Adey-Wakeling Zoe, Jolliffe Laura, O'Shannessy Elizabeth, Hunter Peter, Morarty Jacqui, Cameron Ian D, Liu Enwu, Lannin Natasha A
Department of Rehabilitation, Flinders University of South Australia, Bedford Park, SA, Australia.
Department of Rehabilitation, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, Australia.
Ann Rehabil Med. 2021 Dec;45(6):413-421. doi: 10.5535/arm.21034. Epub 2021 Dec 31.
To examine the frequency and timing of inpatient engagement in meaningful activities within rehabilitation (within and outside of structured therapy times) and determine the associations between activity type, goal awareness, and patient affect.
This prospective observational study performed behavioral mapping in a 42-bed inpatient brain injury rehabilitation unit by recording patient activity every 15 minutes (total 42 hours). The participants were randomly selected rehabilitation inpatients with acquired brain injury; all completed the study. The main outcome measures included patient demographics, observation of activity, participation, goal awareness, and affect.
The inpatients spent 61% of the therapeutic day (8:30 to 16:30) in their single room and were alone 49% of the time. They were physically socially inactive for 76% and 74% of their awake time, respectively, with neutral affect observed for about half of this time. Goal-related activities were recorded for only 25% of the inpatients' awake time. The odds of physical activity were 10.3-fold higher among in patients receiving support to address their goals within their rehabilitation program (odds ratio=10.3; 95% confidence interval, 5.02-21.16).
Inpatients in a mixed brain injury rehabilitation unit spent a large amount of their awake hours inactive and only participated in goal-related activities for a quarter of their awake time. Rehabilitation models that increase opportunities for physical, cognitive, and social activities outside of allied health sessions are recommended to increase overall activity levels during inpatient rehabilitation.
研究住院患者在康复期间（包括结构化治疗时间内和之外）参与有意义活动的频率和时间，并确定活动类型、目标意识和患者情感之间的关联。
这项前瞻性观察性研究在一个拥有42张床位的住院脑损伤康复单元进行行为映射，每15分钟记录一次患者活动（共42小时）。参与者为随机选取的后天性脑损伤康复住院患者；所有患者均完成了研究。主要结局指标包括患者人口统计学信息、活动观察、参与情况、目标意识和情感。
住院患者在治疗日（8:30至16:30）有61%的时间待在单人病房，独处时间占49%。他们在清醒时间里分别有76%和74%的时间身体和社交活动不活跃，在此期间约一半时间观察到情感中性。仅25%的住院患者清醒时间记录到与目标相关的活动。在康复计划中接受支持以实现目标的住院患者进行身体活动的几率高出10.3倍（优势比=10.3；95%置信区间，5.02 - 21.16）。
混合性脑损伤康复单元的住院患者在清醒时间里大量时间处于不活动状态，仅在四分之一的清醒时间参与与目标相关的活动。建议采用增加联合健康治疗课程之外的身体、认知和社交活动机会的康复模式，以提高住院康复期间的总体活动水平。
