Nutritional Recovery After Critical Illness: A Qualitative Study of ICU Survivors' Experiences After Hospital Discharge

INTRODUCTION: Substantial and persistent barriers to achieving adequate nutritional intake exist for adult survivors of critical illness in the year following hospital discharge. Despite the clear burden, nutrition rehabilitation remains a largely neglected component of post-ICU recovery. Greater understanding of lived experiences is needed to inform person-centred dietetic interventions. The aim was to explore how survivors of critical illness describe, interpret, and navigate their nutritional recovery after hospital discharge, and the personal, relational, and systemic factors that shape these experiences. METHODS: A qualitative study adopted a narrative enquiry approach to elicit participants lived experiences and stories using in-depth interviews. The Transtheoretical Model was used as a sensitising concept that emerged during analysis. Participants were recruited through convenience sampling, and sample size determined using information power. Narrative analysis and reflexive thematic analysis was used. RESULTS: Sixteen participants (11 women, 5 men) took part (median age 53 years; median of 2.4 years since discharge). Four coexisting themes were identified: (1) Eating in the shadow of critical illness, (2) Nutritional care that worked (3) Unmet nutritional needs, and (4) What we wish we'd had. Integration of narrative and thematic analysis revealed two broad nutritional recovery processes, an enabling and a constraining recovery process, shaped by psychological readiness, agency, relational support, and access to care. CONCLUSIONS: Nutritional recovery after critical illness is dynamic and multidimensional shaped not only by physical symptoms, but also by trauma, identity disruption, readiness to change, relational environments and systemic support. These findings provide groundwork for person-centred dietetic interventions following hospital discharge.