Key result
Patients and care partners define early mobility within six hours post-surgery, identifying brain fuzziness as the top barrier.
Why the study?
Post-intensive care syndrome is prevalent after cardiac surgery and early mobility interventions are not optimally integrated into cardiac surgery ICU care, partly due to lack of engagement of people with lived experience.
Engaging patients with lived experience of cardiac surgery ICU care identifies unique patient-centered definitions, barriers, and outcomes for early mobility that can inform the design of future clinical trials.
Answers are grounded in this paper and cite their sources.
Patient co-created mobility definition and barriers may inform cardiac ICU trial design; leaves open effects on outcomes.
Introduction New or worsening cognitive, mental, and/or physical health after a stay in an intensive care unit (ICU) defines post-intensive care syndrome (PICS). PICS is prevalent post-cardiac surgery (CS), and interventions are needed for prevention. Early mobility shows potential to prevent PICS but is not optimally integrated into CSICU clinical care. This may relate to the absence of engagement of people with lived experience (PWLE) in CSICU early mobility research. Methods PWLE of the CSICU were engaged to meet three objectives: 1) co-create a definition of early mobility, 2) identify barriers and facilitators to early mobility, and 3) prioritize outcome and experience measures for use in future intervention research. Engagement occurred through two virtual consultation workshops involving group discussions, consensus building, and prioritization using the nominal group technique. Results Eight patients and two care partners participated. The co-created definition of early mobility was a progression of functional life activities that begins as soon as the patient can participate (typically within six hours post-surgery), where the patient uses their muscle strength intentionally. The top barrier to early mobility was brain “fuzziness/fogginess”. The top facilitator was a “positive attitude”. The top physical outcome was “Do you feel lightheaded/dizzy?”. The top cognitive outcome was “Do you feel fuzzy/foggy”. The top mental outcome was “Are you focusing on the positives in your life right now?”. The top experience measure was “Do you feel your doctors gave you the care and attention you needed?”. Discussion This important contribution of the lived experience with early mobility in the CSICU advances the literature and will empower future research to align with the perspectives and priorities of people undergoing CS. This contribution may advance the integration of early mobility into CSICU clinical care and reduce the prevalence of adverse cognitive, mental, and/or physical health outcomes that are seen in PICS.
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Phillips et al. (2026) studied Post-cardiac surgery intensive care (n=10). Patient engagement workshop for early mobility was evaluated on Co-created definition of early mobility and prioritized barriers, facilitators, and outcomes. Patients and care partners co-created a definition of early mobility as a progression of functional activities starting within six hours post-surgery, prioritizing brain fuzziness as the top barrier.
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