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Rationale Ventilator Assisted Individuals (VAIs) frequently remain in intensive care units (ICUs) for a prolonged period once clinically stable due to a lack of transition options. These VAIs occupy ICU beds and resources that patients with more acute needs could better utilize. Moreover, VAIs experience improved outcomes and quality of life in long-term and community-based environments. Objective To better understand the perspectives of healthcare providers (HCPs) working in an Ontario ICU regarding barriers and facilitators to referral and transition of VAIs from the ICU to a long-term setting. Methods We conducted semi-structured interviews with ten healthcare providers involved in VAI transitions. Main Results Perceived barriers included long wait times for long-term care settings, insufficient bed availability at discharge locations, medical complexity of patients, long waitlists, and a lack of transparency of waitlists. Facilitators included strong partnerships and trusting relationships between referring and discharge locations, a centralized referral system, and utilization of community partnerships across care sectors. Conclusions Insufficient resourcing of long-term care is a key barrier to transitioning VAIs from ICU to long-term settings; strong partnerships across care sectors are a facilitator. System-level approaches, such as a single-streamlined referral system, are needed to address key barriers to timely transition. [ABSTRACT FROM AUTHOR]

Techniques to increase physical activity among pulmonary rehabilitation patients outside of the rehabilitation context are warranted. Implementation intentions are a strategy used to initiate goal-directed behaviour, and have been found to be useful in other populations. This study compared the long-term effects of exercise and social implementation intentions interventions on objectively measured physical activity in 40 pulmonary rehabilitation patients randomly assigned to condition. Repeated measures ANOVAs found that those in the exercise implementation intentions group took more steps (p =.007) at the end of pulmonary rehabilitation than those in the social implementation intentions group. Improvements attained by the exercise group during the intervention were not maintained 6-months following rehabilitation. Implementation intentions targeting physical activity appear to have positive short term effects on physical activity, although the long term effects are less consistent. This may be due in part to methods used to assess physical activity behaviour. Keywords Pulmonary rehabilitation * Physical activity * Implementation intention * Intervention * Experimental * Longitudinal, Introduction Respiratory diseases are the fourth leading cause of death in Canada, behind cardiovascular disease, cancer, and stroke (Life and breath: Respiratory Disease in Canada, 2007). With an aging population, [...]

Purpose: We aimed to elicit patients' views of research priorities related to pulmonary rehabilitation (PR). Method:We used a modified nominal group technique in which participants with chronic lung conditions who had completed PR attended one of five meetings during which they generated ideas, discussed them with the group, and prioritized their top three topics. Afterward, they completed member checking and satisfaction questionnaires. Results:Fourteen participants (mean age 71 years) prioritized 25 topics, which included music as a motivator, education about the reason for various assessments and exercises, and ongoing patient assessment and follow-up. Most participants "totally agreed" that the summarized topics matched what they thought was important in PR research (75%) and that the meeting was a positive experience (100%). Participants indicated that the findings of this study accurately reflected their priorities. Conclusions:Individuals who have completed PR may have questions about programme components including assessment, treatment, and strategies for promoting motivation. To inform future research projects and identify knowledge translation needs, we will distribute a questionnaire to a larger sample of former PR patients to further prioritize the 25 topics identified in the meetings. Objectif : connaître les points de vue des patients sur les priorités de la recherche en réadaptation pulmonaire (RP). Méthodologie : les chercheurs ont utilisé une technique de groupe nominale modifiée selon laquelle les participants atteints d'une pneumopathie chronique qui ont effectué une RP ont assisté à l'une des cinq rencontres pour générer des idées, en parler en groupe et prioriser leurs trois thèmes principaux. Ils ont ensuite rempli les questionnaires de vérification et de satisfaction des membres. Résultats : quatorze participants (d'un âge moyen de 71 ans) ont priorisé 25 thèmes, qui incluaient la musique comme élément motivateur, l'éducation sur la raison des diverses évaluations et des divers exercices ainsi que l'évaluation et le suivi continus des patients. La plupart des participants étaient « totalement d'accord » avec le fait que les thèmes résumés correspondaient à ce qu'ils considéraient comme important en recherche sur la RP (75 %) et que la rencontre était une expérience positive (100 %). Les participants ont indiqué que les résultats de cette étude étaient un reflet exact de leurs priorités. Conclusions : les personnes qui ont effectué la RP peuvent avoir des questions sur les éléments du programme, y compris l'évaluation, le traitement et les stratégies pour promouvoir la motivation. Afin d'éclairer les projets de recherche et de déterminer les besoins en application des connaissances, les chercheurs distribueront un questionnaire à un plus grand échantillon d'anciens patients en RP afin de mieux prioriser les 25 thèmes établis pendant les rencontres. [ABSTRACT FROM AUTHOR]