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Patients' Outcomes After Acute Respiratory Failure: A Qualitative Study With the PROMIS Framework
Michelle N Eakin1, Yashika Patel2, Pedro Mendez-Tellez2
1All are members of the Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland. Michelle N. Eakin is an associate professor, Yashika Patel is a research assistant, and Victor D. Dinglas is a research associate, Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University. Pedro Mendez-Tellez is an assistant professor, Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University. Dale M. Needham is a professor, Division of Pulmonary and Critical Care Medicine and Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University. Alison E. Turnbull is an assistant professor, Division of Pulmonary and Critical Care Medicine, School of Medicine and Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University. Meakin1@jhmi.edu.
Background:
As mortality rates for patients treated in intensive care units decrease, greater understanding of the impact of critical illness on patients' well-being is needed.
Objective:
To describe the survivorship experience of patients who had acute respiratory failure by using the Patient Reported Outcomes Measurement Information System (PROMIS) framework.
Methods:
A total of 48 adult patients who had acute respiratory failure completed at least 1 semistructured telephone-based interview between 5 and 18 months after their stay in the intensive care unit. Participants were asked about overall well-being and important health outcomes.
Results:
Major themes were identified within each of the 3 PROMIS components: physical health, mental health, and social health. The following themes were particularly prominent: mobility impairments, pulmonary symptoms, fatigue, anxiety and depression symptoms, and decreased ability to work and participate in valued activities. Impacts on overall well-being and on relationships with friends and family members varied among the survivors. Some survivors reported gratitude, increased appreciation of life, and closer relationships to loved ones. Other survivors reported boredom, social isolation, and wishing they had not survived.
Conclusions:
Survivors of acute respiratory failure reported substantial issues with their physical, mental, and social health. Holistic assessments of outcomes of survivors of critical illness should capture the complex beneficial and adverse impacts of critical illness on survivors' well-being and social health.
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