Organization of rehabilitation care in Portuguese intensive care units

ABSTRACT Objective: To describe the different rehabilitation care models in practice in Portuguese adult intensive care units. Methods: A simple observational (cross-sectional) study was conducted through an online survey sent to the head nurses or individuals responsible for the 58 adult intensive care units that are part of the database of the Sociedade Portuguesa de Cuidados Intensivos. Results: We identified three models of organization of rehabilitation care: care provided by the staff of the intensive care unit (22.9%), care provided by specialized external teams (25.0%), and a mixture of the previous models, combining the two situations (52.1%). In the first model, the care was provided mainly by nurses with specialization in rehabilitation and, in the second model, the care was provided by physiotherapists. No significant differences were found between the models regarding the availability of care, in hours/day or days/week (p = 0.268 and 0.994, respectively), or results such as length of hospital stay in intensive care, ventilation time, or mortality rate in the unit (p = 0.418, 0.923, and 0.240, respectively). Conclusion: The organization of rehabilitation care in Portuguese intensive care units is unique and heterogeneous. Despite different care organization models, the availability of hours of care is similar, as are the overall results observed in patients.

摘要
研究目的：旨在描述葡萄牙成人重症监护病房（Intensive Care Unit, ICU）现行的各类康复护理模式。
研究方法：本研究为单纯观察性（横断面）研究，通过线上问卷向葡萄牙重症护理学会（Sociedade Portuguesa de Cuidados Intensivos）数据库收录的58家成人重症监护病房的护士长或相关负责人开展调研。
研究结果：本研究共识别出三类康复护理组织模式：由重症监护病房自身医护团队提供的护理服务（占比22.9%）、由专业化外部团队提供的护理服务（占比25.0%），以及融合前两种模式的混合护理模式（占比52.1%）。其中第一类模式的护理服务主要由具备康复专科资质的护士提供，第二类模式则由物理治疗师提供。三类模式在每日/每周护理时长的可及性（分别对应p=0.268与p=0.994），以及重症监护住院时长、机械通气时长、病房病死率等临床结局指标（分别对应p=0.418、0.923与0.240）上均未发现显著统计学差异。
研究结论：葡萄牙重症监护病房的康复护理组织模式兼具独特性与异质性。尽管采用了不同的护理组织模式，其护理时长可及性及患者的整体临床结局均无明显差异。