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Published on: January 16, 2019
Sepsis Survivors' Functional Recovery and Symptom Experience Following Intensive Care Unit Hospitalization
Daniel Liebzeit1,2,3,4,5, Amiritha Kumar1,2,3,4,5, Maria Hein1,2,3,4,5
1Daniel Liebzeit , is a PhD-prepared nurse and Assistant Professor at the University of Iowa College of Nursing. He has expertise in promoting function and health during older adult care transitions, as well as caregiving.
Purpose Of Study:
The purpose is to describe sepsis survivors' functional recovery and symptom experience following Intensive Care Unit (ICU) hospitalization.
Primary Practice Settings:
Academic Medical Center, Community Living.
Methodology And Sample:
This longitudinal observational study recruited participants during hospitalization at two adult ICUs in a single Midwestern academic medical center. Participants completed surveys to assess function and symptom experience at baseline (discharge), 1-month, 3-months, and 6-months post-discharge.
Results:
Participants were non-Hispanic Whites with mean age 55.4 years (SD = 17.0). The majority were discharged to home (78.6%), with 3 (21.4%) discharged to a skilled nursing facility or acute rehabilitation unit. Participants had notable improvements in mobility, self-rated health, and fatigue from discharge to 6-months post-discharge. Increases in mobility from discharge to 1 month, 3 months, and 6 months were statistically significant (α < .05). Decreases in fatigue from discharge to 1 month and 6 months were statistically significant (α < .05). Cognitive and social engagement and other symptom experience measures did not differ significantly during the study period.
Implications For Case Management Practice:
Findings reveal trends in mobility recovery and symptom experience post-hospitalization, which are important considerations post-ICU sepsis hospitalization. This study reinforces the need to promote early mobilization of patients during hospitalization and work with patients to develop strategies for mobility recovery post-hospitalization, as part of a comprehensive plan which integrates a client's medical, behavioral, social, psychological, functional, and other needs. The authors encourage assessment of common symptoms, including pain, fatigue, anxiety, and sleep disturbance, experienced by sepsis survivors during and post-hospitalization. As a result, case managers will be better positioned to implement evidence-based interventions to promote recovery and reduce symptom burden and improve outcomes. Evidence-based interventions should include those that are centered on client's functional and symptom-related needs, preferences, safe mobility, and facilitate awareness of and connections with community supports and resources.
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