Life after intensive care : identity, recovery, and the evolving needs of post-ICU patients

Abstract

Objectives: This study aimed to explore how former Intensive Care Unit (ICU) patients interpreted their critical care experiences and how these influenced their evolving identity, emotional recovery, and reintegration into everyday life following discharge. Research Design: A qualitative research design was employed, using narrative inquiry (NI) as its methodological framework. The study was underpinned by Clandinin and Connelly’s three-dimensional narrative structure: temporality, sociality, and spatiality. Identity Theory (IT) provided a framework to understand how participants’ sense of self changed after ICU. Narrative inquiry and Identity Theory guided both data collection and interpretation. Settings: The study was conducted within the community setting in Malta. All interviews took place after the participants had returned home from their ICU stay. Participants: Six former ICU patients who had spent a minimum of four days in intensive care were recruited through purposive and snowball sampling. All participants had been discharged home, fluent in Maltese or English and able to reflect on their experience. Methods: Data were collected through semi-structured, in-depth interviews conducted in Maltese. The interviews were transcribed, translated, and analysed thematically using Braun and Clarke’s approach. Results: 1) Emotional and Psychological Struggles, including vivid memories and coping strategies like faith and inner strength; 2) Interpersonal Support and Recovery, highlighting the role of family and continuity of care in emotional healing and validating survivors’ experiences; 3) Transformations through Survival, reflecting changes in self-perception, priorities, and identity, with a renewed sense of purpose. Discussion: The study highlights that ICU recovery extends beyond physical healing. Survivors undergo a complex emotional and identity reconstruction process, influenced by both personal resilience and the quality of support received. Recommendations: Post-ICU care should adopt trauma-informed, identity-sensitive, and person-centred approaches. Structured follow-up, family engagement, and opportunities for narrative expression may enhance long-term recovery. Further research is recommended to explore gendered identity shifts and relational aspects of survivorship.