Post ICU Follow up: A Questionnaire Survey of Aftercare in Denmark

Study Overview
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Brief Summary
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This study aims to investigate current aftercare activities in Denmark after intensive care unit (ICU) treatment. The hypothesis is that a large number of hospitals offer aftercare, and these interventions are heterogenic and differ between hospitals and regions. This study is an electronic questionnaire survey that aim to describe and map Danish aftercare activities, and future development plans in this field.

Detailed Description
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Annually, more than 30,000 patients are admitted for treatment at Danish intensive care units (ICUs). These critically ill patients are some of the most vulnerable in the health care system. For years, focus has primarily been on treatment and survival of this patient group. As treatment effectiveness has gradually increased, the overall survival rate is now above 80%. Consequently, the period following ICU discharge has gained increasing focus and follow up interventions in the period after ICU treatment have become more common. These different follow up interventions has given name to the concept of 'aftercare'. Aftercare activities includes both early rehabilitation initiated during the continued hospital admission and also the following rehabilitation after hospital discharge. Complications after intensive care treatment are numerous, including both physical, cognitive and psychological impairments, e.g. depression, muscle weakness, anxiety and social isolation. Together these symptoms are defined as post intensive care syndrome (PICS). While it is clear that a need for aftercare exists, the optimal evidence based activities remains to be determined. The current follow-up activities are established as local initiatives and the methods vary greatly. Examples of present aftercare interventions include use of diaries, follow-up consultations, revisiting the ICU and assessment of quality of life. A recent systematic review examined these different rehabilitation efforts, without finding significant effects of the present interventions, although usage of ICU-diaries had a minor preventive effect on post-traumatic stress syndrome (PTSD). A Danish meta-analysis from 2015 on follow-up consultations showed similar results. Aftercare is a rapidly developing area and it is necessary to further investigate this important topic. Therefore, the investigators want to describe the current level of aftercare with a new mapping of activities in all Danish ICUs. Hereby, the investigators hope to create a better and up-to-date foundation for further development within Danish aftercare. Furthermore, the investigators wish to research on the clinician-experienced (the participants) attitude towards and limitations for aftercare activities, in order to discuss directions for future development.

Official Title
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Follow-up After Intensive Care Treatment: a Questionnaire Survey of Intensive Care Aftercare in Denmark.

Conditions
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Critical Illness, Intensive Care Unit Syndrome

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All Intensive Care Units in Denmark treating adult patients. Exclusion Criteria: Intensive care units with a specialty field within these four groups: Neurology and neurosurgery Cardiothoracic surgery Pediatrics or neonatology (PICU/NICU) Postoperative care units
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of ICUs offering early aftercare to patients after discharge from ICU | The respondent will choose 'yes' or 'no' | From May 15th to September 31st 2016 | 
| Incidence of ICUs offering late aftercare to patients after discharge from hospital | The respondent will choose 'yes' or 'no' | From May 15th to September 31st 2016 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Size of hospital (number of beds) |  | From May 15th to September 31st 2016 | 
| Size of ICU (number of beds) |  | From May 15th to September 31st 2016 | 
| Early aftercare: Use of protocol or checklist at patient visit | The respondent will choose 'yes' or 'no' | From May 15th to September 31st 2016 | 
| Late aftercare: Use of protocol or checklist at patient visit | The respondent will choose 'yes' or 'no' | From May 15th to September 31st 2016 | 
| Early aftercare: Selection of patients offered aftercare | The respondent will choose from a list of options: All patients, Depending of length of stay, days with mechanical ventilation, or other: the respondent will specify | From May 15th to September 31st 2016 | 
| Late aftercare: Selection of patients offered aftercare | The respondent will choose from a list of options: All patients, Depending of length of stay, days with mechanical ventilation, or other: the respondent will specify | From May 15th to September 31st 2016 | 
| Early aftercare: Time from ICU-discharge to first contact | The respondent will choose from a list of options: How many hours to days until the patient is contacted at the general wards | From May 15th to September 31st 2016 | 
| Late aftercare: Time from hospital discharge to first contact | The respondent will choose from a list of options: How many months from discharge, until the patient is contacted | From May 15th to September 31st 2016 | 
| Early aftercare: Aftercare team members | The respondent will choose from a list of options: The personnel participating in the aftercare: Doctor, nurse, occupational therapist, physical therapist, pharmacist, psychologist or other | From May 15th to September 31st 2016 | 
| Early aftercare: Consumption of time | The respondent will choose from a list of options: How much time is spent (in minutes) pr. contact with the patient | From May 15th to September 31st 2016 | 
| Late aftercare: Aftercare team members | The respondent will choose from a list of options: The personnel participating in the aftercare: Doctor, nurse, occupational therapist, physical therapist, pharmacist, psychologist or other | From May 15th to September 31st 2016 | 
| Late aftercare: Consumption of time | The respondent will choose from a list of options: How much time is spent (in minutes) pr. contact with the patient | From May 15th to September 31st 2016 | 
| Early aftercare: Type of aftercare interventions during general ward stay | The respondent will be choosing interventions from a list, and also be able to specify other interventions not present on the list | From May 15th to September 31st 2016 | 
| Late aftercare: Type of aftercare interventions after hospital discharge | The respondent will be choosing interventions from a list, and also be able to specify other interventions not present on the list | From May 15th to September 31st 2016 | 
| Early aftercare: Type of screening tools or other methods used for patient assessment | The respondent will be choosing screening tools and methods from a list, and also be able to specify other screening tools and methods not present on the list | From May 15th to September 31st 2016 | 
| Late aftercare: Type of screening tools or other methods used for patient assessment | The respondent will be choosing screening tools and methods from a list, and also be able to specify other screening tools and methods not present on the list | From May 15th to September 31st 2016 | 
| Late aftercare: Contact method | The respondent will choose from a list of options: How the ICU contacts the patient after hospital discharge. By phone, by letter, by mail, by digital inbox | From May 15th to September 31st 2016 | 
| Late aftercare: Participation of family members | The respondent will choose from a list: Whether the family is invited to participate in the consultation with the patient or not. Yes/No | From May 15th to September 31st 2016 | 
| Classifications of reasons for not having an aftercare programme at ICUs without an aftercare programme | The respondent will choose from a list of options: Not enough money, resistance from the general wards, not an important subject, and also be able to write their own answer. | From May 15th to September 31st 2016 | 
| The responsible party for the financing of aftercare | The respondent will choose from a list of options: The ICU itself, the general ward, the region or through funds? | From May 15th to September 31st 2016 | 
| The respondent's own assessment of how aftercare will be prioritized at their ICU in one year. | The respondent will choose on a scale: More aftercare? Same level of aftercare? Less aftercare? | From May 15th to September 31st 2016 | 
| Should aftercare be offered? | The respondent will choose on a scale: Totally agree, partially agree, neither agree or disagree, partially disagree, totally disagree | From May 15th to September 31st 2016 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Rehabilitation, Aftercare