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)

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 > School of Cardiovascular & Metabolic Health; 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

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
303784		Collaboration Assessment of ICU Recovery Needs	Tara Quasim	Society of Critical Care Medicine (SCCM)	GN17CC589	Med - Anaesthesia
307748		Improving health and social care integration delivery in the acute care environment	Joanne McPeake	University of Cambridge (HEI-CAMB)	RG88620	HW - MRC/CSO Social and Public Health Sciences Unit