Hope among patients discharged from an intensive care unit: A prospective cohort study.
Mona Austenå, Tone Rustøen, Milada Cvancarova Hagen and 3 others
PMID 39763165WHAT IT FOUND
Hope stayed stable from 3 to 12 months after ICU discharge.
Higher hope was linked to no prior mental health problems, fewer early post-traumatic stress symptoms and more social support. The nurse-led follow-up intervention did not improve hope at 3 months.
Key findings
01After the study groups were merged, estimated mean hope scores were 37.9 at 3 months, 37.9 at 6 months and 37.7 at 12 months on a 12 to 48 scale, and the paper reports no change over time.
02Higher 12-month hope was independently associated with lack of prior mental health problems, lower early post-traumatic stress symptoms and more social support at 3 months; in the repeated-measures model, lack of prior mental health problems was associated with two points higher hope, a 10-unit decrease in post-traumatic stress symptoms with about one point higher hope, and a 10-unit increase in social support with four points higher hope.
03The original intervention was nurse-led follow-up consultations based on cognitive behavioural therapy, narrative methods and salutogenic theory; it was not designed to impact hope and showed no effect on hope at 3 months, so the groups were merged for this analysis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study included only patients who could consent and excluded poor language skills, self-inflicted injuries, severe psychiatric or psychotic disorders, terminal disease and cognitive impairment. No data were available on patients who refused participation or were transferred before inclusion, so the sample may not represent all discharged ICU patients. Several patients were too weak early after discharge and were lost for inclusion. Hope was first measured at 3 months, so earlier levels were missed. 64 patients died during follow-up, and their hope levels were not compared with survivors. The study was single centre in Norway, so it may not apply elsewhere. Self-report questionnaires may not fully capture patients' situation. Analyses were exploratory, with no correction for multiple testing, and can show association but not cause. The effect of post-traumatic stress symptoms on hope was small, about one point per 10-unit symptom decrease, so its clinical relevance is uncertain. The data collection ended in 2018, and this was a sub-study of a previous trial.
Declared interests
Funded by Oslo University Hospital and Norsk Sykepleierforbund. No additional conflicts of interest are reported.
The easy way to misread this
Do not conclude that nurse-led follow-up consultations raise hope. The intervention was not designed to impact hope and showed no effect on hope at 3 months. The links with prior mental health problems, post-traumatic stress symptoms and social support are associations, not proof that changing them will increase hope.