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Critical care medicine · Dec 2022
Patient and Caregiver-Derived Health Service Improvements for Better Critical Care Recovery.
- Kimberley J Haines, Nina Leggett, Elizabeth Hibbert, Tarli Hall, Leanne M Boehm, Rita N Bakhru, Anthony J Bastin, Brad W Butcher, Tammy L Eaton, Wendy Harris, Aluko A Hope, James Jackson, Annie Johnson, Janet A Kloos, Karen A Korzick, Pamela Mactavish, Joel Meyer, Ashley Montgomery-Yates, Tara Quasim, Andrew Slack, Dorothy Wade, Mary Still, Giora Netzer, Ramona O Hopkins, Mark E Mikkelsen, Theodore J Iwashyna, Joanne McPeake, Carla M Sevin, and Society of Critical Care Medicine’s Thrive Initiative.
- Department of Physiotherapy, Western Health, Sunshine Hospital, Melbourne, VIC, Australia.
- Crit. Care Med. 2022 Dec 1; 50 (12): 177817871778-1787.
ObjectivesTo engage critical care end-users (survivors and caregivers) to describe their emotions and experiences across their recovery trajectory, and elicit their ideas and solutions for health service improvements to improve the ICU recovery experience.DesignEnd-user engagement as part of a qualitative design using the Framework Analysis method.SettingThe Society of Critical Care Medicine's THRIVE international collaborative sites (follow-up clinics and peer support groups).SubjectsPatients and caregivers following critical illness and identified through the collaboratives.InterventionsNone.Measurements And Main ResultsEighty-six interviews were conducted. The following themes were identified: 1) Emotions and experiences of patients-"Loss of former self; Experiences of disability and adaptation"; 2) Emotions and experiences of caregivers-"Emotional impacts, adopting new roles, and caregiver burden; Influence of gender roles; Adaptation, adjustment, recalibration"; and 3) Patient and caregiver-generated solutions to improve recovery across the arc of care-"Family-targeted education; Expectation management; Rehabilitation for patients and caregivers; Peer support groups; Reconnecting with ICU post-discharge; Access to community-based supports post-discharge; Psychological support; Education of issues of ICU survivorship for health professionals; Support across recovery trajectory." Themes were mapped to a previously published recovery framework (Timing It Right) that captures patient and caregiver experiences and their support needs across the phases of care from the event/diagnosis to adaptation post-discharge home.ConclusionsPatients and caregivers reported a range of emotions and experiences across the recovery trajectory from ICU to home. Through end-user engagement strategies many potential solutions were identified that could be implemented by health services and tested to support the delivery of higher-quality care for ICU survivors and their caregivers that extend from tertiary to primary care settings.Copyright © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
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