Testing a Peer Support Program for Intensive Care Unit Survivors to improve Psychological Recovery - Pilot Randomized Controlled Trial

INTERVENTION: TIDieR criteria Study Intervention Item 1. Brief name: Provide the name or a phrase that describes the intervention: In‐person, facilitated peer support group Item 2. Why: Describe any rationale, theory, or goal of the elements essential to the intervention: Physical, cognitive, emotional, financial and social problems are quite common among survivors (patients and families). This is recognised as Post Intensive Care Syndrome. When survivors leave ICU, they are required to navigate increasingly complex health systems and reintegrate with their communities, while trying to make sense of their experiences and possible new impairments. This occurs at a time when they may be most vulnerable with potentially little support from the health system. Currently in Australia, ICU survivors receive little to no follow‐up. Peer support has potential to address some of these challenges and system deficiencies and is relatively unexplored in critical care. Item 3. What (materials): Describe any physical or informational materials used in the intervention, including those provided to participants or used in intervention delivery or in training of intervention providers: Participants randomised to the intervention group will receive the following informational materials: * Upon recruitment, participants will receive an information letter outlining details of the icuRESOLVE Peer Support Program, including: What is Post Intensive Care Syndrome (PICS), How does it affect me and my family/carer, What is Peer Support, When are the Peer Support Sessions and what does attendance involve. * Reminder letter posted to their postal address with dates/times of the Peer Support Sessions prior to each session. Reminder text message within the week preceding each Peer Support Session. * Intervention Delivery ‐ Each Peer Support Session will be delivered by a clinician/s with ICU and group facilitation experience (e.g. Social Worker, Psychologist). Sessions will incorporate a short talk/presentation by a clinician on a relevant topic to ICU survival. E.g. What is PICS, Coping, Adjustment & Self Care... * Facilitators: Facilitators will all be registered clinicians in their speciality field of practice (Social Work and/or Psychology) and group facilitation is part of their scope of practice. These staff members are co‐investigators of the project. The Project Manager is senior intensive care physiotherapist with expertise in follow‐up of intensive care survivors and is highly skilled in debriefing (a method used in simulation training which has transferrable skills to group facilitation). Item 4. What (procedures): Describe each of the procedures, activities, and/or processes used in the intervention, including any enabling or support activities: The icuRESOLVE Peer Support Program (developed via co‐design methodology in Phase 1) informs the intervention in Phase 2: Format: Face to face, group based. Duration of Program: 6 sessions, fortnightly over 12 weeks. The program will run as a rolling/continuous program so that participants can commence the program upon recruitment in to the study Location: A non clinical room at the hospital site with space for 20 participants including chairs, tables and access to bathrooms, tea/coffee, accessible for people with disability Time: Alternating mornings and afternoons e.g. 10am‐12pm; 12‐2pm Session Length: 2 hours Facilitator: A clinician with ICU and group facilitation experience. E.g. Social worker, psychologist. Example Format: ‐ Tea/Coffee break including a light snack (e.g. biscuits) ‐ 2nd hour: Informal, non‐facilitated conversation / discussion amongst group members Infrastructure: ‐ icuRESOLVE Session Invite Letter, Reminder letters and text messages for upcoming sessions, attendance: RSVP via phone/text. The group may setup a Facebook page/group. ‐ 1st hour: Formal: a short talk on a relevant topic followed by facilitated group discussion with survivors sharing their stories. The group may also work on tasks (e.g. developing information sheets for the ICU waiting room). The group takes ownership of the content of future meetings. Guest Speakers: Examples include: What is PICS, Physiotherapist, Psychologist, Clinician Stories, Occupational Therapist, HARP, Social Worker. The group will identify the topics for future sessions and the icuRESOLVE Project Officer will identify Professionals to deliver the content at subsequent sessions. Enabling Activities: Prior to each icuRESOLVE Peer Support Program Session, a session plan and overview will be developed by the icuRESOLVE Project Lead and circulated amongst the icuRESOLVE facilitators. Attendance: Attendance for each participant will be documented on an attendance log. Item 5. Who provided: For each category of intervention provider (for example, psychologist, nursing assistant), describe their expertise, background and any specific training given. icuRESOLVE Project Lead: An CONDITION: Critical Illness Patient and family reported psychological outcomes PRIMARY OUTCOME: Feasibility of implementing the peer support model as measured by the following uptake, participant satisfaction and process measures: ; • Percentage of participants who agreed to participate of those who were approached for recruitment ; • Percentage of participants who agreed to participate when approached by a) in‐person approach vs. b) phone approach only (if unable to recruit in‐person). ; • Attendance rate of participants in the intervention group (e.g. percentage who attended more than half of the six sessions, percentage who attended less than half of the session and reasons unable to attend). ; • ICU survivors satisfaction survey of the intervention (intervention group only) ‐ questionnaire developed by the researchers ; • Percentage of participants who completed pre and post outcome measures (both groups) ; SECONDARY OUTCOME: Anxiety and Depression ‐ measured using HADS Change in Resilience ‐ Connor Davidson Resilience Scale (CD‐RISC) Post‐traumatic growth ‐ Post‐Traumatic Growth Inventory Post‐traumatic stress disorder ‐ measured using IES‐R Quality of Life – measured using EQ‐5D‐5L Social support ‐ PROMIS Inventory respectively (Social Isolation, Informational Support and Emotional Support from the PROMIS inventory) INCLUSION CRITERIA: ICU survivors: • ICU admission at Sunshine hospital • Age >18 years • Able to speak and understand English • Able to receive and participate in phone surveys • Living in the community Carer/Family Members • Age >18 years • Able to speak and understand English • Able to receive and participate in phone surveys • Living in the community