title: Self-reported physical symptoms in intensive care unit (ICU) survivors: pilot exploration over four months post-ICU discharge.
abstract: BACKGROUND
  Survivors of critical illness must overcome persistent physical and psychological challenges. Few studies have longitudinally examined self-reported physical symptoms in intensive care unit (ICU) survivors.
  
  
  OBJECTIVE
  To describe prevalence and severity of self-reported symptoms in 28 adult medical ICU survivors during the first four months post-ICU discharge and their associations with family caregiver responses.
  
  
  METHODS
  Patients completed the Modified Given Symptom Assessment Scale. Caregivers completed the Shortened 10-item Center for Epidemiologic Studies Depression Scale, Brief Zarit Burden Score, Pittsburgh Sleep Quality Index, and the Caregiver Health Behavior form. Data at ICU discharge (two weeks or less), and two and four months post-ICU discharge were analyzed.
  
  
  RESULTS
  Across the time points, most patients reported one or more symptoms (88.5-97%), with sleep disturbance, fatigue, weakness, and pain the most prevalent. For these four symptoms with the highest prevalence, there were: 1) moderate correlations among symptom severity at two and four months post-ICU discharge; and 2) no difference in prevalence or severity by patients' disposition (home vs. institution), except worse fatigue in patients at home at two weeks or less post-ICU discharge. Patients' overall symptom burden showed significant correlation with caregivers' depressive symptoms two weeks or less post-ICU discharge. There were trends of moderate correlations between patients' overall symptom burden and caregivers' health risk behaviors and sleep quality at two and four months post-ICU discharge.
  
  
  CONCLUSIONS
  In our sample, sleep disturbance, fatigue, weakness, and pain were the four key symptoms during first four months post-ICU discharge. Future studies focusing on these four symptoms are necessary to promote quality in post-ICU symptom management.
authors.affiliation: Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA. Electronic address: jic11@pitt.edu.
authors.forename: JiYeon
authors.initials: J
authors.lastname: Choi
authors.affiliation: Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Hoffman
authors.affiliation: University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
authors.affiliation: Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Tate
authors.affiliation: Division of Pulmonary, Allergy & Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Donahoe
authors.affiliation: Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA; Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
authors.forename: Dianxu
authors.initials: D
authors.lastname: Ren
authors.affiliation: College of Nursing, The Michigan State University, East Lansing, Michigan, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Given
authors.affiliation: Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA; Department of Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Paula R
authors.initials: PR
authors.lastname: Sherwood
mesh_terms: D017028:Caregivers; D017281:Cost of Illness; D016638:Critical Illness / Q000453:epidemiology* / Q000628:therapy*; D005221:Fatigue / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000453:epidemiology / Q000503:physiopathology; D010146:Pain / Q000453:epidemiology / Q000503:physiopathology; D010351:Patient Discharge; D015995:Prevalence; D057566:Self Report; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000503:physiopathology; D017741:Survivors; D013997:Time Factors
keywords: ICU; Intensive care unit; caregivers; critical illness; fatigue; pain; sleep; weakness