Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit?
Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit?
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DOI：
10.1097/cce.0000000000000088
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发表时间：
2020-04-01
影响因子：
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通讯作者：
Sevin, Carla M
中科院分区：
文献类型：
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作者：
McPeake, Joanne;Boehm, Leanne M;Sevin, Carla M
从参加和未参加ICU康复计划的患者的角度了解成功计划的最重要组成部分是什么以及如何组织这些计划。设计：国际定性研究。地点：美国、英国和澳大利亚的14家医院。患者：我们对不同组的患者进行了66次半结构化访谈，其中52人使用了ICU康复计划，14人没有。干预措施:没有。测量和主要结果：使用内容分析，记录流行主题，以了解是什么改善了他们的结果。对比未接受某些方面护理的患者的报价，用于确定感知的差异有效性。成功的ICU康复计划有五个关键组成部分：1)护理的连续性；2)改善症状状态；3)规范化和期望管理；4)内部和外部的进度验证；5)减少内疚和无助感。通过早期参与（甚至在出院之前）、ICU工作人员的直接参与以及对传统疾病、症状和社会福利需求的整合的关注，促进了实现这些目标的护理的提供。结论：在这项横跨三大洲的多中心研究中，患者确定了从ICU康复计划中获得的特异性和可重复的获益模式，这可能是未来干预改进的目标。
To understand from the perspective of patients who did, and did not attend ICU recovery programs, what were the most important components of successful programs and how should they be organized.DESIGN: International, qualitative study.SETTING: Fourteen hospitals in the United States, United Kingdom, and Australia.PATIENTS: We conducted 66 semi-structured interviews with a diverse group of patients, 52 of whom had used an ICU recovery program and 14 whom had not.INTERVENTIONS: None.MEASUREMENTS AND MAIN RESULTS: Using content analysis, prevalent themes were documented to understand what improved their outcomes. Contrasting quotes from patients who had not received certain aspects of care were used to identify perceived differential effectiveness. Successful ICU recovery programs had five key components: 1) Continuity of care; 2) Improving symptom status; 3) Normalization and expectation management; 4) Internal and external validation of progress; and 5) Reducing feelings of guilt and helplessness. The delivery of care which achieved these goals was facilitated by early involvement (even before hospital discharge), direct involvement of ICU staff, and a focus on integration across traditional disease, symptom, and social welfare needs.CONCLUSIONS: In this multicenter study, conducted across three continents, patients identified specific and reproducible modes of benefit derived from ICU recovery programs, which could be the target of future intervention refinement.