Barriers and facilitators to oral nutrition intake in hospitalised adult patients following critical illness: A scoping review protocol.

BACKGROUND & AIMS: Nutrition following liberation of mechanical ventilation and throughout acute hospitalisation may be important in aiding recovery. While oral nutrition is the most common mode of nutrition provision in this time period, it is unclear what factors influence oral nutrition intake due to limited research in the area to date. This article outlines the methods for a scoping review to explore and collate reported barriers and facilitators to oral nutrition intake in patients following liberation of mechanical ventilation. METHODS: A scoping review will be conducted, and the following databases searched: MEDLINE, Embase, Emcare, and CINAHL. Grey literature, including but not limited to conference abstracts and theses will be searched for via ProQuest, Scopus, Web of Science and PsychInfo. Study selection, data extraction and data charting will be conducted by two reviewers. Data will be synthesised into figures and tables, with the COM-B framework providing a structure for grouping themes and findings. Included literature will comprise of primary research studies, reviews and grey literature from 2000 onward, that include critically ill adult patients who have been recruited in an ICU, received a therapy usually delivered in ICU, or had an average length of ICU stay greater than or equal to two days. Studies that report the presence of oral nutrition-related barriers or facilitators following liberation of mechanical ventilation will be considered for inclusion.

An observational study investigating the use of patient-owned technology to quantify physical activity in survivors of critical illness.

BACKGROUND: Physical activity after intensive care unit (ICU) discharge is challenging to measure but could inform research and practice. A patient's smartphone may provide a novel method to quantify physical activity. OBJECTIVES: We aimed to evaluate the feasibility and accuracy of using smartphone step counts among survivors of critical illness. METHODS: We performed a prospective observational cohort study in 50 patients who had an ICU length of stay>48 h, owned a smartphone, were ambulatory before admission, and were likely to attend follow-up at 3 and 6 months after discharge. At follow-up, daily step counts were extracted from participants' smartphones and two FitBit pedometers, and exercise capacity (6-min walk test) and quality of life (European Quality of Life-5 Dimensions) were measured. RESULTS: Thirty-nine (78%) patients returned at 3 months and 33 (66%) at 6 months, the median [interquartile range] smartphone step counts being 3372 [1688-5899] and 2716 [1717-5994], respectively. There was a strong linear relationship, with smartphone approximating 0.71 (0.58, 0.84) of FitBit step counts, P < 0.0001, R-squared = 0.87. There were weak relationships between step counts and the 6-min walk test distance. CONCLUSION: Although smartphone ownership and data acquisition limit the viability of using extracted smartphone steps at this time, mean daily step counts recorded using a smartphone may act as a surrogate for a dedicated pedometer; however, the relationship between step counts and other measures of physical recovery remains unclear.