Early Therapeutic Mobility and Changes in Scores for Pain and Fatigue
Chris Winkelman1, Abdus Sattar2, Hasina Momotaz2
1Chris Winkelman is an associate professor at Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Abdus Sattar is an associate professor in the Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, Ohio. Hasina Momotaz is a graduate student in statistics at Case Western Reserve University. Kimberly Johnson is an associate professor in the College of Nursing, University of Cincinnati, Cincinnati, Ohio. Peter Morris is professor and chief of the Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky Health-Care, Lexington, Kentucky. Sheryl Feeney is a nursing professional development specialist, MetroHealth System, Cleveland, Ohio. Alan Levine is a professor in the Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine chris.winkelman@case.edu.
Abstract:
This report is a secondary analysis of data from a larger study of a nurse-led early therapeutic mobility intervention among patients receiving mechanical ventilation. This analysis evaluated whether intervention frequency or intensity was associated with pain or fatigue. Frequency was defined as once-daily versus twice-daily interventions. Intensity was defined as low (in-bed activities) or moderate (out-of-bed activities). Thirty-nine patients self-reported pain and fatigue immediately before and after the intervention. Neither pain nor fatigue increased significantly (mean increase, <1 [scale of 0-10] for 95% of interventions). Four patients reported decrements in pain; 1 reported a decrease in fatigue. Less than 5% of enrolled patients indicated a score change of +4 to +6 for pain or fatigue, typically with the first intervention that included sitting at the edge of the bed. Future research could examine the distress associated with these symptoms in critically ill adults receiving early therapeutic mobility interventions.
