Patient and carer experience of hospital-based rehabilitation from intensive care to hospital discharge: mixed methods process evaluation of the RECOVER randomised clinical trial

ObjectivesTo explore and compare patient/carer experiences of rehabilitation in the intervention and usual care arms of the RECOVER trial (ISRCTN09412438); a randomised controlled trial of a complex intervention of post-intensive care unit (ICU) acute hospital-based rehabilitation following critical...

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Bibliographic Details
Published in:BMJ open 2016-07, Vol.6 (8), p.e012041-e012041
Main Authors: Ramsay, Pam, Huby, Guro, Merriweather, Judith, Salisbury, Lisa, Rattray, Janice, Griffith, David, Walsh, Timothy
Format: Article
Language:English
Subjects:
Adult
Aged
Case Management
Cost analysis
Critical Care
Critical Illness - rehabilitation
Female
Focus groups
Health Personnel
Hospitalization
Hospitals
Humans
Intensive Care
Intensive Care Units
Male
Medical research
Middle Aged
Nutrition Therapy
Patient Care Team
Patient Discharge
Patient Education as Topic
Patient Satisfaction
Patients
Physical Therapy Modalities
Qualitative research
Quality of Health Care
Quality of service
Questionnaires
Rehabilitation
Respiration, Artificial
Scotland
Surveys and Questionnaires
Ventilation
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Summary:ObjectivesTo explore and compare patient/carer experiences of rehabilitation in the intervention and usual care arms of the RECOVER trial (ISRCTN09412438); a randomised controlled trial of a complex intervention of post-intensive care unit (ICU) acute hospital-based rehabilitation following critical illness.DesignMixed methods process evaluation including comparison of patients' and carers' experience of usual care versus the complex intervention. We integrated and compared quantitative data from a patient experience questionnaire (PEQ) with qualitative data from focus groups with patients and carers.SettingTwo university-affiliated hospitals in Scotland.Participants240 patients discharged from ICU who required ≥48 hours of mechanical ventilation were randomised into the trial (120 per trial arm). Exclusion criteria comprised: primary neurologic diagnosis, palliative care, current/planned home ventilation and age 3 months postrandomisation.InterventionsA complex intervention of post-ICU acute hospital rehabilitation, comprising enhanced physiotherapy, nutritional care and information provision, case-managed by dedicated rehabilitation assistants (RAs) working within existing ward-based clinical teams, delivered between ICU discharge and hospital discharge. Comparator was usual care.Outcome measuresA novel PEQ capturing patient-reported aspects of quality care.ResultsThe PEQ revealed statistically significant between-group differences across 4 key intervention components: physiotherapy (p=0.039), nutritional care (p=0.038), case management (p=0.045) and information provision (p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2016-012041