Exploring the acceptability and feasibility of a digital intensive care unit recovery pathway with an embedded goal...

Digital health interventions address healthcare access inequalities but have only recently been employed for post-intensive care unit (ICU) recovery. In 2021, we developed and implemented a multicomponent 12-week digital ICU recovery pathway focused on personalised recovery goal setting.

Following promising early acceptability and feasibility metrics, we sought to further explore perceived (i) acceptability of the digital recovery pathway, including goal menu, goal-setting process, and recovery coordinator role and (ii) feasibility of engaging with components.

We conducted a multiple-methods study recruiting participants following completion of the digital ICU recovery pathway. We digitally administered questionnaires (Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM)) and conducted semi-structured interviews via Microsoft Teams. We analysed qualitative data inductively using thematic analysis with the Theoretical Framework of Acceptability as a flexible analytic lens.

We recruited 59 of 156 (38%) participants completing the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure and 30 participants taking part in interviews. At least 80% of participants agreed or completely agreed, with 11 of 12 questionnaire items indicating pathway acceptability and feasibility. We derived three themes: (i) Therapeutic relationship through dedicated specialist support; (ii) Structured goal setting enhances motivation, accountability, and achievement; and (iii) Challenges of recovery pathway engagement. Fifteen subthemes mapped to four Theoretical Framework of Acceptability (TFA) constructs: affective attitude, perceived effectiveness, burden, and intervention coherence. Participants gained reassurance through regular access to specialist ICU knowledge and normalisation of the ICU recovery experience, care acceleration, and a pathway addressing unmet needs. Goal setting enhanced motivation and confidence and accountability. Challenges included feeling pressured, technical complexity, physical and cognitive challenges, and information overload.

Our 12-week digital ICU recovery pathway with embedded goal setting was deemed acceptable, feasible and enhances recovery through reassurance, motivation, confidence, and accountability. Challenges include technical complexity, pressure of digital reminders, and information overload in the context of post-ICU deficits.