Modification of social determinants of health by critical illness and consequences of that modification for recovery: an international qualitative study
Objectives Social determinants of health (SDoH) contribute to health outcomes. We identified SDoH that were modified by critical illness, and the effect of such modifications on recovery from critical illness.Design In-depth semistructured interviews following hospital discharge. Interview transcrip...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/9/e060454.full |
| _version_ | 1811194949555716096 |
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| author | Giora Netzer Anthony Bastin Tara Quasim Theodore Iwashyna Joanne McPeake Ramona O Hopkins Andrew Slack James Jackson Dorothy Wade Joel Meyer Ashley Montgomery-Yates Judith McCartney Leanne Boehm Elizabeth Hibbert Katrina Hauschildt Rita Bakhru Brad Butcher Tammy Eaton Wendy Harris Aluko Hope Annie Johnson Janet Kloos Karen Korzick Mary Still Mark E Mikkelsen Kimberley Haines Carla Sevin |
| author_facet | Giora Netzer Anthony Bastin Tara Quasim Theodore Iwashyna Joanne McPeake Ramona O Hopkins Andrew Slack James Jackson Dorothy Wade Joel Meyer Ashley Montgomery-Yates Judith McCartney Leanne Boehm Elizabeth Hibbert Katrina Hauschildt Rita Bakhru Brad Butcher Tammy Eaton Wendy Harris Aluko Hope Annie Johnson Janet Kloos Karen Korzick Mary Still Mark E Mikkelsen Kimberley Haines Carla Sevin |
| author_sort | Giora Netzer |
| collection | DOAJ |
| description | Objectives Social determinants of health (SDoH) contribute to health outcomes. We identified SDoH that were modified by critical illness, and the effect of such modifications on recovery from critical illness.Design In-depth semistructured interviews following hospital discharge. Interview transcripts were mapped against a pre-existing social policy framework: money and work; skills and education; housing, transport and neighbourhoods; and family, friends and social connections.Setting 14 hospital sites in the USA, UK and Australia.Participants Patients and caregivers, who had been admitted to critical care from three continents.Results 86 interviews were analysed (66 patients and 20 caregivers). SDoH, both financial and non-financial in nature, could be negatively influenced by exposure to critical illness, with a direct impact on health-related outcomes at an individual level. Financial modifications included changes to employment status due to critical illness-related disability, alongside changes to income and insurance status. Negative health impacts included the inability to access essential healthcare and an increase in mental health problems.Conclusions Critical illness appears to modify SDoH for survivors and their family members, potentially impacting recovery and health. Our findings suggest that increased attention to issues such as one’s social network, economic security and access to healthcare is required following discharge from critical care. |
| first_indexed | 2024-04-12T00:34:50Z |
| format | Article |
| id | doaj.art-0925ab26c1a14eb1a164b0d9294c2f95 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-12T00:34:50Z |
| publishDate | 2022-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-0925ab26c1a14eb1a164b0d9294c2f952022-12-22T03:55:10ZengBMJ Publishing GroupBMJ Open2044-60552022-09-0112910.1136/bmjopen-2021-060454Modification of social determinants of health by critical illness and consequences of that modification for recovery: an international qualitative studyGiora Netzer0Anthony Bastin1Tara Quasim2Theodore Iwashyna3Joanne McPeake4Ramona O Hopkins5Andrew Slack6James Jackson7Dorothy Wade8Joel Meyer9Ashley Montgomery-Yates10Judith McCartney11Leanne Boehm12Elizabeth Hibbert13Katrina Hauschildt14Rita Bakhru15Brad Butcher16Tammy Eaton17Wendy Harris18Aluko Hope19Annie Johnson20Janet Kloos21Karen Korzick22Mary Still23Mark E Mikkelsen24Kimberley Haines25Carla Sevin26Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, Maryland, USADepartment of Peri-operative Medicine, Barts Health NHS Trust, London, UKCritical Care, NHS Greater Glasgow and Clyde, Glasgow, UKDepartment of Internal Medicine, Division of Pulmonary & Critical Care, University of Michigan, Ann Arbor, Michigan, USACritical Care, The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UKCenter for Humanizing Critical Care and Pulmonary/Critical Care Medicine, Intermountain Medical Center, Murray, Utah, USADepartment of Critical Care, Guy`s and St Thomas` Hospitals NHS Trust, London, UKCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University, Nashville, Tennessee, USACritical Care, University College London Hospitals NHS Foundation Trust, London, UKDepartment of Critical Care, Guy`s and St Thomas` NHS Foundation Trust, London, UKUniversity of Kentucky, Lexington, Kentucky, USACritical Care, NHS Greater Glasgow and Clyde, Glasgow, UKSchool of Nursing, Vanderbilt University, Nashville, Tennessee, USADepartment of Physiotherapy, Western Health Foundation, Sunshine, Victoria, AustraliaCenter for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USADepartment of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USADepartment of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USAVA HSR&D Center for the Study of Healthcare Innovation, Implementation, & Policy, University of Michigan, Ann Arbor, Michigan, USIntensive Care Unit, University College London, London, UKDepartment of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Oregon Health & Science University (OHSU), Portland, Oregon, USAPulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USADepartment of Acute and Critical Care Nursing, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USADepartment of Pulmonary and Critical Care Medicine, Geisinger Medical Center, Danville, Pennsylvania, USACritical Care, Emory University Hospital, Atlanta, Georgia, USADivision of Pulmonary, Allergy, and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USADepartment of Physiotherapy, Sunshine Hospital, Melbourne, Victoria, AustraliaDepartment of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USAObjectives Social determinants of health (SDoH) contribute to health outcomes. We identified SDoH that were modified by critical illness, and the effect of such modifications on recovery from critical illness.Design In-depth semistructured interviews following hospital discharge. Interview transcripts were mapped against a pre-existing social policy framework: money and work; skills and education; housing, transport and neighbourhoods; and family, friends and social connections.Setting 14 hospital sites in the USA, UK and Australia.Participants Patients and caregivers, who had been admitted to critical care from three continents.Results 86 interviews were analysed (66 patients and 20 caregivers). SDoH, both financial and non-financial in nature, could be negatively influenced by exposure to critical illness, with a direct impact on health-related outcomes at an individual level. Financial modifications included changes to employment status due to critical illness-related disability, alongside changes to income and insurance status. Negative health impacts included the inability to access essential healthcare and an increase in mental health problems.Conclusions Critical illness appears to modify SDoH for survivors and their family members, potentially impacting recovery and health. Our findings suggest that increased attention to issues such as one’s social network, economic security and access to healthcare is required following discharge from critical care.https://bmjopen.bmj.com/content/12/9/e060454.full |
| spellingShingle | Giora Netzer Anthony Bastin Tara Quasim Theodore Iwashyna Joanne McPeake Ramona O Hopkins Andrew Slack James Jackson Dorothy Wade Joel Meyer Ashley Montgomery-Yates Judith McCartney Leanne Boehm Elizabeth Hibbert Katrina Hauschildt Rita Bakhru Brad Butcher Tammy Eaton Wendy Harris Aluko Hope Annie Johnson Janet Kloos Karen Korzick Mary Still Mark E Mikkelsen Kimberley Haines Carla Sevin Modification of social determinants of health by critical illness and consequences of that modification for recovery: an international qualitative study BMJ Open |
| title | Modification of social determinants of health by critical illness and consequences of that modification for recovery: an international qualitative study |
| title_full | Modification of social determinants of health by critical illness and consequences of that modification for recovery: an international qualitative study |
| title_fullStr | Modification of social determinants of health by critical illness and consequences of that modification for recovery: an international qualitative study |
| title_full_unstemmed | Modification of social determinants of health by critical illness and consequences of that modification for recovery: an international qualitative study |
| title_short | Modification of social determinants of health by critical illness and consequences of that modification for recovery: an international qualitative study |
| title_sort | modification of social determinants of health by critical illness and consequences of that modification for recovery an international qualitative study |
| url | https://bmjopen.bmj.com/content/12/9/e060454.full |
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