None listed
Conditions
Brief summary
Rehabilitation is required for functional recovery from many acute illnesses such as stroke, orthopedic fractures and de-conditioning seen during extended hospitalization. Unfortunately, research into physical, social and cognitive activity of patients undergoing rehabilitation has shown that patients spend almost all of their time alone, inactive and disengaged. There is increasing interest in how changing the physical environment may improve activity levels, and therefore recovery, but it is currently unknown what impact changing design features such as single vs. multi- bedrooms and proximity to outdoor areas and communal spaces has on physical activity levels. The move to the new Kawana Hospital provides a unique opportuntity to examine this, and consequently this study will determine how changes in hospital design influences physical, social and cognitive activity levels of patients in Acute Stroke and Rehabilitation Units. This prospective observational study will examine the effects of the change in physical environment with transition to a new hospital by observing total activity levels using behavioral mapping and accelerometers in patients recovering in acute stroke and sub-acute rehabilitation units before and after transition. By embedding the use of advanced technologies such as Actigraph and Stepwatch accelerometers, and the building of collaborative networks with the University of the Sunshine Coast, our hospital and health service is set to lead the development of interventions that may guide national and international treatment guidelines.
Interventions
SETTING:
Observation Period II:
The second observation period will be recorded at the Sunshine Coast University Hospital Acute Stroke Unit and Inpatient Rehabilitation units. Participants will receive the normal standard care and treatment of an Acute Stroke Unit and Sub-Acute Rehabilitation Unit. It will take place over the same length as the first observation period 2017 November, December and January 2018. Each participant will be observed from one Thursday until the Sunday of that week, a
SETTING: Observation Period II: The second observation period will be recorded at the Sunshine Coast University Hospital Acute Stroke Unit and Inpatient Rehabilitation units. Participants will receive the normal standard care and treatment of an Acute Stroke Unit and Sub-Acute Rehabilitation Unit. It will take place over the same length as the first observation period 2017 November, December and January 2018. Each participant will be observed from one Thursday until the Sunday of that week, a four day period. Sunshine Coast University Hospital Acute Stroke Unit: Bed configuration – open beds (16 x single, 2 x double) Floor space /patient (once access is granted to the site floor space sqm will be calculated and will open with 20 patients) Common areas Therapy spaces ( one gym area located on ward level) Outdoor access (via lifts to ground level) Walking distances (bed to- toilet / gym / common area /outdoors Sunshine Coast University Hospital Acute Rehabilitation unit: Bed configuration – open beds (20 x single, 14 x double) Floor space /patient (once access is granted to the site floor space sqm will be calculated and will open with 30 patients) Common areas (2 lounge and 2 dining rooms) Therapy spaces (one large gym with an outdoor mobility garden, one OT gym, one multi-purpose gym, two large assessment rooms) Outdoor access (at the ward level a outdoor mobility garden and sitting area near the therapy gyms and doors from the 2 lounge and 2 dining rooms lead to a large sitting area) Walking distances (will be calculated once we have access to the site)
Sponsors
isaac tonello
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants in the ASU: - The patient is admitted to the Acute Stroke Unit with the diagnosis of a stroke and enrollment to the study will occur within 7 days after stroke onset. - Patient is an adult > 18 years. - Patients have an expected stay of more than 2 days. - The patient is fit for rehabilitation. The patient requires assistance for basic ADL’s at the time of recruitment. - The patient is not deteriorating in the 24 hours before recruitment. - The patient or their substitute decision maker is able to provide written informed consent. Pre morbid status for ASU: - The patient was walking independently. Participants in the Rehabilitation Unit: - The patient is admitted with one of the following AN-SNAP codes; Stroke 3-204, 3-206, 3-208, 3-209; Orthopaedic fractures 3-227, 3-228, 3-229, and Re-conditioning 3-242, 3-243 and 3-244. - Patient enrollment will occur within 7 days of admission to the rehab unit - Patient is an adult > 18 years and older. - The patient or their substitute decision maker is able to provide written informed consent. - Patients are in the Rehabilitation Assessment Unit (RAU) during their admission or Acute Inpatient Rehabilitation ward at the Sunshine Coast University Hospital. - Patients expected length of stay is of no less than 14 days on admission to the inpatient rehabilitation unit Pre morbid status for Rehabilitation Unit: - The patient was walking independently.
Exclusion criteria
Participants in the Acute Stroke Unit - with an extensive psychiatric history and who are unable to participate in rehabilitation due to current active medical condition/s Participants in the Rehabilitation Unit - with an extensive psychiatric history and who are unable to participate in rehabilitation due to current active medical condition/s
Outcome results
None listed