Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Céline Gélinas, McGill University,
- Second opponent: Ass. professor Lotti Orwelius, University Hospital Linköping,
- Third member and chair of the evaluation committee: Professor Jo Kramer-Johansen, University of Oslo
Chair of the Defence
Professor II Pål Aksel Næss, University of Oslo
Principal Supervisor
Professor Kristin Hofsø, Lovisenberg Diaconal Hospital
Summary
This thesis has investigated patient reported symptoms during intensive care unit (ICU) admission and after discharge. The overall aim was to investigate the prevalence, intensity, and distress of five common symptoms: thirst, pain, anxiousness, tiredness, and shortness of breath, during the first seven days of ICU admission, and to explore associations with long-term outcomes.
A prospective multicenter cohort study was conducted from 2018 to 2020 in six ICUs within the Health South-East region of Norway. Symptoms were assessed daily using the Patient Symptom Survey. Associations between covariates and symptom intensity over time were analyzed using generalized estimating equations. Latent class analysis identified patient symptom classes based on co-occurring symptoms, and logistic regression examined associations with long term physical, cognitive, and mental health symptoms.
In total, 603 adult ICU patients were included, of whom 353 (median age 63 years, 60% male) self-reported symptoms during seven days. Thirst was the most prevalent and intense symptom (64%), while anxiousness, although less prevalent (25%), was the most distressing. Analysis of associated factors with symptom intensity of the five symptoms revealed different associations including age, sex, mechanical ventilation, sepsis diagnosis, analgesic administration, and family caregivers’ visits.
Three symptom classes were identified: low, middle, and high. Patients in the High symptom class (n=50) had a high prevalence of all five symptoms and received more ICU treatments than those in the Low and Middle. Patients in the High class had also higher odds of reporting worse physical, cognitive and mental health symptoms three months after ICU admission, also known as the post intensive care syndrome (PICS).
Systematic assessment of patient-reported symptoms should be the first step in targeted symptom management and to improve multidisciplinary communication.
Additional information
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