More self-efficacy is associated with longitudinally higher health-related quality of life in mechanically ventilated COVID-19 ICU survivors: The prospective MaastrICCht cohort.

Background: More self-efficacy leads to greater confidence in one's ability to perform actions to achieve treatment goals. Therefore, self-efficacy may affect patient recovery and health-related quality of life (HRQoL) after ICU discharge.

Aim: In a cohort of mechanically ventilated COVID-19 survivors, we examined the associations between self-efficacy at 3 months and HRQoL at 3, 12 and 24 months after discharge.

Study design: Mechanically ventilated survivors of the MaastrICCht cohort that completed a self-efficacy assessment with the General Self-Efficacy Scale (GSES) were included. HRQoL was measured using the EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), subdivided into a health utility score (EQ-HUS) and visual analogue scale (EQ-VAS). Linear regression models were used to investigate associations between self-efficacy and HRQoL and were adjusted for age, sex, body mass index (BMI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, ICU length of stay and hospital discharge location.

Results: In 87 ICU survivors, more self-efficacy at 3 months after ICU discharge was associated with longitudinally higher EQ-HUS (β = 0.01; 95% CI: 0.01-0.02; p < 0.001) and higher EQ-VAS (β = 1.00; 95% CI: 0.66-1.35; p < 0.001) up to 2 years after ICU discharge. After adjustment for age, sex, BMI, APACHE II score, ICU length of stay, and hospital discharge location, associations were similar.

Conclusions: More self-efficacy at 3 months after ICU discharge was associated with longitudinally higher HRQoL up to 2 years after ICU discharge in mechanically ventilated COVID-19 survivors.

Relevance to clinical practice: Screening for self-efficacy in patients post-ICU as well as developing interventions to improve self-efficacy are a target post-ICU to enhance HRQoL over the long term.