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Patient and Caregiver-Derived Health Service Improvements for Better Critical Care Recovery.
Haines, Kimberley J; Leggett, Nina; Hibbert, Elizabeth; Hall, Tarli; Boehm, Leanne M; Bakhru, Rita N; Bastin, Anthony J; Butcher, Brad W; Eaton, Tammy L; Harris, Wendy; Hope, Aluko A; Jackson, James; Johnson, Annie; Kloos, Janet A; Korzick, Karen A; Mactavish, Pamela; Meyer, Joel; Montgomery-Yates, Ashley; Quasim, Tara; Slack, Andrew; Wade, Dorothy; Still, Mary; Netzer, Giora; Hopkins, Ramona O; Mikkelsen, Mark E; Iwashyna, Theodore J; McPeake, Joanne; Sevin, Carla M.
Afiliação
  • Haines KJ; Department of Physiotherapy, Western Health, Sunshine Hospital, Melbourne, VIC, Australia.
  • Leggett N; Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, VIC, Australia.
  • Hibbert E; Department of Physiotherapy, Western Health, Sunshine Hospital, Melbourne, VIC, Australia.
  • Hall T; Department of Physiotherapy, Western Health, Sunshine Hospital, Melbourne, VIC, Australia.
  • Boehm LM; Department of Physiotherapy, Western Health, Sunshine Hospital, Melbourne, VIC, Australia.
  • Bakhru RN; School of Nursing, Vanderbilt University, Nashville, TN.
  • Bastin AJ; Department of Internal Medicine, Section of Pulmonary, Critical Care, Allergy and Immunology, Wake Forest University School of Medicine, Winston-Salem, NC.
  • Butcher BW; Department of Peri-operative Medicine, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
  • Eaton TL; Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Harris W; Department of Physiotherapy, Western Health, Sunshine Hospital, Melbourne, VIC, Australia.
  • Hope AA; Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, VIC, Australia.
  • Jackson J; School of Nursing, Vanderbilt University, Nashville, TN.
  • Johnson A; Department of Internal Medicine, Section of Pulmonary, Critical Care, Allergy and Immunology, Wake Forest University School of Medicine, Winston-Salem, NC.
  • Kloos JA; Department of Peri-operative Medicine, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
  • Korzick KA; Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Mactavish P; Critical Illness Recovery Center at UPMC Mercy, Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Meyer J; Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI.
  • Montgomery-Yates A; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI.
  • Quasim T; University College London Hospitals NHS Foundation Trust, London, United Kingdom.
  • Slack A; Division of Critical Care Medicine, Albert Einstein College of Medicine of Yeshiva University, New York, NY.
  • Wade D; Vanderbilt University Medical Center, Nashville, TN.
  • Still M; Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
  • Netzer G; University Hospitals Cleveland Medical Center, Cleveland, OH.
  • Hopkins RO; Pulmonary and Critical Care Medicine, Geisinger Medical Center, Scranton, PA.
  • Mikkelsen ME; Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Scotland, United Kingdom.
  • Iwashyna TJ; Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.
  • McPeake J; Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, KY.
  • Sevin CM; Emory University Hospital (Emory Healthcare), Atlanta, GA.
Crit Care Med ; 50(12): 1778-1787, 2022 12 01.
Article em En | MEDLINE | ID: mdl-36205494
OBJECTIVES: To engage critical care end-users (survivors and caregivers) to describe their emotions and experiences across their recovery trajectory, and elicit their ideas and solutions for health service improvements to improve the ICU recovery experience. DESIGN: End-user engagement as part of a qualitative design using the Framework Analysis method. SETTING: 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 and identified through the collaboratives. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eighty-six interviews were conducted. The following themes were identified: 1) Emotions and experiences of patients-"Loss of former self; Experiences of disability and adaptation"; 2) Emotions and experiences of caregivers-"Emotional impacts, adopting new roles, and caregiver burden; Influence of gender roles; Adaptation, adjustment, recalibration"; and 3) Patient and caregiver-generated solutions to improve recovery across the arc of care-"Family-targeted education; Expectation management; Rehabilitation for patients and caregivers; Peer support groups; Reconnecting with ICU post-discharge; Access to community-based supports post-discharge; Psychological support; Education of issues of ICU survivorship for health professionals; Support across recovery trajectory." Themes were mapped to a previously published recovery framework (Timing It Right) that captures patient and caregiver experiences and their support needs across the phases of care from the event/diagnosis to adaptation post-discharge home. CONCLUSIONS: Patients and caregivers reported a range of emotions and experiences across the recovery trajectory from ICU to home. Through end-user engagement strategies many potential solutions were identified that could be implemented by health services and tested to support the delivery of higher-quality care for ICU survivors and their caregivers that extend from tertiary to primary care settings.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cuidadores / Assistência ao Convalescente Tipo de estudo: Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cuidadores / Assistência ao Convalescente Tipo de estudo: Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article