Transitions of care after critical illness – challenges to recovery and adaptive problem solving

Haines, K. J. et al. (2021) Transitions of care after critical illness – challenges to recovery and adaptive problem solving. Critical Care Medicine, 49(11), pp. 1923-1931. (doi: 10.1097/CCM.0000000000005095) (PMID:34091486)

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Abstract

Objectives: Investigate the challenges experienced by survivors of critical illness and their caregivers across the transitions of care from intensive care to community, and the potential problem-solving strategies used to navigate these challenges. Design: Qualitative design—data generation via interviews and data analysis via the framework analysis method. Setting: Patients and caregivers from three continents, identified through the Society of Critical Care Medicine’s THRIVE international collaborative sites (follow-up clinics and peer support groups). Subjects: Patients and caregivers following critical illness. Interventions: Nil Measurements and Main Results: From 86 interviews (66 patients, 20 caregivers), we identified the following major themes: 1) Challenges for patients—interacting with the health system and gaps in care; managing others’ expectations of illness and recovery. 2) Challenges for caregivers—health system shortfalls and inadequate communication; lack of support for caregivers. 3) Patient and caregiver-driven problem solving across the transitions of care—personal attributes, resources, and initiative; receiving support and helping others; and acceptance. Conclusions: Survivors and caregivers experienced a range of challenges across the transitions of care. There were distinct and contrasting themes related to the caregiver experience. Survivors and caregivers used comparable problem-solving strategies to navigate the challenges encountered across the transitions of care.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mactavish, Mrs Pamela and Quasim, Professor Tara and McPeake, Dr Jo
Authors: Haines, K. J., Hibbert, E., Leggett, N., Boehm, L. M., Hall, T., Bakhru, R. N., Bastin, A. J., Butcher, B. W., Eaton, T. L., Harris, W., Hope, A. A., Jackson, J., Johnson, A., Kloos, J. A., Korzick, K. A., Mactavish, P., Meyer, J., Montgomery-Yates, A., Quasim, T., Slack, A., Wade, D., Still, M., Netzer, G., Hopkins, R. O., Iwashyna, T. J., Mikkelsen, M. E., McPeake, J., and Sevin, C. M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:Critical Care Medicine
Publisher:Lippincott, Williams & Wilkins
ISSN:0090-3493
ISSN (Online):1530-0293
Published Online:05 June 2021
Copyright Holders:Copyright © 2021 The Society of Critical Care Medicine and Wolters Kluwer Health, Inc
First Published:First published in Critical Care Medicine 49(11): 1923-1931
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303784Collaboration Assessment of ICU Recovery NeedsTara QuasimSociety of Critical Care Medicine (SCCM)GN17CC589Med - Anaesthesia
307748Improving health and social care integration delivery in the acute care environmentJoanne McPeakeUniversity of Cambridge (HEI-CAMB)RG88620HW - MRC/CSO Social and Public Health Sciences Unit