"I will get out of this" - The patients' experiences of early mobilisation in intensive care. A hermeneutic study

Abstract

Background: The significance of early mobilisation in intensive care has become increasingly apparent along with a growing understanding of patient experiences within this critical setting. However, there is still a need for more knowledge regarding the complex experiences of the patients. Therefore, this study aimed to gain an in-depth understanding of the significance and deeper meaning of early mobilisation in patients recently treated in intensive care.

Methods: A qualitative study with a hermeneutic, interpretive approach. Semi-structured interviews were conducted with 30 participants recently treated in the intensive care units, in two different hospitals.

Findings: The analysis yielded three themes: 'Struggling to regain independence and normal life', 'Interaction with healthcare professionals' and 'Early mobilisation in a chaotic, confused context without control'. The first theme captures the participants' experiences, motivations, and the deeper significance of early mobilisation, which was hope, the beginning of recovery and a willingness to fight. The other themes describe the context and circumstances surrounding the participants' mobilisation including the collaboration with healthcare professionals.

Conclusion: Early mobilisation's significance and deeper meaning in intensive care were understood as the starting point of recovery. It had the ability to evoke hope and strengthen the fighting spirit, especially when it included leaving bed. The patients' pre-existing understanding that resilience and persistence were crucial for regaining strength and mobility contributed, as well as positive interactions with healthcare professionals that restored human dignity and facilitated involvement and participation contributed.

Implications for practice: Early mobilisation should be used to inspire hope and a willingness to fight for recovery in patients treated in intensive care. Efforts should be made to engage patients in positive interactions with healthcare professionals that encourage this fighting spirit and active participation in early mobilisation. Mobilisations involving patients getting up and leaving bed should be used as much as possible.

Keywords: Barrier; Early Mobilisation; Immobilisation; Intensive care; Patient; Person-centered care; Qualitative research.