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Transitions of Care After Critical Illness-Challenges to Recovery and Adaptive Problem Solving.

PMID: 34091486 (view PubMed database entry)
DOI: 10.1097/ccm.0000000000005095 (read at publisher's website )

Kimberley J Haines, Elizabeth Hibbert, Nina Leggett, Leanne M Boehm, Tarli Hall, Rita N Bakhru, Anthony J Bastin, Brad W Butcher, Tammy L Eaton, Wendy Harris, Aluko A Hope, James Jackson, Annie Johnson, Janet A Kloos, Karen A Korzick, Pamela Mactavish, Joel Meyer, Ashley Montgomery-Yates, Tara Quasim, Andrew Slack, Dorothy Wade, Mary Still, Giora Netzer, Ramona O Hopkins, Theodore J Iwashyna, Mark E Mikkelsen, Joanne McPeake, Carla M Sevin, ,

<h4>Objectives</h4>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.<h4>Design</h4>Qualitative design-data generation via interviews and data analysis via the framework analysis method.<h4>Setting</h4>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).<h4>Subjects</h4>Patients and caregivers following critical illness.<h4>Interventions</h4>Nil.<h4>Measurements and main results</h4>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.<h4>Conclusions</h4>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.

Crit Care Med (Critical care medicine)
[2021, 49(11):1923-1931]

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