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A pilot survey of ventilated cancer patients’ perspectives and recollections of early mobility in the intensive care unit

Abstract

Purpose

To determine the level of recall, satisfaction, and perceived benefits of early mobility (EM) among ventilated cancer patients after extubation in the intensive care unit (ICU).

Methods

A survey of patients’ perceptions and recollections of EM was administered within 72 h of extubation. Data on recall of EM participation, activities achieved, adequacy of staffing and rest periods, strength to participate, activity level of difficulty, satisfaction with staff instructions, breathing management, and overall rating of the experience were analyzed. The Confusion Assessment Method for ICU (CAM-ICU) was used for delirium screening.

Results

Fifty-four patients comprised the study group. Nearly 90% reported satisfaction with instructions, staffing, rest periods, and breathing management during EM. Participants indicated that EM maintained their strength (67%) and gave them control over their recovery (61%); a minority felt optimistic (37%) and safe (22%). Patients who achieved more sessions and “out-of-bed” exercises had better recall of actual activities compared with those who exercised in bed. Overall, patients with CAM-ICU-positive results (33%) performed less physical and occupational therapy exercises.

Conclusions

Ventilated cancer patients reported an overall positive EM experience, but factual memory impairment of EM activities was common. These findings highlight the needs and the importance of shaping strategies to deliver a more patient focused EM experience.

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Financial support

Supported, in part, by the Core Grant (P30 CA008748) and the Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center.

Author information

All the listed authors were involved in the study design, data collection, analysis and interpretation, and manuscript drafting. Critical manuscript revision was performed by L.P.V., S.M.P., and N.A.H., and final manuscript approval was provided by all authors.

Correspondence to Louis P. Voigt.

Ethics declarations

Recommendations from the pilot were incorporated into the final version of the survey, which was approved by the Institutional Review Board (IRB). Informed consent was obtained from all study patients.

Conflict of interest

The authors declare that they have no conflict of interest.

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Hsu, S.H., Campbell, C., Weeks, A.K. et al. A pilot survey of ventilated cancer patients’ perspectives and recollections of early mobility in the intensive care unit. Support Care Cancer 28, 747–753 (2020). https://doi.org/10.1007/s00520-019-04867-1

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Keywords

  • Early mobility
  • Mechanical ventilation
  • Satisfaction
  • Perception
  • Memory recall