Scandinavian healthcare professionals' perceptions of rehabilitation practices in the intensive care unit. A cross-sectional survey.

Abstract

Objective: To describe healthcare professionals' perception of current early rehabilitation practices and their preconditions, focusing on functional and cognitive stimulation facilitated by nurses and other healthcare professionals in Scandinavian intensive care units (ICUs).

Design: Cross-sectional electronic survey administered to healthcare professionals. The survey was developed in Danish, translated into Norwegian and Swedish, and delivered using Google Forms. The qualitative data were analysed using the framework method.

Setting: Scandinavian ICUs.

Results: Practices facilitated by nurses and other healthcare professionals in the ICU often began with weaning from the ventilator and reducing sedation. This was followed by increased mobilisation and building physical strength. There was attention to optimising nutrition, swallowing function, and oral intake. Enabling communication and employing cognitively stimulating activities and bodily stimulation to engage the patient's mind were also framed as rehabilitation. To avoid delirium and overexertion, it was important to balance rest and activity and to shield the patient from unnecessary stimulation. Furthermore, it was important to support the patient's will to live and to involve the family in rehabilitation. Post-discharge rehabilitation activities included reaching out to patients discharged to wards and homes.

Conclusion: Rehabilitation was described as progressing from passive to active as patients gained consciousness and strength. Weaning, balancing rest and activity, supporting the patient's life courage and will to recover, open visitation policies, and multi-professional collaboration were important prerequisites for rehabilitation.

Implications for practice: All aspects of patient care can function as important opportunities for physical and cognitive rehabilitation. Balancing rest and activity is important for conserving the patient's energy for rehabilitation.