PDF(Pubmed)
Abstract：
BACKGROUND: Early mobility (EM) is vital in the intensive care unit (ICU) to counteract immobility-related effects. A multidisciplinary approach is key, as it requires precise initiation knowledge. However, physicians\' understanding of EM in adult ICU settings remains unexplored. This study was conducted to investigate the knowledge and clinical competency of physicians working in adult ICUs toward EM.
METHODS: This cross-sectional study enrolled 236 physicians to assess their knowledge of EM. A rigorously designed survey comprising 30 questions across the demographic, theoretical, and clinical domains was employed. The criteria for knowledge and competency were aligned with the minimum passing score (70%) stipulated for physician licensure by the medical regulatory authority in Saudi Arabia.
RESULTS: Nearly 40% of the respondents had more than 5 years of experience. One-third of the respondents received theoretical knowledge about EM as part of their residency training, and only 4% of the respondents attended formal courses to enhance their knowledge. Almost all the respondents (95%) stated their awareness of EM benefits and its indications and contraindications and considered it safe to mobilize patients on mechanical ventilators. However, 62.3% of the respondents did not support EM for critically ill patients on mechanical ventilators until weaning. In contrast, 51.7% of respondents advised EM for agitated patients with RASS > 2. Only 113 (47.9%) physicians were competent in determining the suitability of ICU patients for EM. For critically ill patients who should be mobilized, nearly 60% of physicians refused to initiate EM.
CONCLUSIONS: This study underscores insufficient practical knowledge of ICU physicians about EM criteria, which leads to suboptimal decisions, particularly in complex ICU cases. These findings emphasize the need for enhanced training and education of physicians working in adult ICU settings to optimize patient care and outcomes in critical care settings.
METHODS: This cross-sectional study enrolled 236 physicians to assess their knowledge of EM. A rigorously designed survey comprising 30 questions across the demographic, theoretical, and clinical domains was employed. The criteria for knowledge and competency were aligned with the minimum passing score (70%) stipulated for physician licensure by the medical regulatory authority in Saudi Arabia.
RESULTS: Nearly 40% of the respondents had more than 5 years of experience. One-third of the respondents received theoretical knowledge about EM as part of their residency training, and only 4% of the respondents attended formal courses to enhance their knowledge. Almost all the respondents (95%) stated their awareness of EM benefits and its indications and contraindications and considered it safe to mobilize patients on mechanical ventilators. However, 62.3% of the respondents did not support EM for critically ill patients on mechanical ventilators until weaning. In contrast, 51.7% of respondents advised EM for agitated patients with RASS > 2. Only 113 (47.9%) physicians were competent in determining the suitability of ICU patients for EM. For critically ill patients who should be mobilized, nearly 60% of physicians refused to initiate EM.
CONCLUSIONS: This study underscores insufficient practical knowledge of ICU physicians about EM criteria, which leads to suboptimal decisions, particularly in complex ICU cases. These findings emphasize the need for enhanced training and education of physicians working in adult ICU settings to optimize patient care and outcomes in critical care settings.
摘要：
背景：在重症监护病房（ICU）中，早期活动（EM）对于抵消与活动相关的影响至关重要。多学科方法是关键，因为它需要精确的启动知识。然而,医生对成人ICU环境中EM的理解仍有待探索。进行这项研究是为了调查在成人ICU工作的医生对EM的知识和临床能力。
方法：这项横断面研究招募了236名医生，以评估他们对EM的了解。一项严格设计的调查，包括整个人口统计中的30个问题，理论,并采用了临床领域。知识和能力标准与沙特阿拉伯医疗监管机构规定的医师执照最低及格分数（70％）保持一致。
结果：近40％的受访者有超过5年的经验。三分之一的受访者接受了关于EM的理论知识，作为他们的住院医师培训的一部分，只有4%的受访者参加了正式课程以提高他们的知识。几乎所有受访者（95％）都表示他们对EM的益处及其适应症和禁忌症的认识，并认为动员患者使用机械呼吸机是安全的。然而,62.3％的受访者在撤机之前不支持机械呼吸机治疗重症患者的EM。相比之下,51.7％的受访者建议EM用于RASS>2的躁动患者。只有113名（47.9％）医生能够确定ICU患者是否适合EM。对于应该动员的危重病人,近60%的医生拒绝启动EM。
结论：本研究强调ICU医师对EM标准的实践知识不足，这导致了次优的决策，特别是在复杂的ICU病例中。这些发现强调需要加强在成人ICU环境中工作的医生的培训和教育，以优化重症监护环境中的患者护理和结果。
方法：这项横断面研究招募了236名医生，以评估他们对EM的了解。一项严格设计的调查，包括整个人口统计中的30个问题，理论,并采用了临床领域。知识和能力标准与沙特阿拉伯医疗监管机构规定的医师执照最低及格分数（70％）保持一致。
结果：近40％的受访者有超过5年的经验。三分之一的受访者接受了关于EM的理论知识，作为他们的住院医师培训的一部分，只有4%的受访者参加了正式课程以提高他们的知识。几乎所有受访者（95％）都表示他们对EM的益处及其适应症和禁忌症的认识，并认为动员患者使用机械呼吸机是安全的。然而,62.3％的受访者在撤机之前不支持机械呼吸机治疗重症患者的EM。相比之下,51.7％的受访者建议EM用于RASS>2的躁动患者。只有113名（47.9％）医生能够确定ICU患者是否适合EM。对于应该动员的危重病人,近60%的医生拒绝启动EM。
结论：本研究强调ICU医师对EM标准的实践知识不足，这导致了次优的决策，特别是在复杂的ICU病例中。这些发现强调需要加强在成人ICU环境中工作的医生的培训和教育，以优化重症监护环境中的患者护理和结果。
