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Title: Mobilization of ventilated patients in the intensive care unit: An elicitation study using the theory of planned behavior
Austin Authors: Holdsworth, Clare;Haines, Kimberley J ;Francis, Jill J;Marshall, Andrea;O’Connor, Denise;Skinner, Elizabeth H
Affiliation: Department of Physiotherapy, Western Health, Footscray, Victoria, Australia
Clinical Education Unit, Austin Health, Heidelberg, Victoria, Australia
School of Health Sciences, City University London, Northampton Square, London, UK
NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute QLD, Griffith University and Gold Coast Health, Gold Coast, Queensland, Australia
School of Public Health and Preventative Medicine, Monash University, Prahran, Victoria, Australia
Allied Health Research Unit, Monash Health, Cheltenham, Victoria, Australia
Department of Physiotherapy, School of Primary Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Frankston, Victoria, Australia
School of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
Issue Date: Dec-2015 2015-08-18
Publication information: Journal of Critical Care 2015; 30(6): 1243-1250
Abstract: PURPOSE: Early mobilization in intensive care unit (ICU) is safe, feasible, and beneficial. However, mobilization frequently does not occur in practice. The study objective was to elicit attitudinal, normative, and control beliefs (barriers and enablers) toward the mobilization of ventilated patients, to inform development of targeted implementation interventions. MATERIALS AND METHODS: A 9-item elicitation questionnaire was administered electronically to a convenience sample of multidisciplinary staff in a tertiary ICU. A snowball recruitment approach was used to target a sample size of 20 to 25. Two investigators performed word count and thematic analyses independently. Themes were cross-checked by a third investigator. RESULTS: Twenty-two questionnaires were completed. Respondents wrote the most text about disadvantages. Positive attitudinal beliefs included better respiratory function, reduced functional decline, and reduced muscle wasting/weakness. The main negative attitudinal beliefs were that mobilization is perceived as time consuming and poses a risk of line dislodgement/disconnection. Positive control beliefs (enablers) included increased staff availability, positive staff attitudes, engagement, and teamwork. Negative control beliefs (barriers) included unstable patient physiology and negative workplace culture. CONCLUSIONS: Intensive care unit staff expressed positive and negative attitudinal, normative, and control beliefs across the spectrum, and disadvantages were most frequently reported. Identified beliefs can be used to inform development of future interventions.
DOI: 10.1016/j.jcrc.2015.08.010
PubMed URL:
Type: Journal Article
Subjects: Mobilization
Implementation science
Critical illness
Mechanical ventilation
Appears in Collections:Journal articles

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