In two related pieces in JAMA, authors discuss patient support after post–intensive care syndrome (PICS) and whether the framework should be broadened. One correspondence agrees that current clinical guidance highlighting physical, cognitive, and psychological sequelae, early screening, and multidisciplinary follow-up is useful. The authors argue that the commonly used PICS framework underrepresents spiritual distress and bereavement, which they say can influence recovery for both patients and families following critical illness. They suggest adding spiritual and bereavement-related dimensions as part of a more comprehensive approach to long-term well-being.
In a reply, another author agrees that addressing spiritual distress and bereavement is important for holistic care. The reply notes that PICS is classically defined by new or worsening impairments in physical, cognitive, or mental health that persist beyond hospitalization, but that the scope remains debated. The correspondence and reply also emphasize ongoing tension in how to define PICS: some view the syndrome-based definition as potentially too broad, while others argue it should expand to include additional social health and quality-of-life domains that may intersect with spiritual well-being and identity reconstruction.
