Early mobility and family partnerships in the intensive care unit: A scoping review of reviews

Nurs Crit Care. 2024 May;29(3):597-613. doi: 10.1111/nicc.12979. Epub 2023 Sep 25.

Abstract

Background: Critical illness significantly impacts the well-being of patients and families. Previous studies show that family members are willing to participate in patient care. Involving families in early mobility interventions may contribute to improved recovery and positive outcomes for patients and families.

Aim: In this scoping review, we investigated early mobility interventions for critically ill patients evaluated in randomized controlled trials and the extent to which family engagement in those interventions are reported in the literature.

Study design: In this scoping review of reviews, EMBASE, CINAHL, PubMed and Cochrane Central databases were searched in October 2019 and updated in February 2022. Systematic reviews were included and assessed using A MeaSurement Tool to Assess Systematic Reviews (AMSTAR) 2. Data were synthesized using a narrative approach. PRISMA-ScR guidelines were adhered to for reporting.

Results: Thirty-three reviews were included which described a range of early mobility interventions for critically ill patients; none explicitly mentioned family engagement. Almost half of the reviews were of low or critically low quality. Insufficient detail of early mobility interventions prompted information to be extracted from the primary studies.

Conclusions: There are a range of early mobility interventions for critically ill patients but few involve families. Given the positive outcomes of family participation, and family willingness to participate in care, there is a need to explore the feasibility and acceptability of family participation in early mobility interventions.

Relevance to clinical practice: Family engagement in early mobility interventions for critically ill patients should be encouraged and supported. How to best support family members and clinicians in enacting family involvement in early mobility requires further investigation.

Keywords: critical care; family partnership; intensive care; mobility; scoping review.

Publication types

  • Review

MeSH terms

  • Critical Care / psychology
  • Critical Illness*
  • Early Ambulation*
  • Family* / psychology
  • Humans
  • Intensive Care Units*