Follow-up after critical care
- 779 Downloads
KeywordsCritical Care Rehabilitation Service Patient Participation Psychological Morbidity Vision Modality
Many patients experience physical and psychological morbidity following a stay in critical care . The National institute of Clinical Excellence (NICE UK) recommends access to follow-up and rehabilitation services for this patient group . We aim to present 1 year's experience following the establishment of a follow-up service at our university teaching hospital.
The multidisciplinary follow-up team consisted of a consultant in critical care, a senior nurse and a critical care physiotherapist. Patients completed a preclinic questionnaire followed by a semi-structured interview to identify potential issues. Twenty-four clinics took place over the 12-month period.
A total of 221 patients were recruited. Of the patients studied 26% attended the clinic and completed the evaluation questionnaire, 30% did not engage follow up services. We identified recurrent themes in both physical and nonphysical problems. Example physical problems include limited physical activities in 77%, with 54% of patients studied finding difficulties with activities of daily living. Alteration in taste, smell, hearing and vision modalities was frequently described. In terms of psychological morbidity, anxiety and post-traumatic stress symptoms seem to predominate. Significant numbers of patients retain memory of their ITU stay, with one-third in the form of flashback memories. Only 5% of patients studied returned to work.
Our findings demonstrate that a wide variety of problems can be identified in an ICU follow-up clinic. The challenge now is to identify those groups of patients who will benefit most from follow-up, to develop effective rehabilitation programmes for these patients, and to find methods to increase patient participation.
- 2.CG83 Rehabilitation after Critical Illness. 2009, London: National Institute for Clinical ExcellenceGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.