TY  - JOUR
PY  - 2017//
TI  - The experience of patients with alcohol misuse after surviving a critical illness: a qualitative study
JO  - Annals of the American Thoracic Society
A1  - Clark, Brendan J.
A1  - Jones, Jacqueline
A1  - Reed, K. Diandra
A1  - Hodapp, Rachel Marie
A1  - Douglas, Ivor S.
A1  - Van Pelt, David
A1  - Burnham, Ellen L.
A1  - Moss, Marc
SP  - 1154
EP  - 1161
VL  - 14
IS  - 7
N2  - RATIONALE: Alcohol misuse is common in patients admitted to the intensive care unit (ICU) but there is currently no evidence-based approach to address drinking in ICU survivors. <br><br>OBJECTIVES: We sought to describe the experience of ICU survivors with alcohol misuse during their hospitalization and the 3 months following hospital discharge in order to inform an alcohol specific intervention for this unique population. <br><br>METHODS: We conducted a descriptive qualitative study of ICU survivors from medical ICUs in three separate hospitals with a positive screening result on the Alcohol Use Disorders Identification Test. Semi-structured interviews were conducted 3 months following hospital discharge in patients. Patients were also allowed to nominate up to two friends or family members for enrollment in order to provide additional perspective on the patient's experience. <br><br>RESULTS: We enrolled 50 patients and 22 of their friends and/or family members. The average APACHE II score was 23, 80% of patients were male, and the average age was 50; 70% of patients and 77% of friends/family members completed the semi-structured interview 3 months after hospital discharge. We identified three domains that could inform an alcohol-specific intervention, each with multiple themes: the context of decision making in the hospital (anxiety and depression, critical illness as a catalyst, delirium and cognitive impairment); patient-provider interactions (autonomy, failure and opportunities to build a therapeutic alliance); and the transition from hospital to home (lack of screening for depression and anxiety, social network support for drinking, social isolation, social network support for abstinence, lack of available and affordable treatment, and negative experiences with Alcoholics Anonymous). <br><br>CONCLUSIONS: An alcohol intervention for ICU survivors would account for the context in which patients are making a decision about their drinking and optimize the patient-provider interaction. Contrary to current paradigms that focus on addressing alcohol consumption only during a hospitalization, an intervention for ICU survivors should continue as patients transition from the hospital to home. Primary source of funding. National Institutes of Health K23 AA 021814.<p />  <p>Language: en</p>
LA  - en
SN  - 2329-6933
UR  - http://dx.doi.org/10.1513/AnnalsATS.201611-854OC
ID  - ref1
ER  -