Citation: Avgeri, K.; Zakynthinos, E.;
Tsolaki, V.; Sgantzos, M.;
Fotakopoulos, G.; Makris, D. Quality
of Life and Family Support in
Critically Ill Patients following ICU
Discharge. Healthcare 2023, 11, 1106.
https://doi.org/10.3390/
healthcare11081106
Academic Editor: Paolo Cotogni
Received: 23 February 2023
Revised: 27 March 2023
Accepted: 9 April 2023
Published: 12 April 2023
Copyright: © 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
healthcare
Article
Quality of Life and Family Support in Critically Ill Patients
following ICU Discharge
Konstantina Avgeri, Epaminondas Zakynthinos, Vasiliki Tsolaki, Markos Sgantzos , George Fotakopoulos
and Demosthenes Makris *
Department of Medical School, University of Thessaly, 41110 Larissa, Greece
* Correspondence: appollon7@hotmail.com; Tel.: +30-6943706079
Abstract: Background: Following discharge from the intensive care unit (ICU), critically ill patients
may present cognitive dysfunction and physical disability. Objectives: To investigate the quality of life
(QoL) of patients following discharge from ICU, physical performance and lung function and to assess
the role of support by family members and friends. Methods: This prospective study was conducted
in the University Hospital of Larissa Greece between 2020 and 2021. Patients hospitalized at the ICU
for at least 48 h were included and assessed at hospital discharge, at 3 and at 12 months later. The
research implements of the study were a dedicated questionnaire and the SF-36 health questionnaire
for the appraisal of the QoL. Lung function changes were assessed by spirometry and physical
performance by the 6-min walking test (6MWT). Results: One hundred and forty-three participants
were included in the study. The mean (SD) of the physical and mental health SF-36 scores at hospital
discharge, 3 and 12 months were 27.32 (19.59), 40.97 (26.34) and 50.78 (28.26) (p < 0.0001) and
42.93 (17.00), 55.19 (23.04) and 62.24 (23.66), (p < 0.0001), respectively. The forced expiratory volume
in one second and 6MWT significantly improved over 12 months. Patients who were supported by
two or more family members or patients who were visited by their friends >3 times/week presented
better scores in the physical and mental SF36 domains at 12 months. Conclusion: This study shows
that the quality of life of Greek patients who were discharged from the ICU can be positively affected
both by the support they receive from their family environment and friends.
Keywords: ICU; patients’ support; family support; PICS; quality of life; critical care
1. Introduction
Intensive care unit (ICU) hospitalization is a considerably stressful situation both
for patients and their families [1,2] and has various physical and mental implications.
Patients following ICU management may present reduced lung function [3], neuromuscular
dysfunction, anxiety and depression. Six months following ICU discharge, patients showed
reduced functional and pulmonary capacity, while an improvement was observed at
12 months after discharge [3]. These disorders in physical, intellectual and mental health
have been described as post-ICU traumatic syndrome [1] and may be present for years,
compromising the QoL of patients [4,5]. Family members may have an important role in the
management of a critical illness, because they are often responsible for making decisions
that the patients are unable to make on their own. Studies show that more than 50% of
patients have to be taken care of by family members [6,7]. In this respect, family members’
support is pivotal in improving the patients’ health by contributing to quality care [8]. In
turn, this has an impact on the lives of those family members. Indeed, when a patient is
at the ICU in critical condition, family members may also suffer from symptoms such as
anxiety, acute stress disorder, post-traumatic stress disorder, depression and complicated
grief [9]. In this respect, the long-term impact of a critical disease on the QoL of both
patients and family and the role of family in supporting critical care patients are important
Healthcare 2023, 11, 1106. https://doi.org/10.3390/healthcare11081106 https://www.mdpi.com/journal/healthcare