# Early pulmonary rehabilitation recommended decision-making behavior experience among pediatric intensive care unit medical staff: a qualitative study

## TL;DR

This study explores how to encourage early pulmonary rehabilitation in critically ill children by understanding the behaviors of medical staff in a pediatric ICU.

## Contribution

The study applies the COM-B and TDF frameworks to identify barriers and facilitators for early pulmonary rehabilitation decision-making in PICU staff.

## Key findings

- Four main themes were identified, including knowledge gaps and communication challenges in pulmonary rehabilitation.
- Multidisciplinary cooperation and external support are crucial for successful early pulmonary rehabilitation.
- Creating a supportive environment can improve PICU staff's adoption of pulmonary rehabilitation practices.

## Abstract

To understand the reasons for hindering and promoting the recommended decision-making behaviors for early pulmonary rehabilitation of PICU medical staff, and to provide a basis for developing corresponding management plans.

Based on the Capability, Opportunity, Motivation-Behavior (COM-B) model and Theoretical Domains Framework (TDF), interview outlines were developed. A descriptive qualitative research method was used, and a purposive sampling method was employed to select medical staff from the intensive care unit of a tertiary children's hospital in Nanjing from September to December 2023 for semi-structured interviews. The interview data were coded using the COM-B and TDF frameworks, and analyzed, summarized, and refined using the Colaizzi 7-step method to extract themes.

Four main themes and 13 sub-themes were extracted, including the need for pulmonary rehabilitation knowledge and skills, the experience of implementing pulmonary rehabilitation in critically ill children, communication and collaboration in the PICU rehabilitation platform, and external support for PICU pulmonary rehabilitation.

In the process of recommending early pulmonary rehabilitation for critically ill children, departments should help PICU medical staff change their views on pulmonary rehabilitation and acquire relevant knowledge and skills, strengthen multidisciplinary cooperation, optimize external support, and create a good practice environment for the implementation and promotion of early pulmonary rehabilitation for critically ill children.