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Abstract

Introduction We wished to obtain the experiences felt by patients during their ICU stay using an original questionnaire and to correlate the memories of those experiences with health-related quality of life (HR-QOL). Methods We conducted a prospective study in 10 Portuguese intensive care units (ICUs). Six months after ICU discharge, an original questionnaire on experiences of patients during their ICU stay, the recollection questionnaire, was delivered. HR-QOL was evaluated simultaneously, with the EQ-5D questionnaire. Between 1 September 2002 and 31 March 2003 1433 adult patients were admitted. ICU and hospital mortalities were 21% and 28%, respectively. Six months after ICU discharge, 464 patients completed the recollection questionnaire. Results Thirty-eight percent of the patients stated they did not remember any moment of their ICU stay. The ICU environment was described as friendly and calm by 93% of the patients. Sleep was described as being good and enough by 73%. The experiences reported as being more stressful were tracheal tube aspiration (81%), nose tube (75%), family worries (71%) and pain (64%). Of respondents, 51% experienced dreams and nightmares during their ICU stay; of these, 14% stated that those dreams and nightmares disturb their present daily life and they exhibit a worse HR-QOL. Forty-one percent of patients reported current sleep disturbances, 38% difficulties in concentrating in current daily activities and 36% difficulties in remembering recent events. More than half of the patients reported more fatigue than before the ICU stay. Multiple and linear regression analysis showed that older age, longer ICU stay, higher Simplified Acute Physiology Score II, non-scheduled surgery and multiple trauma diagnostic categories, present sleep disturbances, daily disturbances by dreams and nightmares, difficulties in concentrating and difficulties in remembering recent events were independent predictors of worse HR-QOL. Multicollinearity analysis showed that, with the exception of the correlation between admission diagnostic categories and length of ICU stay (0.47), all other correlations between the independent variables and coefficient estimates included in the regression models were weak (below 0.30). Conclusion This study suggests that neuropsychological consequences of critical illness, in particular the recollection of ICU experiences, may influence subsequent HR-QOL.

“Not being able to talk was horrid”: A descriptive, correlational study of communication during mechanical ventilation

“…Thirty percent of participants in this study recalled being unable to let people know what they wanted, similar to findings by Rattray et al (2010). However this percentage is lower than reported in other studies in which 40 to 62% of patients reported communication as stressful or difficult (Granja et al, 2005; Happ et al, 2011; Patak et al, 2004). This discrepancy may in part be due to the wording of the communication item in the ICEQ that asks participants to rate how often they were able to let people know what they wanted, a measure of effectiveness of communication rather than the stress related to communication.…”

Accuracy of Critical Care Pain Observation Tool and Behavioral Pain Scale to assess pain in critically ill conscious and unconscious patients: prospective, observational study

“…Pain is highly underestimated although it seems to be the patients’ worst memory in intensive care unit (ICU) [1, 2] even after 5 years from ICU discharge [3]. The perception of pain in ICU patients is mainly associated with respiratory therapy, positioning of nasogastric tube, venous and arterial catheters, and lack of mobilization [2].…”

Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool

“…Our research team reviewed existing questionnaires for distress in critical care [8-10], but found none were suitable as a quick screening tool. Existing questionnaires were too long, contained many items not relevant to this purpose, or were primarily measures of post-critical care recall rather than current experience of critical care.…”