LAUSR

Introduction/Hypothesis: Significant disabilities are common in ICU survivors. Rehabilitation resources required to optimize quality of life (QoL) post-ICU are poorly understood. The purpose of this qualitative study was to define “QoL” from ICU survivor’s perspective and explore survivor’s perception of resources required for QoL recovery. Methods: Interview guide developed using questions from previous QoL studies and Long-Term Care Services/Supports Score Card. Interviews conducted with ICU survivors attending ICU Recovery Clinic within 12 months of hospital discharge. Interview data transcribed verbatim and hand-coded via qualitative software program (MAXQDA) for thematic analysis. Coding performed by 3 investigators and differences resolved via consensus. Number of survivor’s interviewed determined by ascertainment of conceptual saturation in themes. 12 ICU survivor interviews were required for conceptual saturation. Results: Survivors consistently expressed gratitude to ICU staff for life-saving care, despite their lingering disabilities. This sense of gratitude allowed them to accept new limitations and see them as opportunities to embrace new life priorities. Survivor QoL depended on feeling prepared for post-ICU life, support presence and ability to adapt to new normalcy. Data found U.S. aftercare lacks unity and is limited by inadequate information around recovery needs, expectations and trajectory. Further, post-ICU care heavily utilizes informal caregivers, who commonly provide survivor support, regardless of survivor’s discharge destination. Most survivors were unaware of out-ofpocket care costs and were distressed by bills from illness. Notably, no patients employed prior to ICU stay returned to work in same capacity. Conclusions: Understanding the true experience of modern ICU survivors is an essential knowledge gap. Survivors report gratitude for medical care and need to adapt to “new normal”, often with informal caregiver assistance. Improved information and resources need to be provided to patients/families around expected trajectory of recovery, rehabilitation, and financial challenges. Future work to improve ICU recovery process requires improvements in rehabilitation systems, improved rehabilitation access, and creation of standardized post-ICU patient education materials.