Patients' experiences with early rehabilitation in intensive care units: A qualitative study about aspects that influence their participation

J Adv Nurs. 2024 May;80(5):1984-1996. doi: 10.1111/jan.15949. Epub 2023 Nov 14.

Abstract

Aim: To explore patients' experiences with early rehabilitation in the intensive care unit and what they perceive to influence their participation.

Design: A qualitative design anchored in phenomenological and hermeneutical traditions utilizing in-depth interviews.

Methods: Thirteen patients were interviewed from 5 to 29 weeks following discharge from three units, in January-December 2022. Analysed using systematic text condensation and the pattern theory of self. Reporting adhered to consolidated criteria for reporting qualitative research.

Results: Interviews described four main categories: (1) A foreign body, how the participants experienced their dysfunctional and different looking bodies. (2) From crisis to reorientation, the transformation the participants experienced from a state of crisis to acceptance and the ability to look forwards, indicating how bodily dysfunctions are interlinked to breakdowns of the patients' selves and the reorganization process. (3) Diverse expectations regarding activity: ambiguous expectations communicated by the nurses. (4) Nurse-patient: a powerful interaction, highlighting the essential significance of positive expectations and tailored bodily and verbal interaction for rebuilding the patient's outwards orientation.

Conclusion: Outwards orientation and reorganization of the self through a reduction in bodily dysfunctions, strengthening the patients' acceptance of the situation, providing tailored expectations and hands-on and verbal interaction appear to be fundamental aspects of patient participation in early rehabilitation.

Implications: Insights into patients' perceptions show how dysfunctional bodies cloud individuals' perceptual fields, causing inwards orientation and negative thoughts concerning themselves, their capabilities, environment and future. This knowledge can improve nurses' ability to tailor care to promote optimal recovery for patients.

Patient or public contribution: User representative contributed to the design of the study.

Keywords: ICU; early rehabilitation; intensive care unit; participation; patient; phenomenology; qualitative.

MeSH terms

  • Humans
  • Intensive Care Units*
  • Medicine*
  • Patient Discharge
  • Patients
  • Qualitative Research