Impact of post-traumatic stress symptoms on the health-related quality of life in a cohort study with chronically critically ill patients and their partners: age matters
Impact of post-traumatic stress symptoms on the health-related quality of life in a cohort study with chronically critically ill patients and their partners: age matters
复制标题
DOI：
10.1186/s13054-019-2321-0
复制
发表时间：
2019-02-08
期刊：
影响因子：
15.1
通讯作者：
Rosendahl, Jenny
中科院分区：
文献类型：
--
作者：
Wintermann, Gloria-Beatrice;Petrowski, Katja;Rosendahl, Jenny
背景 患有持续器官功能障碍和不受控制的炎症反应的急性危重疾病的幸存者很容易发展为慢性危重疾病。作为精神后遗症，创伤后应激障碍和健康相关生活质量（QoL）的相关下降不仅发生在患者身上，也发生在他们的伴侣身上。目前，缺乏对慢性危重病患者-伴侣二人组的长期精神困扰的研究，缺乏使用适当的二元分析策略（对相同变量进行测量和关联的患者和伴侣）并控制背景因素的研究。 方法本研究调查了n = 70对慢性危重病患者及其伴侣的创伤后应激症状（PTSS）和健康相关生活质量的相互依赖性，使用考虑情境因素（年龄、性别、合作关系时长）的参与者-合作伙伴-相互依赖模型（APIM）。从急性护理 ICU 转移到急性后 ICU 后最多 6 个月内，对患者及其伴侣应用创伤后应激量表 (PTSS-10) 和欧洲生活质量 (EQ-5D-3L)。结果 17.1% 的患者和 18.6% 的伴侣报告了临床相关的创伤后应激症状。慢性危重患者及其患有更严重创伤后应激症状的伴侣也表现出与健康相关的生活质量下降。与女性伴侣或女性患者相比，后者在男性伴侣中更为明显。在年轻伴侣（57岁）中，较高的创伤后应激症状与患者生活质量下降相关。结论应向慢性危重患者及其伴侣提供心理健康筛查和心理治疗选择。未来的研究需要满足年轻患者与伴侣在长期 ICU 治疗后的特殊需求。试验注册德国临床试验注册号 DRKS00003386。注册日期：2011 年 11 月 13 日
BackgroundSurvivors of an acute critical illness with continuing organ dysfunction and uncontrolled inflammatory responses are prone to become chronically critically ill. As mental sequelae, a post-traumatic stress disorder and an associated decrease in the health-related quality of life (QoL) may occur, not only in the patients but also in their partners. Currently, research on long-term mental distress in chronically critically ill patient-partner dyads, using appropriate dyadic analysis strategies (patients and partners being measured and linked on the same variables) and controlling for contextual factors, is lacking.MethodsThe present study investigates the interdependence of post-traumatic stress symptoms (PTSS) and the health-related QoL in n=70 dyads of chronically critically ill patients and their partners, using the Actor-Partner-Interdependence Model (APIM) under consideration of contextual factors (age, gender, length of partnership). The Post-traumatic Stress Scale (PTSS-10) and Euro-Quality of Life (EQ-5D-3L) were applied in both the patients and their partners, within up to 6months after the transfer from acute care ICU to post-acute ICU.ResultsClinically relevant post-traumatic stress symptoms were reported by 17.1% of the patients and 18.6% of the partners. Both the chronically critically ill patients and their partners with more severe post-traumatic stress symptoms also showed a decreased health-related QoL. The latter was more pronounced in male partners compared to female partners or female patients. In younger partners (57years), higher values of post-traumatic stress symptoms were associated with a decreased QoL in the patients.ConclusionsMental health screening and psychotherapeutic treatment options should be offered to both the chronically critically ill patients and their partners. Future research is required to address the special needs of younger patient-partner dyads, following protracted ICU treatment.Trial registrationGerman Clinical Trials Register No. DRKS00003386. Registered 13 November 2011