"How Do I Test the Waters? How Do I Go Forward?": Codesigning a Supportive Pathway after Critical Illness

Area of Science:

• Critical care medicine
• Rehabilitation science
• Health psychology

Background:

• Post-intensive care syndrome (PICS) significantly impacts long-term recovery and return to daily activities for critical illness survivors.
• A need exists for enhanced, streamlined support systems to aid intensive care unit (ICU) patients experiencing PICS symptoms during recovery.

Purpose of the Study:

• To explore the recovery experiences of former ICU patients, their caregivers, and clinicians.
• To co-design a rehabilitation intervention prototype to support ICU patients facing PICS.

Main Methods:

• An experience-based codesign (EBCD) study utilizing the Behavior Change Wheel framework.
• Workshops involving 15 ICU patients, 2 caregivers, and 23 multidisciplinary clinicians from two Australian hospitals.
• Reflective thematic analysis of workshop data to identify recovery themes and develop the intervention prototype.

Main Results:

• Fifteen major themes emerged, highlighting the transition home as a critical period for adjustment, with physical and mental health burdens becoming apparent.
• Participants reported poor community understanding and lack of support for PICS.
• A rehabilitation prototype was developed, including a hospital-directed support program (psychology, physical therapy) and a digital health package.

Conclusions:

• The transition from hospital to home is a critical juncture requiring enhanced recovery support for ICU survivors.
• A co-designed rehabilitation prototype, integrating physical and psychological interventions with a digital health toolkit, addresses this need.
• The intervention package is slated for future development and clinical trials with ICU patients and their families.