Intensive Care Unit Syndrome Clinical Trial
Official title:
Patterns of PTSD Over Time in Adult Intensive Care Patients - Observations From the RAPIT Trial
This study aims to describe adult patients' patterns of Post-traumatic stress disorder (PTSD) at discharge, 3, and 12 months after intensive care.
The present study is a secondary analysis of the RAPIT-trial study treating data from
patients on Post-traumatic stress disorder (PTDS) (Jensen et al., 2016).
Design Observational study based on data from the RAPIT trial that is a non-blinded,
multicentre, parallel-group RCT conducted between December 2012-2015, at 10 intensive care
units (ICUs) in four out of five regions in Denmark.
Participants Patients were consecutively recruited during the first 18 months of the study.
We included Danish-speaking adults (≥18 years) who received mechanically ventilated ≥48 hours
and did not meet the baseline criteria of dementia. We excluded delirious patients unable to
give informed consent at randomization, or patients, who were enrolled in other studies. A
total of 386 adult patients were randomized to standard care (SC) plus a nurse-led intensive
care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC).
Outcomes In this study, we will describe variations in patients, who experience symptoms of
PTSD at ICU-discharge, 3 and 12 months after intensive care based on the data collection in
the RAPIT-trial (Jensen et al., 2016). We will report trial participants' symptoms of PTSD at
baseline, three months and twelve months after Intensive care using the Harvard Trauma
Questionnaire (HTQ) supplemented with descriptions of patients' experiences of PTSD. Symptoms
of anxiety and depression were collected at 3 and 12 months, and utilization of healthcare
services including mortality were obtained from hospital charts combined with self-reported
data from patients. We will use descriptive statistical methods to analyze data.
Symptoms of PTSD by HTQ-IV consisted of 17 items covering three core symptoms corresponding
to DSM-IV criteria for PTSD: re-experience (5 items), avoidance (7 items), and arousal (5
items). This was supplemented by four additional items: one functional and three related to
stress. We used a total score, and a cut-off of ≥40 is categorized as "positive PTSD".
Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression
Scale (HADS) covering two dimensions: anxiety (7 items) and depression (7 items); subscale
scores were 0-21 with higher scores reflecting greater psychological distress.
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