Julie Stutzbach1, Jacqueline Jones2, Anna Taber3, John Recicar4, Robert E Burke5, Jennifer Stevens-Lapsley6. 1. Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado. Electronic address: Julie.stutzbach@cuanschutz.edu. 2. College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colorado. 3. College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colorado; College of Nursing, Nevada State College, Henderson, Nevada. 4. College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colorado; Trauma and Burn Program, Children's Hospital Colorado, Aurora, Colorado. 5. Center for Health Equity Research and Promotion, Corporal Crescenz VA Medical Center, Philadelphia, Pennsylvania; Hospital Medicine Section, Division of General Internal Medicine, Department of Medicine, University of Perelman School of Medicine, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania. 6. Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado; Eastern Colorado VA Geriatric Research Education and Clinical Center (GRECC), Aurora, Colorado.
Abstract
OBJECTIVE: To describe how different key stakeholders (ie, interprofessional clinical care team and patients) perceive their role in promoting in-hospital mobility by systematically synthesizing qualitative literature. DATA SOURCES: PubMed, Ovid MEDLINE, Ovid PsychInfo, and Cumulative Index to Nursing and Allied Health were searched using terms relevant to mobility, hospitalization, and qualitative research. A total of 510 unique articles were retrieved and screened for eligibility. STUDY SELECTION: Eligible qualitative studies included stakeholder perspectives on in-hospital mobility, including patients, nursing staff, rehabilitation staff, and physicians. Eleven articles remained after inclusion/exclusion criteria were applied. DATA EXTRACTION: At least 2 authors independently read, coded, and derived themes from each study. We used a team-based inductive approach to thematic synthesis informed by critical realism and the socioecological model. Reciprocal translation unified convergent and divergent constructs across primary studies. Investigator triangulation enhanced interpretation. DATA SYNTHESIS: Three primary themes emerged: (1) patient, family, and clinician expectations shape roles in in-hospital mobility; (2) stakeholders' role in mobility depends on hospital environment, infrastructure, culture, and resources; and (3) teamwork creates successful in-hospital mobility, but lack of coordination and cooperation leads to delay in mobilizing. Studies suggested that while mobility is an essential construct in the professional role of clinicians and in the personal identity of patients, the ability of stakeholders to realize their role in mobility is highly dependent on the hospital physical and cultural environment, administrative support, clarity in professional roles, and teamwork. CONCLUSIONS: Interventions designed to address the problem of low hospital mobility should take a systems approach and consider allocation of resources, clarity around professional responsibilities, and elevation of patient and clinician expectations surrounding mobility.
OBJECTIVE: To describe how different key stakeholders (ie, interprofessional clinical care team and patients) perceive their role in promoting in-hospital mobility by systematically synthesizing qualitative literature. DATA SOURCES: PubMed, Ovid MEDLINE, Ovid PsychInfo, and Cumulative Index to Nursing and Allied Health were searched using terms relevant to mobility, hospitalization, and qualitative research. A total of 510 unique articles were retrieved and screened for eligibility. STUDY SELECTION: Eligible qualitative studies included stakeholder perspectives on in-hospital mobility, including patients, nursing staff, rehabilitation staff, and physicians. Eleven articles remained after inclusion/exclusion criteria were applied. DATA EXTRACTION: At least 2 authors independently read, coded, and derived themes from each study. We used a team-based inductive approach to thematic synthesis informed by critical realism and the socioecological model. Reciprocal translation unified convergent and divergent constructs across primary studies. Investigator triangulation enhanced interpretation. DATA SYNTHESIS: Three primary themes emerged: (1) patient, family, and clinician expectations shape roles in in-hospital mobility; (2) stakeholders' role in mobility depends on hospital environment, infrastructure, culture, and resources; and (3) teamwork creates successful in-hospital mobility, but lack of coordination and cooperation leads to delay in mobilizing. Studies suggested that while mobility is an essential construct in the professional role of clinicians and in the personal identity of patients, the ability of stakeholders to realize their role in mobility is highly dependent on the hospital physical and cultural environment, administrative support, clarity in professional roles, and teamwork. CONCLUSIONS: Interventions designed to address the problem of low hospital mobility should take a systems approach and consider allocation of resources, clarity around professional responsibilities, and elevation of patient and clinician expectations surrounding mobility.
Authors: Juliessa M Pavon; Richard J Sloane; Carl F Pieper; Cathleen S Colón-Emeric; Harvey J Cohen; David Gallagher; Katherine S Hall; Miriam C Morey; Midori McCarty; Susan N Hastings Journal: J Am Geriatr Soc Date: 2019-11-20 Impact factor: 5.562
Authors: F Dijkstra; G van der Sluis; H Jager-Wittenaar; L Hempenius; J S M Hobbelen; E Finnema Journal: Int J Behav Nutr Phys Act Date: 2022-07-30 Impact factor: 8.915