The partnership-based self-management programme had benefits concerning perception of the intrusiveness of chronic obstructive pulmonary disease and its treatment on lifestyles, activities and interests for young patients with the disease in its early stages. High satisfaction in control group, low family attendance and the relatively short treatment period may explain the less than expected benefits of the programme.

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Purpose: Although mobilization is a widely practiced intervention for patients who are critically ill, the clinical reasoning and decision-making processes used by physical therapists to maximize its effectiveness warrants elucidation. This study's purpose was to investigate factors guiding physical therapists' clinical reasoning and decision-making processes when initiating and progressing mobilization in patients who are critically ill. Methods: In a 2-phased qualitative research design, 12 physical therapists working in a tertiary care university hospital were observed before, during, and after a mobilization session with 1 patient, followed by a semistructured interview. Results: Six categories (patient; intensive care unit-context; physical therapist; transfer; FITT parameters [frequency, intensity, type, and time]; and expected outcome) and 4 encompassing factors (safety and well-being; continuous assessment and intervention intertwined; individualized and response-driven intervention; and barriers and solutions) emerged as important in guiding participants' clinical reasoning when mobilizing their patients. Conclusions: The categories and encompassing factors identified, influenced, and guided participants in their clinical reasoning and decision-making when they initiated mobilization and progressed its parameters. The approach was goal-oriented and tailored to each patient's needs based on moment-to-moment evaluation of responses. The categories and factors that emerged favored a response-driven rather than a protocol-driven approach to mobilizing patients who are critically ill.

In recent years, ICU research has increasingly focused on understanding factors that influence patients' recovery and how long-term outcomes can be maximized. 9,10 ICU patients are heterogeneous, thus their trajectory of physical recovery is diverse. 1,11 Gender, 1,11,12 older age, 1,2,11,13,14 comorbidity, 2,15 duration of continuous sedation, 11 duration of bed rest, 6,16 and ICU length of stay (LOS), 11,13,16 have all been reported to impact the physical recovery of ICU survivors. Men have been reported to experience better physical recovery after critical illness than women. 1,12 Younger women with a shorter duration of sedation and