Date of Award

December 2018

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Peninnah Kako

Committee Members

Julia Snethen, Laura Otto-Salaj, Jill Guttormson

Keywords

Critical Illness, Intensive Care Unit, Outcomes, Phenomonology, Qualitative, Survivor

Abstract

Surviving critical illness with its physical, cognitive, and psychosocial morbidities is a growing clinical and research challenge and an important public health concern. Currently, there are few interventions for survivors of critical illness after hospital discharge. Potential interventions include rehabilitation services, Intensive Care Unit (ICU) diaries and ICU follow-up clinics, however, most survivors do not have access to these post-hospital interventions.

The purpose of this study is to gain a better understanding of how critical illness survivors experience their recovery, interventions they use, and what they perceive as facilitators and barriers to their recovery. A better understanding of these factors, as reported by critical illness survivors, may lead to identification and development of interventions that can be more broadly implemented in the community setting.

This multi-site study was guided by interpretive phenomenology, using semi-structured interviews. Purposive sampling was used to identify study participants from six different ICUs. Eighteen participants were recruited for the study. Interpretive phenomenological analysis (IPA) was used to analyze interview transcripts. Six major themes emerged from the interviews; Experiences of Recovery, Self-Managing Recovery, Following Recommendations, Support, Barriers to Recovery, and Unmet Needs.

Major findings of this study included participants’ reports of unmet needs of mental health and psychological recovery that were not addressed by healthcare providers. In addition, participants also lacked appropriate knowledge of what to expect during their recovery, which contributed to frustration and anxiety.

Findings from this study have implications for nursing practice, education, and research. Nurses are in a unique position to help patients cope with their emotions prior to discharge and provide them with anticipatory guidance once they are discharged. Carefully planned discharge should include a discussion of barriers that critical illness survivors may encounter once they are discharged and also include guidance on how to problem solve those challenges.

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