Intensive care survivors’ experience of returning to work: An explorative qualitative study

Background Survivors of an intensive care unit (ICU) admission experience physical, psychological and cognitive impairments that can profoundly impact their ability to return to meaningful occupations such as paid work, volunteering or studying. In the United Kingdom, there are no specific vocational rehabilitation services for ICU survivors. To address this service gap and to inform development of tailored interventions, a necessary step is to explore factors influencing return to occupations, recovery, vocational met and unmet needs, and strategies used for occupation return. Objective To explore ICU survivors’ experiences of return, or inability to return to their occupations of work, volunteering or studying. Methods We used an exploratory qualitative design, conducting one-on-one semi-structured interviews with ICU survivors recruited via professional networks and social media. Interview data were analysed inductively using reflexive thematic analysis. Findings We interviewed 19 ICU survivors in 2024, aged from 24-60 years old; 11 were female. Most were admitted for COVID-19. Prior to admission, 17 were working; 2 were volunteering. Four main themes with thirteen accompanying subthemes were identified. 'Emergence of a New Identity' reflected ICU as a life-changing experience with transformative impact on identity. 'Disconnect between Critical Care, Rehabilitation and Return to Work´ included navigating recovery, unmet recovery and vocational needs and family support. ‘Workplace Characteristics’ encompassed work challenges whilst living with post-intensive care syndrome, organisational processes and cross sector support. ‘Vocational strategies’ included education, stakeholder involvement and implementing reasonable adjustments. Conclusions Our findings highlight unmet vocational rehabilitation needs and emphasise the need for vocational interventions to address the multi-factorial and heterogenous needs of ICU survivors. There is a need for policy changes, tailored interventions and education to enhance reintegration of critical care survivors to their preferred occupational roles.