This dissertation is an exploration of mental health (MH) and behavioral concepts related to the experience of critical illness survivors (CISs). Physical issues of survivorship after critical illness have long been studied and treated; however, less is known about the mental health of CISs, what influences them to seek MH treatment, and if there are differences in these phenomena in rural and nonrural CISs. The first manuscript is a concept analysis of “powerlessness” as it relates to the intensive care unit (ICU) patient experience. The second manuscript explores the MH outcomes of sepsis patients, the most common diagnosis in ICUs, and how ICU nurses can support the MH of sepsis patients. The third manuscript represents the primary research study. Using an adapted Social Cognitive Theory model as a guide, a convergent mixed methods feasibility study examined Post-Traumatic Stress Disorder symptoms, self-efficacy, powerlessness, seeking MH treatment, health-related goals, and perceived barriers and facilitators to seeking MH treatment in rural and nonrural CISs. In completing this dissertation, the researcher was able to lay the foundation for future research involving rural and nonrural CISs. Implications for future research and practice are considered and discussed.

Date of publication

Summer 2023

Document Type




Persistent identifier


Committee members

Dr. Beth Mastel-Smith, Dr. Barbara McAlister, Dr. Amy Hayes


PhD in Nursing

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