Quality of life 6 months after intensive care: Results of a prospective multicenter study using a generic health status scale and a satisfaction scale
Quality of life 6 months after intensive care: Results of a prospective multicenter study using a generic health status scale and a satisfaction scale
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DOI：
10.1007/s001340050336
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发表时间：
1997-03-01
影响因子：
38.9
通讯作者：
Brivet, F
中科院分区：
文献类型：
--
作者：
Hurel, D;Loirat, P;Brivet, F
目的：评价重症监护患者出院后6个月的生活质量。设计：多中心前瞻性研究。环境：四所法国大学医院的内科外科重症监护室。患者：在1989年1月1日至3月31日期间入住4个icu的589例患者中，329例进行了调查。测量方法和结果：在出院后6个月邮寄一份评估健康相关生活质量的通用量表、诺丁汉健康概况（NHP）、满意度量表、感知生活质量量表（PQOL）和一份职业状况问卷。记录年龄、急性疾病严重程度（用简化急性生理评分评估）和主要诊断数据。可分析问卷223份，占67.8%。79.7%的患者职业状态保持不变，但病假明显增加（15.3% vs 22.1%） （p < 0.01）。用NHP评估的生活质量是公平的(50（th）百分位数= 0.73（0 - 1量表），而用PQOL衡量的满意度较低（50（th）百分位数= 0.61）。两个量表相关性良好（z = 9.853; p = 0.0001），但离散度较大。NHP量表显示，精力、睡眠和情绪反应严重下降，而社交孤立、疼痛和身体残疾则不常见。家庭支持在PQOL评分中被评为非常好，而对娱乐和职业活动则表示不满。随后的病假与较差的生活质量相关（p < 0.05）。生活质量主要是诊断的功能，而不是年龄和疾病的严重程度：因自杀企图或慢性阻塞性肺病入院的患者表现不佳。结论：ICU住院6个月后，与健康相关的生活质量量表和满意度量表测量的生活质量取决于入院诊断。生活质量的不同维度受到不同程度的影响。
Objective: To assess the quality of life of intensive care survivors 6 months after discharge.Design: Multicenter prospective study.Setting: Medical-surgical intensive care units (ICUs) of four French university hospitals.Patients: Among the 589 patients admitted to the four ICUs between 1 January and 31 March 1989, 329 were investigated.Measurements and results: A generic scale assessing health-related quality of life, the Nottingham Health Profile (NHP), a satisfaction scale, the Perceived Quality of Life scale (PQOL) and a questionnaire on professional status were sent by mail 6 months after discharge. Data concerning age, severity of acute illness (assessed by the Simplified Acute Physiology Score) and main diagnosis were recorded. A total of 223 questionnaires (67.8 %) were analysable. The professional status remained unchanged in 79.7 % of the patients, despite a significant (p < 0.01) increase (15.3 vs 22.1 %) in sick leave. Quality of life, assessed with NHP, was fair (50(th) percentile = 0.73 on a 0 to 1 scale), whereas satisfaction measured by PQOL was lower (50(th) percentile = 0.61). Both scales correlated well (z = 9.853; p = 0.0001) but with a large dispersion. The NHP scale showed a severe reduction in energy, sleep and emotional reactions, whereas social isolation, pain and physical handicap were infrequent. Family support was rated with the PQOL score as very good, whereas dissatisfaction concerning recreational and professional activities was expressed. Subsequent sick leave was associated with a poor quality of life (p < 0.05). Quality of life was mainly a function of the diagnosis, not of age and severity of illness: patients admitted for suicide attempt or chronic obstructive pulmonary disease fared poorly.Conclusions: Quality of life measured with a health-related quality of life scale and a satisfaction scale 6 months after an ICU stay depended on the admission diagnosis. Different dimensions of quality of life were variably affected.