Survivorship after critical illness: An integrated systematic literature review
This project aims to develop a framework of survivorship following critical care to inform a subsequent study of how to best support critical care survivors and their families.
Surviving critical illness goes beyond initial physical recovery with patients and families living through lengthy periods of adjustments; economically, socially and physically. It is unclear what survivorship, the time after discharge home, means or what outcomes are important to patients and families. We will systematically review the literature, mapping and exploring how ‘survivorship’ can be theoretically defined. The definition of survivorship will help us to (i) develop research that is theoretically grounded, (ii) design and guide studies that address the needs of survivors and their families across both health and social care services and therefore (iii) inform policy and practice.
Critical care survivorship has become a significant and worldwide challenge. There were around 36,800 survivors from critical care last year in Scotland alone. One of the top three priorities identified in a James Lind priority setting exercise for critical care research is the support patients and families need when they start living at home again. Previous research has established that critical illness survivors often experience post-intensive care syndrome (PICS) encompassing physical, cognitive and psychological impairments which significantly challenge and impact on patients and families lives post-discharge.
Families constitute a significant support network for ICU survivors, but it is also evident that we still need research to understand and inform how best to support patients and family members beyond discharge not to just survive, but to recover their lives. We currently have a significant knowledge gap in relation to patients and families’ experiences of living with longer-term issues post-critical illness. Interestingly, there were approximately 31,500 people were diagnosed in 2015 with cancer in Scotland in comparison to 36,800 patients surviving critical illness. The currently existing literature on survivorship is largely descriptive and predominately focuses on cancer survivors, impacting health policy and support groups for cancer survivors but this has yet to be explored and developed for (non-disease specific) critical care patients.
This project is an integrated literature review and funded by the Chief Scientist Office.
Dr Susanne Kean, University of Edinburgh
Sheila Rodgers, University of Edinburgh
Angus Bancroft, University of Edinburgh