Barriers to early mobilization in adult intensive care units: an analysis of multidisciplinary perceptions
DOI:
https://doi.org/10.55892/jrg.v9i20.3010Keywords:
early mobilization, intensive care unit, hospital physical therapy service, comprehensive health care, multidisciplinary healthcare teamAbstract
Introduction: Despite technological advances in intensive care, patient immobility remains frequent in intensive care units (ICUs), negatively affecting the functional recovery of critically ill patients. Early mobilization (EM) is recognized as a safe and effective strategy; however, its implementation is still limited by multiple barriers within the care context. Objective: To analyze the perceptions of the multidisciplinary team regarding the barriers that hinder the implementation of early mobilization in adult ICUs. Methods: This was a cross-sectional, descriptive, and quantitative study conducted with professionals working in adult ICUs of a public hospital in Teresina, Piauí, Brazil. Professionals at secondary, technical, and higher education levels were included. Data were collected using an online questionnaire structured into three domains: sociodemographic data, knowledge about EM, and identification of barriers. The internal consistency of the instrument was assessed using Cronbach’s alpha (α). Statistical analysis was performed using SPSS, applying nonparametric tests, with a significance level set at p < 0.05. Results: The instrument demonstrated excellent internal consistency (α = 0.93). The sample consisted of 125 professionals who recognized EM as safe, beneficial, and effective. Nevertheless, 85% of participants reported barriers to its implementation. Structural limitations, such as lack of equipment and staff shortages, were prominent, as well as process-related barriers, including communication failures and the absence of daily patient screening; clinical barriers, particularly sedation and hemodynamic instability; and cultural barriers, such as lack of encouragement, institutional support, and interprofessional conflicts, with significant associations among professional categories. Conclusion: Despite the high level of knowledge and recognition of the benefits of early mobilization, its implementation remains limited due to the presence of multifactorial barriers of structural, procedural, clinical, and cultural nature.
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