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Embedding an enriched environment in an acute stroke unit increases activity in people with stroke: a controlled before---after pilot study.
- Source :
- Clinical Rehabilitation; Nov2017, Vol. 31 Issue 11, p1516-1528, 13p, 1 Diagram, 4 Charts
- Publication Year :
- 2017
-
Abstract
- Objectives: To determine whether an enriched environment embedded in an acute stroke unit could increase activity levels in acute stroke patients and reduce adverse events. Design: Controlled before-after pilot study. Setting: An acute stroke unit in a regional Australian hospital. Participants: Acute stroke patients admitted during (a) initial usual care control period, (b) an enriched environment period and (c) a sustainability period. Intervention: Usual care participants received usual one-on-one allied health intervention and nursing care. The enriched environment participants were provided stimulating resources, communal areas for eating and socializing and daily group activities. Change management strategies were used to implement an enriched environment within existing staffing levels. Main Measures: Behavioural mapping was used to estimate patient activity levels across groups. Participants were observed every 10 minutes between 7.30 am and 7.30 pm within the first 10 days after stroke. Adverse and serious adverse events were recorded using a clinical registry. Results: The enriched environment group (n = 30, mean age 76.7 ± 12.1) spent a significantly higher proportion of their day engaged in 'any' activity (71% vs. 58%, P = 0.005) compared to the usual care group (n = 30, mean age 76.0 ± 12.8). They were more active in physical (33% vs. 22%, P < 0.001), social (40% vs. 29%, P = 0.007) and cognitive domains (59% vs. 45%, P = 0.002) and changes were sustained six months post implementation. The enriched group experienced significantly fewer adverse events (0.4 ± 0.7 vs.1.3 ± 1.6, P = 0.001), with no differences found in serious adverse events (0.5 ± 1.6 vs.1.0 ± 2.0, P = 0.309). Conclusions: Embedding an enriched environment in an acute stroke unit increased activity in stroke patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- STROKE treatment
ANALYSIS of covariance
ANALYSIS of variance
ECOLOGY
LIFE skills
LONGITUDINAL method
MEDICAL care
SCIENTIFIC observation
HEALTH outcome assessment
PATIENTS
PROBABILITY theory
PSYCHOLOGICAL tests
QUALITY of life
QUESTIONNAIRES
RESEARCH funding
SAMPLE size (Statistics)
PILOT projects
ACTIVITIES of daily living
UNOBTRUSIVE measures
VISUAL analog scale
PRE-tests & post-tests
REPEATED measures design
CONTENT mining
SEVERITY of illness index
ACUTE diseases
DATA analysis software
MANN Whitney U Test
BARTHEL Index
NIH Stroke Scale
STROKE units
Subjects
Details
- Language :
- English
- ISSN :
- 02692155
- Volume :
- 31
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Clinical Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 125810055
- Full Text :
- https://doi.org/10.1177/0269215517705181