| Objectives:To understand the long-term quality of life status of severe patients treated by ECMO,analyze and discuss its influencing factors,and provide reference for the development of the content or program of continuous care for such patients.Methods:A sequential research method in a mixed-methods study was used.For the qualitative study,according to the objective sampling method,19 long-term survival patients discharged from a tertiary class A general hospital in Sichuan Province who were treated with extracorporeal membrane oxygenation were selected for in-depth interviews,and the data were sorted and analyzed by Colaizzi seven-step analysis method.The quantitative study included 106 long-term survival patients treated with ECMO.General Information Questionnaire,36-item Health Survey Short Form,Barthel Index Rating Scale,Post Traumatic Stress Disorder Self-Rating Scale,and Nottingham Health Profile Part Ⅱ Scale were used to investigate.Frequency and composition ratios were used for statistical description of count data,mean ± standard deviation or median and interquartile spacing were used for statistical description of measures,and two-sample rank sum test or multiple-sample Kruskal Wallis test,Spearman correlation analysis,and multiple linear regression analysis were used for statistical inference.Results:1.Five themes have been analyzed and refined in qualitative research,namely:①Physical recovery;②Life change;③Psychological distress and repair;④The source of security;⑤The need for continuity of care.2.The univariate analysis of the quantitative study found that critically ill patients treated with extracorporeal membrane oxygenation had a score of(63.72 ± 20.87)for the physiological health content dimension and(72.69 ± 23.67)for the mental health content dimension of long term quality of life.Statistically significant variables for the physiological health content dimension were:age,gender,marital status,education level,employment status,type of caregiver,smoking,and chronic disease(P<0.05);statistically significant variables for the mental health content dimension were:place of residence,education level,employment status,income,type of health insurance,type of caregiver,and chronic disease(P<0.05).3.Correlation analysis revealed that the long term quality of life physical health content dimension was positively correlated(P<0.01)with Barthel Index rating score(r=0.560)and negatively correlated(P<0.01)with PTSD self-assessment score(r=-0.58)and Nottingham Health Profile Part Ⅱ score(r=-0.757);the long term quality of life mental health content dimension were positively correlated(P<0.01)with Barthel Index rating scores(r=0.589)and negatively correlated(P<0.01)with PTSD self-rated scores(r=-0.741)and Nottingham Health Profile Part Ⅱ scores(r=-0.647).4.In multiple linear regression analysis,it was found that in the physical health content dimension,caregiver type,on-the-job status,Barthel Index rating score,PTSD self-assessment score and Nottingham Health Profile Part Ⅱ score were independent influences(P<0.05),explaining a total of 82.6%of the variance;in the mental health content dimension,on-the-job status,place of residence,Barthel Index scores,PTSD scores and Nottingham Health Profile Part Ⅱ scores were independent influences(P<0.05),explaining 73.9%of the variance.Conclusion:1.The long-term quality of life of critically ill patients treated with extracorporeal membrane oxygenation is low,with varying degrees of physical,psychological,and social dysfunction,especially social functioning that needs urgent restoration.2.Long-term quality of life in critically ill patients treated with extracorporeal membrane oxygenation varies in demographic and clinical data,suggesting that our health care team needs to provide more precise interventions or programs.3.The higher the PTSD self-assessment score and Nottingham Health Profile PartⅡ score,the lower the level of long-term quality of life,and the higher the Barthel Index score,the higher the level of long-term quality of life in critically ill patients treated with extracorporeal membrane oxygenation.4.The long-term quality of life of critically ill patients treated with extracorporeal membrane oxygenation is affected by a variety of factors,and a professional health care team is needed to open a post-extracorporeal membrane oxygenation patient management clinic to provide assistance to patients. |
