Deans' stroke musings: Exploring staff experience of an “enriched environment” within stroke rehabilitation: a qualitative sub-study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, December 30, 2013

Exploring staff experience of an “enriched environment” within stroke rehabilitation: a qualitative sub-study

This was written about by Dale Corbett back in Feb. 2011

What the hell is it going to take to get this into a stroke protocol rolled out to all hospitals? Are we going to need a scenario like Denzel Washington had in the movie

Exploring staff experience of an “enriched environment” within stroke rehabilitation: a qualitative sub-study

Jennifer H. White¹, Katherine Alborough¹, Heidi Janssen¹, Neil Spratt², Louise Jordan¹, and Michael Pollack³

¹Hunter Stroke Service, John Hunter Campus,

New Lambton, New South Wales

, Australia,

²Department of Medical Sciences, The University of Newcastle,

Callaghan, New South Wales

, Australia, and

³Rankin Park Unit,

New Lambton, New South Wales

, Australia

Address for correspondence:

Jennifer H. White, MMSc (Occupational Therapy), Hunter Stroke Service, Level 2, The Lodge

, John Hunter Campus,

Lookout Rd, New Lambton, New South Wales 2301

, Australia. E-mail: jennifer.white@hnehealth.nsw.gov.au

Abstract

Background: Environmental Enrichment (EE) is shown to facilitate recovery of motor and cognitive function in animal models of stroke. The efficacy of EE in the clinical setting with stroke survivors remains unknown. Successful implementation of EE in a busy rehabilitation unit requires identification of barriers and enablers which are best informed by staff feedback. Aim: To qualitatively explore the experiences of nursing staff involved in a pilot study investigating the feasibility of EE in a rehabilitation ward. Methods: This was a qualitative study consisting of analysis of semi-structured interviews with nine nursing staff who were asked to reflect on “routine care” and their own “experience of the EE study”. An inductive thematic approach was used to collect and analyse data using a process of constant comparison. Results: Male and female staff with varying years of experience working in stroke rehabilitation participated in focus group and individual interviews. Three key themes were identified concerning the implementation of EE including: (i) “Nurses are so busy” – perceptions on routine work practice; (ii) “A better outlook” – perceptions of the benefit of EE; (iii) “They’re just not going to participate” – perceptions of barriers to EE. Indeed, the challenges identified in this study align with practice change literature, which indicates that staff workload, routine and attitudes can influence the implementation of a new practice. Discussion: Staff perceived the use of an EE in their rehabilitation unit promoted activity/participation and increased patient moral. The barriers and enablers experienced by staff in this study may be used to inform the design and conduct of future studies investigating the efficacy of EE during inpatient stroke rehabilitation after stroke.