A longitudinal qualitative exploration of healthcare and informal support needs among survivors of critical illness: the RELINQUISH protocol.

Introduction and background
Survival following critical illness is associated with a significant burden of physical, emotional and psychosocial morbidity. Recovery can be protracted and incomplete, with important and sustained effects upon everyday life, including family life, social participation and return to work. In stark contrast with other critically ill patient groups (e.g. those following cardiothoracicsurgery), there are comparatively few interventional studies of rehabilitation among the general
Intensive Care Unit (ICU) patient population. This paper outlines the protocol for a sub-study of the RECOVER study: a randomised controlled trial evaluating a complex intervention of enhanced ward-based rehabilitation for patients following discharge from intensive care (described in detail elsewhere in this journal).
Methods and analysis
The RELINQUISH study is a nested longitudinal, qualitative study of family support and perceived healthcare needs among RECOVER participants at key stages of the recovery process and at up to one year following hospital discharge. Its central premise is that recovery is a dynamic process wherein patients' needs evolve over time. RELINQUISH is novel in that we will incorporate two parallel strategies into our data analysis: (i) a pragmatic, health services
oriented approach, using an a priori analytical construct; the “Timing it Right” framework and (ii) a constructivist grounded theory approach which allows the emergence of new themes from the data. We will subsequently use Qualitative Health Needs Assessment methodology to inform the development of timely and responsive healthcare interventions throughout the recovery process.
Ethics and dissemination
The protocol has been approved by the Lothian Research Ethics Committee (protocol number HSRU011). The study has been added to the UK Clinical Research Network Database (Study Id. 9986). We will disseminate our findings in peer reviewed publications and to relevant critical care stakeholder groups.