GM09 - Morbidity and quality of life of patients with COPD admitted on the ICU – kwalitatief onderzoek MST.docx

GM09 - Morbidity and quality of life of patients with COPD admitted on the ICU – kwalitatief onderzoek naar de ervaringen van patiënten met hun opname op de IC van het MST

Type opdracht:

Ma

In –of extern?:

Extern, standplaats MST Ziekenhuis, Enschede

Max aantal studenten?

1

Zelf data verzamelen?

Ja

Type onderzoek:

Kwalitatief

Opdrachtomschrijving:

Chronic Obstructive Pulmonary Disease (COPD) frequently presents with an acute exacerbation (AECOPD). Debate exists as to whether these patients should be admitted to intensive care units (ICUs). In critically ill patients the presence of COPD is an independent risk factor for mortality and morbidity and is associated with prolonged mechanical ventilation and prolonged weaning.

Aim of the study

To assess the impact of ‘being admitted to the ICU’ on performance and quality of life. The aim of this study is to clarify and rank items that influence patient’s perception and expectations of ICU admission and the impact of that on personal functioning. In future, we can use the results to support treatment decisions and to discuss restriction of treatment (NRIC-) with patients and family whether admission to the ICU is meaningful.

Methods

The ICU department has a database which contains data on patients known with COPD admitted to the ICU because of respiratory failure and patients with COPD admitted because of another reason (but not respiratory insufficiency). The database contains a number of parameters such as age, reason of admission, co-morbidity and duration of admission, duration of ventilation. However, a number of parameters are missing, such as whether the ventilation was invasive or non-invasive, outcome parameters after discharge (mortality) and pre-and post-admission respiratory parameters, such as GOLD stage, FEV1, pO2 in stable phase, performance scale etcetera. In a separate study these data will be gathered and added to the database (not part of this study).

All patients who survived will be invited for an in-depth interview (at the hospital or at home). This interview is not yet available. Part of the study is to develop a questionnaire which is able to answer your research questions.

We are interested in the knowledge of patients on several subjects with respect to their disease, prognosis and treatment options on the ICU. Furthermore, we are interested in the expectations of patients with respect to their quality of life. The questionnaire contains questions on ‘ideas and expectations of admission on the ICU and possibilities of respiratory support (invasive/ non-invasive)’, on ‘ideas and expectations on resuscitation’,

The interview should also address the aspect that the patient has been admitted to the ICU. Is her or his opinion with respect to invasive treatment/ support and resuscitation changed after admission? Is the quality of life diminished?

Besides the interview a number of objective parameters can be investigated, such as the Karnofsky score, the BORG score and lung function parameters.

Wie zoeken we?

Student met interesse voor het thema , die in staat is regelmatig op locatie aanwezig te zijn. Van de student wordt verwacht dat hij of zij de uitkomsten van het onderzoek aan het einde van de stage presenteert aan de betrokkenen in het MST

Wat bieden we?

De student krijgt een werkplek aangeboden op 1 van beide afdelingen. Hij of zij krijgt de mogelijkheid om op beide afdelingen mee te kijken hoe patiënten worden opgevangen en behandeld door bij het ochtendrapport aanwezig te zijn, bij visites aanwezig te zijn, en een keer mee te lopen met de zaalarts en/of specialist.

Meer info

Wanda Hagmolen of ten Have, longarts i.o. (w.hagmolenoftenhave@mst.nl)

Begeleider:

Marcel Pieterse (m.e.pieterse@utwente.nl)

Extra

Messer et al. Q J Med (2012) 115

Funk et al. ERJ (ahead of publication) 2012