Clinician and patient perspectives on the barriers and facilitators to physical rehabilitation in intensive care: a qualitative interview study

This qualitative study used semi-structured interviews and thematic framework analysis across four ICUs at three London hospital sites. Interviews were conducted with 11 former ICU patients, 3 family members, and 16 clinicians including doctors, nurses, and therapists. Six barrier themes were identified: safety and physiological concerns, patient participation and engagement, clinician experience and knowledge, teamwork, equipment and environment, and perceived risks and benefits of rehabilitation. Safety concerns included risks of dislodging lines, physiological instability, and dependence on organ support. Clinician-perceived barriers included differences of opinion over patient readiness, anxiety about loss of physiological control, and knowledge gaps. The overarching facilitator was shifting from a multidisciplinary to an interdisciplinary working model where all team members share accountability for patient-centred rehabilitation.