In this blog, we highlight the importance of initiating early rehabilitation using the findings from our study of intensive care survivors in Zambia, one of the first research studies in this field. In low-income countries such as Zambia, critical care survival is increasing, however, the focus has been on lifesaving procedures, with little emphasis on ongoing rehabilitation needs (Notter et al., 2023). The Recovery for Intensive Care Survivors Engagement (RISE) project was conducted in collaboration with the Ministry of Health in Zambia and the Critical Care Nurses Association of Zambia. The project involved following up patients recently discharged from an intensive care unit.
Using convenience sampling an exploratory descriptive qualitative methodology was used to interview 10 patients and/or families. From this sample, 5 patients and 5 relatives were interviewed. The themes that emerged from the interviews encompassed the whole process from pre-admission (including access healthcare services) to care at home. However, it was a cause for concern that for most, rehabilitation was limited as was communication around their experience and what they would need to do when they went home.
The findings from this study will be used to contribute to raising the profile of this topic amongst healthcare professionals and communities in Zambia (and internationally). Other activities have included national television interviews, conference presentations and giving voice to ICU survivors. In addition, there has been the development of resources for healthcare professionals, promoting rehab champions in practice working to promote early rehabilitation in practice and pilot critical care outreach / follow up projects. The theme of the 2025 Critical Care Nurses Association of Zambia conference was ‘Critical Care without Walls: from Emergency to Rehabilitation’, reflecting the recognition of the need for a comprehensive patient pathway. The team were delighted that the Minister of Health, the Permanent Secretary and Director of Nursing from the Ministry of Health attended the conference. Additional resources were donated by Kate Tantam (#RehabLegend) who provided badges, footballs and goals to promote rehabilitation. These resources were distributed to participants who pledged to promote rehabilitation activities in their units.
With ICU Survivors often hidden in plain sight, there is an urgent need to recognising and support this growing group and their families. While it is accepted healthcare resources are limited across the patient pathway, it is important and as we have shown it is possible to develop context specific support strategies for survivors and their families.
The findings from the RISE study will be presented at the British Association of Critical Care Nurses conference. This work will also feed into the wider advocacy work of the Centre for International Health Partnerships who are working in collaboration with the Ministry of Health and other stakeholders in an ongoing campaign to raise the profile of rehabilitation following critical illness.
Reference:
Notter J. Carter C. Nsonga M, Chongwe M. (2023). The challenge of rehabilitation following critical illness in low-income countries. British Journal of Nursing. 32 (21). DOI.org/10.12968/bjon.2023.32.21.1054