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How do patients spend their time in stroke rehabilitation units in England? The REVIHR study

Chouliara, Niki; Fisher, Rebecca; Crosbie, Brian; Guo, Boliang; Sprigg, Nikola; Walker, Marion

Authors

Niki Chouliara

Rebecca Fisher

Brian Crosbie

Boliang Guo

Nikola Sprigg



Abstract

Aim: To examine how patients spend their time in stroke rehabilitation units in England.Methods: We recruited 144 patients within a month after stroke from four stroke rehabilitation units and observed their activity type, interactions and location. Each participant was observed for 1 min every 10-minutes, for a total of 20 h, over three consecutive days. Multilevel modelling was performed to assess differences across sites.Results: Across the four sites a total of 12,248 observations were performed. Patients spent on average 37% of the observed time inactive and 60% alone. A health care professional was present for 18% of the observations and patients' most frequent contact was with family members (19%). Patients were mainly physically active in the presence of therapists, but they practiced self-care activities of daily living most frequently in the presence of nursing staff. There were limited opportunities for activity away from the bedside. Significant differences were found between the units, including patients' level of contact with rehabilitation assistants and nursing staff, but not in their time with occupational therapists and physiotherapists.Conclusions: Stroke patients in England spend a large proportion of their day inactive and alone. Opportunities to promote a rehabilitation focused environment may include: a) enhancing the role of rehabilitation assistants, b) supporting nursing staff in maximising opportunities for the practice of activities of daily living and c) involving family members in the rehabilitation process.

Journal Article Type Article
Print ISSN 0963-8288
Publisher Taylor & Francis Open
Peer Reviewed Peer Reviewed
APA6 Citation Chouliara, N., Fisher, R., Crosbie, B., Guo, B., Sprigg, N., & Walker, M. (in press). How do patients spend their time in stroke rehabilitation units in England? The REVIHR study. Disability and Rehabilitation,
Keywords Stroke; rehabilitation units; evidence-based practice; behavioural mapping; activities of daily living