Abstract Objective Social frailty is a concept emerging within the older adult literature; it describes a progressive state of being vulnerable with a loss of the resources needed to fulfil basic social needs. Social frailty and vulnerability are known to negatively impact physical outcomes and mortality, resulting in higher healthcare costs and resource use. Social frailty after acute and critical illness has not been described and might be an important mechanism which prevents full recovery. Using multi-centre qualitative data, we sought to establish if social frailty was important during recovery from sepsis and characterise its features. Methods and Analysis We undertook in-depth interviews with sepsis survivors, their family members and clinicians from across the UK. Interviews took place virtually and data analysis was underpinned by the Framework Method. Results Across the three groups, 44 (40%) participants were interviewed (11 (25.0%) clinicians, 27(61.4%) survivors and 6 (13.6%) family members). Social frailty appeared to be important during recovery and was characterised by four major concepts: financial insecurity; social interactions; ongoing treatment related issues (treatment burden) and family and relationship challenges (social resources). The mechanisms that appeared to drive social frailty were both related to the illness pathway and the provision (or lack of) health and social care services. Importantly we found that new or worsening physical frailty following critical illness appeared to worsen social frailty; similarly social frailty appeared to have a negative influence on physical and mental health outcomes. Conclusion This qualitative analysis of multi-perspective data has characterised the key features of social frailty in survivors of sepsis. Future research should explore how social frailty could be managed across the recovery trajectory, including how services could be implemented in clinical practice.
McPeake et al. (Fri,) studied this question.