ABSTRACT
BACKGROUND: Early mobilization (EM) of critically ill adult patients in intensive care units (ICUs) is a newer concept. It is known to improve overall outcomes, but little is known regarding the attitude and knowledge of healthcare providers (HCPs) and multidisciplinary barriers to its use in the Indian scenario. AIMS AND OBJECTIVES: To study the knowledge and attitude of HCPs in ICU about the EM of adult patients who are critically ill and identify perceived barriers to the application of EM. MATERIALS AND METHODS: In a cross-sectional survey conducted in a tertiary care academic institute, the HCPs, namely, physicians, anesthetists, surgeons, nursing staff, and physiotherapists working in ICU were interviewed using a self-structured questionnaire. The data were presented as descriptive statistics. RESULTS: There was 80% response rate. The benefits of EM as shortened length of mechanical ventilation (MV) were acknowledged by 78% respondents and 54% believed that it maintains muscle strength. It was considered crucial by 44% respondents, who opined that it should be started as the patient's cardiorespiratory status stabilizes. The favorable attitudes observed were recognition of benefits for patients under MV exceeded the risks and readiness by physicians to reduce sedation levels and change the parameters of MV. The main barriers identified were the absence of written guidelines or protocols for EM, limited staff to mobilize patients, inadequate training of HCP to facilitate EM, excessive sedation, and medical instability. CONCLUSION: There exists an awareness of the benefits of EM and favorable attitudes to its application. However, the actual performance of EM was perceived as a challenge due to barriers identified in the study. HOW TO CITE THIS ARTICLE: Akhtar PM, Deshmukh PK. Knowledge, Attitudes, and Perceived Barriers of Healthcare Providers toward Early Mobilization of Adult Critically Ill Patients in Intensive Care Unit. Indian J Crit Care Med 2021;25(5):512-518.
ABSTRACT
Yoga has proven beneficial effects on various health domains including musculoskeletal conditions, cardiopulmonary conditions through the practice of asana and pranayamas as well as on mental health, as it is known to enhance the body-and mind coordination. There is paucity of data on the effect of yoga on functional capacity in literature using 6 min walk test. The present study aims to look at the effect of yoga on 6-min walked distance, rating of perceived exertion (RPE), recovery time following the walk and state of well being. This is a hospital-based longitudinal study where 30 physiotherapy students of the age group 18 - 22 years of either sex were enrolled. Subjects having musculoskeletal problems, cardio respiratory disease and those who were not willing to volunteer were excluded They received Yoga intervention in form of Yogic practices which included a combination of asanas, pranayamas and omkar chanting for 1 h for 30 sessions. A baseline 6-min walk test was conducted on subjects and the 6-min walked distance, rating of perceived exertion (RPE) on modified Borg's scale were recorded. The baseline state of well-being was noted using the Warwick- Edinburgh mental well-being scale and similar recording was done post intervention after 30 sessions. Of the 30 subjects, there were no drop outs as these were committed college students. Of them, 24 were females and 6 were males with a mean age of 21.5 years SD 2.38. Statistically significant improvements were observed in 6-min walk distance (P value = 0.000), RPE (P value < 0.000), recovery time (P value < 0.000) and sense of well being score (P value < 0.000). Yoga practices are beneficial in improving the functional capacity in young healthy adults. Yoga can very well be incorporated in medical practice for increasing the patient's functional capacity, for those who have limitations in performing aerobic training due to various health reasons. The improved state of well being motivates the patients to adhere to yogic practices.
