Abstract
BackgroundICU survivorship includes a diverse burden of disease. Current questionnaires used for collecting information about health-related problems and their relation to quality of life lack detailed questions in several areas relevant to ICU survivors. Our aim was to construct a provisional questionnaire on health-related issues based on interviews with ICU survivors and to test if this questionnaire was able to show differences between ICU survivors and a control group.MethodsThirty-two ICU survivors were identified at a post-ICU clinic and interviewed at least six months after ICU discharge. Using an established qualitative methodology from oncology, all dysfunctions and disabilities were extracted, rephrased as questions and compiled into a provisional questionnaire. In a second part, this questionnaire was tested on ICU survivors and controls. Inclusion criteria for the ICU survivors were ICU stay at least 72 h with ICU discharge six months to three years prior to the study. A non-ICU-treated control group was obtained from the Swedish Population Register, matched for age and sex. Eligible participants received an invitation letter and were contacted by phone. If willing to participate, they were sent the questionnaire. Descriptive statistics were applied.ResultsAnalysis of the interviews yielded 238 questions in 13 domains: cognition, fatigue, physical health, pain, psychological health, activities of daily living, sleep, appetite and alcohol, sexual health, sensory functions, gastrointestinal functions, urinary functions and work life. In the second part, 395 of 518 ICU survivors and 197 of 231 controls returned a completed questionnaire, the response rates being 76.2% and 85.3%, respectively. The two groups differed significantly in 13 of 22 comorbidities. ICU survivors differed in a majority of questions (p ≤ 0.05) distributed over all 13 domains compared with controls.ConclusionsThis study describes the development of a provisional questionnaire to identify health-related quality of life issues and long-term burden of disease after intensive care. The questionnaire was answered by 395 ICU survivors. The questionnaire could identify that they experience severe difficulties in a wide range of domains compared with a control group.Trial registry ClinicalTrials.gov Ref# NCT 02767180
Highlights
Intensive care unit (ICU) survivorship may come at a price—the price of cognitive [1] and physical dysfunction [2], psychiatric and psychological problems [3], financial and work-related shortcomings [4] and healthcare consumption [5].To identify and describe these problems, the intensive care community uses a synthesis of tests, examinations and questionnaires depending on the context: Short-form health survey (SF-36) and EuroQoL’s five dimensions instrument (EQ-5D) are the most commonly used questionnaires for measuring health-related quality of life [6, 7], but concerns regarding their ability to identify issues valued by ICU survivors have been raised [8]
To identify and describe these problems, the intensive care community uses a synthesis of tests, examinations and questionnaires depending on the context: SF-36 and EQ-5D are the most commonly used questionnaires for measuring health-related quality of life [6, 7], but concerns regarding their ability to identify issues valued by ICU survivors have been raised [8]
We hypothesized that a questionnaire mainly based on interviews with ICU survivors would contain a majority of issues experienced after intensive care, as well as carry a discriminative capacity to identify those issues with a magnitude distinct from a non-ICU-treated population
Summary
ICU survivorship may come at a price—the price of cognitive [1] and physical dysfunction [2], psychiatric and psychological problems [3], financial and work-related shortcomings [4] and healthcare consumption [5].To identify and describe these problems, the intensive care community uses a synthesis of tests, examinations and questionnaires depending on the context: SF-36 and EQ-5D are the most commonly used questionnaires for measuring health-related quality of life [6, 7], but concerns regarding their ability to identify issues valued by ICU survivors have been raised [8]. Within the domains of physical, cognitive and mental health, the concept of PICS (post-intensive care syndrome) points out directions for investigations rather than provides scales. All three of these domains have numerous specific measurements, with for example at least 26 different tools to measure functional outcome [9]. We hypothesized that a questionnaire mainly based on interviews with ICU survivors would contain a majority of issues experienced after intensive care, as well as carry a discriminative capacity to identify those issues with a magnitude distinct from a non-ICU-treated population. Our aim was to construct a provisional questionnaire on health-related issues based on interviews with ICU survivors and to test if this questionnaire was able to show differences between ICU survivors and a control group
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