Patient, Family and Provider Priorities in ICU Rehabilitation: An Experience-Based Co-Design Study.

IF 2.6 3区 医学 Q1 NURSING
Jiyeon Kang, Sun Ju Chang, Mi-Kyeong Jeon, Gee Young Suh, Chi Ryang Chung
{"title":"Patient, Family and Provider Priorities in ICU Rehabilitation: An Experience-Based Co-Design Study.","authors":"Jiyeon Kang, Sun Ju Chang, Mi-Kyeong Jeon, Gee Young Suh, Chi Ryang Chung","doi":"10.1111/nicc.70151","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit (ICU) rehabilitation has been shown to improve physical, psychological and functional outcomes in critically ill patients. However, implementation varies widely, and clinical practice guidelines (CPGs) are needed to ensure consistent, evidence-based care. Incorporating patient and public involvement (PPI) into CPG development is essential to reflect the lived experiences and priorities of service users.</p><p><strong>Aim: </strong>To explore the experiences of ICU rehabilitation from the perspectives of patients, families and healthcare providers and to identify shared priorities that can inform the development of Korean CPGs for ICU rehabilitation and post-intensive care syndrome.</p><p><strong>Study design: </strong>This study applied the Experience-Based Co-Design (EBCD) approach. We conducted observations of ICU rehabilitation practices through institutional educational video recordings, individual interviews with four ICU survivors and a focus group interview with five ICU healthcare professionals. A trigger audio recording, derived from the patient interviews, and thematic touchpoints from qualitative analysis were presented in a group feedback event. ICU clinicians involved in CPG development participated to validate the findings and identify shared priorities.</p><p><strong>Results: </strong>Four core priorities were identified: patients and families as partners, person-centred approach, fostering rehabilitation culture and teamwork, and ensuring sustainability of rehabilitation.</p><p><strong>Conclusions: </strong>Successful ICU rehabilitation requires placing patients and families at the centre throughout the entire rehabilitation journey, from ICU admission to community reintegration. Structural support addressing workforce limitations and cost reimbursement issues, complemented by a culturally sensitive team approach, is essential for establishing effective linkages between ICU rehabilitation and community services.</p><p><strong>Relevance to clinical practice: </strong>ICU healthcare providers should create more opportunities for patient and family engagement in rehabilitation processes. A dynamic team approach that flexibly incorporates diverse staff is crucial for delivering person-centred services. Administrators and policymakers should develop comprehensive strategies and policies that facilitate seamless continuation of rehabilitation from ICU to community settings.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70151"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nursing in Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/nicc.70151","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Intensive care unit (ICU) rehabilitation has been shown to improve physical, psychological and functional outcomes in critically ill patients. However, implementation varies widely, and clinical practice guidelines (CPGs) are needed to ensure consistent, evidence-based care. Incorporating patient and public involvement (PPI) into CPG development is essential to reflect the lived experiences and priorities of service users.

Aim: To explore the experiences of ICU rehabilitation from the perspectives of patients, families and healthcare providers and to identify shared priorities that can inform the development of Korean CPGs for ICU rehabilitation and post-intensive care syndrome.

Study design: This study applied the Experience-Based Co-Design (EBCD) approach. We conducted observations of ICU rehabilitation practices through institutional educational video recordings, individual interviews with four ICU survivors and a focus group interview with five ICU healthcare professionals. A trigger audio recording, derived from the patient interviews, and thematic touchpoints from qualitative analysis were presented in a group feedback event. ICU clinicians involved in CPG development participated to validate the findings and identify shared priorities.

Results: Four core priorities were identified: patients and families as partners, person-centred approach, fostering rehabilitation culture and teamwork, and ensuring sustainability of rehabilitation.

Conclusions: Successful ICU rehabilitation requires placing patients and families at the centre throughout the entire rehabilitation journey, from ICU admission to community reintegration. Structural support addressing workforce limitations and cost reimbursement issues, complemented by a culturally sensitive team approach, is essential for establishing effective linkages between ICU rehabilitation and community services.

Relevance to clinical practice: ICU healthcare providers should create more opportunities for patient and family engagement in rehabilitation processes. A dynamic team approach that flexibly incorporates diverse staff is crucial for delivering person-centred services. Administrators and policymakers should develop comprehensive strategies and policies that facilitate seamless continuation of rehabilitation from ICU to community settings.

ICU康复中的患者、家庭和提供者优先事项:一项基于经验的联合设计研究。
背景:重症监护病房(ICU)康复已被证明可以改善危重患者的身体、心理和功能结局。然而,实施差异很大,需要临床实践指南(cpg)来确保一致的循证护理。将患者和公众参与(PPI)纳入CPG发展,对于反映服务使用者的生活经验和优先事项至关重要。目的:从患者、家属和医疗保健提供者的角度探讨ICU康复的经验,并确定共同的优先事项,为韩国ICU康复和重症监护后综合征CPGs的发展提供信息。研究设计:本研究采用基于经验的协同设计(EBCD)方法。我们通过机构教育录像、对4名ICU幸存者的个人访谈和对5名ICU医护人员的焦点小组访谈,对ICU康复实践进行了观察。在小组反馈活动中提出了来自患者访谈的触发录音和来自定性分析的主题接触点。参与CPG开发的ICU临床医生参与验证研究结果并确定共同的优先事项。结果:确定了四个核心优先事项:以患者和家庭为合作伙伴,以人为本,培养康复文化和团队合作,确保康复的可持续性。结论:成功的ICU康复需要将患者和家属置于整个康复过程的中心,从ICU入院到重新融入社区。解决劳动力限制和费用报销问题的结构性支持,辅以对文化敏感的团队方法,对于在ICU康复和社区服务之间建立有效联系至关重要。与临床实践的相关性:ICU医疗保健提供者应该为患者和家属参与康复过程创造更多的机会。灵活结合不同工作人员的动态团队方法对于提供以人为本的服务至关重要。管理人员和决策者应制定全面的战略和政策,促进从ICU到社区环境的无缝持续康复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.00
自引率
13.30%
发文量
109
审稿时长
>12 weeks
期刊介绍: Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics. Papers published in the journal normally fall into one of the following categories: -research reports -literature reviews -developments in practice, education or management -reflections on practice
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信