Centre for Health and Rehabilitation Technologies (CHaRT), Institute of Nursing and Health Research, Ulster University, Newtownabby, United Kingdom.
*Joint first/senior authors.
J Intensive Care Med. 2019 Nov-Dec;34(11-12):978-984. doi: 10.1177/0885066617724738. Epub 2017 Aug 22.
The REVIVE randomized controlled trial (RCT) investigated the effectiveness of an individually tailored (personalized) exercise program for patients discharged from hospital after critical illness. By including qualitative methods, we aimed to explore patients' perceptions of engaging in the exercise program.
Patients were recruited from general intensive care units in 6 hospitals in Northern Ireland. Patients allocated to the exercise intervention group were invited to participate in this qualitative study. Independent semistructured interviews were conducted at 6 months after randomization. Interviews were audio-recorded, transcribed, and content analysis used to explore themes arising from the data.
Of 30 patients allocated to the exercise group, 21 completed the interviews. Patients provided insight into the physical and mental sequelae they experienced following critical illness. There was a strong sense of patients' need for the exercise program and its importance for their recovery following discharge home. Key facilitators of the intervention included supervision, tailoring of the exercises to personal needs, and the exercise manual. Barriers included poor mental health, existing physical limitations, and lack of motivation. Patients' views of outcome measures in the REVIVE RCT varied. Many patients were unsure about what would be the best way of measuring how the program affected their health.
This qualitative study adds an important perspective on patients' attitude to an exercise intervention following recovery from critical illness, and provides insight into the potential facilitators and barriers to delivery of the program and how programs should be evolved for future trials.
REVIVE 随机对照试验（RCT）研究了个体化量身定制（个性化）运动方案对重症后出院患者的有效性。通过纳入定性方法，我们旨在探讨患者对参与运动方案的看法。
患者从北爱尔兰 6 家医院的普通重症监护病房招募。将随机分配到运动干预组的患者邀请参加这项定性研究。在随机分组后 6 个月进行独立的半结构式访谈。对访谈进行录音、转录，并使用内容分析法探讨数据中出现的主题。
在分配到运动组的 30 名患者中，有 21 名完成了访谈。患者提供了他们在重症后经历的身体和心理后遗症的深刻见解。患者强烈需要运动方案，并且认为该方案对他们出院后的恢复非常重要。该干预的关键促进因素包括监督、根据个人需求定制运动以及运动手册。障碍包括心理健康不佳、现有身体限制和缺乏动力。患者对 REVIVE RCT 中结局测量的看法各不相同。许多患者不确定衡量方案如何影响他们健康的最佳方法是什么。
这项定性研究为患者对重症后康复的运动干预的态度提供了一个重要的视角，并深入了解了方案实施的潜在促进因素和障碍，以及未来试验中应如何改进方案。
