School of Education, Health and Social Studies, Dalarna University, SE-791 88 Falun, Sweden.
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, SE-141 83 Huddinge, Sweden.
Int J Environ Res Public Health. 2019 Jul 6;16(13):2409. doi: 10.3390/ijerph16132409.
Health services will change dramatically as the prevalence of home healthcare increases. Only technologically advanced acute care will be performed in hospitals. This-along with the increased healthcare needs of people with long-term conditions such as stroke and the rising demand for services to be more person-centred-will place pressure on healthcare to consider quality across the continuum of care. Research indicates that planned discharge tailored to individual needs can reduce adverse events and promote competence in self-management. However, the environmental factors that may play a role in a patient's recovery process remain unexplored. This paper presents a protocol with the purpose to explore factors in the built environment that can facilitate/hinder a person-centred rehabilitation process in the home. The project uses a convergent parallel mixed-methods design, with ICF (International Classification of Functioning, Disability and Health) and person-environment theories as conceptual frameworks. Data will be collected during home visits 3 months after stroke onset. Medical records, questionnaires, interviews and observations will be used. Workshops will be held to identify what experts and users (patients, significant others, staff) consider important in the built environment. Data will be used to synthesise the contexts, mechanisms and outcomes that are important to support the rehabilitation process at home.
随着家庭医疗保健的普及，医疗服务将发生巨大变化。只有技术先进的急性护理才会在医院进行。这一点——加上患有长期疾病（如中风）的人对医疗保健的需求增加，以及对更以患者为中心的服务的需求增加——将给医疗保健带来压力，使其在整个护理连续体中考虑质量。研究表明，根据个人需求制定的计划出院可以减少不良事件，并促进自我管理能力。然而，在患者康复过程中可能发挥作用的环境因素仍未得到探索。本文提出了一项方案，旨在探索建筑环境中的因素，这些因素可以促进/阻碍家庭中以患者为中心的康复过程。该项目采用了汇聚平行混合方法设计，以国际功能、残疾和健康分类（ICF）和人与环境理论为概念框架。数据将在中风发病后 3 个月的家访期间收集。将使用病历、问卷、访谈和观察。将举办研讨会，以确定专家和用户（患者、重要他人、工作人员）认为建筑环境中重要的因素。数据将用于综合与支持家庭康复过程相关的背景、机制和结果。
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