DEVELOPMENT OF A NEUROLOGICAL REHABILITATION ENVIRONMENT - AN OBSERVATIONAL STUDY

Background: Engagement in therapeutic activity among stroke inpatients is advocated by many rehabilitation professionals. However, there is a lack of published evidence to indicate whether this is currently bei ng achieved. Objective: To investigate the extent and types of 'rehabi litation' activities on a new neurological rehabilitation ward, and ex amine change in patients' behaviour related to the new environment and new initiatives. Design: Five one-week observation periods were condu cted over two-years, with a total of 67 patients being observed. A com parison was made with results of an earlier study of stroke patients' activities conducted at the same hospital.Results: Patients spent an a verage 43 min per day with therapists (9%) of the working day) and thi s was only marginally supplemented by self-exercise 12% of the working day - approximately 10 min). However, the provision of a new rehabili tation environment was associated with a marked decrease in the time p atients spent at their bedsides, and a decrease in time spent passivel y gazing or watching others. Conclusions: Overall there was some posit ive change in patients' behaviour. We suggest that structured guidance is required from the whole multi-disciplinary team to stimulate more self-directed therapy practice and recreation.