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To cite: Schade Skov C,
Østervang C, Brabrand M,
et al. How do sepsis
survivors experience life after
sepsis? A Danish qualitative
study exploring factors of
importance. BMJ Open
2024;14:e081558. doi:10.1136/
bmjopen-2023-081558
► Prepublication history
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Received 31 October 2023
Accepted 31 January 2024
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1
Department of Emergency
Medicine, Odense University
Hospital, Odense, Denmark
2
Department of Clinical
Research, University of Southern
Denmark, Odense, Denmark
3
Department of Geriatric
Medicine, Odense University
Hospital, Odense, Denmark
Correspondence to
Camilla Schade Skov;
​camilla.​schade.​hansen@​rsyd.d​ k
How do sepsis survivors experience life
after sepsis? A Danish qualitative study
exploring factors of importance
Camilla Schade Skov ‍ ‍,1,2 Christina Østervang ‍ ‍,1 Mikkel Brabrand,1,2
Annmarie Touborg Lassen ‍ ‍,1,2 Dorthe Susanne Nielsen2,3
ABSTRACT
Objective Sepsis is a condition associated with high
mortality and morbidity, and survivors often experience
physical and psychological decline. Previous research has
primarily focused on sepsis survivors discharged from
the intensive care unit (ICU). We aimed to explore and
understand the consequences of sepsis experienced by
sepsis survivors in general.
Design A qualitative study inspired by a
phenomenological hermeneutical approach was
conducted. Data were analysed using systematic text
condensation.
Setting Patients with sepsis were identified on admission
to the emergency department and invited to an interview
3 months after discharge.
Participants Sixteen sepsis survivors were purposively
sampled and interviewed. Among these survivors, one
patient was admitted to the ICU.
Results Three main themes were derived from the
analysis: new roles in life, cognitive impairment and
anxiety. Although many survivors described a physical
decline, they experienced psychological and cognitive
impairments after sepsis as the most influential factors
in daily life. The survivors frequently experienced fatigue,
withdrawals from social activities and anxiety.
Conclusion Sepsis survivors’ experiences appeared to
overlap regardless of ICU admission or treatment at the
general ward. Identifying patients with sepsis-­related
decline is important to understand and support overall
patient processes and necessary in meeting specific needs
of these patients after hospital discharge.
BACKGROUND
Sepsis is a potentially life-­threatening condi-
tion defined as organ dysfunction caused by a
dysregulated host response to infection.1 The
exact incidence is unknown, but a Danish
study estimated an incidence of community-­
acquired sepsis of 731/100 000 person-­years
at risk based on symptoms and clinical notes
on hospital admission.2 The condition is asso-
ciated with high mortality and morbidity.3–5
Those who survive sepsis often experience
long-­term consequences such as fatigue,
muscle weakness, cognitive impairment, func-
tional decline, etc.6 7 During the past years,
Schade Skov C, et al. BMJ Open 2024;14:e081558. doi:10.1136/bmjopen-2023-081558
Original research
STRENGTHS AND LIMITATIONS OF THIS STUDY
⇒ We used in-­depth interviews to collect detailed in-
formation on the patients’ perceptions of the conse-
quences of sepsis, which allowed us to gain insight
into their lived experiences.
⇒ Patients with sepsis were prospectively included on
admission in the emergency department before the
course of sepsis was known.
⇒ The patients were recruited from a single centre,
which might have lowered the generalisation of our
results.
⇒ Selection bias was difficult to avoid because older
patients with severe sepsis and substantial comor-
bidities often are unable to participate because of
their continued critical condition.
the number of sepsis survivors has increased,
leaving an increase in the proportion of survi-
vors with possible disabilities.5 8 Despite this,
posthospital recovery is an area with sparse
knowledge and a lack of guidelines.6
Tools such as the 36-­Item Short Form Health
Survey (SF-­ 36) and the EuroQoL-­ 5D (EQ-­
5D) have traditionally been used to evaluated
health-­related quality of life (HRQL) after
critical illness.9 Most research on long-­term
consequences related to sepsis has used these
tools and have focused on patients admitted
to the intensive care unit (ICU), although
many patients with sepsis are treated at the
hospital ward.10 11 Few studies have focused
on the patients’ perspectives without using
predefined tools and questionnaires.12–14 In a
German study, 15 sepsis survivors discharged
from the ICU were interviewed to identify
important HRQL. The study found that
return to normal living was most important
for sepsis survivors and concluded that tradi-
tionally used instruments (SF-­36 and EQ-­5D)
are inadequate when describing HRQL after
sepsis because many HRQL domains are not
captured by the tools (eg, ability to walk, self-­
perception and control over one’s life).13
1
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With the increasing incidence of sepsis and increasing
number of sepsis survivors, understanding the impact
of sepsis on the everyday life of sepsis survivors is funda-
mental—also among patients with sepsis not necessarily
treated in the ICU.15 This information is important for
the development of posthospital guidelines. We aimed to
explore the consequences of sepsis experienced by sepsis
survivors and to gain knowledge of the important factors
related to their sepsis trajectories. Through their expe-
riences, we aimed to understand the consequences of
sepsis from their perspective.
BMJ Open: first published as 10.1136/bmjopen-2023-081558 on 13 February 2024. Downloaded from http://bmjopen.bmj.com/ on February 15, 2024 by guest. Protected by copyright.
METHODS
Study design
We conducted individual semi-­structured interviews using
a phenomenological hermeneutical approach.16 An inter-
view guide (table 1) inspired by clinical experiences and
the existing literature was created before the interviews.
The structure of the interview guide was inspired by Kvale
and Brinkmann,17 and the content was discussed and
adjusted by three authors (CSS, DSN and ATL).
Setting
The study was conducted at Odense University Hospital,
which is located in the Region of Southern Denmark
and covers a contingency population of 290 000 people.
Potential participants were identified in the emergency
department (ED), where approximately 69 000 patients

Table 1 Semi-­structured interview guide

Research question
The course of sepsis and
transition from hospital to
home—‘the new normal’
How do sepsis survivors
experience hospitalisation with ► Did you need any daily help/support after discharge?
sepsis and the transition to
their own homes?
Everyday life after discharge How will you describe your everyday life before you got sick?
How does a hospitalisation
with sepsis affected everyday life?
life post hospitalisation?
Self-­understanding
Has sepsis changed their self-­ How do you see yourself in relation to others?
understanding?
Social relationships
Has the hospitalisation
with sepsis had any social
consequences?
Ending
Interview question
How did you discover that something was wrong? Did anything feel differently? How?
Can you tell me at which department you were admitted, and what kind of infection you had?
How did you experience being hospitalised?
Is there anything in particular that you remember from your hospitalisation that has become
important to you?
How have you experienced the transition from being hospitalised to coming home?
► If so, which help/support did you need? And who helped you?
► What are your thoughts about needing this help?
Have you received the help/support you needed? If not, how should it have been different?
Have you received help/support daily?
Can you describe if/how your everyday life has changed after your hospitalisation with sepsis?
Do you experience any inconveniences/challenges? If so, how does it affect your everyday
Do you experience any inconveniences/challenges in everyday life that you will characterise
as:
► psychological?
► physical?
Why? Please elaborate.
Do you experience limitations in your everyday life now compared with your life before you got
sick? What are these limitations? How does this affect your everyday life?
What has been the most difficult thing since you came home?
What has been the best thing since you came home?
What has been the most important matter to you since you came home?
How would you describe yourself before you got sick?
Do you feel like you have changed? If so, how?
What matters most to you right now?
Has your hospitalisation impacted other than yourself? (spouse/partner, family and friends)
If so, which impact?
Do you feel they look at you differently compared with before the hospitalisation?
We are almost finished with the interview, but before ending this conversation, I have a few
final questions.
What impact do you feel this course of illness has had on you?
Is there something you think we need to talk about? Anything you would like to add?

2 Schade Skov C, et al. BMJ Open 2024;14:e081558. doi:10.1136/bmjopen-2023-081558


are treated every year. The ED is divided into sections: the
orthopaedic, abdominal surgery, neurology, cardiology
and general internal medicine sections.
Participants
All adult patients (aged ≥18 years) admitted through
the ED who were diagnosed with sepsis within 24 hours
after admission were potential participants. We included
patients who initially arrived in the general internal medi-
cine section. Sepsis was defined in accordance with the
Third International Consensus Definitions for Sepsis and
Septic Shock.1 Organ failure was classified according to
the Sepsis-­related Organ Failure Assessment score modi-
fied for the ED18 (see online supplemental appendix).
Patients were purposively sampled by one author (CSS).
To cover the diversity among the patients with sepsis, we
included patients with different ages, sexes, infection foci
and organ failure classifications.
To be included, the patients had to be able to give
informed consent, undergo a negative confusion assess-
ment method at the time of inclusion19 and finally, had
to be assessed as cognitively functioning by a healthcare
professional taking care of the patient. All three criteria
had to be fulfilled at the time of inclusion. Furthermore,
the patient had to speak and understand Danish. Patients
were included either in the ED or at the general ward,
depending on when they fulfilled the inclusion criteria.
Three months after hospital discharge, the patients were
contacted by telephone and invited to be interviewed.
Data collection
The patients were included during September 2022–
January 2023. The interviews were conducted in January–
April 2023, with a duration of 22–72 min. Relatives were
present during some interviews and participated if the
patient preferred this. In some cases, the presence of a
relative was essential to make the patient comfortable.
One author (CSS) conducted all interviews 3 months
after hospital discharge. The interviews were performed
in Danish, audio recorded and later transcribed verbatim.
Selected quotes were translated into English for this
paper.
The interviews were interactive and contained ques-
tions related to the patients’ lives before, during and after
hospitalisation with sepsis, with room for their narratives.
These in-­depth interviews provided detailed information
on the patient’s perception of the consequences of sepsis
and enlightened the interviewer about their lived experi-
ences. All interviews were face-­to-­face in the patient’s resi-
dence or at the hospital, if the patient preferred.
Patient and public involvement
Patients and public involvement were not used in study
design, conduct, reporting, dissemination plans of our
research.
Researcher reflexivity
The interviewer, CSS, an ED medical physician, wrote
down her preconceptions regarding the research subjects
Schade Skov C, et al. BMJ Open 2024;14:e081558. doi:10.1136/bmjopen-2023-081558
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before conducting the interviews. This was done to
increase reflexivity and as a reminder of not letting her
own views and experiences affect the participants.
Analysis
Systematic text condensation, inspired by Malterud,20
was used to analyse the interviews. This inductive explor-
ative analysis consisted of four steps: (1) the transcripts
were read several times to get an overall impression, and
major preliminary themes were identified; (2) meaning
units that represented information about the themes
were sorted into code groups; (3) the meaning units were
specified within each code group and condensed and (4)
the meaning of the condensation within the code groups
was synthesised.20 The first step was conducted by CSS
and DSN. After the preliminary themes were identified,
CSS identified meaning units and preliminary codes with
guidance from DSN. All the authors gathered to discuss
the findings to strengthen reflexivity and increase validity.
During this investigator triangulation, the meaning units
and codes were discussed, and the preliminary themes
were revised. We choose this approach to increase the
depth understanding of the patients’ perspectives
in-­
and to achieve reflexivity about highlighting the most
important perspectives. This investigator triangulation
strengthened the trustworthiness of our data. None of the
participants in the interviews expressed a need to read
the transcripts, and no further member checking was
performed. The NVivo software was used to support the
systematic analysis of the data. The Consolidated criteria
for reporting qualitative research was used.21
RESULTS
Among the patients with sepsis who were admitted to
the ED between September 2022 and January 2023, 22
were contacted regarding participation. They were found
suitable for participation and represented different age
groups, genders, organ failure classifications and infec-
tion foci. Unfortunately, some patients with sepsis were
ineligible for participation for various reasons such as
aphasia or dementia. One of the contacted patients with
sepsis declined to participate. Among the 21 patients
who agreed to participate, 5 died within the following
3 months. All 16 patients who were alive after 3 months
agreed to be interviewed. No further inclusion criteria
were added after 3 months. The patient characteristics
are outlined in table 2.
We identified three themes that represent the most
important matters to sepsis survivors in relation to their
everyday life: (1) new roles in life, (2) cognitive impair-
ment and (3) anxiety.
New roles in life
Many sepsis survivors described how their relationships
with other people had changed because of psycho-
logical impairment and physical limitations not previ-
ously present. Everyday tasks and domestic work were
3
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described how her persistent lack of energy had led to
Table 2 Characteristics of interviewed participants
uncertainty about her new role in life. She was unsure if
Clinical characteristics of interviewed patients her new condition was a result of her sepsis or a sign of
Sex, n (%) nearing end of life. Another patient described how his
Male 9 (56.3) powerlessness made him feel less like a man.
Age (median, IQR) 63 (50–75) The thing about me not being able to do anything… I feel
Diagnosis, n (%) like punching myself over the head… I feel like a slightly
 Pneumonia 7 (43.8) weaker man. I think it is too early for me to feel like this.
(Male patient in his 40s)
 Urinary tract infection 2 (12.5)
 Erysipelas 2 (12.5) Altered physical conditions were considered a limi-
 Psoas abscess 1 (6.3) tation in everyday life, and survivors who experienced
these saw themselves from a different perspective. A
 Primary bacteraemia 1 (6.3)
patient distanced herself from her leg, which had become
 Unknown site of infection 3 (18.8) dysfunctional compared with before sepsis. She refused
ICU admission, n (%) 1 (6.3) to identify herself with her new physical status. The ability
Length of hospital stay (median, IQR) 10 (5.5–15.5) to walk was outlined as important to those who had
Employment, n (%) experienced a decline. Some had regained full physical
functioning, while other sepsis survivors still struggled
 Employed 4 (25)
with reduced mobility 3 months after discharge from the
 Unemployed 1 (6.3) hospital. Returning to what they considered as a normal
 Early retirement 4 (25) physical state was important. Reduced ability to walk was
 Retired 7 (43.7) associated with an identity of being old.
Civil status, n (%) I always thought that those who used a walker were some
 Married/Cohabiting partner 13 (81.2) older people who did not walk to well. And so, I have become
 Single 3 (18.8) one. (Male patient in his 70s)
ICU, intensive care unit; IQR, inter-­quartile-­range.
Cognitive impairment
Many patients described a decline in cognitive function.
distributed differently among family members or handled They experienced a lack of initiative, fatigue, disorien-
more slowly than before. For some, it affected their rela- tation and loss of previous skills (eg, overview of own
tionship with family members, and they found themselves finances and mathematical calculations). One patient
playing a new role in the family. Owing to these acquired described how he lost his routines at work. He spent a
disabilities, working life was less important, and for some, longer time doing the same work as earlier, and still was
it became an unwanted burden despite previous joy and unsure if he completed the task satisfactorily. Sometimes,
satisfaction at work. loss of a specific cognitive function was first noticed when
the patient was unable to solve a task, and sometimes by
I have a grandson… I cannot do the same thing with him
the spouse. The impact on everyday life differed among
as I did before. We used to go on vacation and to the play-
the patients depending on their need for the lost ability
ground. Grandmother crawled around. I cannot do that
in everyday life.
anymore… I have always been fit, and as I told you, I do not
want my work to ruin my life. I can tell you, I have applied It is only within the last month that I dared to let him drive
for senior pension. (Female patient in her 60s) alone. Even in Skagen (city in Denmark), where he was
born and raised, he could not remember… He speaks French
Despite finding social relationships important, many
again… but the mathematical calculations are lost. (Wife to
sepsis survivors withdrew from social activities because
a man in his 70s)
they found themselves unable to participate in gather-
ings. This was associated with a great loss. Many sepsis survivors experienced fatigue, which could
be overwhelming and worsen with demanding activities.
I have been a member of Rotary for 30–40 years… I am
A patient described how he had to sleep for 2 hours after
unreliable at showing up. So, I resigned from the fellowship,
a drive with his family. Some described how they struggled
and also from the other fellowship where I was also unreli-
with lack of initiative, but despite their awareness of this,
able. These two things are those I miss the most… the social
they found themselves unable to do anything about it.
and developing for me. (Male patient in his 70s)
Three of four of the interviewed sepsis survivors who
The physical and psychological impairments expe- were working before sepsis had returned to work on
rienced by the sepsis survivors lead to a change in reduced hours. Working full-­time or part-­time, all except
self-­understanding for some. This was especially recur- one patient, described extreme fatigue after a working
rent among those who experienced fatigue. A patient day, leaving them without energy for household, family

4 Schade Skov C, et al. BMJ Open 2024;14:e081558. doi:10.1136/bmjopen-2023-081558


or friends. Some patients explained their fatigue as a
‘fatigue in the brain’.
It was fatigue. A fatigue that comes to the brain. It feels
like it is both your memory, your vocabulary, and what you
were supposed to say… I cannot separate the dizziness I get
when I try to stand and walk from fatigue, but I can tell, if
I lie down and sleep for 1.5–2 hours, it usually disappears.
(Female patient in her 60s)
The consequences of fatigue were pervasive in everyday
life, especially for those with a demanding everyday life.
Furthermore, it was associated with a decreased desire for
social relations, for which several patients stated insuffi-
cient mental resources.
My head is tired, so I cannot get things done. Our gar-
den tends to be much prettier, but I cannot get it done…
I prefer a long walk with the dog where I do not need to
think and do not have to relate to other people. (Male
patient in his 40s)
Anxiety
Anxiety was a major theme that emerged in the inter-
views. Anxiety was related to two main issues: the
fear of dying and the fear of relationships with other
people.
Anxiety about dying
Anxiety and thoughts of death during sepsis and after
discharge from the hospital were recurrent themes. Both
memory loss in the acute phase and the uncertainty
followed from being a patient with sepsis added further
anxiety. The fear of dying was extremely strong among
the patients with children, several of whom described how
they were afraid of dying, leaving their children behind to
uncertainty.
… Suddenly, I started to cry. It was simply because I thought,
‘What about my son if I die? He has nothing else’. (Male pa-
tient in his 40s)
For some patients, sepsis was a ground-­breaking event
associated with a fear of recurrence. They described
sepsis as an unexpected and disgusting event that over-
shadowed other life-­threatening illnesses. A patient even
expressed that she was more afraid of getting sepsis again
than a relapse of her breast cancer.
I have never cleaned my leg as I do now. I am more afraid
of my leg than I am of this breast cancer. (Female patient in
her 60s)
Increased attention towards avoiding a new episode of
sepsis resulted in changed behaviours for some patients,
who felt a need for surveillance of their own health
status and regularly measured their saturation levels or
temperatures. Returning to what the patients considered
a normal physical state was important. Workout became
important to some of the survivors, as this made them
Schade Skov C, et al. BMJ Open 2024;14:e081558. doi:10.1136/bmjopen-2023-081558
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feel more prepared if sepsis should happen to them
again. Some searched for a cause and had undue guilt.
They continued to analyse what they had been doing days
before their sepsis.
I am afraid that the trip to Oslo [capital city of Norway]
has been the reason for this. I usually do not drink, but on
the trip, I had a gin and tonic. (Female patient in her 50s)
Anxiety from a relationship perspective
Increased awareness and care from the family was a
consistently important factor among all the interviewed
patients. For some of the survivors, sepsis created uncer-
tainty and anxiety in the relationship. This was sometimes
observed through the actions or changed behaviours of
family members.
My children are more delighted to spend time with me…
Previously, the little one did not want me to follow her into
class in school—now I have to follow her in. (Male patient
in his 40s)
A few patients experienced increased conflicts in the
home because their spouses felt overwhelmed by tasks
with poor opportunities for support. This had a nega-
tive impact on their relationships, and they felt guilty
about not being helpful at home. Some sequelae, such
as fatigue, is not always evident, which could lead to
misunderstandings.
It was difficult not to be able to be who you normally are… It
can be difficult for your partner not to understand that you
feel ill, because you do not always look like someone who is
ill… (Male patient in his 30s)
Family members had been confronted with the mortality
of their beloved ones, and several sepsis survivors noticed
increased awareness and concerns regarding their phys-
ical statuses or possible symptoms of disease. Overall, the
sepsis survivors experienced increased support and care
from their family members. Some sepsis survivors even
stated that sepsis had strengthened their relationships
and love.
I am in love with my wife again. Because she helps me, she
gives her all. (Male patient in his 50s)
DISCUSSION
This qualitative study highlighted the most important
matters to sepsis survivors experienced by themselves,
and how they experience life 3 months after discharge.
Through our analysis, we identified three main themes:
new roles in life, cognitive impairment and anxiety.
The sepsis survivors frequently experienced fatigue,
trouble with thoughts of death, a decreased desire for
being social, a decline in cognitive function and physical
decline, all of which had an impact on their everyday life
and brought changes that they had to adapt to. Most of
our reported outcomes have been previously described
5
Open access
in other qualitative studies that explored sepsis survivors’
experiences and perceptions.13 14 22 However, these studies
primarily included sepsis survivors from the ICU. As most
patients with sepsis in Denmark are treated outside the
ICU during hospitalisation, we intended to include a
sample representative of sepsis survivors in general. We
prospectively included patients with sepsis who were
admitted through the ED; thus, the disease course of
sepsis was unknown on inclusion. We found that the expe-
riences of the sepsis survivors admitted to the ICU and
those treated at the general ward have substantial similar-
ities.13 14 22 This indicates a need for posthospital aware-
ness of patients with sepsis treated at the general ward.
Critical illness has been associated with long-­ term
cognitive impairment, depression, anxiety, post-­traumatic
stress disorder, decreased pulmonary and neuromus-
cular functions and reduced HRQL.7 11 23 24 Among ICU
survivors the associated long-­ term impairments have
been given the overall designation ‘postintensive care
syndrome’ (PICS).25 To some extent, we found an overlap
between symptoms in relation to PICS and the lived
experiences of our study participants. A previous quali-
tative study has described fatigue among stroke survivors.
Their experiences of poststroke fatigue appeared quite
similar to the fatigue experienced by the sepsis survivors
in our study, with descriptions of exhaustion, difficulties
in being social, difficulties in keeping up with others,
interferences with daily activities, reduced working hours
or retirement.26 This indicates that similar experiences
may be found among survivors of other potential life-­
threatening diseases treated outside the ICU. However,
such knowledge goes beyond this study.
The sepsis survivors in our study experienced psycho-
logical and cognitive impairments after sepsis as most
influential on daily life. This might be because of the
sufficient resources spent on minimising physical decline.
Almost all sepsis survivors in our study were offered reha-
bilitation with physiotherapy, some both during hospi-
talisation and after discharge. Few were still undergoing
rehabilitation 3 months after hospitalisation. Only two
patients reported being offered consultation with a
psychologist. This could indicate that mental needs are
not necessarily handled after sepsis. Likewise, in a study
from Germany, researchers found that sepsis survivors
often applied for rehabilitation, but these rehabilitations
mostly addressed physical impairments, whereas other
impairments (eg, fatigue or psychological problems)
were rarely addressed.12
Although most of the sepsis survivors in our study expe-
rienced the previously described declines after hospi-
talisation, a few reported they recovered their previous
health status and only experienced minor declines (eg,
pain on deep inspiration, shortness of breath or received
domestic help for minor tasks).
Preferences and needs after hospitalisation are
generally based on physicians’ and other healthcare
professionals’ judgements during hospitalisation,
and no consensus has been reached regarding sepsis
6 Schade Skov C, et al. BMJ Open 2024;14:e081558. doi:10.1136/bmjopen-2023-081558
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rehabilitation programmes. This increases the risk of
insufficient diagnostics and treatment of sepsis sequelae.
Identifying the patients who struggles with anxiety, fatigue
and other cognitive declines is important to understand
and support overall patient processes and necessary to
meet specific needs after hospitalisation. However, these
declines are not always evident during the hospitalisation.
The Surviving Sepsis Campaign recommends follow-­up
for both physical, cognitive and emotional problems after
hospitalisation, but concludes that data are insufficient to
suggest specific tools to assess these problems.27
Strengths and limitations
A major strength of this study is how the sepsis survivors
were included on admission, which broadens the under-
standing of the impact of sepsis in general. All inter-
views were conducted as in-­depth face-­to-­face interviews
either at the patient’s own resident or at the hospital if
preferred by the patient. This was chosen to avoid chal-
lenges in getting to the hospital and to ensure that the
patient felt comfortable during the interview. It provided
the interviewer with an insight into the patient’s everyday
life, which is not possible to achieve at the hospital and
strengthens the relationship between the interviewer
and the sepsis survivor. All 16 sepsis survivors consented
to participate on their admission, and the follow-­up time
was approximately equal for all survivors. This study has
limitations that should be acknowledged. The results
were only based on the perceptions and experiences of
16 sepsis survivors. From the 16 interviews, the authors
assessed that no further themes emerged during the
analysis. Previous literature has suggested that approxi-
mately 12 participants are enough to achieve saturation
when investigating a single phenomenon.28 The patients
were all included from a single centre, Odense Univer-
sity Hospital. Selection bias was difficult to avoid because
older patients with sepsis are often unable to participate
owing to their critical conditions. The five patients who
died during the follow-­up period were all older people
with substantial frailty and comorbidities. Their experi-
ences and perceptions of the impact of sepsis might have
been different from those described in this study. The
transcripts were coded by one author (CSS). To reduce
the risk of preconceived ideas, the coding process was
supported by DSN. The derived meaning units, codes and
preliminary themes were discussed by all the authors.
CONCLUSION
This qualitative study increases the understanding of the
impact of sepsis on everyday life among sepsis survivors
not necessarily admitted to the ICU. However, the expe-
riences of sepsis survivors appeared to overlap, regardless
of ICU admission or treatment at the general ward. We
hope that these findings will enable healthcare profes-
sionals to inform the patients better and contribute to the
development of relevant multidisciplinary rehabilitation
programmes targeting the specific needs of the sepsis

survivor in question. As sepsis also influences the everyday
life of family and relatives, it would probably be benefi-
cial to involve them in the process. Furthermore, we hope
that it would help raise awareness of sepsis sequelae in
general and not only for ICU-­treated sepsis survivors.
Twitter Christina Østervang @C_Oestervang
Contributors CSS, DSN and ATL conceptualised the study. CSS and DSN planned
the study design. The study guide was conducted by CSS, discussed and revised
with inputs from DSN and ATL. All interviews were conducted by CSS with
supervision from DSN. CSS transcribed and coded the data. CSS and DSN did the
primary analysis. All authors were gathered to discuss and interpret the results.
CSS wrote the article. All authors revised and approved the final version. CSS is the
guarantor of this study.
Funding This study was funded by the University of Southern Denmark and
Odense University Hospital.
Competing interests ATL was supported by an unrestricted grant to the University
of Southern Denmark from Tryg Fonden. All other authors declared no conflicts of
interest.
Patient and public involvement Patients and/or the public were not involved in
the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not applicable.
Ethics approval This study was approved by the Record of Data Process of
Registry, Region of Southern Denmark (no. 22/42571). According to the Danish
law, approval from the National Committee on Health Research Ethics (ref. no.
20222000-­96) was not required. Data were stored at a logged server approved by
the Region of Southern Denmark, as required by the Danish law. All the participants
received oral and written information prior to inclusion and consented to participate.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available. The data used in this study is
considered confidential. The study participants have been assured that the data is
not available to anyone other than the authors.
Supplemental material This content has been supplied by the author(s). It has
not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been
peer-­reviewed. Any opinions or recommendations discussed are solely those
of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and
responsibility arising from any reliance placed on the content. Where the content
includes any translated material, BMJ does not warrant the accuracy and reliability
of the translations (including but not limited to local regulations, clinical guidelines,
terminology, drug names and drug dosages), and is not responsible for any error
and/or omissions arising from translation and adaptation or otherwise.
Open access This is an open access article distributed in accordance with the
Creative Commons Attribution Non Commercial (CC BY-­NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non-­commercially,
and license their derivative works on different terms, provided the original work is
properly cited, appropriate credit is given, any changes made indicated, and the use
is non-­commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
ORCID iDs
Camilla Schade Skov http://orcid.org/0000-0002-2207-8883
Christina Østervang http://orcid.org/0000-0001-5990-0167
Annmarie Touborg Lassen http://orcid.org/0000-0003-4942-6152
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