Latent Trajectories of Activities of Daily Living Disability and Associated Factors Among Adults with Post-Intensive Care Syndrome One Week After ICU Discharge

Abstract

Xiying Zhang,1 Zhixia Jiang,2 Aiai Huang,3 Fuyan Zhang,4 Yuancheng Zhang,5 Fang Zhang,6 Lin Gao,7 Xiaoling Yang,8 Rujun Hu9 1Department of Intensive Care Unit, Jinsha County People’s Hospital, Bijie, Guizhou Province, 551800, People’s Republic of China; 2Office of the Director, Guizhou Nursing Vocational and Technical College, Guiyang, Guizhou Province, 550081, People’s Republic of China; 3Department of Nursing, Panyu Maternal and Child Care Service Center of Guangzhou, Guangzhou, Guangdong Province, 511400, People’s Republic of China; 4Department of Nursing, Jinsha County People’s Hospital, Bijie, Guizhou Province, 551800, People’s Republic of China; 5Department of Orthopaedics, Jinsha County People’s Hospital, Bijie, Guizhou Province, 551800, People’s Republic of China; 6Surgical Teaching and Research Office, Guizhou Nursing Vocational and Technical College, Guiyang, Guizhou Province, 550081, People’s Republic of China; 7Department of Endocrinology, Jinsha County People’s Hospital, Bijie, Guizhou Province, 551800, People’s Republic of China; 8Comprehensive Department of Nursing, Guizhou Nursing Vocational and Technical College, Guiyang, Guizhou Province, 550081, People’s Republic of China; 9Department of Intensive Care Unit, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, 563000, People’s Republic of ChinaCorrespondence: Xiying Zhang, Department of Intensive Care Unit, Jinsha County People’s Hospital, Yangdeng Community, Xiluo Street, Jinsha County, Bijie City, Guizhou Province, People’s Republic of China, Tel [phone], Email [email protected]: To identify the latent trajectories of activities of daily living (ADL) disability and the influential factors among adults with post-intensive care syndrome (PICS).Methods: We evaluated five-time longitudinal data about PICS diagnosed in 434 of 593 assessed patients (73.19%). Disability was measured by the Barthel index scale, which grades individuals according to how difficult it is to carry out ADL. We utilized the growth mixture model (GMM) to identify latent trajectories and associated factors.Results: Two groups with distinct trajectories of ADL disability were identified, including the Severe Disability Sustained Group and the Disability Recovery Group. People who were of advanced age transferred to another hospital for treatment, or had cognitive impairment or depression were more likely to be classified into the Severe Disability Sustained Group (P < 005).Conclusion: There are two potential trajectories of ADL disability in patients with PICS, which are the severe disability persistence group and the disability recovery group. Improvement in cognitive impairment or depression may contribute to recovery from disability, transfer to hospital or advanced age may not be conducive to recovery of ADL ability, and disability may last longer.Keywords: activities of daily living, critical illness, disability, growth mixture model, post-intensive care syndrome

Keywords

• activities of daily living
• critical illness
• disability
• growth mixture model
• post-intensive care syndrome