- Open Access
Patients’ primary activities prior to critical illness: how well do clinicians know them and how likely are patients to return to them?
© The Author(s). 2018
- Received: 31 October 2018
- Accepted: 28 November 2018
- Published: 17 December 2018
Admission to the intensive care unit (ICU) can make patients feel anonymous and depersonalized . Knowledge of a patient’s primary activity can mitigate the risk of depersonalization by providing insight into a patient’s values, preferences, and overall function. A patient’s primary activity is defined by how they report spending their free time. This information can be used to engage in shared decision-making, ensuring patients receive care that is goal-concordant based on the feasibility of recovering from their critical illness . Therefore, we conducted a prospective observational study to determine if ICU physicians and nurses could identify their patients’ primary activities. Other objectives included determining if patients were able to return to these activities and the probability of patients surviving based on their primary activity.
Activity category and frequency, description, ability to return to activity, and survival
Description and examples
Full return to activity (%)a
Did not fully return to activity (%)b
Work, vocation, or employment status
Involves school or academics
Physical exercise or strain (i.e., weight lifting, walking)
Chores requiring some amount of activity (i.e., cleaning house, shopping)
Involves activity but not as main focus (i.e., traveling, fishing)
Engaging with other people (i.e., family time, visiting friends, therapy)
No physical strain but requires active engagement (i.e., arts and crafts, reading)
No physical strain and no active engagement (i.e., watching TV)
No activity listed
Physician and nurse accuracy in predicting patient primary activities
Physicians (n = 300; %)a
Nurses (n = 303; %)a
No patient responsed
No clinician responsee
We believe that knowing how patients spend their time prior to their illness can help in shared decision-making and ensure the delivery of goal-concordant care . In our study, ICU clinicians rarely reported knowing their patient’s primary activity and were correct in only half of those responses, suggesting that ICU clinicians lack an understanding of their patients’ lives prior to critical illness. This is consistent with previous work that assessed physicians’ knowledge of patients’ broader values . The systematic collection of information related to patients’ values may mitigate the risk of depersonalization. Further work is needed to understand the potential impact of whether knowledge of patient activities leads to improved health outcomes and the delivery of goal-concordant care.
ICU Intensive care unit
Availability of data and materials
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
ATG, MCS, AMD, and MED came up with study design, implementation, data analysis, and manuscript preparation. All authors read and approved the final manuscript.
Ethics approval and consent to participate
The University of Pennsylvania institutional review board approved this study.
Consent for publication
The authors declare that they have no competing interests.
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