Physical, mental and cognitive functioning in daily life of former Dutch Intensive Care patients, who perceive a decline in quality of life, one year after ICU admission. A qualitative study

Abstract

Abstract Background As a result of improving treatments in intensive care medicine, more patients survive severe illness. Long-term consequences of an Intensive Care (ICU) admission, referred to as Post Intensive Care Syndrome (PICS), can have serious impact on a patient’s health and quality of life (QoL). Research into the experiences of Dutch ICU survivors with functioning in daily life, perceived health and QoL is scarce. Aim To gain insight into the experienced quality of life and the physical, mental and cognitive functioning in daily life of former intensive care patients, who perceive a decline in quality of life, one year after ICU-admission. Method Fifteen ICU survivors, who indicated a decline in the PCS and MCS of the SF-36 questionnaire were interviewed in a generic qualitative study. Semi-structured interviews were conducted face to face and by (video)call. The interview-guide was based on the PROMIS framework, exploring physical, mental (including cognitive-) and social health. QoL was added as a domain, because of its importance to ICU-patients. Results Theoretical analysis was applied and identified 25 themes within the 4 PROMIS domains. Major issues were cognitive problems with impaired memory and concentration, physical limitations in mobility, decreased stamina, fatigue and changed priorities and relationships. Impairments had impact on the performance of work and hobbies. Aspects such as acceptance and being independent increased QoL. Most patients found their QoL sufficient. Conclusion Most participants indicated impairments in one or more domains of physical, mental (cognitive-) and social health. Although Health Related QoL was decreased, most participants rated their QoL as sufficient. Recommendation Having knowledge of the outcomes in health domains and QoL of ICU-patients is relevant for caregivers. It can help them to improve healthcare and policy decisions.