The number of patients who are admitted into the ICU and those who survive their stay continues to increase. However, patients who survive the ICU often suffer from chronic and life-changing physical, psychosocial and cognitive changes, often referred to as the “Post Intensive Care Syndrome.” This can have a significant impact on patient-reported outcomes such as health-related quality of life, family life, social participation and return to work. Providing support to these patients throughout recovery and through survivorship is thus a major priority. As they transition from the environment of the ICU to the environment of their home, their support needs tend to change.
A review was conducted using House's Social Support Needs framework which categorises patient support needs into informational, emotional, instrumental and appraisal. These needs are mapped against the Timing it Right framework which reflects the patient's transition from the ICU to ward and subsequently their home. 702 patients from UK, Europe, Canada, USA, Australasia, Hong Kong, Jordan and multi-country were included in this analysis.
As per the results of this analysis, informational, emotional, instrumental, appraisal and spiritual support needs were evident. Informational needs changed from basic (at time of admission) to detailed (at time of treatment) and then onto coping. Emotional needs changed from needing to cope to anxiety and comfort to a need for security and family presence and finally the need for counselling and community support. Instrumental needs during the early phase included the need to manage sleep, fatigue, pain and needing nursing care and moved on to the need for physical and cognitive ability support, strength training and personal hygiene. At home, instrumental needs were more related to regaining independence, strength and returning to work. Appraisal needs included the need to obtain feedback on progress while in the hospital and needing reassurance from others about the ICU experience after discharge.
Overall, changes in social support needs was evident in ICU survivors as they transition from the ICU to their home environment. By understanding these needs, healthcare providers can improve support for survivors.
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