The impact of early physical mobilisation for the management and prevention of intensive care unit delirium: A qualitative study exploring patients' perspectives.

Background: The intensive care unit (ICU) may be described as a 'deliriogenic' environment. Critically ill patients diagnosed with delirium are at increased risk of long-term cognitive impairment and hospital mortality. Best practice guidelines recommend early mobilisation interventions to manage and prevent delirium in ICUs. However, evidence evaluating the impact and role of early mobilisation upon delirium in ICUs from the patient perspective is lacking. The aim of this study was to understand the experience of early mobilisation from the perspective of patients diagnosed with delirium in the ICU. Methods: This qualitative study adopted a phenomenological approach. One focus group including three participants and seven semi-structured one-to-one interviews were conducted with patients previously diagnosed with delirium in the ICU. Data were analysed using Braun and Clarke's thematic analysis. Face validity of findings was reviewed by a public representative on the research team. Results: Six main themes were identified: (1). The vivid reality and isolation of delirium, (2). Loss of control, (3). Delirium as a barrier to mobilisation, (4). The role of different methods of mobilisation (5). Facilitating mobilisation and recovery of self, and (6). Grounded back into reality. Conclusion: This qualitative study demonstrated the impact and role of mobilisation interventions going beyond the patients' physical recovery from critical illness. These findings support current best practice recommendations for the implementation of early mobilisation interventions in ICUs.