Exploring differences in reported mental health outcomes and quality of life between physically restrained and non-physically restrained ICU patients; a prospective cohort study
Abstract
BACKGROUND
Physical restraints are frequently used in ICU patients, while their effects are unclear.
OBJECTIVE
To explore differences in patient reported mental health outcomes and quality of life between physical restrained and non-physical restrained ICU patients at 3- and 12-months post ICU admission, compared to pre-ICU health status.
RESEARCH METHODOLOGY/DESIGN
Prospective cohort study. Patients were included when 16 years or older, admitted for at least 12 h and provided informed consent. Differences between groups were analysed using linear mixed model analyses.
SETTING
Two ICUs, a 35 bed academic ICU and a 12 bed ICU in a teaching hospital in the Netherlands.
MAIN OUTCOME MEASURES
Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale, post-traumatic stress disorder using the Impact of Event Scale-Revised, and Quality of life using the Short Form-36 scores.
RESULTS
2,764 patients were included, of which 486 (17.6 %) were physically restrained for median 2 [IQR 1-6] days. Significantly worse outcomes were reported at 3-months by physically restrained patients (symptoms of depression 0.89, 95 %CI 0.37 to 1.41, p < 0.001; PCS -2.82, 95 %CI -4.47 to -1,17p < 0.001; MCS -2.67, 95 %CI -4.39 to -0.96, p < 0.01). At 12-months, only the PCS scores remained significantly lower (-1.71, 95 %CI -3.42 to -0.004, p < 0.05).
CONCLUSION
Use of physical restraints is associated with worse self-reported symptoms of depression and decreased…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 2,764 participants or records.
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