Background
Supraventricular tachycardia (SVT) is a common arrhythmia with associated symptoms such as palpitation, dizziness, and fatigue. It significantly affects patients’ quality of life (QoL). Radiofrequency cardiac ablation (RFCA) is a highly effective treatment to eliminate arrhythmia and improve patients’ QoL. The purpose of this study was to assess the level of QoL among patients with SVT and examine the difference in QoL before and after RFCA.
Methods One group pre-posttest design with a convenience sample of 112 patients was used. QoL was assessed by 36-Item Short Form (SF-36). Data were collected at admission through face-to-face interviews and 1-month post-discharge through phone interviews.
Results There was a significant difference between QoL before (33.7±17.0) and 1 month after (62.5±18.5) the RFCA. Post-RFCA patients diagnosed with atrioventricular nodal reentrant tachycardia had higher QoL than other types of SVT. Moreover, there were significant negative relationships between QoL and the number and duration of episodes pre- and post-RFCA. There were no significant differences in QoL based on: age, sex, working status, marital status, smoking, coronary artery disease, diabetes mellitus, and hypertension.
Conclusions After RFCA, the QoL of patients with ST improved for both physical and mental component subscales.
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Acute Crit Care. 2022;37(3):295-302. Published online June 27, 2022
Background
To explore the feasibility, safety, and potential benefits of administration of the anabolic steroid nandrolone to patients in the recovery phase from critical illness weakness.
Methods In this phase II, double blind, randomized, controlled trial, adult critically ill patients admitted to one of two tertiary Intensive Care Units in Western Australia for longer than 7 days with significant weakness were enrolled. Patients received nandrolone (200 mg males, 100 mg females) intramuscularly or placebo weekly for up to 3 weeks in addition to standard care. The primary outcome measures were improvement in grip strength, Medical Research Council muscle strength sum score, and functional activity level (Chelsea critical care assessment tool [CPAx]).
Results A total of 22 patients was enrolled between September 2017 and May 2019. No significant adverse events were detected. Median grip strength change was non-significantly greater in the nandrolone group (8.5 vs. 13.0, P=0.185), while hospital length of stay (36 vs. 26 days, P=0.023) and duration of mechanical ventilation (377 vs. 168, P=0.032) were lower. The discharge CPAx and intensive care unit mobility scores were higher in the nandrolone group, although there was no difference in the change in CPAx score (17.0 vs. 17.7, P=0.865). There were no changes in ultrasound-detected muscle thickness between the two groups.
Conclusions In patients with prolonged critical illness, nandrolone appears to be safe. However, a larger study, potentially combined with resistance exercise, is needed to definitively address the potential benefits of nandrolone.
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Background To identify the necessary care for dying patients in intensive care units (ICUs), we designed a retrospective study to evaluate the quality of dying and death (QODD) experienced by the surrogates of patients with medical illness who died in the ICU of a tertiary referral hospital.
Methods To achieve our objective, the authors compared the QODD scores as appraised by the relatives of patients who died of cancer under hospice care with those who died in the ICU. For this study, a Korean version of the QODD questionnaire was developed, and individual interviews were also conducted.
Results Sixteen people from the intensive care group and 23 people from the hospice care group participated in the survey and completed the questionnaire. The family members of patients who died in the ICU declined participation at a high rate (50%), with the primary reason being to avoid bringing back painful memories (14 people, 87.5%). The relatives of the intensive care group obtained an average total score on the 17-item QODD questionnaire, which was significantly lower than that of the relatives of the hospice group (48.7±15.5 vs. 60.3±14.8, P=0.03).
Conclusions This work implies that there are unmet needs for the care of dying patients and for the QODD in tertiary hospital ICUs. This result suggests that shared decision making for advance care planning should be encouraged and that education on caring for dying patients should be provided to healthcare professionals to improve the QODD in Korean ICUs.
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BACKGROUND This study was designed to analyze the influences of ICU patients' experiences in the ICU setting and the effect of ICU patient families' stress derived from their needs and daily life stress on the patients' quality of life. METHODS: ICU patients' quality of life was evaluated with KQOLS surveying 144 patients alive. The data was classified into 2 groups according to severity of illness and analyzed with an ANOVA. With a t-test, comparative analysis was made to examine deficiency of responses on patient families' needs and patients' quality of life. RESULTS: The patients in the group of higher severity of illness showed lower quality of life. The APACHEII score had a negative correlation with all domains except health status change domain, health status perception domain, and spiritual domain. There was a negative correlation between patients' age and three domains of physical function, role limitation, and social function and a positive correlation between patients' hospital LOS and health status change domain. The families in the group of lower severity of illness showed higher level of deficiency of responses on their needs for medical treatment and nursing information, and emotional support. Also, patients' quality of life in lower daily life stress group was higher than that in higher stress group especially in psychological health domain. CONCLUSIONS: The findings show that ICU patients `quality of life was influenced by not only medical factors but also psychosocial factors and suggest that multidimensional intervention plans are required for improving patients' quality of life and recovering their health.