The Importance of the Built Environment in Person-Centred Rehabilitation at Home: Study Protocol

Abstract

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.

How is the environment integrated into post‐stroke rehabilitation? A qualitative study among community‐dwelling persons with stroke who receive home rehabilitation in Sweden

“…This study is part of a larger project called Rehabilitation and Architecture (REARCH) aiming to increase the knowledge of how the environment can facilitate and/or hinder person‐centred rehabilitation at home (Kylén et al., 2019). In REARCH we are working in partnership with persons with stroke, their organisations and several stroke units.…”

Why hospital design matters: A narrative review of built environments research relevant to stroke care

“…79,80 Future design considerations for stroke recovery should also extend to the home environment. 81…”

Assessment of the effects of a multi-component, individualized physiotherapy program in patients receiving hospice services in the home

“…Another innovative element of the program was also the help of a physiotherapist in reorganizing the home space in order to adapt it to the functional needs of the patient. The patient's environment may constitute a barrier or facilitation [23]; thus, eliminating barriers and maximizing facilitation allow the patients to get around better and to remain active in their environment [24]. Bethancourt et al showed that structural barriers (e.g., inadequate equipment) could hinder the physical activity of people with reduced fitness [25].…”