Culture Care Program: a Mixed-methods Study Evaluating the Effect of an Innovative In-hospital Experience on Patient Mobility After Thoracic or Abdominal Surgery
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 204
- 试验地点
- 2
- 主要终点
- Daily time spent out of bed
研究概览
简要总结
A sedentary behavior in the postoperative phase has a negative impact on recovery from various types of surgery (e.g. abdominal, pulmonary, cardiac or esophageal). In fact, sedentary behavior in the days following surgery is associated with an increased risk of postoperative complications, longer hospital stays and, consequently, higher healthcare costs. Stimulating early mobilization and increasing the level of physical activity after surgery therefore remains a relevant current challenge. The Culture Care program will propose a new experience of the hospital towards an attractive and stimulating intrahospital environment, including art and culture. The hypothesis is that the innovative, positive hospital experience offered by the Culture Care program could contribute to increasing patients' mobility in the postoperative phase and thus reduce the sedentary behaviour compared with a control group included before the implementation of the program.
The aim of this study is to explore the effect of the Culture Care program (Control group versus Culture Care group) on the mobility of patients hospitalized after thoracic or abdominal surgery, by determining the level of prediction in relation to the influencing covariates reported in the literature.
The first quantitative part of this research project will compare the mobility of patients hospitalized after surgery, before (control group) and after the implementation of the Culture Care program (Culture Care group). Patients will be asked to wear an accelerometer for the first five post-operative days, and to complete three questionnaires (psychological well-being, physical recovery, perception of their mobility).
Healthcare workers will be asked to complete a survey on their readiness to stimulate patients' mobility before and after the Culture Care program.
The second part will be qualitative including individual semi-structured interviews with patients and healthcare workers during the Culture Care program, to gather their experiences.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Prevention
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Admission to Surgical Units in the Surgical Department of the Hôpital de Neuchâtel implementing the Culture Care program.
- •Elective thoracic or abdominal surgery with an expected hospital stay of at least 2 days (i.e. discharge on postoperative day 3).
- •Neurocognitive and physical ability to complete questionnaires and individual participation in the Culture Care program.
- •Full capacity of discernment and signed informed consent to participate in the study.
排除标准
- •Outpatient surgery.
- •Emergency surgery.
- •Mobility severely impaired prior to surgery: patients with 1 or 2 lower-limb amputations, patients with wheelchair mobility only, neurodegenerative diseases.
- •Bed restiction between POD 1 and POD 5 for medical reasons, i.e. surgery, post-operative complications or other pre-existing cardiorespiratory, neurological or orthopedic reasons.
- •Transfer to ICU
- •Only during the Culture Care phase, an unplanned transfer to another unit that does not have the Culture Care program (e.g. Medicine units).
- •Technical problem with the accelerometer (e.g. disfunctioning battery).
- •Allergic reaction to any dressing used to attach the accelerometer.
- •End-of-life patients.
研究组 & 干预措施
Control group of patients
Patients hospitalized after thoracic or abdominal surgery in a conventional in-hospital environment (not modified, before the implementation of the Culture Care program). Patients will receive standard of care, including early mobilization prescribed by the physician according to the ERAS guidelines.
Culture Care group of patients
Patients hospitalized after thoracic or abdominal surgery in an in-hospital environment modernized by the Culture Care program. As with control patients, patients in the Culture Care group will receive the similar standard of care, including early mobilization prescribed by the physician according to the ERAS guidelines.
干预措施: Culture Care program (Other)
Control group of healthcare workers
Healthcare workers working in the surgical units, with a conventional in-hospital environment (before implementation of the Culture Care program)
Culture Care group of healthcare workers
Healthcare workers working in the surgical units, with an in-hospital environment modernized by the Culture Care program
干预措施: Culture Care program (Other)
结局指标
主要结局
Daily time spent out of bed
时间窗: From postoperative day 1 to postoperative day 3.
This outcome will be assessed by accelerometry
Daily steps number
时间窗: From postoperative day 1 to postoperative day 3.
This outcome will be assessed by accelerometry
次要结局
- Number of patients mobilized on the day of surgery(The day of surgery (Day 0))
- Daily steps number(From postoperative day 1 to postoperative day 5.)
- Mean daily duration of physical inactivity, light physical activity and moderate-to-vigorous physical activity(From postoperative day 1 to postoperative day 5.)
- Quality of recovery after surgery(At postoperative day 2 and at discharge (maximum 1 day before))
- Psychological well-being(At postoperative day 2)
- Experience of in-hospital mobility(At postoperative day 2)
- Postoperative complications rate(From the day of surgery to hospital discharge (from maximum 1 day before discharge to 2 days after discharge))
- Length of hospital stay(At hospital discharge (from maximum 1 day before discharge to 2 days after discharge))
- Number of patients with adverse events(At hospital discharge (from maximum 1 day before discharge to 2 days after discharge))
- Number of adverse events per patients(At hospital discharge (from maximum 1 day before discharge to 2 days after discharge))
- Perception of the work environment and readiness to stimulate the mobility of hospitalized patients after surgery(During the 2 month period before the implementation of the Culture Care. This outcome will be assessed 3 month after the implementation of the Culture Care program.)
研究者
Dugernier Jonathan
Dr
Haute Ecole ARC Sante