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

Gloria-Beatrice Wintermann,Bernhard Strauß,Kerstin Weidner,Jenny Rosendahl,Katja Petrowski

doi:10.1186/s13054-019-2321-0

Abstract

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 6 months 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 (≤ 57 years), 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

Highlights

Survivors of an acute critical illness with continuing organ dysfunction and uncontrolled inflammatory responses are prone to become chronically critically ill [1]
The partners of the chronically critically ill patients were assessed with respect to post-traumatic stress and health-related quality of life (QoL) at a median time of 4.8 months (IQR 3.9–6.5) following the intensive care unit (ICU) discharge
The primary aim of the present study was to investigate the association between post-traumatic stress and health-related quality of life (QoL) simultaneously in chronically critically ill patients and their partners following the discharge from the intensive care unit (ICU)

Summary

Introduction

Survivors of an acute critical illness with continuing organ dysfunction and uncontrolled inflammatory responses are prone to become chronically critically ill [1]. A cluster of adverse mental sequelae may occur in family members, including depression, anxiety, and acute/post-traumatic stress disorder (PTSD). These have been referred to as Post-intensive Care Syndrome-Family (PICS-F) [8, 9]. A post-traumatic stress disorder and an associated decrease in the health-related quality of life (QoL) may occur, in the patients and in their partners. 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

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