Ready, Willing But Not Enabled: Families’ Perspectives on Participation in Early Mobilisation in ICU
Abstract
Introduction: Family participation in healthcare improves care quality and patient health outcomes (Price et al., 2022). It redirects family psychological distress into an active participatory role, humanising the patient's illness and recovery experience (Van Delft et al., 2021). Studies have focused on family participation in medical rounds, nutritional care, delirium assessment, and physical care of ICU patients (Goldfarb et al., 2023). Early mobilisation is advised for restoring functional ability, but patient-related issues, staffing shortages, and budget limitations may prevent its use in ICU settings (Bakhru et al., 2016). Current approaches to facilitate early mobility can be time-consuming, increase nurse burden, and be costly (Dirkes & Kozlowski, 2019). Despite these challenges, families can significantly influence the early mobilisation of patients in ICU. However, limited research explored families' perspectives on participation in these settings
Objectives: To explore families’ perspectives on their participation in the early mobilisation of adult patients in the ICU.
Methods: Utilising a multimethod qualitative approach, data were collected in three adult ICUs in a tertiary hospital in Saudi Arabia. Data collection included interviews (10 families and 16 clinicians), document analysis, and observation. Data analysis was conducted via content analysis approach.
Findings: The study revealed families are willing and want to participate in the early mobilisation of adult ICU patients. However, several barriers hinder their participation. These include a lack of specific skills and knowledge related to mobilisation, feelings of intimidation, and being overwhelmed by the ICU setting. Although family members expressed willingness to “participate and help with that, and I desire to do that," they were reluctant to offer support themselves, relying on explicit invitations from clinicians to participate in mobilisation activities. Despite families’ willingness, some clinicians were reluctant to engage them in the mobilisation process, expressing concern about patient safety and potential disruptions to workflow.
Conclusion: Families are keen to support early mobilisation in the ICU, but practical and emotional barriers, as well as clinicians' reluctance to engage, hinder participation. Addressing these barriers through targeted education, increased support, and active clinician involvement could improve patient outcomes and foster family-centred ICU practices.
Notes
References:
Bakhru, R. N., McWilliams, D. J., Wiebe, D. J., Spuhler, V. J., & Schweickert, W. D. (2016). Intensive Care Unit Structure Variation and Implications for Early Mobilization Practices. An International Survey. Annals of the American Thoracic Society, 13(9), 1527-1537. https://doi.org/10.1513/AnnalsATS.201601-078OC
Dirkes, S. M., & Kozlowski, C. (2019). Early Mobility in the Intensive Care Unit: Evidence, Barriers, and Future Directions. Critical Care Nurse, 39(3), 33-42. https://doi.org/10.4037/ccn2019654
Goldfarb, M., Alviar, C., Berg, D., Katz, J., Lee, R., Liu, S., Maitz, T., Padkins, M., Prasad, R., Roswell, R., Shah, K., Thompson, A., van Diepen, S., Zakaria, S., & Morrow, D. (2023). Family Engagement in the Adult Cardiac Intensive Care Unit: A Survey of Family Engagement Practices in the Cardiac Critical Care Trials Network. Circulation: Cardiovascular Quality and Outcomes, 16(9), e010084. https://doi.org/10.1161/CIRCOUTCOMES.123.010084
Price, A. M., McAndrew, N. S., Thaqi, Q., Kirk, M., Brysiewicz, P., Eggenberger, S., & Naef, R. (2022). Factors influencing critical care nurses' family engagement practices: An international perspective. Nursing in Critical Care, n/a(n/a). https://doi.org/10.1111/nicc.12824
Van Delft, L. M. M., Valkenet, K., Slooter, A. J. C., & Veenhof, C. (2021). Family participation in physiotherapy-related tasks of critically ill patients: A mixed methods systematic review. Journal of Critical Care, 62, 49-57. https://doi.org/10.1016/j.jcrc.2020.11.014
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Mixed/Multi Method Research
Keywords:
Health Equity or Social Determinants of Health, Interprofessional, Interdisciplinary, Intensive Care Unit, Family Participation
Recommended Citation
Alahmari, Turkiah Saeed; Drury, Peta; Rihari-Thomas, John; Arabi, Yaseen; and Everett, Bronwyn, "Ready, Willing But Not Enabled: Families’ Perspectives on Participation in Early Mobilisation in ICU" (2025). International Nursing Research Congress (INRC). 124.
https://www.sigmarepository.org/inrc/2025/posters_2025/124
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Ready, Willing But Not Enabled: Families’ Perspectives on Participation in Early Mobilisation in ICU
Seattle, Washington, USA
Introduction: Family participation in healthcare improves care quality and patient health outcomes (Price et al., 2022). It redirects family psychological distress into an active participatory role, humanising the patient's illness and recovery experience (Van Delft et al., 2021). Studies have focused on family participation in medical rounds, nutritional care, delirium assessment, and physical care of ICU patients (Goldfarb et al., 2023). Early mobilisation is advised for restoring functional ability, but patient-related issues, staffing shortages, and budget limitations may prevent its use in ICU settings (Bakhru et al., 2016). Current approaches to facilitate early mobility can be time-consuming, increase nurse burden, and be costly (Dirkes & Kozlowski, 2019). Despite these challenges, families can significantly influence the early mobilisation of patients in ICU. However, limited research explored families' perspectives on participation in these settings
Objectives: To explore families’ perspectives on their participation in the early mobilisation of adult patients in the ICU.
Methods: Utilising a multimethod qualitative approach, data were collected in three adult ICUs in a tertiary hospital in Saudi Arabia. Data collection included interviews (10 families and 16 clinicians), document analysis, and observation. Data analysis was conducted via content analysis approach.
Findings: The study revealed families are willing and want to participate in the early mobilisation of adult ICU patients. However, several barriers hinder their participation. These include a lack of specific skills and knowledge related to mobilisation, feelings of intimidation, and being overwhelmed by the ICU setting. Although family members expressed willingness to “participate and help with that, and I desire to do that," they were reluctant to offer support themselves, relying on explicit invitations from clinicians to participate in mobilisation activities. Despite families’ willingness, some clinicians were reluctant to engage them in the mobilisation process, expressing concern about patient safety and potential disruptions to workflow.
Conclusion: Families are keen to support early mobilisation in the ICU, but practical and emotional barriers, as well as clinicians' reluctance to engage, hinder participation. Addressing these barriers through targeted education, increased support, and active clinician involvement could improve patient outcomes and foster family-centred ICU practices.
Description
Family participation in healthcare improves care quality and patient health outcomes. However, barriers like lack of skills, intimidation, and workload concerns hinder participation. A study in Saudi Arabia found that families are willing to support early mobilisation, but barriers like lack of knowledge and fear of disruptions hinder their involvement. Addressing these barriers through education, support, and active participation could lead to improved patient outcomes.