Abstract
Background
Patients often develop cognitive dysfunction during admission to the ICU and after
being transferred out of the ICU, which leads to physical disorders, sleep disorders,
and psychological stress.Cognitive rehabilitation training can significantly improve
patients' planning, decision-making ability, and executive function.
Objective
The aim of this study was to explore the role of early cognitive rehabilitation training
in improving cognitive impairment in critically ill patients.
Methods
This study was a prospective, randomised, controlled clinical trial conducted from
January 2017 to June 2021. Critically ill patients with cognitive impairment admitted
to the Department of Intensive Care Medicine of The Third Hospital of Mianyang were
randomly divided into the control (n = 68) and intervention groups (n = 68). Cognitive
rehabilitation training (including digital operating system training, music therapy,
aerobic training, and mental health intervention) was applied to the patients in the
intervention group for 6 months, while the control group did not receive any cognitive
intervention. Before 3 and 6 months after enrolment, the Montreal Cognitive Assessment
and the 36-Item Short Form Health Survey Scale were used to evaluate cognitive function
and quality of life, respectively, in both groups.
Results
A total of 136 critical patients were included in the final analysis. There were no
significant differences in sex, age, years of education, complications, intensive
care unit hospitalisation time, mechanical ventilation time, or the total score of
the Montreal Cognitive Assessment scale when transferred out of the intensive care
unit in 24 hours between the two groups. Six months later, the results of the follow-up
showed that the cognitive function score in the intervention group was significantly
higher than that in the control group (26.69 ± 2.49 vs. 23.03 ± 3.79). The analysis
of quality of life showed that the scores in all areas in the intervention group improved.
There were significant differences in physical functioning (69.02 ± 8.14 vs. 63.38 ± 11.94),
role physical (62.02 ± 12.18 vs. 58.09 ± 8.83), general health (46.00 ± 15.21 vs.
40.38 ± 13.77), vitality (61.00 ± 11.01 vs. 54.38 ± 13.80), social functioning (70.00 ± 10.29
vs. 64.41 ± 13.61), role emotional (78.00 ± 8.00 vs. 72.15 ± 12.18), and mental health
(71.00 ± 12.33 vs. 55.37 ± 10.76) between the two groups (P < 0.05).
Conclusion
Early cognitive rehabilitation training can improve cognitive impairment in critically
ill patients and their quality of life.
Keywords
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Article info
Publication history
Published online: December 02, 2022
Accepted:
October 24,
2022
Received in revised form:
October 22,
2022
Received:
July 24,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
