Biopsychosocial Environment of the Physiotherapist in the Intensive Care Unit (ICU) and Palliative Care Area: A systematic review

Abstract

The biopsychosocial model explains that illnesses are caused by complementary biomedical (somatic) and psychological (mental) causes, with the influence of the social environment; physiotherapy is defined as the set of actions, techniques and methods that, through the application of physical means, prevent, recover and adapt people affected by somatic dysfunctions or those who wish to maintain an adequate level of health, This profession has been added to multidisciplinary teams in the different areas of health services, as well as its role in the Intensive Care Unit (ICU) created for the purpose of recovery, it has been shown that the physiotherapist by starting with early mobilisation reduces the length of stay in this unit while maintaining the vital functions of patients at risk of losing their lives;  In the area of palliative care, which is based on ‘good dying’, the physiotherapist will intervene in pain control through a treatment protocol. Objective: To analyse which factors affect the biopsychosocial environment of the physiotherapist in the Intensive Care Unit (ICU) and palliative care by means of a literature review. Materials and methods: Study population mainly focused on physiotherapists and health professionals who interact with patients and families, with a focus on the factors that influence the biopsychosocial environment of the professional in samples or populations of individuals in ICU and palliative care, articles published in the last 7 years of the period from 2016-2023, articles uploaded in English and Spanish available in full text, opinion articles and duplicate articles or articles that did not meet the established requirements were excluded. Results:   The biopsychosocial model explains that illnesses are caused by complementary biomedical (somatic) and psychological (mental) causes, with the influence of the social environment; physiotherapy is defined as the set of actions, techniques and methods that, through the application of physical means, prevent, recover and adapt people affected by somatic dysfunctions or those who wish to maintain an adequate level of health, This profession has been added to multidisciplinary teams in the different areas of health services, as well as its role in the Intensive Care Unit (ICU) created for the purpose of recovery, it has been shown that the physiotherapist by starting with early mobilisation reduces the length of stay in this unit while maintaining the vital functions of patients at risk of losing their lives;  In the area of palliative care, which is based on ‘good dying’, the physiotherapist will intervene in pain control through a treatment protocol. Likewise, healthcare personnel such as doctors and nurses who also provide services in these areas have noticed that their biopsychosocial environment has been affected by both internal and external factors. Conclusions: Both groups investigated are influenced by different factors and circumstances such as assigned area, number of patients attended by shifts, years of experience, etc., which can affect physiotherapists working in these units, being necessary that the staff in these areas carry out activities of self-care, self-compassion, resilience and stress management