A qualitative exploration of perceived barriers, facilitators and preferences of early mobilisation after aneurysmal subarachnoid haemorrhage.

Abstract

To determine the barriers, enablers and preferences for engagement in early mobilisation from the perspective of aneurysmal subarachnoid haemorrhage (aSAH) survivors in acute and intensive care settings. A descriptive qualitative study using semi-structured interviews was conducted, audio recorded and transcribed. Thematic analysis was conducted to identify participant's preferences and perceived barriers and enablers to participation in early mobilisation using the Capability, Opportunity and Motivation - Behaviour (COM-B) model as a guiding framework. Thirteen aSAH survivors were interviewed; mean (SD) age was 53 (12) years, 70% were females. Enablers to mobilisation included mobility independence, knowledge of exercise benefits, self-confidence, self-motivation to recover, staff encouragement, toileting, staff and equipment availability and family visits. The key barriers identified were fatigue and headache, difficulty processing events, lack of information, hospital environment constraints, medical monitoring requirements, feeling conscious of other patients and concerns regarding potential risks. Four preference themes were identified which included increased opportunities to exercise, desire for information, social connections and adjunct therapies. This in-depth exploration has identified patient preferences, barriers and enablers that influence participation in early mobilisation. Findings will inform the design of early mobilisation programs that better meet the needs of patients following aSAH.