Beyond Functional Outcomes: Exploring Quality of Life After Critical Illness-A Qualitative Study

Area of Science:

• Critical Care Medicine
• Health Psychology
• Patient Outcomes Research

Background:

• Intensive care unit (ICU) survivors often experience a diminished quality of life (QoL) compared to the general population.
• Existing research indicates that physical, mental, and cognitive deficits alone do not fully account for the observed QoL impairments.
• This suggests that other, less understood factors play a crucial role in the long-term QoL of ICU survivors.

Purpose of the Study:

• To explore the experienced quality of life (QoL) in ICU survivors 1-2 years after discharge.
• To identify determinants of QoL beyond traditional functional outcomes in the post-ICU period.
• To gain a deeper understanding of the multifaceted nature of QoL in this patient population.

Main Methods:

• A qualitative interview study was conducted across seven hospitals in the Netherlands.
• Twenty-four ICU survivors (aged 16+) were purposively sampled and interviewed between March and June 2024.
• Interviews were analyzed using thematic content analysis, with ongoing recruitment until data saturation.

Main Results:

• Seven main themes emerged from the analysis, encompassing functional impairments, participation, support systems, environmental factors, individual values, social comparison, and coping strategies.
• These themes collectively influenced patients' perceived QoL, both positively and negatively.
• Patients described a complex interplay between their health status and various psychosocial and contextual elements.

Conclusions:

• Perceived quality of life (QoL) after critical illness is a complex construct influenced by functional impairments as well as participation, support, environment, individual values, comparison, and coping.
• The identified themes highlight the need to consider individual patient circumstances and contextual factors for effective post-ICU care.
• Optimizing post-ICU support requires a holistic approach that addresses the diverse needs of survivors beyond their immediate medical recovery.