The purpose of this study is to compare the effect of an early and integral communication strategy (EICS) versus standard care, on the rate of depressive symptoms at 3 months after discharge from the ICU, in patients with severe Covid-19, their family members and health personnel. Evaluating the rate of depressive symptoms at 3 months after discharge from the ICU, with a) Hospital Anxiety and Depression, b) Posttraumatic Stress Disorder Checklist (S)
We designed a pre-post intervention study, the groups were non-randomly allocated. The study is implementation in 10 Chilean hospitals, admitting 350 patients. Pre-intervention: The practices of each ICU will be maintained, until the moment that according to randomization corresponds the beginning of the intervention, in each center. Post-intervention: EICS to facilitate communication between the family, patient and health team, through written material, via the web (tablet and webmaster) and by telephone.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
350
This intervention will be implemented in patients since they are hospitalized in the ICU where is expected: * Facilitate contact and communication between patients, families and the health team. * Respond to the communication needs of family members. * Reduce equipment overload and facilitate communication with families and patients, providing tools and timely support. * Build a positive and trusting relationship of relatives and patients with health teams. The intervention considers the following actions: 1. \- Training in communication to the health team 2. \- Written material 3. \- Family website 4. \- Standardized and daily telephone information 5. \- Health Team Support Strategy 6. \- Weekly multidisciplinary virtual meeting with the family 7. \- ICU diaries for family members
Pontificia Universidad Católica de Chile - Medicina
Santiago, Santiago Metropolitan, Chile
Rate of depressive symptoms
The rate of depressive symptoms after discharge from the ICU will be evaluated in patients with severe Covid-19, their relatives and health personnel with the instrument HADS (Hospital Anxiety and Depression Scale)
Time frame: Third month post-discharge from ICU
Risk factors of depressive symptoms
Identify risk factors associated with depressive symptoms at 3 months post ICU in patients with severe Covid-19, their relatives and health team. Considering physical health, mental health and sociodemographic factors. To measure depressive symptoms will be used Hospital Anxiety and Depression Scale (HADS), total scores for depression range from 0 to 21, categorized as: normal (0-7), mild (8-10), moderate (11-14) or severe (15-21)
Time frame: Third month post-discharge from ICU
Functional independence post-ICU
Barthel will be used in patients, the score are ordered: 0-20 suggests total dependence, 21-60 severe dependence, 61-90 moderate dependence and 91-99 slight dependence, 100 independence
Time frame: Third month post-discharge from ICU
Functional independence post-ICU
Barthel will be used in patients
Time frame: Twelfth month post-discharge from ICU
Functionality Status post-ICU
Post-COVID-19 Functional Status (PCFS) will be used in patients, the score are : 0 = No functional limitations, 1=Negligible functional limitations, 2=Slight functional limitations, 3=Moderate functional limitations,4=Severe functional limitations, 5=death
Time frame: Third month post-discharge from ICU
Functionality Status post-ICU
Post-COVID-19 Functional Status (PCFS) will be used in patients
Time frame: Twelfth month post-discharge from ICU
Post traumatic stress post-ICU
This mental health condition will be evaluated in patients, family members and the health team, with the instrument Impact of Event Scale Revised (IES-R). Score Interpretation: 24-32: PTSD is a clinical concern, 33-38: This represents the best cutoff for a probable diagnosis of PTSD, 39 and above: This is high enough to suppress your immune system's functioning
Time frame: Third month post-discharge from ICU
Post traumatic stress post-ICU
This mental health condition will be evaluated in patients, family members and the health team, with the instrument Impact of Event Scale Revised (IES-R).
Time frame: Twelfth month post-discharge from ICU
Cognition status post-ICU
MOCA blind instrument will be applied to patients. The total possible score is 22 points; a score of 18 or above is considered normal
Time frame: Third month post-discharge from ICU
Cognition status post-ICU
MOCA blind instrument will be applied to patients.
Time frame: Twelfth month post-discharge from ICU
Quality of life post ICU
Euro Qol (EQ-5D) will be applied to patients. An EQ-5D summary index is derived by applying a formula that essentially attaches values (weights) to each of the levels in each dimension. The index can be calculated by deducting the appropriate weights from 1, the value for full health
Time frame: Third month post-discharge from ICU
Quality of life post ICU
Euro Qol (EQ-5D) will be applied to patients.
Time frame: Twelfth month post-discharge from ICU
ICU memories post ICU
ICU Memory Tool (ICUMT) will be applied to patients.In ICUMT, memories are categorized in subscales of factual memories, memories of feelings, and memories of delusion
Time frame: Third month post-discharge from ICU
ICU memories post ICU
ICU Memory Tool (ICUMT) will be applied to patients.In ICUMT, memories are categorized in subscales of factual memories, memories of feelings, and memories of delusion
Time frame: Twelfth month post-discharge from ICU
Anxiety post ICU
This mental health condition will be evaluated in patients, family members and the health team, with the instrument HADS total scores for anxiety range from 0 to 21, categorized as: normal (0-7), mild (8-10), moderate (11-14) or severe (15-21)
Time frame: Third month post-discharge from ICU
Anxiety post ICU
This mental health condition will be evaluated in patients, family members and the health team
Time frame: Twelfth month post-discharge from ICU
Rate of depressive symptoms
The rate of depressive symptoms after discharge from the ICU will be evaluated in patients with severe Covid-19, their relatives and health personnel with the instrument HADS (Hospital Anxiety and Depression Scale)
Time frame: Twelfth month post-discharge from ICU
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