Optimizing Critical Illness Recovery: Perspectives and Solutions From the Caregivers of ICU Survivors

• Authors: Carla M Sevin, Vanderbilt University; Leanne M Boehm, Vanderbilt University; Elizabeth Hibbert, Western Health, Melbourne; Anthony J Bastin, St Bartholomew’s Hospital, Barts Health NHS Trust; James C Jackson, Vanderbilt University; Joel Meyer, Guy’s and St Thomas’ NHS Foundation Trust; Tara Quasim, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde; Rita N Bakhru, Wake Forest University; Ashley Montgomery-Yates, University of Kentucky, Lexington; Andrew Slack, Guy’s and St Thomas’ NHS Foundation Trust; Mary Still, Emory University; Giora Netzer, University of Maryland Baltimore; Mark E Mikkelsen, University of Pennsylvania; Theodore J Iwashyna, University of Michigan, Ann Arbor; Kimberly J Haines, Western Health, Melbourne; Joanne McPeake, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde
• Journal Title: Critical Care Explorations
• Volume: Volume 3, Number 5
• Publisher: Wolters Kluwer Health | 2021-05-12
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1097/CCE.0000000000000420
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: caregivers; critical illness; intensive care unit follow-up clinics; peer support; postintensive care syndrome

Abstract

Objectives: To understand the unmet needs of caregivers of ICU survivors, how they accessed support post ICU, and the key components of beneficial ICU recovery support systems as identified from a caregiver perspective. Design: International, qualitative study. Subjects: We conducted 20 semistructured interviews with a diverse group of caregivers in the United States, the United Kingdom, and Australia, 11 of whom had interacted with an ICU recovery program. Setting: Seven hospitals in the United States, United Kingdom, and Australia. Interventions: None. Measurements and Main Results: Content analysis was used to explore prevalent themes related to unmet needs, as well as perceived strategies to improve ICU outcomes. Post-ICU care was perceived to be generally inadequate. Desired caregiver support fell into two main categories: practical support and emotional support. Successful care delivery initiatives included structured programs, such as post discharge telephone calls, home health programs, post-ICU clinics, and peer support groups, and standing information resources, such as written educational materials and online resources. Conclusions: This qualitative, multicenter, international study of caregivers of critical illness survivors identified consistently unmet needs, means by which caregivers accessed support post ICU, and several care mechanisms identified by caregivers as supporting optimal ICU recovery.