Abstract
PURPOSE OF STUDY: The purpose is to describe sepsis survivors' functional recovery and symptom experience following Intensive Care Unit (ICU) hospitalization. PRIMARY PRACTICE SETTINGS: Academic Medical Center, Community Living. METHODOLOGY AND SAMPLE: This longitudinal observational study recruited participants during hospitalization at two adult ICUs in a single Midwestern academic medical center. Participants completed surveys to assess function and symptom experience at baseline (discharge), 1-month, 3-months, and 6-months post-discharge. RESULTS: Participants were non-Hispanic Whites with mean age 55.4 years (SD = 17.0). The majority were discharged to home (78.6%), with 3 (21.4%) discharged to a skilled nursing facility or acute rehabilitation unit. Participants had notable improvements in mobility, self-rated health, and fatigue from discharge to 6-months post-discharge. Increases in mobility from discharge to 1 month, 3 months, and 6 months were statistically significant (α < .05). Decreases in fatigue from discharge to 1 month and 6 months were statistically significant (α < .05). Cognitive and social engagement and other symptom experience measures did not differ significantly during the study period. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Findings reveal trends in mobility recovery and symptom experience post-hospitalization, which are important considerations post-ICU sepsis hospitalization. This study reinforces the need to promote early mobilization of patients during hospitalization and work with patients to develop strategies for mobility recovery post-hospitalization, as part of a comprehensive plan which integrates a client's medical, behavioral, social, psychological, functional, and other needs. The authors encourage assessment of common symptoms, including pain, fatigue, anxiety, and sleep disturbance, experienced by sepsis survivors during and post-hospitalization. As a result, case managers will be better positioned to implement evidence-based interventions to promote recovery and reduce symptom burden and improve outcomes. Evidence-based interventions should include those that are centered on client's functional and symptom-related needs, preferences, safe mobility, and facilitate awareness of and connections with community supports and resources.