Kylén Maya, Sturge Jodi, Lipson-Smith Ruby, Schmidt Steven M, Pessah-Rasmussen Hélène, Svensson Tony, de Vries Laila, Bernhardt Julie, Elf Marie
Department of Health Sciences, Lund University, Lund, Sweden.
School of Health and Welfare, Dalarna University, Falun, Sweden.
JMIR Res Protoc. 2023 Nov 9;12:e52489. doi: 10.2196/52489.
A global trend is to move rehabilitation closer to people's neighborhoods and homes. Still, little attention has been given to how the built environment outside the hospital setting might impact rehabilitation and recovery for stroke survivors.
The overarching objective of this project is to develop conceptual models of built environments that support stroke rehabilitation and recovery outside the hospital setting. Specifically, the project will explore factors and characteristics of the built environment that support people with stroke and their families and identify innovative built environments that can be designed for local health care. The project will examine facilitators and obstacles for implementing built environmental solutions and evaluate the potential benefits, feasibility, and acceptability.
The project uses a mixed methods design approach with 3 phases. In phase 1, factors and characteristics of the built environment for rehabilitation will be identified. Based on the results from phase 1, phase 2 will involve co-designing prototypes of environments to support the rehabilitation process for people with stroke. Finally, the prototypes will be evaluated in phase 3. Qualitative and quantitative methods will include a literature review, a concept mapping (CM) study, stakeholder interviews, prototype development, and testing. The project will use multidimensional scaling, hierarchical cluster analysis, descriptive statistics for quantitative data, and content analysis for qualitative data. Location analysis will rely on the location-allocation model for network problems, and the rule-based analysis will be based on geographic information systems data.
As of the submission of this protocol, ethical approval for the CM study and the interview study has been obtained. Data collection is planned to start in September 2023 and the workshops later in the same year. The scoping review is ongoing from January 2023. The CM study is ongoing and will be finalized in the spring of 2024. We expect to finish the data analysis in the second half of 2024. The project is a 3-year project and will continue until December 2025.
We aim to determine how new environments could better support a person's control over their day, environment, goals, and ultimately control over their recovery and rehabilitation activities. This "taking charge" approach would have the greatest chance of transferring the care closer to the patient's home. By co-designing with multiple stakeholders, we aim to create solutions with the potential for rapid implementation. The project's outcomes may target other people with frail health after a hospital stay or older persons in Sweden and anywhere else. The impact and social benefits include collaboration between important stakeholders to explore how new environments can support the transition to local health care, co-design, and test of new conceptual models of environments that can promote health and well-being for people post stroke.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52489.
将康复服务设置得更靠近人们的社区和家庭是一种全球趋势。然而，对于医院环境之外的建筑环境如何影响中风幸存者的康复和恢复，人们关注较少。
本项目的总体目标是开发支持医院环境之外中风康复和恢复的建筑环境概念模型。具体而言，该项目将探索支持中风患者及其家庭的建筑环境因素和特征，并确定可为当地医疗保健设计的创新型建筑环境。该项目将研究实施建筑环境解决方案的促进因素和障碍，并评估潜在益处、可行性和可接受性。
该项目采用混合方法设计，分为三个阶段。在第一阶段，将确定康复建筑环境的因素和特征。基于第一阶段的结果，第二阶段将共同设计环境原型，以支持中风患者的康复过程。最后，将在第三阶段对原型进行评估。定性和定量方法将包括文献综述、概念映射（CM）研究、利益相关者访谈、原型开发和测试。该项目将使用多维尺度分析、层次聚类分析对定量数据进行描述性统计，对定性数据进行内容分析。位置分析将依赖于网络问题的位置分配模型，基于规则的分析将基于地理信息系统数据。
截至本方案提交时，CM研究和访谈研究已获得伦理批准。计划于2023年9月开始数据收集，同年晚些时候举办研讨会。范围综述于2023年1月开始。CM研究正在进行中，将于2024年春季完成。我们预计在2024年下半年完成数据分析。该项目为期3年，将持续到2025年12月。
我们旨在确定新环境如何能更好地支持个人对其日常生活、环境、目标的掌控，最终实现对其康复活动的掌控。这种“自主掌控”方法最有可能将护理服务更靠近患者的家。通过与多个利益相关者共同设计，我们旨在创造有可能快速实施的解决方案。该项目的成果可能针对瑞典及其他任何地方住院后健康状况不佳的其他人或老年人。其影响和社会效益包括重要利益相关者之间的合作，以探索新环境如何支持向当地医疗保健的过渡、共同设计以及测试可促进中风后人群健康和福祉的新环境概念模型。
国际注册报告识别号（IRRID）：DERR1-10.2196/52489。
