A humanistic trajectory of critical illness – patient perspectives

Initial findings from doctoral study “Patient & Families in adult critical care; a Grounded Theory approach” Introduction: Patients admitted to Adult General Critical Care Units (AGCCUs) are critically ill requiring both respiratory and organ supportive interventions. Whilst physiological safety is paramount there is an increasing awareness of the psychological harm that can occur over the patient’s (and family members) critical illness journey. Method: Within this qualitative study, Glaser & Strauss Grounded Theory method adapted by Charmaz (2014) was applied. A spiral of constant comparative data collected from September 2013 to November 2014 was undertaken. Face to face interviews were recorded and transcribed verbatim utilising prompts and probes. Analysis and theory construction with coding and memo writing commenced with the first interview. Patients were interviewed 3-6 months post discharge from AGCCU as an adjunct to follow up. Theoretical sampling involving searching for patterns and variations until theoretical saturation was achieved and no further data were required. Ultimately a substantive or formal theory will develop that accounts for data and context variations. IRAS and NHS Trust R&D approval granted. Findings: Thematic analysis of thirteen patient interviews is ongoing but emerging themes include: (1) Loss (2) Disruption of relationships (3) Fatigue (4) Abandonment (5) “Survival is not enough”. Higher order themes will be presented. Practical relevance: Critical Care survivorship is arguably the greatest global challenge to critical care practitioners in the 21st century (Hart 2014).This study will contribute towards a framework for preventative, supportive and therapeutic intervention for patients and their families who have to experience life threatening illness. Charmaz,K. 2014 Constructing Grounded Theory – A practical guide through Qualitative Analysis, 2nd Ed, Sage Publications, Hart,N. 2014 Therapeutic and Rehabilitation Strategies in ICU in The Legacy of Critical Care –Textbook of Post-ICU medicine, Oxford University Press