Critical care therapies associated with longterm outcomes after acute lung injury

描述（由申请人提供）：创伤后应激障碍（PTSD）和抑郁症是危重病后可能发生的常见疾病。这些疾病已经在危重病幸存者以及危重病幸存者的家庭成员中描述。这两种疾病都会带来沉重的负担，导致无法工作或恢复到以前的功能水平，以及生活质量下降和由于医疗保健成本增加而增加的社会成本。家庭成员是一个需要考虑的重要群体，因为重症监护室的护理经验不仅限于重症患者，还包括重症患者的家庭成员。该提案的目标是确定ICU护理的特定过程与急性肺损伤幸存者及其家人的长期心理结局（包括PTSD和抑郁症）之间的关联。我们假设患者的精神症状与其家庭成员的类似症状之间存在显着相关性，这种相关性将为针对患者及其家庭的干预措施提供见解。数据将作为纵向队列研究在哈博维尤医疗中心收集，哈博维尤医疗中心是西雅图，华盛顿的一家大型县级医院。患者及其家属将在ICU出院后3个月和6个月接受调查。将使用多变量分析来检查患者特定护理过程与患者长期心理和生活质量结果之间的关联。额外的多变量分析将被用来检查家庭特定的护理过程和家庭长期的心理和生活质量的结果之间的关联。最后，我们将寻找患者及其家庭成员的这些结果之间的相关性，为未来的干预措施提供见解。急性肺损伤在ICU中很常见，长期的心理后果似乎在这种危重疾病的幸存者中很常见。家人也会因为亲人的重病而产生长期的心理后果。重要的是要确定与这些心理结果相关的具体护理过程，以便制定有针对性的干预措施，以减少这种发病率。

DESCRIPTION (provided by applicant): Post-traumatic stress disorder (PTSD) and depression are common conditions that can occur after critical illness. These disorders have been described among survivors of critical illness as well as family members of survivors of critical illness. Both conditions have significant burdens associated with them, with inability to work or return to prior levels of functioning, as well as reduced quality of life and increased cost to society due to increased health care costs. Family members are an important group to consider because the experience of care in the intensive care unit extends beyond critically ill patients to the family members of those who are critically ill. The goal of this proposal is to identify associations between specific processes of ICU care and long-term psychological outcomes including PTSD and depression among survivors of acute lung injury and their family members. We hypothesize that there will be significant correlation between psychiatric symptoms of patients and similar symptoms of their family members and that this correlation will provide insights for interventions targeting patients and their families. Data will be collected as a longitudinal cohort study at Harborview Medical Center, a large county hospital in Seattle, Washington. Patients and their family members will be surveyed at 3 and 6 months following discharge from the ICU. Multivariate analysis will be used to examine associations between patient specific processes of care and patient long-term psychological and quality of life outcomes. Additional multivariate analysis will be used to examine associations between family specific processes of care and family long-term psychological and quality of life outcomes. Finally, we will look for correlation between these outcomes in patients and their family members to provide insights for future interventions. Acute lung injury is common in the ICU, and long-term psychological outcomes appear to be common among survivors of this critical illness. Family members also have long-term psychological consequences of their loved one's critical illness. It is important to identify specific processes of care associated with these psychological outcomes in order to develop focused interventions to decrease this morbidity.