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)和抑郁是危重疾病后可能发生的常见疾病。在危重疾病幸存者以及危重疾病幸存者的家属中描述了这些障碍。这两种疾病都有很大的相关负担，无法工作或恢复以前的功能水平，以及由于医疗费用增加而降低了生活质量和增加了社会成本。家庭成员是一个需要考虑的重要群体，因为重症监护病房的护理经验不仅限于危重患者，还包括危重患者的家人。这项建议的目的是确定ICU护理的具体过程与急性肺损伤幸存者及其家人的长期心理结果之间的联系，包括创伤后应激障碍和抑郁。我们假设，患者的精神症状与其家人的相似症状之间将存在显著的相关性，这种相关性将为针对患者及其家人的干预提供洞察力。数据将以纵向队列研究的形式在华盛顿州西雅图的大型县医院哈博维尤医疗中心收集。患者及其家属将在出院后3个月和6个月接受调查。多变量分析将被用来检验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系。此外，还将使用多变量分析来检验特定于家庭的护理过程与家庭长期心理和生活质量结果之间的关系。最后，我们将寻找患者及其家庭成员之间的这些结果之间的相关性，为未来的干预提供见解。急性肺损伤在ICU中很常见，在这种危重疾病的幸存者中，长期的心理结果似乎也很常见。家庭成员也会对他们所爱的人的危重疾病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.