Patient and family experiences of early cognitive rehabilitation in critical illness: A qualitative study protocol

Background: Physical, mental and cognitive impairments are known severe adverse outcomes in critically ill patients who have beenadmitted to an intensive care unit (ICU). Early rehabilitation interventions such as lighter sedation and increased mobilization have improved patient outcomes, but evidence for early cognitive rehabilitation is sparse. Aim: The study aims to describe the experiences of ICU survivors and their families regarding early cognitive stimulation as part of rehabilitation during and after ICU admission. Design: Our study has a qualitative, descriptive design using individual and dyad interviews as well as focus groups with ICU survivors and their families. Methods: Eligible participants are adult ICU survivors and families who are able to recall events during and after the ICU stay. We will use purposeful sampling in the outpatient clinic in the Department of Intensive Care at the Copenhagen University Hospital. We plan to conduct five individual patient interviews, four dyad interviews with patients and families, and two focus groups with patients. All interviews will follow a semi-structured interview guide based on the study objectives and input from a patient and public involvement (PPI) panel. We will use the framework method for analysis and invite the PPI panel to participate in the analysis process to strengthen the findings. Written informed consent will be obtained from all participants, and data will be anonymized before analyses. Relevance for Clinical Practice: This study protocol provides a methodological framework to understand early cognitive rehabilitation from the perspectives of ICU survivors and their families. This study protocol presents one of the first studies to investigate the concept of early cognitive rehabilitation during critical illness from this perspective. The findings will facilitate a tailored approach to early rehabilitation to be investigated in further studies.