Patient and carer experience of hospital-based rehabilitation from intensive care to hospital discharge: mixed methods process evaluation of the RECOVER randomised clinical trial

Ramsay, Pam; Huby, Guro; Merriweather, Judith; Salisbury, Lisa; Rattray, Janice; Griffith, David; Walsh, Timothy

Abstract

Objectives To explore and compare patient/carer experiences of rehabilitation in the intervention and usual care arms of the RECOVER trial (ISRCTN09412438); a randomised controlled trial of a complex intervention of post-intensive care unit (ICU) acute hospital-based rehabilitation following critical illness.

Design Mixed methods process evaluation including comparison of patients' and carers' experience of usual care versus the complex intervention. We integrated and compared quantitative data from a patient experience questionnaire (PEQ) with qualitative data from focus groups with patients and carers.

Setting Two university-affiliated hospitals in Scotland.

Participants 240 patients discharged from ICU who required ≥48 hours of mechanical ventilation were randomised into the trial (120 per trial arm). Exclusion criteria comprised: primary neurologic diagnosis, palliative care, current/planned home ventilation and age 3 months postrandomisation.

Interventions A complex intervention of post-ICU acute hospital rehabilitation, comprising enhanced physiotherapy, nutritional care and information provision, case-managed by dedicated rehabilitation assistants (RAs) working within existing ward-based clinical teams, delivered between ICU discharge and hospital discharge. Comparator was usual care.

Outcome measures A novel PEQ capturing patient-reported aspects of quality care.

Results The PEQ revealed statistically significant between-group differences across 4 key intervention components: physiotherapy (p=0.039), nutritional care (p=0.038), case management (p=0.045) and information provision (p

Citation

Ramsay, P., Huby, G., Merriweather, J., Salisbury, L., Rattray, J., Griffith, D., & Walsh, T. (2016). Patient and carer experience of hospital-based rehabilitation from intensive care to hospital discharge: mixed methods process evaluation of the RECOVER randomised clinical trial. BMJ Open, 6(8), Article e012041. https://doi.org/10.1136/bmjopen-2016-012041

• Journal Article Type: Article
• Acceptance Date: Jun 16, 2016
• Online Publication Date: Aug 1, 2016
• Publication Date: 2016-07
• Deposit Date: Sep 20, 2016
• Publicly Available Date: Apr 25, 2019
• Journal: BMJ Open
• Print ISSN: 2044-6055
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: 8
• Article Number: e012041
• DOI: https://doi.org/10.1136/bmjopen-2016-012041
• Keywords: Rehabilitation, hospital care, intensive care, RECOVER, case management,
• Public URL: http://researchrepository.napier.ac.uk/Output/375742