Surviving Critical Illness: New Insights From Mixed-Methods Research

Abstract

Current advanced medical technology allows survival of critical illness. However, the patient's psychological response to survival is relatively unexplored. Interviews with 32 older adult survivors, using the Hospital Anxiety and Depression Scale (HADS) and the Experience after Treatment in Intensive Care (ETIC-7) scale, Miller's Q-sort, and social work clinical wisdom, yielded unique and unexpected research results. Four response types were identified: avoiding, depressed, denial, and coping. Psychological agency during illness was found to be important. Participants did not reveal posttraumatic stress disorder–related phenomena predicted in previous literature but instead experienced posttraumatic growth. Hallucinatory experiences during illness were not traumatic, whereas social support emerged as a complicated concept. Participants unexpectedly revealed that childhood trauma was an important factor. Implications for clinical social work practice and research are outlined following the discussion of findings.

Keywords:

• surviving critical illness
• ICU
• PTSD
• psychological agency
• hypnagogic hallucinations
• childhood trauma