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A multiprofessional intervention for patients at risk of physical and psychological problems after ICU stay: A
Katinka Siesage1, Anna Schandl1, Eva Joelsson-Alm1
1Department of Perioperative and Intensive Care, Södersjukhuset, Stockholm, Sweden; Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Objectives:
This study aimed to evaluate the feasibility and fidelity of a multiprofessional intervention for intensive care survivors at increased risk of physical and/or psychological problems.
Methods:
The study was conducted in two ICUs, with a single-arm interventional design. Adult patients (≥18 years) with an ICU length of stay of>12 hours were assessed using a combined validated screening instrument to estimate the risk of physical and/or psychological morbidity. The intervention consisted of 1) in-hospital follow-up comprising several components, a first ward visit by a case manager within 1-5 days after ICU discharge and establishment and follow-up of an individual rehabilitation plan; 2) out-of-hospital telephone follow-up for 12 weeks. Data on process feasibility (recruitment, retention, and assessment completion) and intervention fidelity (adherence and experiences of intervention delivery) were collected. Intervention acceptability was assessed through interviews with participants and family members, while the in-hospital follow-up programme was evaluated using a questionnaire completed by healthcare professionals and patient-reported outcomes three months after ICU discharge.
Results:
Of 155 patients screened for increased risk of long-term sequelae at ICU discharge, 57 were identified as high risk, and 41 consented to participate in the study. The intervention was feasible (retention rate 90%), and acceptable from the perspectives of the participants, family members and healthcare professionals. Fidelity of the intervention components varied, with high adherence to the initial ward visit, development of a rehabilitation plan and involvement of multiple healthcare professionals based on individual needs.
Conclusions:
A multiprofessional follow-up programme for high-risk ICU patients is feasible. Feedback informed logistical adjustments while preserving core principles. The findings support a future effectiveness trial, with refinements to improve screening and assessment completion.
Implications For Clinical Practice:
Early multiprofessional follow-up after intensive care appears to be feasible and appreciated by patients at risk of physical and/or psychological problems after ICU stay.
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