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16.02.2017 | Systematic Review

Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies

verfasst von: Selina M. Parry, Laura D. Knight, Bronwen Connolly, Claire Baldwin, Zudin Puthucheary, Peter Morris, Jessica Mortimore, Nicholas Hart, Linda Denehy, Catherine L. Granger

Erschienen in: Intensive Care Medicine | Ausgabe 4/2017

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Abstract

Purpose

To identify, evaluate and synthesise studies examining the barriers and enablers for survivors of critical illness to participate in physical activity in the ICU and post-ICU settings from the perspective of patients, caregivers and healthcare providers.

Methods

Systematic review of articles using five electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus. Quantitative and qualitative studies that were published in English in a peer-reviewed journal and assessed barriers or enablers for survivors of critical illness to perform physical activity were included. Prospero ID: CRD42016035454.

Results

Eighty-nine papers were included. Five major themes and 28 sub-themes were identified, encompassing: (1) patient physical and psychological capability to perform physical activity, including delirium, sedation, illness severity, comorbidities, weakness, anxiety, confidence and motivation; (2) safety influences, including physiological stability and concern for lines, e.g. risk of dislodgement; (3) culture and team influences, including leadership, interprofessional communication, administrative buy-in, clinician expertise and knowledge; (4) motivation and beliefs regarding the benefits/risks; and (5) environmental influences, including funding, access to rehabilitation programs, staffing and equipment.

Conclusions

The main barriers identified were patient physical and psychological capability to perform physical activity, safety concerns, lack of leadership and ICU culture of mobility, lack of interprofessional communication, expertise and knowledge, and lack of staffing/equipment and funding to provide rehabilitation programs. Barriers and enablers are multidimensional and span diverse factors. The majority of these barriers are modifiable and can be targeted in future clinical practice.

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Titel: Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies
verfasst von: Selina M. Parry
Laura D. Knight
Bronwen Connolly
Claire Baldwin
Zudin Puthucheary
Peter Morris
Jessica Mortimore
Nicholas Hart
Linda Denehy
Catherine L. Granger
Publikationsdatum: 16.02.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 4/2017
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-017-4685-4

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Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies

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Purpose

Methods

Results

Conclusions

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