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Post ICU Follow up: A Questionnaire Survey of Aftercare in Denmark

Completed
Conditions
Intensive Care Unit Syndrome
Critical Illness
Registration Number
NCT02784574
Lead Sponsor
Zealand University Hospital
Brief Summary

This study aims to investigate current aftercare activities in Denmark after intensive care unit (ICU) treatment. The hypothesis is that a large number of hospitals offer aftercare, and these interventions are heterogenic and differ between hospitals and regions.

This study is an electronic questionnaire survey that aim to describe and map Danish aftercare activities, and future development plans in this field.

Detailed Description

Annually, more than 30,000 patients are admitted for treatment at Danish intensive care units (ICUs). These critically ill patients are some of the most vulnerable in the health care system.

For years, focus has primarily been on treatment and survival of this patient group. As treatment effectiveness has gradually increased, the overall survival rate is now above 80%. Consequently, the period following ICU discharge has gained increasing focus and follow up interventions in the period after ICU treatment have become more common. These different follow up interventions has given name to the concept of 'aftercare'. Aftercare activities includes both early rehabilitation initiated during the continued hospital admission and also the following rehabilitation after hospital discharge.

Complications after intensive care treatment are numerous, including both physical, cognitive and psychological impairments, e.g. depression, muscle weakness, anxiety and social isolation. Together these symptoms are defined as post intensive care syndrome (PICS).

While it is clear that a need for aftercare exists, the optimal evidence based activities remains to be determined. The current follow-up activities are established as local initiatives and the methods vary greatly. Examples of present aftercare interventions include use of diaries, follow-up consultations, revisiting the ICU and assessment of quality of life.

A recent systematic review examined these different rehabilitation efforts, without finding significant effects of the present interventions, although usage of ICU-diaries had a minor preventive effect on post-traumatic stress syndrome (PTSD). A Danish meta-analysis from 2015 on follow-up consultations showed similar results.

Aftercare is a rapidly developing area and it is necessary to further investigate this important topic. Therefore, the investigators want to describe the current level of aftercare with a new mapping of activities in all Danish ICUs. Hereby, the investigators hope to create a better and up-to-date foundation for further development within Danish aftercare. Furthermore, the investigators wish to research on the clinician-experienced (the participants) attitude towards and limitations for aftercare activities, in order to discuss directions for future development.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
31
Inclusion Criteria
  • All Intensive Care Units in Denmark treating adult patients.
Exclusion Criteria

Intensive care units with a specialty field within these four groups:

  • Neurology and neurosurgery
  • Cardiothoracic surgery
  • Pediatrics or neonatology (PICU/NICU)
  • Postoperative care units

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Incidence of ICUs offering late aftercare to patients after discharge from hospitalFrom May 15th to September 31st 2016

The respondent will choose 'yes' or 'no'

Incidence of ICUs offering early aftercare to patients after discharge from ICUFrom May 15th to September 31st 2016

The respondent will choose 'yes' or 'no'

Secondary Outcome Measures
NameTimeMethod
Late aftercare: Selection of patients offered aftercareFrom May 15th to September 31st 2016

The respondent will choose from a list of options: All patients, Depending of length of stay, days with mechanical ventilation, or other: the respondent will specify

Early aftercare: Use of protocol or checklist at patient visitFrom May 15th to September 31st 2016

The respondent will choose 'yes' or 'no'

Size of ICU (number of beds)From May 15th to September 31st 2016
Early aftercare: Type of screening tools or other methods used for patient assessmentFrom May 15th to September 31st 2016

The respondent will be choosing screening tools and methods from a list, and also be able to specify other screening tools and methods not present on the list

The responsible party for the financing of aftercareFrom May 15th to September 31st 2016

The respondent will choose from a list of options: The ICU itself, the general ward, the region or through funds?

Early aftercare: Aftercare team membersFrom May 15th to September 31st 2016

The respondent will choose from a list of options: The personnel participating in the aftercare: Doctor, nurse, occupational therapist, physical therapist, pharmacist, psychologist or other

Late aftercare: Consumption of timeFrom May 15th to September 31st 2016

The respondent will choose from a list of options: How much time is spent (in minutes) pr. contact with the patient

Size of hospital (number of beds)From May 15th to September 31st 2016
Late aftercare: Use of protocol or checklist at patient visitFrom May 15th to September 31st 2016

The respondent will choose 'yes' or 'no'

Early aftercare: Selection of patients offered aftercareFrom May 15th to September 31st 2016

The respondent will choose from a list of options: All patients, Depending of length of stay, days with mechanical ventilation, or other: the respondent will specify

Early aftercare: Time from ICU-discharge to first contactFrom May 15th to September 31st 2016

The respondent will choose from a list of options: How many hours to days until the patient is contacted at the general wards

Early aftercare: Consumption of timeFrom May 15th to September 31st 2016

The respondent will choose from a list of options: How much time is spent (in minutes) pr. contact with the patient

Late aftercare: Aftercare team membersFrom May 15th to September 31st 2016

The respondent will choose from a list of options: The personnel participating in the aftercare: Doctor, nurse, occupational therapist, physical therapist, pharmacist, psychologist or other

Late aftercare: Type of aftercare interventions after hospital dischargeFrom May 15th to September 31st 2016

The respondent will be choosing interventions from a list, and also be able to specify other interventions not present on the list

Late aftercare: Contact methodFrom May 15th to September 31st 2016

The respondent will choose from a list of options: How the ICU contacts the patient after hospital discharge. By phone, by letter, by mail, by digital inbox

Late aftercare: Participation of family membersFrom May 15th to September 31st 2016

The respondent will choose from a list: Whether the family is invited to participate in the consultation with the patient or not. Yes/No

Classifications of reasons for not having an aftercare programme at ICUs without an aftercare programmeFrom May 15th to September 31st 2016

The respondent will choose from a list of options: Not enough money, resistance from the general wards, not an important subject, and also be able to write their own answer.

Late aftercare: Time from hospital discharge to first contactFrom May 15th to September 31st 2016

The respondent will choose from a list of options: How many months from discharge, until the patient is contacted

Early aftercare: Type of aftercare interventions during general ward stayFrom May 15th to September 31st 2016

The respondent will be choosing interventions from a list, and also be able to specify other interventions not present on the list

Late aftercare: Type of screening tools or other methods used for patient assessmentFrom May 15th to September 31st 2016

The respondent will be choosing screening tools and methods from a list, and also be able to specify other screening tools and methods not present on the list

The respondent's own assessment of how aftercare will be prioritized at their ICU in one year.From May 15th to September 31st 2016

The respondent will choose on a scale: More aftercare? Same level of aftercare? Less aftercare?

Should aftercare be offered?From May 15th to September 31st 2016

The respondent will choose on a scale: Totally agree, partially agree, neither agree or disagree, partially disagree, totally disagree

Trial Locations

Locations (1)

Zealand University Hospital

🇩🇰

Køge, Denmark

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