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A comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction—The significance of the built environment

Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the pur...

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Autores principales: Anåker, Anna, von Koch, Lena, Sjöstrand, Christina, Bernhardt, Julie, Elf, Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519004/
https://www.ncbi.nlm.nih.gov/pubmed/28727727
http://dx.doi.org/10.1371/journal.pone.0177477
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author Anåker, Anna
von Koch, Lena
Sjöstrand, Christina
Bernhardt, Julie
Elf, Marie
author_facet Anåker, Anna
von Koch, Lena
Sjöstrand, Christina
Bernhardt, Julie
Elf, Marie
author_sort Anåker, Anna
collection PubMed
description Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients’ activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole. The data were collected using a behavioral mapping technique at three different time points: in the original unit, in the temporary unit and in the new unit. A total of 59 patients were included. The analysis included field notes from observations of the physical environment and examples from planning and design documents. The findings indicated that in the new unit, the patients spent more time in their rooms, were less active, and had fewer interactions with staff and family than the patients in the original unit. The reconstruction involved a change from a primarily multi-bed room design to single-room accommodations. In the new unit, the patients’ lounge was located in a far corner of the unit with a smaller entrance than the patients’ lounge in the old unit, which was located at the end of a corridor with a noticeable entrance. Changes in the design of the stroke unit may have influenced the patients’ activities and interactions. This study raises the question of how the physical environment should be designed in the future to facilitate the delivery of health care and improve outcomes for stroke patients. This research is based on a case study, and although the results should be interpreted with caution, we strongly recommend that environmental considerations be included in future stroke guidelines.
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spelling pubmed-55190042017-08-07 A comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction—The significance of the built environment Anåker, Anna von Koch, Lena Sjöstrand, Christina Bernhardt, Julie Elf, Marie PLoS One Research Article Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients’ activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole. The data were collected using a behavioral mapping technique at three different time points: in the original unit, in the temporary unit and in the new unit. A total of 59 patients were included. The analysis included field notes from observations of the physical environment and examples from planning and design documents. The findings indicated that in the new unit, the patients spent more time in their rooms, were less active, and had fewer interactions with staff and family than the patients in the original unit. The reconstruction involved a change from a primarily multi-bed room design to single-room accommodations. In the new unit, the patients’ lounge was located in a far corner of the unit with a smaller entrance than the patients’ lounge in the old unit, which was located at the end of a corridor with a noticeable entrance. Changes in the design of the stroke unit may have influenced the patients’ activities and interactions. This study raises the question of how the physical environment should be designed in the future to facilitate the delivery of health care and improve outcomes for stroke patients. This research is based on a case study, and although the results should be interpreted with caution, we strongly recommend that environmental considerations be included in future stroke guidelines. Public Library of Science 2017-07-20 /pmc/articles/PMC5519004/ /pubmed/28727727 http://dx.doi.org/10.1371/journal.pone.0177477 Text en © 2017 Anåker et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Anåker, Anna
von Koch, Lena
Sjöstrand, Christina
Bernhardt, Julie
Elf, Marie
A comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction—The significance of the built environment
title A comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction—The significance of the built environment
title_full A comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction—The significance of the built environment
title_fullStr A comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction—The significance of the built environment
title_full_unstemmed A comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction—The significance of the built environment
title_short A comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction—The significance of the built environment
title_sort comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction—the significance of the built environment
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519004/
https://www.ncbi.nlm.nih.gov/pubmed/28727727
http://dx.doi.org/10.1371/journal.pone.0177477
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