Barreiras percebidas e contraindicações para mobilização precoce: conhecimento do profissional fisioterapeuta na Unidade de Terapia Intensiva

Abstract

Introduction: With the technological and scientific advancement of advanced life support and the consequent improvement in health care, critical patients are kept for a prolonged period in the intensive care unit (ICU) and their mobilization needs to be included in the care process . Despite the potential benefits of early mobilization, effective implementation is not widely performed in the ICU. Its implementation goes through several difficulties and limitations that may be associated with the presence of some barriers. Objectives: To assess the knowledge of professional physiotherapists about the barriers and contraindications of early mobilization (EM) in the intensive care unit. Material and Methods: A descriptive cross-sectional study was carried out involving physiotherapists who work in the ICU. They answered a questionnaire containing questions related to their professional profile, work process and structure, and knowledge about early mobilization. Mann-Whitney and Kruskal-Wallis tests with Dunn post-hoc were performed to compare categorical dependent variables with quantitative independent variables. The chi-square analysis of independence examines the existence of an association between the dependent variables and the categorical independent variables. Binary and multinomial logistic regression models were obtained to predict the dependent variables. Analyzes were performed using the Statistical Package for Social Sciences software (IBM, version 24) and results that showed p<0.05 were admitted to be statistically significant. Results: A total of 227 physiotherapists participated in the study, most of them female (n=154, 67.8%), with a mean age of 33.5 ± 6.8 years and a mean time working in the ICU of 7.1 ±6 years. Regarding the barriers for EM, it was observed that 11.5% of the physiotherapists did not hit any barriers, 69.6% hit 1 to 4 barriers and 19% hit 5 or more barriers. Regarding the contraindication, 21.6% of the physiotherapists answered none or one contraindication for EM and 78.4% answered all the contraindications correctly. Conclusion: Brazilian physiotherapists trained in private institutions, with a master's degree, with good communication between the team, performing early mobilization twice a day, at least, are able to better recognize the barriers and contraindications for performing early mobilization. Understanding these factors is essential for strategies to be adopted by both professionals and hospital managers so that patients are assisted by increasingly qualified professionals.