Dataset Information

Post-hospital recovery trajectories of family members of critically ill COVID-19 survivors: an international qualitative investigation.

ABSTRACT:

Purpose

The immediate impact of coronavirus disease 2019 (COVID-19) visiting restrictions for family members has been well-documented. However, the longer-term trajectory, including mechanisms for support, is less well-known. To address this knowledge gap, we aimed to explore the post-hospital recovery trajectory of family members of patients hospitalised with a critical care COVID-19 admission. We also sought to understand any differences across international contexts.

Methods

We undertook semi-structured interviews with family members of patients who had survived a COVID-19 critical care admission. Family members were recruited from Spain and the United Kingdom (UK) and telephone interviews were undertaken. Interviews were analysed using a thematic content analysis.

Results

Across the international sites, 19 family members were interviewed. Four themes were identified: changing relationships and carer burden; family health and trauma; social support and networks and differences in lived experience. We found differences in the social support and networks theme across international contexts, with Spanish participants more frequently discussing religion as a form of support.

Conclusions

This international qualitative investigation has demonstrated the challenges which family members of patients hospitalised with a critical care COVID-19 admission experience following hospital discharge. Specific support mechanisms which could include peer support networks, should be implemented for family members to ensure ongoing needs are met.

SUBMITTER: McPeake J

PROVIDER: S-EPMC10556116 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Post-hospital recovery trajectories of family members of critically ill COVID-19 survivors: an international qualitative investigation.

McPeake Joanne J Castro Pedro P Kentish-Barnes Nancy N Cuzco Cecilia C Azoulay Elie E MacTavish Pamela P Quasim Tara T Puxty Kathryn K

Intensive care medicine 20230912 10

<h4>Purpose</h4>The immediate impact of coronavirus disease 2019 (COVID-19) visiting restrictions for family members has been well-documented. However, the longer-term trajectory, including mechanisms for support, is less well-known. To address this knowledge gap, we aimed to explore the post-hospital recovery trajectory of family members of patients hospitalised with a critical care COVID-19 admission. We also sought to understand any differences across international contexts.<h4>Methods</h4>We ...[more]

PMID: 37698596

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Project description:ObjectivesThird delay refers to delays in delivering requisite care to patients after they arrive at a health facility. In low-resource care settings, effective triage and flow of care are difficult to guarantee. In this study, we aimed to identify delays in the delivery of care to critically ill patients and possible ways to address these delays.DesignThis was an exploratory qualitative study using in-depth interviews and patient journeys. The qualitative data were transcribed and aggregated into themes in NVivo V.12 Plus using inductive and deductive approaches.SettingThis study was conducted in four secondary-level public Kenyan hospitals across four counties between March and December 2021. The selected hospitals were part of the Clinical Information Network.ParticipantsPurposive sampling method was used to identify administrative and front-line healthcare providers and patients. We conducted 12 in-depth interviews with 11 healthcare workers and patient journeys of 7 patients. Informed consent was sought from the participants and maintained throughout the study.ResultsWe identified a cycle of suboptimal systems for care with adaptive mechanisms that prevent quality care to critically ill patients. We identified suboptimal systems for identification of critical illness, inadequate resources for continuity care and disruption of the flow of care, as the major causes of delays in identification and the initiation of essential care to critically ill patients. Our study also illuminated the contribution of inflexible bureaucratic non-clinical business-related organisational processes to third delay.ConclusionEliminating or reducing delays after patients arrive at the hospital is a time-sensitive measure that could improve the care outcomes of critically ill patients. This is achievable through an essential emergency and critical care package within the hospitals. Our findings can help emphasise the need for standardised effective and reliable care priorities to maintain of care of critically ill patients.

Project description:Prior research has indicated that adopting strict glycemic control measures might elevate the risk of hypoglycemia and result in higher mortality rates among critically ill patients. However, there is a lack of studies investigating the incidence of hypoglycemia and its consequential outcomes in real-world clinical settings. This retrospective cohort study was conducted at Taichung Veterans General Hospital, utilizing critical care databases covering the period from 2015 to 2020. The objective was to examine the outcomes and identify risk factors associated with hypoglycemia in critically ill patients. Out of the total of 16,699 patients admitted to the intensive care units (ICUs), 2,115(12.7%) experienced at least one episode of hypoglycemia were included in the analysis. Critically ill patients who developed hypoglycemia had a significantly higher hospital mortality rate compared to those who did not experience hypoglycemia. (48.9% vs. 15.9%, p < 0.001). Moreover, patients with more severe hypoglycemia exhibited a higher mortality rate (moderate hypoglycemia: hazard ratio [HR] 1.477, 95% confidence interval [C.I.] 1.351-1.614, p < 0.001; severe hypoglycemia: HR 1.847, 95% C.I. 1.607-2.123, p < 0.001) compared to those without hypoglycemia. Additionally, patients with greater frequency of hypoglycemic episodes also showed a higher mortality rate (one episode HR 1.504, 95% C.I. 1.366-1.657, p < 0.001; multiple episodes HR 1.613, 95% C.I. 1.444-1.801, p < 0.001) compared to those without hypoglycemia. Patient who experienced spontaneous hypoglycemia (53.9% vs. 42.4%, p < 0.001) and those without a prior diagnosis of diabetes (60.2% vs. 37.0%, p < 0.001) had higher mortality rate. Hypoglycemia frequently occurs and serves as an independent risk factor for mortality among critically ill individuals, particularly in cases of severe and recurrent episodes. Patients experiencing spontaneous hypoglycemia, as well as those lacking a diabetes diagnosis, demonstrated elevated mortality rates.

Project description:ObjectivesTo analyze functional recovery groups of critically ill COVID-19 survivors during their hospital stay and to identify the associated factors.DesignProspective observational multicenter study.SettingDemographic, clinical, and therapeutic variables were collected, and physical and functional status were evaluated. The Barthel index was evaluated at three time points: 15 days before hospitalization, at ICU discharge, and at hospital discharge from the ward.PatientsPatients with functional independence before COVID-19 diagnosis were recruited from four hospitals and followed up until hospital discharge.Measurements and main resultsThree groups of functional recovery were described for 328 patients: functional independence ( n = 144; 44%), which included patients who preserved their functional status during hospitalization; recovered functionality ( n = 109; 33.2%), which included patients who showed dependence at ICU discharge but recovered their independence by hospital discharge; and functional dependency ( n = 75; 22.8%), which included patients who were dependent at ICU discharge and had not recovered their functional status at hospital discharge. The factors associated with becoming functionally dependent at ICU discharge were time to out-of-bed patient mobilization (odds ratio [OR], 1.20; 95% CI, 1.11-1.29), age (OR, 1.02; 95% CI, 1.01-1.04), hyperglycemia (OR, 2.52; 95% CI, 1.56-4.07), and Simplified Acute Physiology Score (OR, 1.022; 95% CI, 1.01-1.04). Recovery to baseline independence during ward stays was associated with ICU length of stay (OR, 0.97; 95% CI, 0.94-0.99) and muscle strength (Medical Research Council test) at ICU discharge (OR, 1.13; 95% CI, 1.08-1.18).ConclusionsAge, hyperglycemia, and time for patient mobilization out of bed were independent factors associated with becoming physically dependent after their ICU stay. Recovery of physical function at hospital discharge was associated with muscle strength at ICU discharge and length of ICU stay.

Dataset Information

Post-hospital recovery trajectories of family members of critically ill COVID-19 survivors: an international qualitative investigation.

Purpose

Methods

Results

Conclusions

Publications

Post-hospital recovery trajectories of family members of critically ill COVID-19 survivors: an international qualitative investigation.

Similar Datasets

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