Finding “I” after ICU: Self-Identity Disruption and Adaptation in Critical Illness Recovery

Purpose Critical illness survivors commonly face lasting physical, cognitive, and psychological consequences known as post-intensive care syndrome (PICS). Despite growing evidence of PICS sequelae, self-identity disruption remains an underexplored consequence of critical illness. This study aimed to describe the nature and dimensions of self-identity disruption and adaptation among critical illness survivors following hospital discharge. Materials and Methods Guided by a qualitative Interpretive Description approach, we conducted a data analysis of semi-structured interviews with 30 ICU survivors and 25 caregivers following hospital discharge, using inductive constant-comparative thematic analysis methods. Results Survivors experienced simultaneous disruptions across four interconnected dimensions of self-identity, including: 1) embodied uncertainty: confronting an unreliable bodily self, 2) fractured selfhood: loss of independence and generativity, 3) relational ruptures: experiences of changed family roles and relationships, including social isolation, and 4) life narrative disruption: life trajectories derailed. Survivors and caregivers also described adaptive processes of identity reconstruction and narrative adaptation that promoted recovery. Conclusions Self-identity disruption is a multidimensional consequence of critical illness that is deeply intertwined with physical, psychological, and social recovery. Findings point to the need for post-ICU care models that address identity reconstruction alongside functional rehabilitation.