Effects of person-centred care and intensive care experience on post-intensive care syndrome in critical care survivors: a multi-centre prospective cohort study

Abstract

Background: Several risk factors for post-intensive care syndrome have been recognised, but the majority of them cannot be altered. While there is potential for negative experiences in the intensive care unit and person-centred care to impact post-intensive care syndrome, the evidence linking the three is insufficient. This study aimed to investigate the impact of person-centred care and the patient’s experience in the intensive care unit on post-intensive care syndrome among critical care survivors during the first year following hospital discharge. Methods: The study was a prospective, multi-centre longitudinal cohort study. This study was conducted in 19 intensive care units at four university hospitals located in Busan, South Korea. The participants were 618 adults who had been admitted to the intensive care unit for more than 24 hours between May 2019 and July 2021. At the time of intensive care unit discharge, participants completed a person-centred care and an intensive care experience questionnaire. We evaluated the post-intensive care syndrome of the participants 3, 6 and 12 months after hospital discharge. Results: The frightening experience in the intensive care unit was a factor that significantly increased post-intensive care syndrome at 3 and 6 months. Person-centred care partially mediated the impact of the frightening experience on post-intensive care syndrome, mitigating its effect. Female gender, older age, comorbidities, delirium and discharge to an extended care facility were factors that increased post-intensive care syndrome at 3, 6 and 12 months. Furthermore, comorbidities and discharge place had a statistically significant influence on the participants' post-intensive care syndrome changes over the course of one year. Conclusions: The findings of this study support the development and implementation of person-centred interventions that reduce patients' frightening experiences in the intensive care unit in order to enhance long-term outcomes. Additionally, the post-intensive care syndrome of survivors who are discharged to an extended care facility requires special attention. Registration: This study is registered at the Korean Clinical Research Information Service (#KCT0004045; date of registration: June 11, 2019; date of 1^st participant recruitment: June 7, 2019).