IMPACT-ICU: IMPROVED UPTAKE AND UNDERSTANDING OF RESEARCH IN THE INTENSIVE CARE UNIT
| dc.contributor.advisor | Kho, Michelle E | |
| dc.contributor.advisor | Turkstra, Lyn S | |
| dc.contributor.advisor | Bosch, Jackie | |
| dc.contributor.author | O'Grady, Heather K | |
| dc.contributor.department | Rehabilitation Science | en_US |
| dc.date.accessioned | 2023-09-27T17:35:14Z | |
| dc.date.available | 2023-09-27T17:35:14Z | |
| dc.date.issued | 2023-11 | |
| dc.description.abstract | Physical rehabilitation (PR) started in the intensive care unit (ICU) may mitigate the physical functional impairments often experienced by survivors. The field of ICU-based PR research is growing; however, trials have had mixed results. While conducting this research, we must consider that deciding whether to participate in clinical research can be stressful for patients and families. This PhD thesis, consisting of four manuscripts, addressed two distinct aims. One explanation for the mixed results in ICU-based trials of PR may be differences across studies in the characteristics of comparator groups. Thus, the first aim was to advance our understanding of comparator groups in this context. The first manuscript (Chapter 2) was a scoping review of the type, content and reporting of comparator groups in 125 ICU-based trials of PR. The second manuscript (Chapter 3) was a secondary analysis of usual care PR received by 30 patients (262 study days) in the comparator group of an ICU-based pilot randomized trial of early in-bed cycling. Together, these manuscripts facilitate the understanding and uptake of current evidence describing comparator groups in ICU-based trials of PR. Traditional research consent forms are long and scientific, particularly for complex interventions and trials, making them challenging to explain and understand in stressful environments such as the ICU. The second aim of this PhD thesis was to support communication for patients, families, and research coordinators during informed consent for a complex ICU-based trial. The first manuscript (Chapter 4) was a protocol for a mixed methods study to co-design and pilot-test a consent infographic. The second manuscript (Chapter 5) reported results of a six-month multi-centre pilot and feasibility study implementing the infographic. Together, these manuscripts provide a foundation for the future evaluation of a consent infographic, which may ease uptake and understanding of trial information during consent discussions. | en_US |
| dc.description.degree | Doctor of Philosophy (PhD) | en_US |
| dc.description.degreetype | Dissertation | en_US |
| dc.description.layabstract | Individuals admitted to the intensive care unit (ICU) may experience a decrease in their physical function for several years after leaving the hospital. To improve outcomes for individuals who survive critical illness, research in physical rehabilitation is rapidly growing. However, recent studies have had mixed results. One explanation for these mixed results may be that similar interventions are assessed against different comparator groups. Thus, the first two papers of this PhD thesis aimed to develop an understanding of comparator groups in studies of physical rehabilitation conducted in the ICU. In addition, with this research occurring during a time of heightened stress, it is important that we consider ways to improve the experience of being asked to participate in research for patients and their families. The second two papers of this thesis describe the design and pilot testing of an infographic to support communication during research consent. | en_US |
| dc.identifier.uri | http://hdl.handle.net/11375/28946 | |
| dc.language.iso | en | en_US |
| dc.title | IMPACT-ICU: IMPROVED UPTAKE AND UNDERSTANDING OF RESEARCH IN THE INTENSIVE CARE UNIT | en_US |
| dc.type | Thesis | en_US |