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. 2025 Oct 22.
doi: 10.1097/CCM.0000000000006913. Online ahead of print.

Experiencing Sepsis: A Meta-Ethnography

Marie W Sim Johnston  1 , Amy J Lorimer  1 , Kimberley J Haines  2   3 , Edward Litton  4   5
Affiliations

Experiencing Sepsis: A Meta-Ethnography

Marie W Sim Johnston et al. Crit Care Med. .

Abstract

Objective: To explore and synthesize the adverse and transformative experiences of sepsis survivors and their caregivers, to generate novel, experience-based insights that inform recovery support and future care strategies.

Data sources: Five databases (MEDLINE, Embase, CINAHL, PsycINFO, Web of Science) were searched from 2000 to 2025.

Study selection: Eligible studies included qualitative or mixed-methods research reporting experiences of adult sepsis survivors and/or caregivers. Studies focusing solely on healthcare providers or published in languages other than English were excluded. Nine studies met inclusion criteria.

Data extraction: First- and second-order constructs were extracted. Study quality was assessed using the Critical Appraisal Skills program. Confidence in findings was evaluated using GRADE-Confidence in Evidence from Reviews of Qualitative Research, which assesses methodological limitations, coherence, adequacy, and relevance.

Data synthesis: A meta-ethnographic approach guided synthesis, using Noblit and Hare's seven-phase methodology. Five third-order themes emerged for survivors:1. Increased dependency (moderate confidence)2. ICU fog (high confidence)3. Psychological adjustment (moderate confidence)4. Gratitude and guilt in relationships (moderate confidence)5. Post-discharge challenges (moderate confidence)Three themes emerged for caregivers:1. Adapting to caregiving (moderate confidence)2. Uncertainty about the future (moderate confidence)3. Communication challenges (low confidence)Experiences were shaped by both adversity and transformation. Dependency emerged as a central theme influencing autonomy, identity, and engagement with healthcare. Caregivers experienced emotional and logistical strain, often unsupported.

Conclusions: Although deeply personal, sepsis survivorship is marked by consistent themes. Survivor experiences reveal critical insights and generate directions for research and intervention. Findings underscore the need to strengthen survivorship care by prioritizing psychological support, effective communication, and responsive post-discharge services.

Keywords: Sepsis; caregivers; meta-ethnography; patients; qualitative research; quality of life; survivors.

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Conflict of interest statement

Dr. Haines’ institution received funding from the National Health and Medical Research Council (NHMRC). Dr. Litton received support for article research from the NHMRC Emerging Leadership Grant (2017081) and is a member of the National Critical Care Research Collaboration and the Australian government. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

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