26066Amsterdam UMC location University of Amsterdam, Rehabilitation Medicine, Amsterdam, Netherlands.
522567Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, Netherlands.
Clin Rehabil. 2022 Oct;36(10):1342-1368. doi: 10.1177/02692155221105337. Epub 2022 Jun 14.
'Better By Moving' is a multifaceted intervention developed and implemented in collaboration with patients and healthcare professionals to improve physical activity in hospitalized adults. This study aimed to understand if, how and why 'Better By Moving' resulted in higher levels of physical activity by evaluating both outcomes and implementation process.
Mixed-methods study informed by the Medical Research Council guidance.
Tertiary hospital.
Adult patients admitted to surgery, haematology, infectious diseases and cardiology wards, and healthcare professionals.
Physical activity was evaluated before and after implementation using the Physical Activity Monitor AM400 on one random day during hospital stay between 8 am and 8 pm. Furthermore, the time spent lying on bed, length of stay and discharge destination was investigated. The implementation process was evaluated using an audit trail, surveys and interviews.
There was no significant difference observed in physical activity (median [IQR] 23 [12-51] vs 27 [17-55] minutes, = 0.107) and secondary outcomes before-after implementation. The intervention components' reach was moderate and adoption was low among patients and healthcare professionals. Patients indicated they perceived more encouragement from the environment and performed exercises more frequently, and healthcare professionals signalled increased awareness and confidence among colleagues. Support (priority, resources and involvement) was perceived a key contextual factor influencing the implementation and outcomes.
Although implementing 'Better By Moving' did not result in significant improvements in outcomes at our centre, the process evaluation yielded important insights that may improve the effectiveness of implementing multifaceted interventions aiming to improve physical activity during hospital stay.
“动得更好”是一项多方面的干预措施，由患者和医疗保健专业人员共同开发和实施，旨在提高住院成年人的身体活动水平。本研究旨在通过评估结果和实施过程，了解“动得更好”如何以及为何导致身体活动水平的提高。
基于医疗研究委员会指南的混合方法研究。
三级医院。
接受手术、血液学、传染病和心脏病学病房治疗的成年患者以及医疗保健专业人员。
在住院期间的 8 点至 8 点之间，在随机一天使用 AM400 活动监测器评估身体活动，在入院前和实施后进行。此外，还调查了卧床时间、住院时间和出院去向。使用审计跟踪、调查和访谈评估实施过程。
实施前后身体活动（中位数[IQR]23[12-51]与 27[17-55]分钟，=0.107）和次要结果无显著差异。患者和医疗保健专业人员对干预措施组件的知晓度中等，接受度低。患者表示他们更多地感受到环境的鼓励，更频繁地进行锻炼，而医疗保健专业人员表示同事的意识和信心有所提高。支持（优先级、资源和参与）被认为是影响实施和结果的关键背景因素。
尽管在我们中心实施“动得更好”并没有导致结果的显著改善，但过程评估提供了重要的见解，可能会提高旨在提高住院期间身体活动水平的多方面干预措施的实施效果。
