NCT03972384

A Problem Solving Intervention for Post-ICU Cognitive Impairment in Older Adults

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 19 (actual)
• Sponsor: Ohio State University · Academic / Other
• Sex: All
• Age: 55 Years – 89 Years
• Healthy volunteers: Not accepted

Summary

This study will apply an evidence based program to assist ICU survivors to overcome cognitive problems as a result of their critical illness. This study will determine feasibility of recruitment, retention and engagement with the program as well as acceptability of the program to the participants.

Detailed description

The Post-Intensive Care Unit Problem Solving (PIC-UPS) is an adaptation of a problem solving strategy developed and tested in diverse patient populations. Its effectiveness has been demonstrated in children with movement disorders or learning difficulties as well as adults with cognitive problems following acute stroke. Participants will be randomized onto usual care and intervention groups. The usual care group will complete study surveys after enrollment and 10 weeks after enrollment. The intervention group will receive the following: In the (PIC-UPS) program, participants will be engaged for 10 sessions, learning how to do skills they select as treatment goals. The first session consists of an assessment, and selecting the goals to meet during the 10 sessions. In the next sessions, conducted at the participant's home, participants practice the skills selected as treatment goals, and assisted by the study team, use strategies to help better learn and perform those skills. Some examples of tasks that others have addressed in these sessions are gardening, yoga breathing, handwriting, managing family finances, medication management, or initiating an exercise regimen. Participants will be encouraged to select tasks most relevant and problematic to their unique situation. In addition to attending the sessions, the participants will be asked to rate the sessions and asked about how useful they were in helping to achieve goals. This involves the completion of some written questionnaires and will take about a half hour. Sample Assessment and Treatment Schedule Session Description 1. Assessment session approximately one and a half hours long. Combination of questionnaires and goal setting interview. Baseline testing of 3 goals. 2. Treatment session + 2 surveys, approximately one hour long. 3. Treatment session 3, approximately one hour long. 4. Treatment session 4, approximately one hour long. 5. Treatment session 5, approximately one hour long. 6. Treatment session 6, approximately one hour long. 7. Treatment session 7, approximately one hour long. 8. Treatment session 8, approximately one hour long. 9. Treatment session 9, approximately one hour long. 10. Treatment session 10, followed by first post-intervention assessments, approximately 2 hours long.

Conditions

• Critical Illness
• Mechanical Ventilation Complication
• Delirium
• Cognitive Impairment

Interventions

Type	Name	Description
BEHAVIORAL	Post-ICU Problem Solving	We have adapted the Cognitive Orientation to Daily Occupational Performance (CO-OP) as the Post-ICU Problem Solving intervention to be delivered in the home to patients following an illness that required an ICU stay. CO-OP is a form of meta-cognitive strategy training that teaches individuals to identify and prioritize problematic daily activities, identify barriers impeding performance, generate and evaluate strategies addressing these barriers, and generalize learning through practice. Thus, strategy training teaches skills that can be used to address disability in "real-life" activities, and is integral to personalized rehabilitation services. CO-OP has been adapted in numerous settings and most recently, it is being utilized successfully in patients with acquired cognitive dysfunction following acute stroke. This represents a useful intervention, tested in similar populations with minimal risk to the participants and potential for maximal benefit for this population.

Timeline

• Start date: 2022-01-21
• Primary completion: 2023-03-01
• Completion: 2023-03-01
• First posted: 2019-06-03
• Last updated: 2024-09-25

Locations

1 site across 1 country: United States