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The physical environment and patients’ activities and care: A comparative case study at three newly built stroke units
Author(s) -
Anåker Anna,
Koch Lena,
Sjöstrand Christina,
Heylighen Ann,
Elf Marie
Publication year - 2018
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.13690
Subject(s) - stroke (engine) , rehabilitation , descriptive statistics , medicine , research design , odds , unit (ring theory) , odds ratio , physical therapy , health care , data collection , physical medicine and rehabilitation , psychology , logistic regression , engineering , sociology , mechanical engineering , social science , statistics , mathematics education , mathematics , pathology , economic growth , economics
Aim To explore and compare the impact of the physical environment on patients’ activities and care at three newly built stroke units. Background Receiving care in a stroke unit instead of in a general ward reduces the odds of death, dependency and institutionalized care. In stroke units, the design of the physical environment should support evidence‐based care. Studies on patients’ activities in relation to the design of the physical environment of stroke units are scarce. Design This work is a comparative descriptive case study. Method Patients ( N = 55) who had a confirmed diagnosis of stroke were recruited from three newly built stroke units in Sweden. The units were examined by non‐participant observation using two types of data collection: behavioural mapping analysed with descriptive statistics and field note taking analysed with deductive content analysis. Data were collected from April 2013 ‐ December 2015. Results The units differed in the patients’ levels of physical activity, the proportion of the day that patients spent with health professionals and family presence. Patients were more physically active in a unit with a combination of single and multi‐bed room designs than in a unit with an entirely single‐room design. Stroke units that were easy to navigate and offered variations in the physical environment had an impact on patients’ activities and care. Conclusions Patients’ activity levels and interactions appeared to vary with the design of the physical environments of stroke units. Stroke guidelines focused on health status assessments, avoidance of bed‐rest and early rehabilitation require a supportive physical environment.