International Journal of Clinical Case Reports, 2025, Vol.15, No.4, 148-158 http://medscipublisher.com/index.php/ijccr 153 6 Factors Influencing the Effectiveness of Early Mobilization 6.1 Patient compliance, pain management and psychological status Whether the patient cooperates is the key to the success of early mobilization. Pre-existing cognitive impairment, delirium, depression and other problems can seriously affect patients' willingness or ability to participate in activities (Said et al., 2021). Pain is also a major obstacle. If pain is not well controlled, patients may be reluctant or refuse to move. However, effective pain relief methods can make patients more willing to move earlier and have better recovery effects (Buecking et al., 2015; Gray et al., 2023). Psychological factors, such as the fear of falling, anxiety and lack of energy, are also crucial. Patients with strong activity ability and good psychological state before fracture are more willing to participate in early activities. Patients with mental confusion or depression tend to be active later and have poorer recovery (Buecking et al., 2015; Said et al., 2021; Gray et al., 2023). Solving these psychological problems with targeted methods can make patients more cooperative and make the rehabilitation process smoother. 6.2 The technical capabilities of nursing staff and the implementation of intervention measures The technical proficiency and active participation of nursing staff are crucial for the safe and effective implementation of early mobilization programs. Staff members must be proficient in determining whether patients are suitable for activity, controlling pain, providing appropriate physical support during activity, and minimizing the risk of falls or hypotension as much as possible (Aprisunadi et al., 2021). If the staff are inadequately trained or lack confidence, it may lead to inconsistent implementation of the mobilization plan and thus miss the opportunity for early activities (Gray et al., 2023). In addition, there are clear guiding principles and standard procedures in the medical environment, which can help patients receive consistent and timely mobilization. Organizational factors such as staffing, workload, and communication among multidisciplinary team members can either facilitate or hinder the implementation of early mobilization measures (Sallehuddin and Ong, 2020; Gray et al., 2023). Therefore, continuously providing education and support to nursing staff is of great significance for ensuring high-quality care and enabling patients to achieve the best rehabilitation outcomes. 6.3 Availability of family support and rehabilitation resources The participation and support of family members are of great help for early mobilization. Encouragement and assistance from family members can enhance patients' enthusiasm, reduce anxiety and help overcome psychological barriers during activities (Gray et al., 2023). On the contrary, the lack of family support may make patients feel lonely, reduce their enthusiasm for participating in rehabilitation and slow down their recovery. Whether rehabilitation resources are sufficient and accessible, such as physical therapy services and specialized equipment, is also very important. Hospitals with well-developed rehabilitation plans and sufficient personnel are more likely to enable patients to move around in a timely manner, resulting in better rehabilitation outcomes (Sallehuddin and Ong, 2020; Gray et al., 2023). Insufficient resources may delay mobilization, increase the possibility of complications and prolong hospital stays, which indicates that investment is needed to build complete rehabilitation facilities. 7 Existing Difficulties and Challenges 7.1 There is a lack of unified activity time standards and operation methods One of the main problems faced by early activities is the lack of generally recognized definitions, standards and plans. Research shows that there are significant differences in how to define early activities (such as within 24, 36 or 48 hours after surgery) and how to measure their impact. This makes it extremely difficult to compare the results and determine the best practices among different hospitals (Said et al., 2021; Gray et al., 2023; Sarkies et al., 2023). Due to the lack of a unified standard, some hospitals may postpone the "as soon as possible" activity because of unclear guidance or different understandings, resulting in inconsistent practices and different rehabilitation effects
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