Abstract Rationale Survivors of critical illness frequently experience persistent physical, psychological, and social sequelae collectively described as Post-Intensive Care Syndrome (PICS). Despite increasing awareness, post-ICU recovery pathways remain fragmented and under-resourced, leaving many survivors to seek support in informal, peer-led spaces. Online platforms provide a unique repository of unfiltered recovery narratives, yet these experiences remain underexplored in the literature. Methods We conducted a qualitative thematic analysis of posts and comments from the ICU Survivor Support Group, a publicly accessible, survivor-moderated Facebook community. Content posted between January 2022 and December 2024 was screened, yielding 1,476 content-rich quotes after exclusion of non-substantive responses. An inductive coding framework was developed through review of posts spanning 2021-2025, defining six parent themes: Physical Recovery, Mental Health Challenges, Identity and Loss, Social and Economic Strain, Peer Support and Validation, and Resources and Advocacy. Two resident physicians independently coded data in Excel, with reflexive discussion to reconcile discrepancies. Thematic interpretation followed Braun and Clarke’s six-phase approach. Results Mental health challenges were the most prevalent theme, present in over half of quotes (56.5%). Survivors described ongoing anxiety, nightmares, intrusive memories, hypervigilance, and enduring cognitive deficits. Delirium-related hallucinations were frequently recalled as vivid and traumatic, often persisting years after ICU discharge. Peer support and validation emerged in 51.1% of quotes, underscoring the centrality of the online community as a space for solidarity, encouragement, and identity reconstruction. Physical recovery challenges (26.8%) included persistent fatigue, ICU-acquired weakness, pain, voice changes, and respiratory symptoms, often framed as unexpected or lifelong. Less frequently, survivors reported social and economic strain (8.3%), including job loss, financial hardship, and relationship disruption, and identity and loss (7.9%), reflecting grief over a perceived loss of self and altered life trajectories. Resources and advocacy (5.5%) centered on peer-led sharing of educational materials and external recovery tools. Across themes, survivors emphasized feeling misunderstood by healthcare providers, family, and friends, contrasting this with the validation and belonging found in the peer group. Conclusion ICU survivorship extends far beyond hospital discharge, encompassing persistent physical, psychological, social, and existential challenges. Online peer communities provide not only emotional support but also serve as active infrastructures for recovery, enabling survivors to share coping strategies, validate experiences, and collaboratively reconstruct disrupted identities. These findings highlight unmet needs within formal post-ICU care pathways and suggest that peer-driven digital platforms can complement traditional models of survivorship care. This abstract is funded by: None
Vaqar et al. (Fri,) studied this question.