Author ORCID Identifier
https://orcid.org/0000-0001-8327-0361
Date Available
9-24-2026
Year of Publication
2024
Degree Name
Doctor of Philosophy (PhD)
Document Type
Doctoral Dissertation
College
Health Sciences
Department/School/Program
Rehabilitation Sciences
First Advisor
Dr. Kirby P. Mayer
Second Advisor
Dr. Rachel Hogg- Graham
Abstract
Patients who survive critical illness have a prolonged recovery which impacts their quality of life and outcomes. The sudden life changes from being critically ill may create or exacerbate social factors or needs also known as social determinants of health. Patients’ SDOH are defined as the environments in which we live, work and play that impact health outcomes. Patients’ SDOH impact their life in early recovery from changes in previous roles to their need for increased financial, physical and emotional support. During this early recovery, patients are often recommended to participate in rehabilitation to improve their physical function. Although, accessing rehabilitation may be impacted by the changes in SDOH therefore, the relationship between patient’s unmet social needs and recovery was explored in this dissertation.
To understand if SDOH were being assessed and rehabilitation utilization was being reported in survivors of critical illness, we completed a systematic review. Our systematic review found that only 4 articles reported detailed rehabilitation utilization and the SDOH reported was low and highly variable. Based on the limited evidence, we prospectively enrolled 45 adult patients who survived admission to the medical intensive care unit (ICU) to collected rehabilitation utilization, SDOH and physical activity data at 3 months after discharge. Patients who received rehabilitation after discharge reported a lower number of unmet social needs (t= 2.14, p=0.041), compared to those that did not receive rehabilitation. The results indicate a relationship between patient’s SDOH and recovery requiring further exploration.
Digital Object Identifier (DOI)
https://doi.org/10.13023./etd.2024.392
Funding Information
Dr. Lindsey Fresenko was supported by grants from the National Institute on Drug Abuse (TL1TR001997) of the National Institutes of Health. The funding agency had no role in study design, data collection or analysis, or preparation and submission of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Dr. Lindsey Fresenko was supported in part by the Promotion of Doctoral Studies Scholarship from the Foundation for Physical Therapy Research from September 1, 2022 to September 1, 2023.
Recommended Citation
Fresenko, Lindsey E., "THE ROLE OF SOCIAL DETERMINANTS OF HEALTH ON PATIENT RECOVERY AFTER CRITICAL ILLNESS" (2024). Theses and Dissertations--Rehabilitation Sciences. 108.
https://uknowledge.uky.edu/rehabsci_etds/108
