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The physical environment and patients' activities and care. A comparative case study at three newly built stroke units
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.ORCID iD: 0000-0002-8694-3127
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2018 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed) Epub ahead of print
Abstract [en]

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: behavioral mapping analyzed with descriptive statistics and field note taking analyzed 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. 

Place, publisher, year, edition, pages
2018.
Keyword [en]
evidence-based design, nursing, physical environment, rehabilitation, stroke guidelines, stroke unit
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-27520DOI: 10.1111/jan.13690PubMedID: 29676493Scopus ID: 2-s2.0-85046626112OAI: oai:DiVA.org:du-27520DiVA, id: diva2:1200328
Note

Open Access APC beslut 10/2018

Available from: 2018-04-24 Created: 2018-04-24 Last updated: 2018-05-28Bibliographically approved

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Anåker, AnnaElf, Marie

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Citation style
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