Anna Anåker1,2, Lena von Koch1,3, Christina Sjöstrand3,4, Ann Heylighen5, Marie Elf1,2,6. 1. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. 2. School of Education, Health and Social Studies, Dalarna University, Falun, Sweden. 3. Department of Neurovascular Diseases, Department of Neurology, Karolinska University Hospital, Stockholm, Sweden. 4. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 5. Department of Architecture, Research[x]Design, KU Leuven, Leuven, Belgium. 6. Department of Architecture and Civil Engineering, The School of Architecture, Chalmers University of Technology, Gothenburg, Sweden.
Abstract
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.
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.