What is the Position of Physical and Psychological Screening Models in the Iranian Contexts?

Health care systems are facing the challenge of caring forcomplex patients described by the presence of co-occurringand multiple chronic diseases that is known asmultimorbidity (1-4). Multimorbidity has a relevant impacton patients' outcomes in both younger and older adults andmany of them are hospitalized in intensive care units (ICU)(1, 5-15).Approximately 10% of these patients die in ICU and 15%are expected to die in hospitals, and the vast majority ofpatients survive to hospital discharge (16).The understanding of short and long term physical andpsychological morbidity associated with ICU survivorship,has led to an exploration and identification of both theprecipitating factors and interventions which could reducethe incidence and severity of complications (14, 17-21).From one side, survivorship from the ICU has doubled froma mere 40% in 1990 up to 80% in 2010 (22-24), and fromthe other side, up to one third of the total mortality thatoccurs after a successful discharge (25). This high mortalityrate after a successful discharge from the ICU emphasizesthe critical need for additional attention to this complexdecision-making process.Numerous follow-up studies have shown significant andlong lasting physical and psychological dysfunctions insurvivors of critical illness, all of which contribute to areduced health-related quality of life (profound tirednessand weakness; pain; ongoing physical disability; sleepingdifficulties; depression; irritability and post-traumatic stress(26), delays in optimal functional recovery for a significantpercentage of survivors (14, 27, 28), an increased risk ofdeath, length of stay, and higher costs (24, 29, 30). (14, 16,27, 31-35).