The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Melbourne, Victoria, Australia.
HERD. 2019 Oct;12(4):142-158. doi: 10.1177/1937586719831450. Epub 2019 Feb 25.
To use Value-Focused Thinking to investigate what is important in the design of inpatient stroke rehabilitation facility buildings.
Many stroke patients require inpatient rehabilitation in a dedicated facility. Rehabilitation facilities are healthcare spaces, but they are also learning spaces where patients practice targeted tasks to acquire new skills and to reacquire skills and abilities that were compromised as a result of their stroke. There is currently no consensus regarding how the design of inpatient rehabilitation facilities could be optimized for patients' learning.
We used Value-Focused Thinking to develop a framework of what interdisciplinary experts consider important for inpatient stroke rehabilitation facility design. Two workshops were conducted. The following experts were invited to participate: past patients with experience of stroke rehabilitation; stroke rehabilitation clinicians; stroke rehabilitation academics; healthcare environments academics; learning environments academics; architects, designers, and wayfinders with experience designing healthcare or learning environments; and healthcare design policy makers.
Thirty experts participated. The experts' final framework included 16 criteria that were considered fundamentally important for inpatient stroke rehabilitation facility design, and 14 criteria that were considered instrumentally important. Inpatient stroke rehabilitation facility design should maximize efficiency, maximize effectiveness (i.e., patients' clinical and functional outcomes), foster emotional well-being, and maximize safety. Opportunities to practice physical, cognitive, and social activity were considered important for patients' outcomes.
Value-Focused Thinking was an effective and equitable means of engaging experts from multiple disciplines. Designers, planners, and developers of inpatient stroke rehabilitation facilities should consider the rehabilitation-specific framework developed in this study alongside evidence from other healthcare settings.
运用价值焦点思维探讨在住院脑卒中康复设施建筑设计中什么是重要的。
许多脑卒中患者需要在专门的设施中进行住院康复治疗。康复设施是医疗保健空间，但它们也是学习空间，患者在这些空间中练习有针对性的任务，以获得新技能，并重新获得因脑卒中而受损的技能和能力。目前，对于如何优化住院康复设施的设计以满足患者的学习需求，尚未达成共识。
我们运用价值焦点思维制定了一个框架，用于确定跨学科专家认为对住院脑卒中康复设施设计重要的因素。为此开展了两次专题研讨会。邀请了以下专家参加：有脑卒中康复经验的既往患者；脑卒中康复临床医生；脑卒中康复学者；医疗环境学者；学习环境学者；有设计医疗或学习环境经验的建筑师、设计师和寻路者；以及医疗保健设计政策制定者。
30 名专家参与了研究。专家们最终确定的框架包括 16 项被认为对住院脑卒中康复设施设计至关重要的标准，以及 14 项被认为具有辅助作用的标准。住院脑卒中康复设施的设计应最大限度地提高效率，最大限度地提高效果（即患者的临床和功能结果），促进情绪健康，并最大限度地提高安全性。为患者的康复提供练习身体、认知和社会活动的机会被认为是重要的。
价值焦点思维是一种有效的、公平的方法，可以让来自多个学科的专家参与其中。住院脑卒中康复设施的设计者、规划者和开发者应考虑本研究中制定的针对康复的框架，并结合其他医疗保健环境的证据进行综合考虑。
