'Intensive Care Unit Survivorship' - a constructivist grounded theory of surviving critical illness

Susanne Kean, Lisa G. Salisbury (Lead / Corresponding author), Janice Rattray, Timothy S. Walsh, Guro Huby, Pamela Ramsay

Research output: Contribution to journalArticle

16 Citations (Scopus)
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Abstract

AIMS & OBJECTIVE: To theorise ICU survivorship after a critical illness based on longitudinal qualitative data.

BACKGROUND: Increasingly patients survive episodes of critical illness. However, the short and long term impact of critical illness include physical, psychological, social and economic challenges long after hospital discharge. An appreciation is emerging that care needs to extend beyond critical illness to enable patients to reclaim their lives post-discharge with the term 'Survivorship' being increasingly used in this context. What constitutes critical illness survivorship has, to date, not been theoretically explored.

DESIGN: Longitudinal-qualitative and constructivist Grounded Theory. Interviews (n = 46) with 17 participants were conducted at four time points: (1) before discharge from hospital, (2) 4-6 weeks post-discharge, (3) 6 months and (4) 12 months post-discharge across two adult intensive care setting.

METHOD: Individual face-to-face interviews. Data analysis followed the principles of Charmaz's Constructivist Grounded Theory. 'ICU survivorship' emerged as the core category and was theorised using concepts such as Status Passages, Liminality and Temporality to understand the various transitions participants made post-critical illness.

FINDINGS: Intensive care survivorship describes the unscheduled status passage of falling critically ill and being taken to the threshold of life and the journey to a life post-critical illness. Surviving critical illness goes beyond recovery; surviving means 'moving on' to life post-critical illness. 'Moving on' incorporates a re-definition of self that incorporates any lingering intensive care legacies and being in control of one's life again.

RELEVANCE TO CLINICAL PRACTICE: For healthcare professionals and policy makers it is important to realise that recovery and transitioning through to survivorship happens within an individual's time frame, not a schedule imposed by the healthcare system. Currently there are no care pathways or policies in place for critical illness survivors that would support ICU survivors and their families in the transitions to survivorship. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)3111-3124
Number of pages13
JournalJournal of Clinical Nursing
Volume26
Issue number19-20
Early online date22 Nov 2016
DOIs
Publication statusPublished - Oct 2017

Fingerprint

Critical Illness
Intensive Care Units
Survival Rate
Critical Care
Survivors
Grounded Theory
Accidental Falls
Interviews
Delivery of Health Care
Administrative Personnel
Appointments and Schedules
Economics
Psychology

Keywords

  • Longitudinal
  • Constructivist grounded theory
  • Interviews
  • Critical illness
  • Intensive care
  • Survivorship
  • Recovery
  • Status passages
  • liminality
  • Temporality

Cite this

Kean, Susanne ; Salisbury, Lisa G. ; Rattray, Janice ; Walsh, Timothy S. ; Huby, Guro ; Ramsay, Pamela. / 'Intensive Care Unit Survivorship' - a constructivist grounded theory of surviving critical illness. In: Journal of Clinical Nursing. 2017 ; Vol. 26, No. 19-20. pp. 3111-3124.
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abstract = "AIMS & OBJECTIVE: To theorise ICU survivorship after a critical illness based on longitudinal qualitative data.BACKGROUND: Increasingly patients survive episodes of critical illness. However, the short and long term impact of critical illness include physical, psychological, social and economic challenges long after hospital discharge. An appreciation is emerging that care needs to extend beyond critical illness to enable patients to reclaim their lives post-discharge with the term 'Survivorship' being increasingly used in this context. What constitutes critical illness survivorship has, to date, not been theoretically explored.DESIGN: Longitudinal-qualitative and constructivist Grounded Theory. Interviews (n = 46) with 17 participants were conducted at four time points: (1) before discharge from hospital, (2) 4-6 weeks post-discharge, (3) 6 months and (4) 12 months post-discharge across two adult intensive care setting.METHOD: Individual face-to-face interviews. Data analysis followed the principles of Charmaz's Constructivist Grounded Theory. 'ICU survivorship' emerged as the core category and was theorised using concepts such as Status Passages, Liminality and Temporality to understand the various transitions participants made post-critical illness.FINDINGS: Intensive care survivorship describes the unscheduled status passage of falling critically ill and being taken to the threshold of life and the journey to a life post-critical illness. Surviving critical illness goes beyond recovery; surviving means 'moving on' to life post-critical illness. 'Moving on' incorporates a re-definition of self that incorporates any lingering intensive care legacies and being in control of one's life again.RELEVANCE TO CLINICAL PRACTICE: For healthcare professionals and policy makers it is important to realise that recovery and transitioning through to survivorship happens within an individual's time frame, not a schedule imposed by the healthcare system. Currently there are no care pathways or policies in place for critical illness survivors that would support ICU survivors and their families in the transitions to survivorship. This article is protected by copyright. All rights reserved.",
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'Intensive Care Unit Survivorship' - a constructivist grounded theory of surviving critical illness. / Kean, Susanne; Salisbury, Lisa G. (Lead / Corresponding author); Rattray, Janice; Walsh, Timothy S.; Huby, Guro; Ramsay, Pamela.

In: Journal of Clinical Nursing, Vol. 26, No. 19-20, 10.2017, p. 3111-3124.

Research output: Contribution to journalArticle

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T1 - 'Intensive Care Unit Survivorship' - a constructivist grounded theory of surviving critical illness

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AU - Salisbury, Lisa G.

AU - Rattray, Janice

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KW - Longitudinal

KW - Constructivist grounded theory

KW - Interviews

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KW - Intensive care

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KW - Recovery

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KW - liminality

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