Background low patient mobility is common during hospitalisation and is associated with adverse outcomes. To change practice, interventions should address barriers and facilitators to mobility. Our aim was to systematically review the literature to provide a synthesised overview of patient-, health care professional (HCP)- and environment-/system-related barriers and facilitators to mobility of patients hospitalised on an acute care medical ward. Methods we searched Medline, Embase, PsycInfo, Web of Science Core Collection, Cochrane CENTRAL, CINHAHL and Google Scholar (inception to 18 October 2021) to identify studies reporting barriers and/or facilitators to mobility of adults hospitalised on an acute medical ward. We applied a deductive and inductive thematic analysis to classify barriers and facilitators into themes and subthemes relevant for clinical practice. Results among 26 studies (16 qualitative, 7 quantitative and 3 mixed methods), barriers and facilitators were categorised into 10 themes: patient situation, knowledge, beliefs, experiences, intentions, emotions, social influences, role/identity, implementation/organisation and environment/resources. Barriers included patient characteristics (e.g. impaired cognitive/physical status) and symptoms, HCPs prioritising other tasks over mobility, HCPs labelling patients as ‘too sick’, fear of injury, lack of time, lack of clarity about responsibility, patient medical devices and non-encouraging environment. Facilitators included knowledge of mobility importance, HCP skills, interdisciplinarity, documentation and unit expectations, encouraging staff, goal individualisation, activity programme, family/visitor/volunteer support and availability of equipment. Conclusion this synthesised overview of patient-, HCP- and environment-/system-related barriers and facilitators to mobility of adults hospitalised on an acute medical ward can help researchers and clinicians focus on what can realistically be influenced to improve mobility. Systematic review registration PROSPERO, CRD42021285954.

中文翻译：

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急诊病房住院患者流动的障碍和促进因素：系统评价

背景 住院期间患者活动能力低下很常见，并且与不良结局相关。为了改变实践，干预措施应解决流动性的障碍和促进因素。我们的目的是系统地回顾文献，以综合概述患者、医疗保健专业人员 (HCP) 和环境/系统相关的障碍和促进在急诊病房住院的患者的流动性。方法我们搜索了 Medline、Embase、PsycInfo、Web of Science 核心合集、Cochrane CENTRAL、CINHAHL 和 Google Scholar（从 2021 年 10 月 18 日开始），以确定报告在急诊病房住院的成人行动障碍和/或促进因素的研究。我们应用演绎和归纳主题分析将障碍和促进因素分类为与临床实践相关的主题和子主题。26 项研究（16 项定性研究、7 项定量研究和 3 种混合方法）的结果、障碍和促进因素分为 10 个主题：患者情况、知识、信仰、经历、意图、情绪、社会影响、角色/身份、实施/组织和环境/资源。障碍包括患者特征（例如认知/身体状况受损）和症状、HCP 优先考虑其他任务而不是移动性、HCP 将患者标记为“病得太重”、害怕受伤、没有时间、缺乏责任感、患者医疗设备和非- 鼓励环境。促进者包括流动重要性的知识、HCP 技能、跨学科性、文件和单位期望，鼓励员工，目标个性化，活动计划，家庭/访客/志愿者支持和设备可用性。结论 这个综合概述了患者、HCP 和环境/系统相关的障碍和促进在急诊病房住院的成年人的流动性，可以帮助研究人员和临床医生专注于可以实际影响改善流动性的因素。系统评价注册PROSPERO，CRD42021285954。HCP 和环境/系统相关的障碍和促进在急诊病房住院的成年人的流动性可以帮助研究人员和临床医生专注于可以实际影响改善流动性的因素。系统评价注册PROSPERO，CRD42021285954。HCP 和环境/系统相关的障碍和促进在急诊病房住院的成年人的流动性可以帮助研究人员和临床医生专注于可以实际影响改善流动性的因素。系统评价注册PROSPERO，CRD42021285954。