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Health Expectations and Quality of Life After Acute Respiratory Failure: A Multicenter Prospective Cohort Study.
Turnbull, Alison E; Lee, Emma M; Dinglas, Victor D; Beesley, Sarah; Bose, Somnath; Banner-Goodspeed, Valerie; Hopkins, Ramona O; Jackson, James C; Mir-Kasimov, Mustafa; Sevin, Carla M; Brown, Samuel M; Needham, Dale M.
Afiliación
  • Turnbull AE; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD. Elect
  • Lee EM; Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, MA.
  • Dinglas VD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD.
  • Beesley S; Division of Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, UT; Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Salt Lake City, UT; Center for Humanizing Critical Care, Intermountain Medical Center, Salt Lake City, UT.
  • Bose S; Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, MA.
  • Banner-Goodspeed V; Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, MA.
  • Hopkins RO; Center for Humanizing Critical Care, Intermountain Medical Center, Salt Lake City, UT; Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT.
  • Jackson JC; Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
  • Mir-Kasimov M; Division of Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, UT; Salt Lake City Veterans Administration, Salt Lake City, UT.
  • Sevin CM; Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
  • Brown SM; Division of Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, UT; Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Salt Lake City, UT; Center for Humanizing Critical Care, Intermountain Medical Center, Salt Lake City, UT.
  • Needham DM; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD; Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore,
Chest ; 164(1): 114-123, 2023 07.
Article en En | MEDLINE | ID: mdl-36682611
BACKGROUND: Patients often have high expectations for recovery after critical illness, but the impact of these expectations on subsequent quality of life (QoL) after serious illnesses has not been evaluated empirically. RESEARCH QUESTION: Among adult survivors of acute respiratory failure (ARF), are met vs unmet expectations for health associated with self-reported QoL 6 months after discharge? STUDY DESIGN AND METHODS: This was a prospective longitudinal cohort study enrolling consecutive adult patients with ARF managed in ICUs at five academic medical centers. At hospital discharge, we evaluated participants' expected health 6 months in the future via a visual analog scale (VAS; range, 0-100), with higher scores representing better expected health. At 6-month follow-up, perceived health was assessed using the EQ-5D VAS, and QoL was assessed using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) instrument. Participants' health expectations were categorized as having been met when perceived health at 6 months was no more than eight points lower than their expectation at study enrollment. The primary analysis compared WHOQOL-BREF domain scores (range, 0-100) at 6 months after discharge in patients with met vs unmet health expectations using the nonparametric Mann-Whitney U test. Secondary analysis modeled WHOQOL-BREF domain scores using multivariate regression, and sensitivity analyses assessed QoL using EQ-5D-5L index values. RESULTS: In the primary analysis, QoL was significantly better among participants with met vs unmet health expectations across all domains of the WHOQOL-BREF: physical health (estimated difference in scores: median, 19 [interquartile range (IQR), 12-15]; P < .001), psychological health (median, 12 [IQR, 6-18]; P < .001), social relationships (median, 6 [IQR, 0-13]; P = .02), and environmental health (median, 12 [IQR, 6-13]; P < .001). In multivariate regression, the difference between expected and perceived health remained associated significantly with the physical health domain score. INTERPRETATION: Fulfillment of health expectations is associated with better QoL after ARF, suggesting a mechanism underpinning successful ICU recovery programs that incorporate normalization and expectation management.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Insuficiencia Respiratoria Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Humans Idioma: En Revista: Chest Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Insuficiencia Respiratoria Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Humans Idioma: En Revista: Chest Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos