Development of a patient centred, structured, individually tailored, multi-component intervention to promote rehabilitation and recovery after critical illness: content, theory, and construction

Brenda O'Neill; Danny McAuley; Rachel Clarke; Sallyanne Duncan; Penelope Firshman; Ella Terblanche; Julie Bruce; Jill Costley; Bronwen Connolly; Judy Martina Bradley

doi:10.3310/nihropenres.14023.1

Development of a patient centred, structured, individually tailored, multi-component intervention to promote rehabilitation and recovery after critical illness: content, theory, and construction

Brenda O'Neill
, Danny McAuley
, Rachel Clarke
, Sallyanne Duncan
, Penelope Firshman
, Ella Terblanche
, Julie Bruce
, Jill Costley
, Bronwen Connolly
, Judy Martina Bradley

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND/AIMS: This paper describes the development (content, theory, and construction) of a patient-centered, structured, individually tailored, multicomponent intervention (the iRehab intervention) to promote rehabilitation and recovery after critical illness.

METHODS: The intervention was informed by the MRC framework for complex interventions and underpinned by existing literature and psychological theories. Key stakeholders included patients who had been in intensive care and multidisciplinary staff with experience in providing healthcare and undertaking research.

RESULTS: The final intervention includes four core components: 1. weekly discussion and guidance regarding symptom management; 2. targeted exercise and physical activity; 3. support for psychological well-being; 4. peer support and information provision. These are packaged as a program to support rehabilitation and recovery after ICU discharge.Programme duration: Six weeks.Format: Weekly one-to-one remote needs assessment to identify individual participant symptoms and provide management plans, exercises, and strategies to best support recovery. Participants are encouraged to attend weekly group-based remote exercise sessions and group-based remote support sessions (iRehab Café).Mode of delivery: Remote delivery facilitated by online platforms such as Microsoft Teams or Zoom supported with video platform BEAM©, and delivery can also be supported by telephone. The preferred mode of remote delivery is agreed with the participant, and potential barriers to implementation are considered. Manuals are posted to all participants to support intervention delivery.

DISCUSSION/CONCLUSION: This paper reports the content, theory and construction of the iRehab intervention. The iRehab intervention is currently being tested in a multicenter RCT (iRehab ISRCTN11266403), and the details reported in this paper will help with understanding of the intervention, interpretation of the findings, and replication of the intervention. Detailed intervention manuals will be available upon the completion of the trial.

Original language	English
Article number	64
Pages (from-to)	1-21
Number of pages	21
Journal	NIHR open research
Volume	5
Early online date	6 Oct 2025
DOIs	https://doi.org/10.3310/nihropenres.14023.1 https://doi.org/https://openresearch.nihr.ac.uk/articles/5-64
Publication status	Published online - 6 Oct 2025

Bibliographical note

Data Access Statement

No data are associated with this article

Funding

This project is funded by the National Institute for Health and Care Research Health Technology Assessment (HTA) Project Number 132871. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Recovery
Rehabilitation
Critical illness
Intervention Development
Intensive Care Unit (Icu)
Intensive Care Unit (ICU)

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e89a615f-b0fc-4fb2-b13c-10b604864dc6_14023_-_brenda_o_neill_v2Final published version, 817 KBLicence: CC BY

Cite this

O'Neill, B., McAuley, D., Clarke, R., Duncan, S., Firshman, P., Terblanche, E., Bruce, J., Costley, J., Connolly, B., & Martina Bradley, J. (2025). Development of a patient centred, structured, individually tailored, multi-component intervention to promote rehabilitation and recovery after critical illness: content, theory, and construction. NIHR open research, 5, 1-21. Article 64. Advance online publication. https://doi.org/10.3310/nihropenres.14023.1, https://doi.org/https://openresearch.nihr.ac.uk/articles/5-64

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abstract = "BACKGROUND/AIMS: This paper describes the development (content, theory, and construction) of a patient-centered, structured, individually tailored, multicomponent intervention (the iRehab intervention) to promote rehabilitation and recovery after critical illness.METHODS: The intervention was informed by the MRC framework for complex interventions and underpinned by existing literature and psychological theories. Key stakeholders included patients who had been in intensive care and multidisciplinary staff with experience in providing healthcare and undertaking research.RESULTS: The final intervention includes four core components: 1. weekly discussion and guidance regarding symptom management; 2. targeted exercise and physical activity; 3. support for psychological well-being; 4. peer support and information provision. These are packaged as a program to support rehabilitation and recovery after ICU discharge.Programme duration: Six weeks.Format: Weekly one-to-one remote needs assessment to identify individual participant symptoms and provide management plans, exercises, and strategies to best support recovery. Participants are encouraged to attend weekly group-based remote exercise sessions and group-based remote support sessions (iRehab Caf{\'e}).Mode of delivery: Remote delivery facilitated by online platforms such as Microsoft Teams or Zoom supported with video platform BEAM{\textcopyright}, and delivery can also be supported by telephone. The preferred mode of remote delivery is agreed with the participant, and potential barriers to implementation are considered. Manuals are posted to all participants to support intervention delivery.DISCUSSION/CONCLUSION: This paper reports the content, theory and construction of the iRehab intervention. The iRehab intervention is currently being tested in a multicenter RCT (iRehab ISRCTN11266403), and the details reported in this paper will help with understanding of the intervention, interpretation of the findings, and replication of the intervention. Detailed intervention manuals will be available upon the completion of the trial.",

keywords = "Recovery, Rehabilitation, Critical illness, Intervention Development, Intensive Care Unit (Icu), Intensive Care Unit (ICU)",

author = "Brenda O'Neill and Danny McAuley and Rachel Clarke and Sallyanne Duncan and Penelope Firshman and Ella Terblanche and Julie Bruce and Jill Costley and Bronwen Connolly and \{Martina Bradley\}, Judy",

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O'Neill, B, McAuley, D, Clarke, R, Duncan, S, Firshman, P, Terblanche, E, Bruce, J, Costley, J, Connolly, B & Martina Bradley, J 2025, 'Development of a patient centred, structured, individually tailored, multi-component intervention to promote rehabilitation and recovery after critical illness: content, theory, and construction', NIHR open research, vol. 5, 64, pp. 1-21. https://doi.org/10.3310/nihropenres.14023.1, https://doi.org/https://openresearch.nihr.ac.uk/articles/5-64

Development of a patient centred, structured, individually tailored, multi-component intervention to promote rehabilitation and recovery after critical illness: content, theory, and construction. / O'Neill, Brenda; McAuley, Danny; Clarke, Rachel et al.
In: NIHR open research, Vol. 5, 64, 06.10.2025, p. 1-21.

Research output: Contribution to journal › Article › peer-review

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AU - O'Neill, Brenda

AU - McAuley, Danny

AU - Clarke, Rachel

AU - Duncan, Sallyanne

AU - Firshman, Penelope

AU - Terblanche, Ella

AU - Bruce, Julie

AU - Costley, Jill

AU - Connolly, Bronwen

AU - Martina Bradley, Judy

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N2 - BACKGROUND/AIMS: This paper describes the development (content, theory, and construction) of a patient-centered, structured, individually tailored, multicomponent intervention (the iRehab intervention) to promote rehabilitation and recovery after critical illness.METHODS: The intervention was informed by the MRC framework for complex interventions and underpinned by existing literature and psychological theories. Key stakeholders included patients who had been in intensive care and multidisciplinary staff with experience in providing healthcare and undertaking research.RESULTS: The final intervention includes four core components: 1. weekly discussion and guidance regarding symptom management; 2. targeted exercise and physical activity; 3. support for psychological well-being; 4. peer support and information provision. These are packaged as a program to support rehabilitation and recovery after ICU discharge.Programme duration: Six weeks.Format: Weekly one-to-one remote needs assessment to identify individual participant symptoms and provide management plans, exercises, and strategies to best support recovery. Participants are encouraged to attend weekly group-based remote exercise sessions and group-based remote support sessions (iRehab Café).Mode of delivery: Remote delivery facilitated by online platforms such as Microsoft Teams or Zoom supported with video platform BEAM©, and delivery can also be supported by telephone. The preferred mode of remote delivery is agreed with the participant, and potential barriers to implementation are considered. Manuals are posted to all participants to support intervention delivery.DISCUSSION/CONCLUSION: This paper reports the content, theory and construction of the iRehab intervention. The iRehab intervention is currently being tested in a multicenter RCT (iRehab ISRCTN11266403), and the details reported in this paper will help with understanding of the intervention, interpretation of the findings, and replication of the intervention. Detailed intervention manuals will be available upon the completion of the trial.

AB - BACKGROUND/AIMS: This paper describes the development (content, theory, and construction) of a patient-centered, structured, individually tailored, multicomponent intervention (the iRehab intervention) to promote rehabilitation and recovery after critical illness.METHODS: The intervention was informed by the MRC framework for complex interventions and underpinned by existing literature and psychological theories. Key stakeholders included patients who had been in intensive care and multidisciplinary staff with experience in providing healthcare and undertaking research.RESULTS: The final intervention includes four core components: 1. weekly discussion and guidance regarding symptom management; 2. targeted exercise and physical activity; 3. support for psychological well-being; 4. peer support and information provision. These are packaged as a program to support rehabilitation and recovery after ICU discharge.Programme duration: Six weeks.Format: Weekly one-to-one remote needs assessment to identify individual participant symptoms and provide management plans, exercises, and strategies to best support recovery. Participants are encouraged to attend weekly group-based remote exercise sessions and group-based remote support sessions (iRehab Café).Mode of delivery: Remote delivery facilitated by online platforms such as Microsoft Teams or Zoom supported with video platform BEAM©, and delivery can also be supported by telephone. The preferred mode of remote delivery is agreed with the participant, and potential barriers to implementation are considered. Manuals are posted to all participants to support intervention delivery.DISCUSSION/CONCLUSION: This paper reports the content, theory and construction of the iRehab intervention. The iRehab intervention is currently being tested in a multicenter RCT (iRehab ISRCTN11266403), and the details reported in this paper will help with understanding of the intervention, interpretation of the findings, and replication of the intervention. Detailed intervention manuals will be available upon the completion of the trial.

KW - Recovery

KW - Rehabilitation

KW - Critical illness

KW - Intervention Development

KW - Intensive Care Unit (Icu)

KW - Intensive Care Unit (ICU)

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ER -

O'Neill B, McAuley D, Clarke R, Duncan S, Firshman P, Terblanche E et al. Development of a patient centred, structured, individually tailored, multi-component intervention to promote rehabilitation and recovery after critical illness: content, theory, and construction. NIHR open research. 2025 Oct 6;5:1-21. 64. Epub 2025 Oct 6. doi: 10.3310/nihropenres.14023.1, https://openresearch.nihr.ac.uk/articles/5-64

Development of a patient centred, structured, individually tailored, multi-component intervention to promote rehabilitation and recovery after critical illness: content, theory, and construction

Abstract

Bibliographical note

Data Access Statement

Funding

UN SDGs

Keywords

Access to Document

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