Application of the occupational therapy program based on PEO model in elderly patients with mechanical ventilation in ICU: study protocol for a randomized controlled trial.

BACKGROUNDS: Delirium is a transient state of confusion caused by multiple causes in the intensive care unit (ICU), characterized by impaired consciousness and altered cognitive function. Non-pharmacological measures are effective measures to prevent delirium in the ICU, including occupational therapy, early mobilization, environmental improvement, and correction of hearing and vision. The purpose of this study is to investigate the effectiveness of occupational therapy regimens based on the Person-Environment-Occupation model (PEO) to reduce the incidence of delirium and improve the prognosis of patients with mechanical ventilation in elderly people in ICU. METHODS: This study is a single-center, randomized, controlled trial. We randomized 52 elderly mechanically ventilated patients admitted to the ICU in a 1:1 ratio into conventional delirium care (control group) and occupational therapy (experiment group). Randomization will be conducted using the sequentially numbered, opaque, sealed envelope (SNOSE) technique. The duration of treatment is from patient enrollment to patient discharge or return to baseline functional independence. The primary outcome was the incidence of delirium, which was assessed using Confusion Assessment Method for the ICU (CAM-ICU). Secondary outcome measures were duration of delirium, ability of daily living, length of ICU stay, grip strength, duration of mechanical ventilation, cognitive status, and the Canadian Occupational Performance Measure (COPM) to assess patients' functional status before and after training. DISCUSSION: This study will investigate whether occupational therapy based on the PEO model affects the incidence and functional outcomes of delirium in elderly mechanically ventilated patients in the ICU. This study will provide new and important evidence on how to optimize outcomes in elderly patients with mechanical ventilation in the ICU. TRIAL REGISTRATION: ChiCTR2500095640. Registered on January 9, 2025. https://www.chictr.org.cn/showproj.html?proj=257005.