Patient and clinician acceptability of an integrated physiotherapy and nutrition intervention after ICU discharge: a qualitative exploration of a pre-specified co-primary feasibility outcome of the PHOENIX trial.
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Where this comes from
- Record sourced from PubMed, PMID 42495105.
- Also identified by DOI 10.1016/j.eclinm.2026.104085 and PMC identifier 13393731.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Recovery after critical illness is complex and multi-faceted. There are widespread variations of rehabilitation interventions delivered when patients step-down onto the ward. The aim of the study was to evaluate the acceptability of a structured, individualised physiotherapy and nutritional intervention delivered to patients following discharge from intensive care, from the perspectives of both patients and healthcare professionals. This qualitative study was embedded within a two-centre randomised controlled feasibility trial of an enhanced physiotherapy and optimised nutrition intervention delivered in the ward setting after ICU discharge. It evaluated acceptability, a pre-specified co-primary feasibility outcome of the trial. Between May 2024 and January 2025, patients stepped down from ICU to ward based care, alongside healthcare professionals involved in or affected by intervention delivery were invited to participate. Semi-structured interviews were conducted, audio recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Themes were then mapped across the constructs of the Theoretical Framework of Acceptability (TFA). The trial was prospectively registered (ClinicalTrials.govNCT06159868). Eleven patients and eight healthcare professionals participated in interviews. Three overarching themes were identified. <i>'Increased awareness of combined nutrition and physical recovery'</i> focused on recognition of the complementary nature of nutritional intake and rehabilitation progress. The second theme-'<i>Accurate nutritional goals to enable focused rehab'</i> emphasised the need for individualised nutritional prescriptions to underpin rehabilitation. The final theme-<i>'Supporting patient recovery to restore independence and purpose'</i> highlighted the need for a holistic recovery following critical illness. These themes were mapped to six of the seven TFA constructs. Both patients and staff perceived the integrated physiotherapy and nutrition delivered in the ward setting as acceptable. This project is funded by the National Institute for Health and Care Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR205370).