More self-efficacy is associated with longitudinally higher health-related quality of life in mechanically ventilated COVID-19 ICU survivors: The prospective MaastrICCht cohort.

This was an observational study, so it shows association, not that self-efficacy causes higher quality of life. Self-efficacy was measured once at 3 months and assumed stable, but the authors did not know whether it changed over time. The study did not test any intervention, so it cannot tell nurses whether an intervention to raise self-efficacy would improve quality of life. Only 87 of 198 survivors alive at discharge completed the self-efficacy questionnaire, and the number analysed fell to 80 at 3 months, 53 at 12 months and 26 at 24 months. Participating survivors had longer ICU stays and longer mechanical ventilation than non-participants, which may have selected for patients with worse disease courses. Missing values were replaced with means for each follow-up measurement, which can bias estimates. The study was single-centre and included only mechanically ventilated COVID-19 survivors during the pandemic, so it may not apply to other ICU survivors. In the adjusted model, the association with the patient-rated EQ-VAS score at 24 months was not significant.

The authors declared no conflicts of interest.

Do not conclude that raising self-efficacy will improve quality of life. This was an association in a cohort with substantial loss to follow-up, and no self-efficacy intervention was tested.