Edinburgh Napier University

  Background: Intensive care survivors suffer chronic and potentially life-changing physical, psychosocial and cognitive sequelae, and supporting recovery is an international priority. As survivors transition from the intensive care unit to home, their support needs develop and change.

Methods:
In this scoping review, we categorised patients’ support needs using House’s Social Support Needs framework (informational, emotional, instrumental, appraisal) and mapped these against the Timing it Right framework reflecting the patient’s transition from intensive care (event/diagnosis); to ward (stabilisation/preparation); and
discharge home (implementation/adaptation). We searched electronic databases from 2000 to 2017 for qualitative research studies reporting adult critical care survivors’ experiences of care. Two reviewers independently screened, extracted and coded
data. Data were analysed using a thematic framework approach.

Results:
From 3035 references, we included 32 studies involving 702 patients. Studies were conducted in UK and Europe (n=17, 53%); Canada and the United States (n=6,19%); Australasia (n=6, 19%); Hong Kong (n=1, 3%); Jordan (n=1, 3%) and multicountry (n=1, 3%). Across the trajectory of recovery, informational, emotional, instrumental, appraisal and spiritual support needs were evident, and the nature and intensity of need differed when mapped against the Timing it Right framework.

Conclusions:
This review is the first to identify the change in social support needs
among intensive care survivors as they transition from intensive care to the home environment. An understanding of needs at different transition periods would help inform health service provision and support for survivors.