TY - JOUR
T1 - Fulfillment of Patient Expectations after Acute Respiratory Failure A Multicenter Prospective Cohort Study
AU - APICS-01 Study Team
AU - Turnbull, Alison E.
AU - Lee, Emma M.
AU - Dinglas, Victor D.
AU - Beesley, Sarah
AU - Bose, Somnath
AU - Banner-Goodspeed, Valerie
AU - Hopkins, Ramona O.
AU - Jackson, James C.
AU - Mir-Kasimov, Mustafa
AU - Sevin, Carla M.
AU - Brown, Samuel M.
AU - Needham, Dale M.
AU - Caraker, Elise
AU - Cherukuri, Sai Phani Sree
AU - Kadiri, Naga Preethi
AU - Kalva, Tejaswi
AU - Koneru, Mounica
AU - Kota, Pooja
AU - Lee, Emma Maelian
AU - Ali Mahmoud, Mazin
AU - Malik, Albahi
AU - Nikooie, Roozbeh
AU - Roberts, Darin
AU - Singu, Sriharsha
AU - Vaziri, Parvaneh
AU - Brown, Katie
AU - Daw, Austin
AU - Merrill, Mardee
AU - Smith, Rilee
AU - Hirshberg, Ellie
AU - Butler, Jorie
AU - Hoenig, Benjamin
AU - Karamourtopoulos, Maria
AU - Hays, Margaret
AU - Abel, Rebecca
AU - High, Craig
AU - Beck, Emily
AU - Armbruster, Brent
AU - Applegate, Darrin
AU - Fergus, Melissa
AU - Kumar, Naresh
AU - Roth, Megan
AU - Mogan, Susan
AU - De Souza Licht, Andre
AU - Londono, Isabel
AU - Larson, Julia
AU - Capers, Krystal
AU - Toksoz-Exley, Andrew
AU - Crane, Julia
AU - Tsai, Lauren
N1 - Publisher Copyright:
Copyright © 2023 by the American Thoracic Society.
PY - 2023/4
Y1 - 2023/4
N2 - Rationale: Discussion of patient expectations for recovery is a component of intensive care unit (ICU) follow-up clinics. However, few studies have formally evaluated recovery-related expectations of ICU survivors. Objectives: To estimate the prevalence of unmet expectations for recovery 6 months after hospital discharge among adult survivors of acute respiratory failure (ARF). Methods: This was a prospective, longitudinal, cohort study of survivors of ARF discharged to home from five U.S. medical centers. Expectations for functional recovery were assessed by asking which activities and instrumental activities of daily living (I/ADLs) survivors expected to perform independently at 6 months. Survivors’ expectations for overall health status were assessed using a visual analogue scale ranging from 0 to 100. At 6-month follow-up, participants reported which I/ADLs they could perform independently and rated their overall health status using a 100-point visual analogue scale. We defined a participant’s functional expectations as being met if they reported independently performing I/ADLs as expected at hospital discharge. Health expectations were considered to be met when self-rated health status at 6 months was no more than 8 points lower than expected at enrollment. Results: Among 180 enrollees, 169 (94%) were alive, and 160 of these (95%) participated in 6-month follow-up. Functional expectations were met for 71% of participating survivors, and overall health expectations were met for 50%. Expectations for functional independence were high, ranging from 87% (housekeeping) to 99% (using a telephone). General health expectations were variable (median, 85; interquartile range [IQR], 75–95). At 6-month follow-up, self-rated, overall health ranged from 2 to 100 (median, 80; IQR, 60–85). In exploratory analyses, participants with met versus unmet expectations differed most in formal education (functional expectations standardized difference = 0.88; health expectations standardized difference = 0.41). Conclusions: Expectations of survivors of ARF about independent functioning were high and generally met, but half had unmet general health expectations 6 months after discharge. It is difficult to predict whose health expectations will be unmet, but possessing less formal education may be a risk factor.
AB - Rationale: Discussion of patient expectations for recovery is a component of intensive care unit (ICU) follow-up clinics. However, few studies have formally evaluated recovery-related expectations of ICU survivors. Objectives: To estimate the prevalence of unmet expectations for recovery 6 months after hospital discharge among adult survivors of acute respiratory failure (ARF). Methods: This was a prospective, longitudinal, cohort study of survivors of ARF discharged to home from five U.S. medical centers. Expectations for functional recovery were assessed by asking which activities and instrumental activities of daily living (I/ADLs) survivors expected to perform independently at 6 months. Survivors’ expectations for overall health status were assessed using a visual analogue scale ranging from 0 to 100. At 6-month follow-up, participants reported which I/ADLs they could perform independently and rated their overall health status using a 100-point visual analogue scale. We defined a participant’s functional expectations as being met if they reported independently performing I/ADLs as expected at hospital discharge. Health expectations were considered to be met when self-rated health status at 6 months was no more than 8 points lower than expected at enrollment. Results: Among 180 enrollees, 169 (94%) were alive, and 160 of these (95%) participated in 6-month follow-up. Functional expectations were met for 71% of participating survivors, and overall health expectations were met for 50%. Expectations for functional independence were high, ranging from 87% (housekeeping) to 99% (using a telephone). General health expectations were variable (median, 85; interquartile range [IQR], 75–95). At 6-month follow-up, self-rated, overall health ranged from 2 to 100 (median, 80; IQR, 60–85). In exploratory analyses, participants with met versus unmet expectations differed most in formal education (functional expectations standardized difference = 0.88; health expectations standardized difference = 0.41). Conclusions: Expectations of survivors of ARF about independent functioning were high and generally met, but half had unmet general health expectations 6 months after discharge. It is difficult to predict whose health expectations will be unmet, but possessing less formal education may be a risk factor.
KW - critical care outcomes
KW - functional status
KW - respiratory distress syndrome
KW - survivorship
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UR - http://www.scopus.com/inward/citedby.url?scp=85151574997&partnerID=8YFLogxK
U2 - 10.1513/AnnalsATS.202207-600OC
DO - 10.1513/AnnalsATS.202207-600OC
M3 - Article
C2 - 36227771
AN - SCOPUS:85151574997
SN - 2329-6933
VL - 20
SP - 566
EP - 573
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 4
ER -