Impact of post-traumatic stress symptoms on the health-related quality of life in a cohort study with chronically critically ill patients and their partners: age matters

Gloria-Beatrice Wintermann, Katja Petrowski, Kerstin Weidner, Bernhard Strauß, Jenny Rosendahl, Gloria-Beatrice Wintermann, Katja Petrowski, Kerstin Weidner, Bernhard Strauß, Jenny Rosendahl

Abstract

Background: Survivors of an acute critical illness with continuing organ dysfunction and uncontrolled inflammatory responses are prone to become chronically critically ill. As mental sequelae, a post-traumatic stress disorder and an associated decrease in the health-related quality of life (QoL) may occur, not only in the patients but also in their partners. Currently, research on long-term mental distress in chronically critically ill patient-partner dyads, using appropriate dyadic analysis strategies (patients and partners being measured and linked on the same variables) and controlling for contextual factors, is lacking.

Methods: The present study investigates the interdependence of post-traumatic stress symptoms (PTSS) and the health-related QoL in n = 70 dyads of chronically critically ill patients and their partners, using the Actor-Partner-Interdependence Model (APIM) under consideration of contextual factors (age, gender, length of partnership). The Post-traumatic Stress Scale (PTSS-10) and Euro-Quality of Life (EQ-5D-3L) were applied in both the patients and their partners, within up to 6 months after the transfer from acute care ICU to post-acute ICU.

Results: Clinically relevant post-traumatic stress symptoms were reported by 17.1% of the patients and 18.6% of the partners. Both the chronically critically ill patients and their partners with more severe post-traumatic stress symptoms also showed a decreased health-related QoL. The latter was more pronounced in male partners compared to female partners or female patients. In younger partners (≤ 57 years), higher values of post-traumatic stress symptoms were associated with a decreased QoL in the patients.

Conclusions: Mental health screening and psychotherapeutic treatment options should be offered to both the chronically critically ill patients and their partners. Future research is required to address the special needs of younger patient-partner dyads, following protracted ICU treatment.

Trial registration: German Clinical Trials Register No. DRKS00003386 . Registered 13 November 2011.

Keywords: Actor-Partner-Interdependence Model (APIM); Chronic critical illness; Health-related quality of life (QoL); Intensive care unit (ICU); Partners; Post-Intensive Care Syndrome-Family (PICS-F); Post-traumatic stress symptoms; Sepsis.

Conflict of interest statement

Ethics approval and consent to participate

The present study was approved by the Ethics Committee of the Friedrich-Schiller University, Jena, Germany.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Actor-Partner-Interdependence Model (APIM) testing actor and partner effects of post-traumatic stress symptoms on the health-related quality of life (QoL) in chronically critically ill patients and their partners/spouses. *≤ .05, ***≤ .001; 1age group ≤ 57 years, 2age group > 57 years< 63 years, 3age group ≥ 63 years

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