Nurse led follow up after being a patient in the ICU

Principal investigator (PI): Kirsti Tøien

Totally 523 patients are included and followed for one year with measurement of post -traumatic stress symptoms, sense of coherence, pain, hope, return to work and health related quality of life. All included patients were screened for post-traumatic stress (PTS) symptoms, and if they had a PTS level above a level that indicated bothersome symptoms they were randomised to follow up consultations (n= 111) with an intensive care nurse with special training in this task, or a control group (n=113). Patients with a score below a bothersome level of PTS symptoms were not randomised but participated as a comparing group (n=299).Two PhD candidates are connected to this project: 

Åse Valsø: will mainly focus on differences in PTS symptoms and sense of coherence in intervention and control group after the intervention and pain in the whole sample.

Mona Austenå: will focus on differences in quality of life, hope and return to work in the different groups.

Symptoms, functional status and quality of life in intensive care patients.

PI, Tone Rustøen, Kristin Hofsø is the main supervisor for four PhD candidates.

A longitudinal study including a heterogeneous sample (n=603) of ICU patients and followed them for 12 months from admission. The impact of pre comorbid conditions, clinical characteristics and treatment on symptoms during the ICU (until 7 days) as well as a set of core outcome measures (i.e., functional status, cognitive function, post-traumatic stress disorder, QOL, anxiety and depression and general symptoms) will be examined longitudinally. The data collection and follow-up period was completed in July 2021.

The following sub-studies, from the above study:

Christin S. Hansen: is investigating symptoms during ICU, and QOL at 12 months.

Renato Mesina: is investigating functional status and activity of daily living in survivors during the first 12 months after ICU admission, from the same study population.

Malin Brandvold: Cognitive functioning at baseline (admission) and during the first year after ICU admission

Klara Friberg: Post traumatic stress symptoms and hope during the first year after ICU admission (Brita Fosser Olsen main supervisor).

Ragnhild Nyhagen: Symptom communication in the intensive care (Marit Kirkevold main supervisor).

Covid 19

Kristin Hofsø: Survival rates and long-term outcomes for patients with COVID-19 admitted to the Norwegian ICUs.

Kristina Fjone: long-term outcomes for patients with COVID-19 admitted to Norwegian ICUs

Kirsti Tøien: Visiting restrain to hospitals; family caregivers of COVID-19 ICU-patients experiences. An exploratory study. A qualitative study describing family caregivers of COVID 19 patients’ experiences and needs during the visiting restrain at the ICU in the COVID19 pandemic. Twelve patients have been included in the study and interviewed with a semi-structured interview guide based on previous research and with input from the health care service users. Analysis of the interviews is in progress. The project group consists of Ranveig Lind PhD, Helene Berntzen PhD and Hanne Alfheim PhD.

Hope in ICU patients

Helene Berntzen and Nina Kynø:

In a qualitative interview study involving 13 patients recently discharged from three different ICUs, we examine facilitating factors and barriers that may impact on levels of hope among ICU patients both during their ICU stay and short after ICU discharge. Analyses are in progress spring 2022. PI is Tone Rustøen.

Kristin Sunde Flatlandsmo, Hanne Alfheim, Kirsti Tøien, Brita Fosser Olsen: To strengthen hope in intensive care unit patients – a randomized controlled trial (HOPE-ICU)

Intraoperative peripheral nerve injuries, symptoms and functional status after steep Trendelenburg positioning with or without lithotomy

PI: Signe Berit Bentsen; PhD student Benedikte Bjøro

Positioning of the patients on the operating table is teamwork where operating room nurses have a pivotal role in order to protect the patients from experiencing injuries due to e.g. nerve compression and compromised circulation. The purpose of this study is to increase the knowledge of intraoperative peripheral injuries (IPNI) related to steep Trendelenburg position with or without lithotomy. As IPNI is an unclear phenomenon that can be difficult to diagnose, we will identify pain and other symptoms immediately after surgery that might have an impact on development of IPNI. A longitudinal study including patients (n=600) undergoing gynecologic-, urologic- and gastro surgical procedures in steep Trendelenburg with or without lithotomy will be included and be followed up to 12 months after surgery.

The experience with nurse-written diaries in intensive care

Tone Rustøen is PI and Helene Berntzen is the main supervisor and Ingrid Egerod/Suzanne Herling co-supervisors.

Lisa M. Högvall’s Phd is investigating the use of diaries in a Norwegian intensive care context with particular focus on acute acquired brain injury (ABI)-patients with an uncertain prognosis of survival or cognitive function. The project comprises one survey to patients who have received a diary after their ICU-stay, one focus-group study with ICU-nurses from different ICUs and one interview study with TBI-survivors and their families using a case study design.

Patient Experienced Symptoms and Complications after Discharge from Day Surgery

PhD-student: Mi Stjernberg, PI: Johan Ræder, Main Supervisor: Marlin Comelon, Co-Supervisors: Tone Rustøen & Berit T. Valeberg.

The aim of this project is to identify potential risk factors and address postdischarge symptoms and complications after day surgery, in a two part sequence. In order to provide better and more dedicated patient education, prophylaxis and drug treatment to prevent and reduce postdischarge symptoms, admission or re-admission, we will perform two large prospective, observational studies at Oslo University Hospital (OUH). The establishment of bench-mark values of incidence and severity of postdischarge complications in a large, Norwegian, non-selected patient material, will be of use also for other institutions in their quality assurance of these large patient populations.

Tapering of Analgosedation and Occurrence of Iatrogenic Withdrawal Syndrome in Paediatric Intensive Care Treatment

Mette Dokken, PhD student, Gunnar Bentsen (main supervisor), Ingrid Egerod, Tone Rustøen, co-supervisors.

The study has both a quantitative and a qualitative approach. Paper 1 is published: To describe the prevalence and severity of iatrogenic Withdrawal Syndrome among severely ill patients in two Norwegian PICUs. In the second paper will to test a new algorithm for tapering analgosedation (opioids and benzodiazepines), and describe whether this algorithm will change the prevalence of IWS. The algorithm is developed by Mette Dokken, Rakel Iren Huse, Gudny Abrahamsen Rosseland, Frode Even Fagermoen and Gunnar Kristoffer Bentsen in PICU RH. In the 3rd paper to explore and understand nurses and physicians experience of using and follow a newly developed algorithm in the tapering of the drugs.

Pain and music based caregiving in nursing home patients

Tone Rustøen PI, Petter Borchgrevink, Reidun Sanvik (main supervisor) and Martin Engelstad (PhD student).

As many as 262 patients with dementia and pain are included. The first paper “Chronic pain conditions and use of analgesics among nursing home patients with dementia” will be submitted soon. In the second paper we will evaluate the effect of music based caregiving in a randomized controlled trial. In the third paper will we look more into the effect of the intervention related to psychosocial symptoms.

Health care, pain medication and treatment outcome after discharge from trauma hospital - experiences and perspectives among patients and physicians

Jeanette Finstad: Phd Project

A substudy of "Improving Patients Outcome after Trauma (IPOT)". The main aim of the IPOT study is to prevent injuries, adverse outcomes and improve trauma treatment. In my qualitative project, we want to gain a better understanding of which factors, before and after injury, are perceived to be related to unfavorable patient outcomes and reduced clinical outcome in trauma patients, including pain treatment, continued use of prescription drugs, disability and reduced quality of life.

We have a network funded by Helse Sør Øst: Norwegian Symptom Management Network (NORSMAN).The overall purpose of this network is to strengthen research that is focused on decreasing symptom burden and improving quality of life outcomes in patients with chronic conditions.

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