A qualitative study on the experiences and coping strategies of patients after prolonged intensive care unit stays

Patients who survive prolonged stays in intensive care units (ICUs) often face lasting physical, psychological, cognitive, and social impairments. The aim of this study was to explore the challenges experienced after ICU discharge and the coping strategies employed.

Eleven semi-structured qualitative interviews were conducted with former patients who had undergone continuous or intermittent invasive mechanical ventilation for at least 7 days. Participants from a Swiss university hospital were interviewed 7-13 months after ICU discharge. Data were analysed using reflexive thematic analysis, following the interpretive descriptive approach.

Six central themes emerged: (i) no longer being the same person; (ii) the social environment as both a help and a burden; (iii) dealing with gaps in memory; (iv) noticing their own progress; (v) navigating setbacks and finding motivation; and (vi) what cannot be understood or changed. Each theme reflected both challenges and coping. Participants reported physical, mental, cognitive, and social challenges, and coping strategies included problem-focused and emotion-focused coping and cognitive reappraisal.

Recovery after prolonged ICU stays involves challenges across all health domains. Patients apply diverse coping strategies, indicating that one-size-fits-all follow-up programs may not be adequate. Aspects of recovery, such as social support, may be experienced as either a resource or a burden, depending on individual circumstances.

Follow-up care should be flexible and individualised and should support the recognition of small improvements. Family members play a key role in recovery but may require guidance in understanding patients' support needs.