Patients' Adaptations After Acute Respiratory Distress Syndrome: A Qualitative Study.
Patients' Adaptations After Acute Respiratory Distress Syndrome: A Qualitative Study.
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DOI：
10.4037/ajcc2021825
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发表时间：
2021-05-01
影响因子：
2.7
通讯作者：
Iwashyna, Theodore J.
中科院分区：
文献类型：
--
作者：
Hauschildt, Katrina E.;Seigworth, Claire;Kamphuis, Lee A.;Hough, Catherine L.;Moss, Marc;McPeake, Joanne M.;Harrod, Molly;Iwashyna, Theodore J.
许多患者在急性呼吸窘迫综合征(ARDS)后面临身体、认知和情绪方面的问题。目前还没有经过验证的治疗方法来解决这些问题，许多患者和家属在几乎没有正式支持的情况下管理新的残疾和康复。了解患者对ARDS住院后出现的问题的适应情况可能有助于确定改善康复的机会。探讨患者如何适应ARDS住院带来或加剧的身体、认知和情绪变化。半结构化访谈是在患者住院后进行的，作为多中心随机对照试验的辅助研究，对象是机械通气的ARDS患者。连续的存活患者被招募，他们说英语，同意随访，并在2017年11月12日至2018年4月5日之间随机分组(N=79)。患者在随机化后9-16个月进行访谈。符合条件的ARDS幸存者中有46/79人(58%)参加；他们的中位年龄为58岁(IQR 48，63)。所有患者都报告了解决ARDS住院后出现的身体、情感和/或认知问题的策略。对于身体和认知问题，患者报告了旨在适应新残疾的调节策略和专注于恢复先前能力的疗养策略。对于情绪问题，以调节和疗养为重点的策略之间没有明确的区别。社会支持和以前对医疗保健系统的熟悉帮助患者制定和利用了许多策略。31/46名患者报告至少有一个持续性问题，他们没有确定可接受的适应。患者报告采用了不同的策略来处理ARDS后的问题，但需要更多的工作来确定并向患者及其家人传播有效的策略。
Many patients confront physical, cognitive, and emotional problems after acute respiratory distress syndrome (ARDS). No proven therapies exist to address these problems and many patients and families manage new disability and recovery with little formal support. Eliciting patients’ adaptations to problems following their ARDS hospitalization may help identify opportunities to improve recovery. To explore how patients adapted to physical, cognitive, and emotional changes brought about or exacerbated by their ARDS hospitalization. Semi-structured interviews were conducted following patients’ hospitalization as an ancillary study to a multi-center RCT among mechanically ventilated ARDS patients. Consecutive surviving patients were recruited who were English-speaking, consented to follow-up, and were randomized between 11/12/2017 and 4/5/2018 (N=79). Patients were interviewed 9–16 months post-randomization. 46/79 (58%) eligible ARDS survivors participated; their median age was 58 (IQR 48, 63). All patients reported strategies to address physical, emotional, and/or cognitive problems that arose following their ARDS hospitalization. For physical and cognitive problems, patients reported accommodative strategies aimed at adapting to new disabilities and recuperative strategies focused on recovering previous ability. For emotional issues, there was not a clear distinction between accommodative- and recuperative-focused strategies. Social support and previous familiarity with the healthcare system helped patients generate and utilize many strategies. 31/46 patients reported at least one persistent problem for which they had not identified an acceptable adaptation. Patients report employing varied strategies to manage problems after ARDS, but more work is needed to identify and disseminate effective strategies to patients and their families.
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影响因子：
8.8
作者：
Fan E;Dowdy DW;Colantuoni E;Mendez-Tellez PA;Sevransky JE;Shanholtz C;Himmelfarb CR;Desai SV;Ciesla N;Herridge MS;Pronovost PJ;Needham DM
通讯作者：
Needham DM
DOI：
10.1164/rccm.201103-0503oc
发表时间：
2012-03-01
影响因子：
24.7
作者：
Bienvenu, Oscar J.;Colantuoni, Elizabeth;Needham, Dale M.
通讯作者：
Needham, Dale M.
DOI：
10.1093/geronb/gbw102
发表时间：
2017-03-01
影响因子：
6.2
作者：
Freedman, Vicki A.;Kasper, Judith D.;Spillman, Brenda C.
通讯作者：
Spillman, Brenda C.
影响因子：
120.7
作者：
Giacomini, MK;Cook, DJ
通讯作者：
Cook, DJ
影响因子：
4.3
作者：
Haines, Kimberley J.;Quasim, Tara;McPeake, Joanne
通讯作者：
McPeake, Joanne