| Summary: | 碩士 === 長庚大學 === 護理學系 === 105 === Background. With the continuing development of medical technology and accumulation of clinical experience, extracorporeal life support systems (ECLS), also called extracorporeal membrane oxygenation, have become widely used with patients suffering from heart and lung failure. ECLS provides more time for damaged organs to recovery, thereby increasing survival rates of patients. However, the complications that ECLS leads to affect the patient's daily life and increase their recovery time, in turn creating psychological distress and lowering the quality of life. Studies indicate that psychological status of critically ill patients has a direct impact on ECLS survivors’ prognosis. Thus, such patients’ anxiety, depression and psychological trauma should not be neglected. However, until now Taiwan’s research has mostly focused on the analysis of factors predicting survival rate of patients who have received ECLS-assisted treatment, and have not yet investigated the effect of psychological factors on their quality of life. Therefore, the aim of this study is to investigate the quality of life in patients who underwent ECLS.
Methods. A cross-sectional and descriptive was used, and the study was conducted from October 2015 to October 2016. The patients were convenience sample of 144 participants who underwent ECLS post discharge. The questionnaires included the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale-Revised (IES-R), the Medical Outcomes Study Short Form 36-Item Version 2 Health Survey (SF-36v2), and the European quality of life 5-dimension 3 level version (EQ-5D).
Results. The results showed that the survial-to-discharge rate was 27% after a median follow-up of 1060 days (44-3612 days). The 144 patients had a low to moderate physical and mental quality of life. Multiple regression analysis revealed that depression, work status, days of hospitalization, self-perceived health status, and body mass index explained 42.7% of the total variance of quality of life in the “physical functioning”. Self-perceived health status, work status, days of hospitalization, and anxiety explained 37.4% of the total variance of quality of life in the “role limitation due to emotional problems”. Depression, body mass index, work status, and psychological trauma explained 34.6% of the total variance of quality of life in the“bodily pain”. Self-perceived health status, anxiety, and work status explained 33.7% of the total variance of quality of life in the“general health”. Depression, anxiety, days of hospitalization, and self-perceived health status explained 39.4% of the total variance of quality of life in the“vitality”. Depression and psychological trauma explained 30.5% of the total variance of quality of life in the“social functioning”. Depression, anxiety, and body mass index explained 41.8% of the total variance of quality of life in the“role limitation due to emotional problems”. Anxiety, depression, and gender explained 39.2% of the total variance of quality of life in the“mental health”. Depression, days of hospitalization and age explained 39.6% of the total variance of EQ-5D index. Self-perceived health status, depression and education explained 49.3%of the total variance of EQ-5D VAS.
Conclusions. The results of the current study are instructive for clinical healthcare professionals to understand patient’s psychological problems, quality of life and factors influencing quality of life. Therefore, healthcare professionals can develop appropriate care plans which meet patients’ needs, in turn, decreasing negative impacts on quality of life resulting from psychological problems.
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