The physical environment and patients’ activities and care: A comparative case study at three newly built stroke units
Artikel i vetenskaplig tidskrift, 2018

Aim: To explore and compare the impact of the physical environment on patients’ activities and care at three newly built stroke units. Background: Receiving care in a stroke unit instead of in a general ward reduces the odds of death, dependency and institutionalized care. In stroke units, the design of the physical environment should support evidence-based care. Studies on patients’ activities in relation to the design of the physical environment of stroke units are scarce. Design: This work is a comparative descriptive case study. Method: Patients (N = 55) who had a confirmed diagnosis of stroke were recruited from three newly built stroke units in Sweden. The units were examined by non-participant observation using two types of data collection: behavioural mapping analysed with descriptive statistics and field note taking analysed with deductive content analysis. Data were collected from April 2013 - December 2015. Results: The units differed in the patients’ levels of physical activity, the proportion of the day that patients spent with health professionals and family presence. Patients were more physically active in a unit with a combination of single and multi-bed room designs than in a unit with an entirely single-room design. Stroke units that were easy to navigate and offered variations in the physical environment had an impact on patients’ activities and care. Conclusions: Patients’ activity levels and interactions appeared to vary with the design of the physical environments of stroke units. Stroke guidelines focused on health status assessments, avoidance of bed-rest and early rehabilitation require a supportive physical environment.


A. Anaker

Högskolan i Dalarna

Karolinska Institutet

Lena von Koch

Karolinska universitetssjukhuset

Karolinska Institutet

C. Sjostrand

Karolinska Institutet

Karolinska universitetssjukhuset

A. Heylighen

KU Leuven

Marie Elf

Karolinska Institutet

Högskolan i Dalarna

Chalmers, Arkitektur och samhällsbyggnadsteknik, Byggnadsdesign

Journal of Advanced Nursing

0309-2402 (ISSN) 1365-2648 (eISSN)

Vol. 74 8 1919-1931


Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi




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