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Feasibility of an App to Measure Patient Stressors in an Intensive Care Unit (ICU Feel Better App)- a Before-and-after Study

Completed
Conditions
Delirium
Registration Number
NCT04880967
Lead Sponsor
Charite University, Berlin, Germany
Brief Summary

This study examines the feasibility and efficacy of a mobile application (app), which enables critically ill patients to report perceived patient stressors to their caregivers.

Detailed Description

For many critically ill patients, treatment in an intensive care unit (ICU) is very stressful, and for some of the patients it is a traumatic experience. The domains of patient stressors encompass physical stressors, mental health stressors, communication stressors, and environmental stressors. The experience of stressors during ICU is associated with a higher risk of worse outcomes including delirium, delayed recovery, and post-intensive care syndrome (PICS). In the context of inpatient intensive care medicine, health care professionals (HCP) have problems to correctly rate the extent of their patients' stress.

In this study, we examine the feasibility and efficacy of a stressor-reporting system based on a mobile application (app), which allows critically ill patients to evaluate by themselves the intensity of their stressors, and thus, to communicate their stress experience to HCPs.

In the first assessment phase of this study, outcome data of a cohort of n=20 patients will be collected (cohort A). Participants of cohort A will not use the ICU Feel Better App. In the second phase, outcome data of another n=20 patients (cohort B) will be collected. Participants of cohort B will have the opportunity to use the ICU Feel Better App from the second day after admission to the ICU until the day of discharge from ICU.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
46
Inclusion Criteria
  • Patients treated in an ICU
  • Duration of treatment ≥48h
  • Age: 18 years and older
  • Male, female, or divers gender
Exclusion Criteria
  • Poor language skills
  • Statement in patient letter or living will that excludes participation
  • Participation in another prospective treatment study with indication delirium
  • Refusal of participation

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Patient reported perceived severity of patient stressorsTime until discharge from the intensive care unit, an expected average of 10 days

Patient reported perceived severity of patient stressors (Mean score of patient stressor list ). Range: 0-4, higher scores indicate higher stress. At day 2 or 3 of ICU treatment (before first use of the app) (t1), and at the day before or the day of discharge from ICU (t2).

Secondary Outcome Measures
NameTimeMethod
Incidence of deliriumTime until discharge from the intensive care unit, an expected average of 10 days

Incidence of delirium is measured by CAM-ICU twice per day until

Length of intensive care unit stayTime until discharge from the intensive care unit, an expected average of 10 days

Length of intensive care unit stay is measured in days.

Acute perceived stressTime until discharge from the intensive care unit, an expected average of 10 days

Acute perceived stress is measured by Stress Thermometer (range: 0-10, higher scores indicate higher stress)

Mental distressTime until discharge from the intensive care unit, an expected average of 10 days

Mental distress is measured by Patient Health Questionnaire 4 \[PHQ-4, range: 0-12, higher scores indicate higher distress\]

State anxietyTime until discharge from the intensive care unit, an expected average of 10 days

State anxiety is measured with the Faces Anxiety Scale \[FAS, range: 1-5, higher scores indicate higher anxiety\]

PainTime until discharge from the intensive care unit, an expected average of 10 days

Pain is measured with the Faces Pain Scale (range: 0-10, higher scores indicate higher pain)

Self-reported cognitive functioningTime until discharge from the intensive care unit, an expected average of 10 days

Self-reported cognitive functioning is measured with a list of problems of cognitive functions (range: 0-4, higher scores indicate worse cognitive functioning)

MedicationTime until discharge from the intensive care unit, an expected average of 10 days

Medication is measured by data retrieved from the patient data management system.

TreatmentTime until discharge from the intensive care unit, an expected average of 10 days

Treatment is measured by data retrieved from the patient data management system.

DiagnosesTime until discharge from the intensive care unit, an expected average of 10 days

Diagnoses are measured by ICD-10 codes retrieved from the patient data management system.

Acceptance of appTime until discharge from the intensive care unit, an expected average of 10 days

Patient reported acceptance of app use, daily until the end of app use

Length of stayTime until discharge from hospital, an expected average of 20 days

Length of stay is measured in days.

Diagnosis of post-intensive care syndrome (PICS)Up to one month

Diagnosis of PICS is measured by an extensive clinical examination.

Log data per patientTime until discharge from the intensive care unit, an expected average of 10 days

Process data of app use: Log data per patient measured from start to end of app use

Duration of mechanical ventilationTime until discharge from the intensive care unit, an expected average of 10 days

Duration of mechanical ventilation is measured in hours.

APACHE II-ScoreTime until discharge from the intensive care unit, an expected average of 10 days

APACHE II score is measured by the Acute Physiology and Chronic Health Evaluation System II.

Stressor intensity-Time until discharge from the intensive care unit, an expected average of 10 days

Process data of app use: Stressor intensity measured from start to end of app use

Mode of intensive care unit admissionTime until discharge from the intensive care unit, an expected average of 10 days

Mode of intensive care unit admission is measured by admission data retrieved from the patient data management system.

Usability of appTime until discharge from the intensive care unit, an expected average of 10 days

Patient reported usability of app, daily until the end of app use

Support of study personalTime until discharge from the intensive care unit, an expected average of 10 days

Number of app use trials with assistance of study personnel.

Relevance and understandability of app stressor itemsTime until discharge from the intensive care unit, an expected average of 10 days

Patient reported relevance and understandability of app stressor items until the end of app use

Trial Locations

Locations (1)

Department of Anesthesiology and Intensive Care Medicine, CVK/CCM, Charité - University Medicine Berlin

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Berlin, Germany

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