Influence of the Culture Care Program on Patient Mobility After Thoracic or Abdominal Surgery: a Mixed-methods Study

Haute Ecole ARC Sante204 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Interventions

Culture Care programOTHER

The Culture Care program modernizes the in-hospital environment by including art and culture proposed in the form of an individualized pathway. It will be offered primarily to hospitalized patients, but also available to families, caregivers and healthcare professionals. It will aim to create a new hospital experience, different from the one we've always known. The Culture Care program will display posters illustrating works of art (paintings, drawings, photographs, etc.) along the hallways. These posters will be interactive, so that a QR code can be scanned to access musical content and audio podcasts (interviews and documentaries) accessible via bone-conduction headphones. The Culture Care program is likely to reduce the sedentary behavior of hospitalized patients, by providing an attractive in-hospital environment that is likely to produce both physical and psychological benefits.

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * 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. Exclusion Criteria: * 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.

Outcomes

Primary Outcomes

Daily time spent out of bed

This outcome will be assessed by accelerometry

Time frame: From postoperative day 1 to postoperative day 3.

Daily steps number

This outcome will be assessed by accelerometry

Time frame: From postoperative day 1 to postoperative day 3.

Secondary Outcomes

Number of patients mobilized on the day of surgery

Out of bed: sitting in the chair, standing, walking, etc. This outcome will be assessed by accelerometry.

Time frame: The day of surgery (Day 0)

Daily steps number

Time frame: From postoperative day 1 to postoperative day 5.

Mean daily duration of physical inactivity, light physical activity and moderate-to-vigorous physical activity

Time frame: From postoperative day 1 to postoperative day 5.

Quality of recovery after surgery

This outcome will be assessed using the Quality of Recovery in 15 questions questionnaire (QoR-15) with a 11-point numerical rating scale with a minimum score of 0 (very poor recovery) and a maximum score of 150 (excellent recovery)

Time frame: At postoperative day 2 and at discharge (maximum 1 day before)

Psychological well-being

This outcome will be assessed using the Hospital Anxiety and Depression scale to measure anxiety and depression, with a score of 0 to 7 considered normal, 8 to 10 indicate mild symptoms, 11 to 14 indicate moderate symptoms and 15 to 21 indicate severe symptoms.

Time frame: At postoperative day 2

Experience of in-hospital mobility

This outcome will be assessed using a survey with Likert scale questions with seven point scale to express how much they agree or disagree with different statements about barriers and facilitators to mobility during the hospital stay. In addition, patients will be asked to rate their satisfaction about the in-hospital environment (with 0 being the lowest and 10 being the highest).

Time frame: At postoperative day 2

Postoperative complications rate

This outcome will be assessed using the Comprehensive Complications Index (CCI®), a score ranging from 0 (no complication) to 100 (death).

Time frame: From the day of surgery to hospital discharge (from maximum 1 day before discharge to 2 days after discharge)

Length of hospital stay

Time frame: At hospital discharge (from maximum 1 day before discharge to 2 days after discharge)

Number of patients with adverse events

Adverse events related to early mobilization of patients in the postoperative phase up to discharge, i.e. number of falls or loss of consciousness, accidental removal of drains or catheters

Time frame: At hospital discharge (from maximum 1 day before discharge to 2 days after discharge)

Number of adverse events per patients

Adverse events related to early mobilization of patients in the postoperative phase up to discharge, i.e. number of falls or loss of consciousness, accidental removal of drains or catheters

Time frame: 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

This outcome will be assessed among the healthcare workers via a survey.

Time frame: 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.

Influence of the Culture Care Program on Patient Mobility After Thoracic or Abdominal Surgery: a Mixed-methods Study

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts