Understanding the needs and perceptions of early mobilization for critically ill patients: A systematic review of qualitative studies

Objective: To synthesize qualitative research findings on intensive care patients' perceptions of early mobilization to identify their needs and understand the factors influencing their participation. Methods: Studies that explored patients' experiences of early mobilization within the intensive care unit were searched. A comprehensive search was conducted by searching five English and four Chinese electronic databases. The systematic review was carried out in line with the Joanna Briggs Institute methodology for systematic reviews of qualitative evidence, and also the thematic synthesis method was used to analyze the data.Results: A total of eight studies were included. Eight descriptive themes were formed: patients' self-determination needs, patients' relationship needs, patients' needs for competency and self-control, perceived benefits of physical function, increased self-confidence, negative emotions, unpleasant experiences and suffering, negative attitudes, and three analytical themes related to patients' perceptions of early mobilization in the intensive care unit were identified, including patients' needs during early mobilization, facilitators prompting patients' actions in early mobilization, and obstacles influencing patients' actions in early mobilization. Conclusion: Many factors influence the critically ill patients' actions in early mobilization. A better understanding of patients' potential needs and psychological responses to early mobilization in the intensive care unit may help health professionals develop strategies to promote the quality of early mobilization.Implications for clinical practice: Recognizing and developing the strategies to meet the needs are essential to improve the patients' actions in early mobilization in the intensive care unit.. Therefore, understanding the relationship between needs support and patients' actions in early mobilization can help them provider better support services during mobilization.