Factors Influencing Rehabilitation Motivation in Cardiovascular Surgery Patients in Intensive Care Settings: an Exploratory Study

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Cardiovascular surgery requiring postoperative intensive care (n=82). Intervention: Living with family and higher preoperative rehabilitation motivation vs. Living alone and lower preoperative rehabilitation motivation. Primary outcome: Non-decline in rehabilitation motivation (VAS score) from postoperative sitting up to walking initiation (OR 5.01, 95% CI 1.203-20.849, p=0.047).

詩織 吉田; Konosuke Sasaki; Ayumi Otani; Chiemi Yasamaki; Fumiko Sato

doi:10.11153/jaccn.22.0_127

March 31, 2026Journal of Japan Academy of Critical Care NursingOpen Access

Factors Influencing Rehabilitation Motivation in Cardiovascular Surgery Patients in Intensive Care Settings: an Exploratory Study

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Key result

Living with family is linked to ~5-fold higher odds of maintaining postoperative rehabilitation motivation.

OR 5.01
95% CI 1.203-20.849
P=0.047
n=82

Key Points

To identify when rehabilitation motivation changes across recovery stages and explore factors associated with motivation from sitting up to walking after cardiovascular surgery in an intensive care setting.
Conducted a self-administered questionnaire survey among patients undergoing cardiovascular surgery with postoperative intensive care unit management at a single university hospital between April 2023 and July 2024.
Analyzed 82 participants (out of 90 enrolled) using visual analogue scales (0 to 100) to measure rehabilitation motivation across four time points: preoperative, sitting up, standing, and walking.
Assessed factors influencing motivation maintenance or improvement from sitting up to walking using univariate tests and multivariate logistic regression analysis.
Among 82 analyzed patients (median age 70.5 years, 58.5% male), median rehabilitation motivation scores were 90.6 preoperatively, 87.1 at sitting up, 86.3 at standing, and 91.5 at walking.
Rehabilitation motivation significantly increased from the sitting-up stage to the walking stage across the overall cohort (p=0.03).
Multivariate logistic regression revealed that higher preoperative rehabilitation motivation and living with family were significant factors associated with maintained or improved motivation from sitting up to walking.

Study Design

Type

Observational (n=82)

Multicenter

No

Structured PICO

P

Population

82 patients (median age 70.5 years, 41.5% female) undergoing cardiovascular surgery with postoperative ICU management and cardiac rehabilitation at a university hospital in Japan, followed from preoperative assessment through postoperative walking completion.

O

Outcome

Rehabilitation motivation measured by a self-administered Visual Analogue Scale (VAS, range 0-100) across four timepoints (preoperative, sitting up, standing, and ambulation initiation), and factors associated with non-decline in rehabilitation motivation from sitting up to ambulation.patient reported

Main Result

Odds Ratio: 5.01 (95% CI 1.203–20.849)

Absolute Event Rate: 92.1% vs 73.7%

p-value: p=0.047

In cardiovascular surgery patients admitted to the ICU, rehabilitation motivation significantly improves between sitting up and ambulation, driven primarily by higher preoperative motivation and living with family.

Limitations

Single-center study limiting generalizability across institutions with different patient demographics
Potential recall bias because postoperative questionnaires for ICU mobilization stages were completed retrospectively in the general ward due to COVID-19 restrictions
Insufficient reliability and validity in Japan for some items of the translated Intensive Care Experience Questionnaire (ICEQ)
Operational definition of motivation decline/non-decline was based solely on VAS change from sitting to walking, potentially misclassifying patients with persistently low motivation
Wide 95% confidence interval for the living with family variable in multivariate logistic regression indicating data variability and need for a larger sample size
Single-center study limiting generalizability
Recall bias due to retrospective questionnaire completion in the general ward rather than the ICU because of COVID-19 restrictions
Insufficient reliability and validity of the Japanese version of the Intensive Care Experience Questionnaire (ICEQ)
Operational definition of decline/non-decline groups based solely on VAS change from sitting up to ambulation may misclassify patients with persistently low motivation
Wide 95% confidence interval for the living with family variable indicating data variability and need for a larger sample size

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Implication

May aid identification of patients at risk for declining postoperative motivation; hypothesis-generating and should not yet change practice.

Abstract

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Cite This Study

吉田 et al. (2026) conducted an observational in Cardiovascular surgery requiring postoperative intensive care (n=82). Living with family and higher preoperative rehabilitation motivation vs. Living alone and lower preoperative rehabilitation motivation was evaluated on Non-decline in rehabilitation motivation (VAS score) from postoperative sitting up to walking initiation (OR 5.01, 95% CI 1.203-20.849, p=0.047). Living with family and preoperative motivation predicted maintained postoperative rehabilitation motivation from sitting to walking.

synapsesocial.com/papers/6af3478ebdf2424ebd04f8b1 https://doi.org/10.11153/jaccn.22.0_127

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Factors Influencing Rehabilitation Motivation in Cardiovascular Surgery Patients in Intensive Care Settings: an Exploratory Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Factors Influencing Rehabilitation Motivation in Cardiovascular Surgery Patients in Intensive Care Settings: an Exploratory Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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