Journal
CRITICAL CARE MEDICINE
Volume 49, Issue 11, Pages 1923-1931Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/CCM.0000000000005095
Keywords
critical care; recovery; transitions of care
Categories
Funding
- Society of Critical Care Medicine
- National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) [K12 HL137943, K12 HL138039]
- THIS Institute Post-Doctoral Fellowship [PD2019-02-16]
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The study found that survivors of critical illness and their caregivers experience a range of challenges across the transitions of care, with distinct themes related to the caregiver experience. However, survivors and caregivers used comparable problem-solving strategies to navigate the challenges encountered during the transitions of care.
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.
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