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

被引:119
|
作者
Parry, Selina M. [1 ]
Knight, Laura D. [2 ]
Connolly, Bronwen [3 ,4 ]
Baldwin, Claire [6 ]
Puthucheary, Zudin [4 ,6 ,7 ]
Morris, Peter
Mortimore, Jessica [3 ,4 ,5 ]
Hart, Nicholas [3 ,4 ,5 ,8 ,9 ]
Denehy, Linda [1 ]
Granger, Catherine L. [1 ,2 ,10 ]
机构
[1] Univ Melbourne, Sch Hlth Sci, Dept Physiotherapy, Level 7 Alan Gilbert Bldg, Parkville, Vic 3010, Australia
[2] Royal Melbourne Hosp, Dept Physiotherapy, Melbourne, Vic, Australia
[3] Natl Inst Hlth Res, Guys & St Thomas NHS Fdn Trust, Kings Coll London, Biomed Res Ctr, London, England
[4] Kings Coll London, Ctr Human & Aerosp Physiol Sci, London, England
[5] Guys & St Thomas NHS Fdn Trust, Lane Fox Clin Resp Physiol Res Ctr, London, England
[6] Univ S Australia, Int Ctr Allied Hlth Evidence iCAHE, Sansom Inst tute, Adelaide, SA, Australia
[7] Univ Coll Hosp, Inst Sports & Exercise Hlth, Div Crit Care, London, England
[8] Kings Coll London, Div Asthma, Allergy & Lung Biol, London, England
[9] Univ Kentucky, Dept Crit Care, Lexington, KY USA
[10] Inst Breathing & Sleep, Melbourne, Vic, Australia
基金
美国国家卫生研究院; 澳大利亚国家健康与医学研究理事会; 英国医学研究理事会;
关键词
Critical care; Rehabilitation; Physical therapy; Review; Behaviour change; Physical activity; INTENSIVE-CARE-UNIT; RENAL REPLACEMENT THERAPY; EARLY MOBILIZATION; EARLY MOBILITY; ILL PATIENTS; OCCUPATIONAL-THERAPY; RESPIRATORY-FAILURE; VENTILATED PATIENTS; PERCEIVED BARRIERS; SUPPORT NEEDS;
D O I
10.1007/s00134-017-4685-4
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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.
引用
收藏
页码:531 / 542
页数:12
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