Pushing and guiding me towards home; patients’ perspectives of person-centred physiotherapy in Intensive Care

Person-centred physiotherapy in Intensive Care Units (ICU) supports patients’ early rehabilitation. Yet little is known about the activity required to enable person-centred physiotherapy in this setting. This study explores the experiences and interpretations of people who received physiotherapy. A qualitative study using Interpretative Phenomenological Analysis was conducted. Eight participants, recruited from a Ventilation Unit in Northwest England, were interviewed. Data were transcribed and managed using NVivo 12 software. Participants described being “pushed” and guided by physiotherapists. The “emotional” pushing through motivation and encouragement, and “physical” pushing through setting goals, were perceived as person-centred activities, despite physiotherapists initially directing them. Other important aspects of individualised care were feeling safe and understanding how their body had changed. Patients viewed physiotherapist led rehabilitation in ICU as being person-centred, despite the lack of collaboration during early recovery, because they were too ill. Models of person-centred physiotherapy could be made more applicable to clinical settings by fully integrating the patient perspective. Patients perceive physiotherapy in Intensive Care Units (ICU) as being person-centred even when they were not involved during early recovery due to being too ill.To be person-centred in ICU, physiotherapists must find the right balance when pushing rehabilitation, foster a sense of safety, explain changes in body, and make logical goals in the patients’ journey towards recovery.For novice physiotherapists working in ICU navigating the balance, between pushing patients too much or too little, is likely to be challenging and should be more fully incorporated into educational curricula. Patients perceive physiotherapy in Intensive Care Units (ICU) as being person-centred even when they were not involved during early recovery due to being too ill. To be person-centred in ICU, physiotherapists must find the right balance when pushing rehabilitation, foster a sense of safety, explain changes in body, and make logical goals in the patients’ journey towards recovery. For novice physiotherapists working in ICU navigating the balance, between pushing patients too much or too little, is likely to be challenging and should be more fully incorporated into educational curricula.