The Survivorship Journey Through Critical Illness in Aotearoa New Zealand: A Grounded Theory Study

Survivorship after critical illness is associated with significant disability, psychological issues, and cognitive dysfunction, collectively termed post-intensive care syndrome. To date, minimal research has been published exploring the survivorship journey, disability, and recovery, in Aotearoa New Zealand. A constructivist grounded theory methodology explored the memories, experiences, and transition from critical illness to recovery with eleven survivors of critical illness. Interviews took place between six and nine months after hospital discharge. Themes and categories were developed from initial line coding followed by axial and selective coding. Data analysis and data collection were conducted simultaneously. Constant comparison was used through memos and field notes until data saturation was reached. The findings from this study describe a survivorship journey through tangible phases of illness interspersed with cascading events, hazy memories, and transitions. In the intensive care unit, the sequelae and complications of critical illness are synonymous with the aftershocks of an earthquake. Physical weakness, psychological distress, amnesia, and delirium are commonly encountered. These complications contribute to the development of post-intensive care syndrome. These aftershocks are experienced for weeks to months after returning home. The grounded theory derived from this study is that of transition through the disaster of critical illness, a journey that is analogous to the core phases of an earthquake. Participants had little help from the healthcare system and were highly dependent on families and friends for protection, care, and support. Whilst systematic follow-up is recommended and often available overseas, it is sparse in Aotearoa New Zealand. Information, reassurance, and psychological support within a culturally appropriate follow-up service setting is needed to support survivors. Te Reo Māori Translation Te hīkoi ki te ora mā roto i ngā māuiui tino tārūrū i Aotearoa: He rangahau whakamahi ariā hou Ngā Ariā Matua Ko te hoa haere o te hīkoi ki te ora i muri i ngā māuiui tino tārūrū ko te hauātanga tūturu, ngā raru ā-hinengaro, te turingonge hirikapo, ēnei katoa ka kīa ko te mate i muri i te noho i te wāhanga whāomoomo. Tae mai ki tēnei wā, he iti noa ngā rangahau kua whakaputaina ki te ao e tūhura nei i te hīkoi ki te ora, te hauātanga, me te whakamātūtū i Aotearoa. I tūhura tētahi tikanga rangahau ariā hou waihanga ara i ngā mahara, i ngā wheako me te whakawhitinga mai i te māuiui tārūrū ki te ora, o ētahi mōrehu tekau mā tahi o te māuiui tino tārūrū. I tū ngā uiui nei e ono marama, e iwa marama rānei, i muri i te putanga atu i te hōhipera. I whakawhanaketia ngā tāhuhu me ngā kāwai mai i ngā waehere whakatāhuhu tuatahi, me ngā waehere tūhonohono, waehere tīpako hoki, i muri. I kawea ngātahitia te tātari raraunga me te kohinga raraunga. I whakatairitea pūpututia ngā mahi, nā ngā tuhinga karere poto, me ngā tuhipoka i te wāhi mahi, taea noatia te pūrenatanga raraunga. Hei whakamārama ngā kitenga o tēnei rangahau i tētahi hīkoi ki te ora mā ētahi wā o te māuiui, ngā tūponotanga mahi, ngā mahara āhua rehu, me ngā whitinga ki tētahi āhua hou. I roto i te wāhanga whāomoomo, he āhua ōrite ngā mahi i pā i muri, me ngā raru o te tārūrū māuiui, ki ngā rū iti ka pā i muri i tētahi rū nui, ko te ngoikore o te tinana tērā, ko te āmaimai hinengaro tērā, ko te wareware tērā, ko te ngutungutu ahi hoki tērā, ēnei katoa ka tau ki runga i te tangata, i te mutunga ka pā te āhua o mate i muri i te noho i te wāhanga whāomoomo. I haere tonu ēnei rū iti i muri i ētahi wiki, i muri hoki i ētahi marama, i muri mai i te hokinga atu ki te kāinga. Ko te ariā hou i takea mai i tēnei rangahau ko te whakawhiti mai i te aituā o te māuiui tārūrū, tētahi haere āhua ōrite ki ngā tūponotanga i muri i tētahi rū. Kāore i tino nui ngā āwhina o te pūnaha hauora ki te hunga whai wāhi, ā, i riro kē nā ngā whānau me ngā hoa rātou i tautiaki, i taurima, i tautoko. Ahakoa e tūtohutia ana ngā mahi tautiaki i te tūroro i ngā rā o muri me te mōhio, e wātea ana i tāwāhi, he tūāporoporo noa i Aotearoa. E hiahiatia ana he mōhiotanga, ngā kupu atawhai, me te tautoko inenga hinengaro i roto i tētahi tautuhitanga ratonga tōtika ā-ahurea, hei tautoko i ngā mōrehu.