Surviving severe COVID‐19: Interviews with patients, informal carers and health professionals

Abstract

Background The COVID‐19 pandemic has been associated with an unprecedented number of critical care survivors. Their experiences through illness and recovery are likely to be complex, but little is known about how best to support them. This study aimed to explore experiences of illness and recovery from the perspective of survivors, their relatives and professionals involved in their care. Study design In‐depth qualitative interviews were conducted with three stakeholder groups during the first wave of the pandemic. A total of 23 participants (12 professionals, 6 survivors and 5 relatives) were recruited from 5 acute hospitals in England and interviewed by telephone or video call. Data analysis followed the principles of Reflexive Thematic Analysis. Findings Three themes were generated from their interview data: (1) Deteriorating fast—a downhill journey from symptom onset to critical care; (2) Facing a new virus in a hospital—a remote place; and (3) Returning home as a survivor, maintaining normality and recovering slowly. Conclusions Our findings highlight challenges in accessing care and communication between patients, hospital staff and relatives. Following hospital discharge, patients adopted a reframed ‘survivor identity’ to cope with their experience of illness and slow recovery process. The concept of survivorship in this patient group may be beneficial to promote and explore further. Relevance to clinical practice All efforts should be made to continue to improve communication between patients, relatives and health professionals during critical care admissions, particularly while hospital visits are restricted. Adapting to life after critical illness may be more challenging while health services are restricted by the impacts of the pandemic. It may be beneficial to promote the concept of survivorship, following admission to critical care due to severe COVID‐19.

Exploring critically ill patients' and their relatives' experiences of intensive care unit during COVID‐19: A qualitative study

“…11,12 Patients with confirmed COVID-19 described the hospitalization as a traumatic experience due to fear and uncertainty about the disease and of their chance to survive. 10,13 They experienced memory gaps and waking up after a period of being sedated with a feeling of alienation, weakness and isolation as they were separated from their families. 10,14 The daily routines in ICU were changed, due to isolation of patients with confirmed COVID-19, and staff had to deal with an unknown illness, new treatment strategies, personal protective equipment, and changes in staffing and visiting restrictions.…”

“…10,13 They experienced memory gaps and waking up after a period of being sedated with a feeling of alienation, weakness and isolation as they were separated from their families. 10,14 The daily routines in ICU were changed, due to isolation of patients with confirmed COVID-19, and staff had to deal with an unknown illness, new treatment strategies, personal protective equipment, and changes in staffing and visiting restrictions. 15 The restrictions to visiting hours were suggested to compromise opportunities for, and quality of, family nursing.…”

“…13,19,20 For the relatives, it was a difficult time, involving unpredictability, loneliness, and a feeling of stress. 10,21 They feared the course of the disease, in which everything was unknown, including admission to ICU and their own lives were put on standby. 10,22 Some feared infection, and some also became infected with COVID-19.…”

“…10,21 They feared the course of the disease, in which everything was unknown, including admission to ICU and their own lives were put on standby. 10,22 Some feared infection, and some also became infected with COVID-19. 23 The relatives experienced that the visiting restrictions separated them from their relatives 22 for weeks or even months, and they felt emotionally distressed in struggling to adjust their family structure without the patient and family relationships were strained.…”

Spotlight on the first issue of NICC for 2023

“…Jenkins et al 14 examined the psychological impact of the Novichok poisoning incident in March 2018 on the staff who were directly involved and drew parallels with the subsequent COVID‐19 pandemic. Gonçalves and colleagues 15 explored the experiences of illness and recovery from severe COVID‐19 from the perspective of survivors, their relatives, and professionals involved in their care. Finally, Jarden et al 16 report on a prototype analysis of the general well‐being of ICU nurses.…”