The current follow-up program, adjusted to individual patients' conditions and needs in terms of different types of contacts and continuity, was found to be of great value. Effects of the program other than the patient perspective are also relevant to evaluate.
Diaries seem to be valuable in understanding what happened, giving a feeling of trust and for talking about their ICU-stay. As many patients described stressful memories, sessions should be offered with ICU staff.
The aim of the study was to investigate the potential role of chest tomosynthesis (CTS) at a tertiary referral centre by exploring to what extent CTS could substitute chest radiography (CXR) and computed tomography (CT). The study comprised 1433 CXR, 523 CT and 216 CTS examinations performed 5 years after the introduction of CTS. For each examination, it was decided if CTS would have been appropriate instead of CXR (CXR cases), if CTS could have replaced the performed CT (CT cases) or if CT would have been performed had CTS not been available (CTS cases). It was judged that (a) CTS had been appropriate in 15 % of the CXR examinations, (b) CTS could have replaced additionally 7 % of the CT examinations and (c) CT would have been carried out in 63 % of the performed CTS examinations, had CTS not been available. In conclusion, the potential role for CTS to substitute other modalities during office hours at a tertiary referral centre may be in the order of 20 and 25 % of performed CXR and chest CT, respectively.
Background: Follow-up for heterogeneous intensive care patients presents challenges for rehabilitation interventions and outcome measurements. The aim was to describe and explore characteristics and determinants for visiting/not visiting a nurse-led clinic (NLC) at different time-points, and to describe physical and mental health (HRQoL) over time.
Methods:Patients with a length of stay (LOS) of ≥72 hours, discharged from a general intensive care unit 2004-2014, who participated in a 6-month follow-up programme offering visits to NLC at 2 and 6 months were included. The register study includes information regarding patients' participation in NLC, clinical and demographic data from the Patient Administrative System within Intensive care, and data on 2-, 6-and 12-month HRQoL by using SF-36 from the Swedish Intensive Care Registry.Results: Of 656 patients, 57% visited the NLC on some occasion. These patients were younger (P = .000), had lower Simplified Acute Physiology scores (P = .001) and higher SF-36 physical health domain scores at 2 months (P < .05) compared to those not visiting at all. Visitors at 2 months only were younger, had shorter LOS and higher physical and mental domain scores than patients visiting at 6 months only. Patients visiting the NLC scored significantly higher in all domains from 2 to 12 months, whereas nonvisiting-patients' did this in four out of eight domains during the same time frame.
Conclusion:Individual patient's characteristics and current health conditions seem to influence visits to NLC or not. The findings may contribute to the development of existing routines to match the diversity of patients' needs and life situations.
| INTRODUC TI ONPost intensive care unit (ICU) follow-up contributes to increased knowledge about patients' needs and recovery after an ICU stay.Patients often report having remaining difficulties caused by the critical illness, treatment and care 1 and may suffer from new or worsening physical, cognitive or mental health problems, collectively named Post Intensive Care Syndrome (PICS). 2 Follow-up clinics may provide opportunities to help patients manage difficulties at different levels of care and at different time points. 3,4 A follow-up service and ICU diary have shown positive effects on posttraumatic stress disorder. 5,6 Patients visiting a nurse-led clinic (NLC) expressed, to a significantly greater extent, that they received advice and information, gained knowledge and re-evaluated memories and experiences from the ICU stay, compared to patients not attending the clinic. 7 However no convincing positive improvements were found regarding Health-Related Quality of Life (HRQoL) in 1 year follow-ups compared to standard care 8,9 or in a recovery programme also measuring sense of coherence and psychological health. 10 Also, systematic reviews have not been able to detect that follow-ups promote recovery. [11][12][13] How to cite this article: Glimelius Petersson C, Jakobsson L, Westergren A, Bergbom I. Factors and health-related quality of life associated wi...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.