence of anxiety and depression: a longitudinal community study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Magnus Johansson ◽  
Markus Jansson-Fröjmark ◽  
Annika Norell-Clarke ◽  
Steven J. Linton
Keyword(s):  
Risk Factor ◽  
Depression Scale ◽  
Binary Logistic Regression ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Dynamic Risk ◽  
Increased Risk ◽  
Longitudinal Association ◽  
Development Of Anxiety

Abstract Background The aim of this investigation was to examine the longitudinal association between change in insomnia status and the development of anxiety and depression in the general population. Methods A survey was mailed to 5000 randomly selected individuals (aged 18–70 years) in two Swedish counties. After 6 months, a follow-up survey was sent to those (n = 2333) who answered the first questionnaire. The follow-up survey was completed by 1887 individuals (80.9%). The survey consisted of questions indexing insomnia symptomatology, socio-demographic parameters, and the Hospital Anxiety and Depression Scale. Change in insomnia status was assessed by determining insomnia at the two time-points and then calculating a change index reflecting incidence (from non-insomnia to insomnia), remission (from insomnia to non-insomnia), or status quo (no change). Multivariate binary logistic regression analyses were used to examine the aim. Results Incident insomnia was significantly associated with an increased risk for the development of new cases of both anxiety (OR = 0.32, p < .05) and depression (OR = 0.43, p < .05) 6 months later. Incident insomnia emerged also as significantly associated with an elevated risk for the persistence of depression (OR = 0.30, p < .05), but not for anxiety. Conclusions This study extends previous research in that incidence in insomnia was shown to independently increase the risk for the development of anxiety and depression as well as for the maintenance of depression. The findings imply that insomnia may be viewed as a dynamic risk factor for anxiety and depression, which might have implications for preventative work.

scholarly journals Post-intensive care syndrome after a critical COVID-19: cohort study from a Belgian follow-up clinic

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anne-Françoise Rousseau ◽  
Pauline Minguet ◽  
Camille Colson ◽  
Isabelle Kellens ◽  
Sourour Chaabane ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Inpatient Rehabilitation ◽  
Quadriceps Strength ◽  
Biological Parameters ◽  
Icu Stay ◽  
Icu Discharge ◽  
Prolonged Icu Stay ◽  
Post Intensive Care Syndrome

Abstract Purpose Many patients with coronavirus disease 2019 (COVID-19) required critical care. Mid-term outcomes of the survivors need to be assessed. The objective of this single-center cohort study was to describe their physical, cognitive, psychological, and biological outcomes at 3 months following intensive care unit (ICU)-discharge (M3). Patients and methods All COVID-19 adults who survived an ICU stay ≥ 7 days and attended the M3 consultation at our multidisciplinary follow-up clinic were involved. They benefited from a standardized assessment, addressing health-related quality of life (EQ-5D-3L), sleep disorders (PSQI), and the three principal components of post-intensive care syndrome (PICS): physical status (Barthel index, handgrip and quadriceps strength), mental health disorders (HADS and IES-R), and cognitive impairment (MoCA). Biological parameters referred to C-reactive protein and creatinine. Results Among the 92 patients admitted to our ICU for COVID-19, 42 survived a prolonged ICU stay and 32 (80%) attended the M3 follow-up visit. Their median age was 62 [49–68] years, 72% were male, and nearly half received inpatient rehabilitation following ICU discharge. At M3, 87.5% (28/32) had not regained their baseline level of daily activities. Only 6.2% (2/32) fully recovered, and had normal scores for the three MoCA, IES-R and Barthel scores. The main observed disorders were PSQI > 5 (75%, 24/32), MoCA < 26 (44%, 14/32), Barthel < 100 (31%, 10/32) and IES-R ≥ 33 (28%, 9/32). Combined disorders were observed in 13/32 (40.6%) of the patients. The EQ-5D-3L visual scale was rated at 71 [61–80]. A quarter of patients (8/32) demonstrated a persistent inflammation based on CRP blood level (9.3 [6.8–17.7] mg/L). Conclusion The burden of severe COVID-19 and prolonged ICU stay was considerable in the present cohort after 3 months, affecting both functional status and biological parameters. These data are an argument on the need for closed follow-up for critically ill COVID-19 survivors.

scholarly journals The Epidemiology of Vancomycin-Resistant Enterococcus Colonization in a Medical Intensive Care Unit

2003 ◽  
Vol 24 (4) ◽  
pp. 257-263 ◽  
Author(s):  
David K. Warren ◽  
Marin H. Kollef ◽  
Sondra M. Seiler ◽  
Scott K. Fridkin ◽  
Victoria J. Fraser
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multiple Logistic Regression Analysis ◽  
Control Measures ◽  
Icu Patients ◽  
Icu Admission ◽  
Contact Precautions ◽  
Icu Stay ◽  
Vancomycin Resistant

AbstractObjective:To determine the epidemiology of colonization with vancomycin-resistant Enterococcus (VRE) among intensive care unit (ICU) patients.Design:Ten-month prospective cohort study.Setting:A 19-bed medical ICU of a 1,440-bed teaching hospital.Methods:Patients admitted to the ICU had rectal swab cultures for VRE on admission and weekly thereafter. VRE-positive patients were cared for using contact precautions. Clinical data, including microbiology reports, were collected prospectively during the ICU stay.Results:Of 519 patients who had admission stool cultures, 127 (25%) had cultures that were positive for VRE. Risk factors for VRE colonization identified by multiple logistic regression analysis were hospital stay greater than 3 days prior to ICU admission (adjusted odds ratio [AOR], 3.6; 95% confidence interval [CI95], 2.3 to 5.7), chronic dialysis (AOR, 2.4; CI95, 1.2 to 4.5), and having been admitted to the study hospital one to two times (AOR, 2.3; CI95,1.4 to 3.8) or more than two times (AOR, 6.5; CI95, 3.7 to 11.6) within the past 12 months. Of the 352 VRE-negative patients who had one or more follow-up cultures, 74 (21%) became VRE positive during their ICU stay (27 cases per 1,000 patient-ICU days).Conclusion:The prevalence of VRE culture positivity on ICU admission was high and a sizable fraction of ICU patients became VRE positive during their ICU stay despite contact precautions for VRE-positive patients. This was likely due in large part to prior VRE exposures in the rest of the hospital where these control measures were not being used.

scholarly journals Impact on Mental, Physical and Cognitive functioning of a Critical care sTay during the COVID-19 pandemic (IMPACCT COVID-19): protocol for a prospective, multicentre, mixed-methods cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053610
Author(s):  
Ana Cristina Castro-Ávila ◽  
Catalina Merino-Osorio ◽  
Felipe González-Seguel ◽  
Agustín Camus-Molina ◽  
Jaime Leppe
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Cognitive Functioning ◽  
Healthcare Professionals ◽  
Cognitive Impairments ◽  
Anxiety And Depression ◽  
Icu Discharge

IntroductionThe ongoing pandemic could affect the duration, variety and severity of the mental, physical, and cognitive impairments intensive care unit (ICU) survivors and their families frequently present. We aim to determine the impact of the COVID-19 pandemic on the mental, physical, and cognitive health of survivors, the experience of their families and their treating healthcare professionals.Methods and analysisProspective, multicentre, mixed-methods cohort study in seven Chilean ICUs. Sample: 450 adults, able to walk independently prior to admission, in ICU and mechanical ventilation >48 hours with and without COVID-19. Clinical Frailty Scale, Charlson comorbidity index, mobility (Functional Status Score for the Status Score for the Intensive Care Unit) and muscle strength (Medical Research Council Sum Score) will be assessed at ICU discharge. Cognitive functioning (Montreal Cognitive Assessment–blind), anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Impact of Event Scale-Revised) symptoms, disability (WHO Disability Assessment Schedule 2.0), quality of life (European Quality of Life Health Questionnaire), employment and survival will be assessed at ICU discharge, 3 months and 6 months. A sample will be assessed using actigraphy and the Global Physical Activity Questionnaire at 6 months after ICU discharge. Trajectories of mental, physical, and cognitive impairments will be estimated using multilevel longitudinal modelling. A sensitivity analysis using multiple imputations will be performed to account for missing data and loss-to-follow-up. Survival will be analysed using Kaplan-Meier curves. The perceptions of family members regarding the ICU stay and the later recovery will be explored 3 months after discharge. Healthcare professionals will be invited to discuss the challenges faced during the pandemic using semistructured interviews. Interviews will be thematically analysed by two independent coders to identify the main themes of the experience of family members and healthcare professionals.Ethics and disseminationThe study was approved by the Clinica Alemana Universidad del Desarrollo Ethics Committee (2020–78) and each participating site. Study findings will be published in peer-reviewed journals and disseminated through social media and conference meetings.Trial registration numberNCT04979897.

Higher Self-Esteem Associated With Less Symptoms of Anxiety and Depression Among Young Adults After the Loss of a Parent to Cancer—A Longitudinal Study

2021 ◽  
pp. 082585972110445
Author(s):  
Tina Lundberg ◽  
Kristofer Årestedt ◽  
Ulla Forinder ◽  
Mariann Olsson ◽  
Carl Johan Fürst ◽  
...  
Keyword(s):  
Young Adults ◽  
Support Group ◽  
Depression Scale ◽  
Self Esteem ◽  
Anxiety And Depression ◽  
Linear Regression Models ◽  
Hospital Anxiety ◽  
Parentally Bereaved ◽  
Loss Of A Parent

Objective: The purpose of the study was to examine associations between self-esteem and symptoms of anxiety and depression among young adults who lost a parent to cancer. Methods: Older adolescents and young adults, aged 16 to 28 years, who had lost their parent to cancer and had accepted an invitation to join a support group, completed a questionnaire 5 to 8 months after the loss and a similar questionnaire about 10 months later (follow-up). Of a total of 77 young adults who participated in the study, 56 completed both questionnaires. Self-esteem was measured with the Rosenberg Self-Esteem Scale. Symptoms of anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Univariate and multiple linear regression models were used to analyze the associations. Result: Self-esteem was significantly associated with symptoms of anxiety and depression at baseline and at follow-up. Conclusion: This study reveals that self-esteem is a valuable explanatory variable, and that it is associated with both symptoms of anxiety and depression in bereavement. This new knowledge could be used to guide future support to parentally bereaved young adults.

The Effect of Early Cardiopulmonary Rehabilitation on the Outcomes of Intensive Care Unit Survivors

2018 ◽  
Author(s):  
Chih-Cheng Lai ◽  
Willy Chou ◽  
Chien-Ming Chao ◽  
Kuo-Chen Cheng ◽  
Chung-Han Ho ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Readmission Rate ◽  
Lower Mortality ◽  
Research Database ◽  
Early Group ◽  
Post Discharge ◽  
Icu Discharge ◽  
Late Group

Background: This study aims to compare the impact of early and late post-discharge cardiopulmonary rehabilitation on the outcomes of intensive care unit (ICU) survivors. Methods: The retrospective, cohort study used a sub-database of the Taiwan National Health Insurance Research Database (NHIRD) that contains information of all patients had ICU admission between 2000 and 2012. Early group was defined if patients had received cardiopulmonary rehabilitation within 30 days after ICU discharge, and late group was define as if patients had received cardiopulmonary rehabilitation between 30 days and one year after ICU discharge. The end points were mortality and re-admission during the 3-year follow-up. Results: Among 2136 patients received cardiopulmonary rehabilitation after ICU discharge, 994 was classified early group and other 1142 patients were classified as late group. Overall, early group had a lower mortality rate (6.64% vs 10.86%, p = 0.0006), and a lower ICU readmission rate (47.8% vs 57.97%, p &lt; 0.0001) than late group after 3-year follow-up. Kaplan-Meier analysis showed that early group had significantly lower mortality (p=0.0009) and readmission rate (p&lt;0.0001) than late group. In multivariate analysis, the risk of ICU readmission was found to be independently associated with late group (HR, 1.28; 95% CI, 1.13-1.47). Conclusions: Early post-discharge cardiopulmonary rehabilitation among ICU survivors has the long-term survival benefit and significantly decreases the readmission rate.

scholarly journals A Retrospective, Pilot Study of De Novo Antidepressant Medication Initiation in Intensive Care Unit Patients and Post-ICU Depression

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Daniel Haines ◽  
Johanna Hild ◽  
Jianghua He ◽  
Lucy Stun ◽  
Angie Ballew ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
De Novo ◽  
Depression Scale ◽  
Antidepressant Medication ◽  
Icu Discharge ◽  
Prevalence Of Depression ◽  
Historical Controls ◽  
Study Inclusion

Post-ICU Syndromes (PICS) remain a devastating problem for intensive care unit (ICU) survivors. It is currently unknown if de novo initiation of an antidepressant medication during ICU stay decreases the prevalence of post-ICU depression. We performed a retrospective, pilot study evaluating patients who had not previously been on an antidepressant medication and who were started on an antidepressant while in the trauma surgical, cardiothoracic, or medical intensive care unit (ICU). The PHQ-2 depression scale was used to ascertain the presence of depression after ICU discharge and compared this to historical controls. Of 2,988 patients admitted to the ICU, 69 patients had de novo initiation of an antidepressant medication and 27 patients were alive and available for study inclusion. We found the prevalence of depression in these patients to be 26%, which is not statistically different than the prevalence of post-ICU depression in historical controls [95% CI (27.6%, 51.6%)]. De novo initiation of an antidepressant medication did not substantially decrease the prevalence of post-ICU depression in this retrospective, pilot study.

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