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

Official title

Culture Care Program: a Mixed-methods Study Evaluating the Effect of an Innovative In-hospital Experience on Patient Mobility After Thoracic or Abdominal Surgery

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.

Interventions

• Other Culture Care program
  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. Th

Primary outcome measures

• Daily time spent out of bed [Time frame: From postoperative day 1 to postoperative day 3.]
• Daily steps number [Time frame: From postoperative day 1 to postoperative day 3.]

Secondary outcome measures (11)

• Number of patients mobilized on the day of surgery [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 [Time frame: At postoperative day 2 and at discharge (maximum 1 day before)]
• Psychological well-being [Time frame: At postoperative day 2]
• Experience of in-hospital mobility [Time frame: At postoperative day 2]
• Postoperative complications rate [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 [Time frame: At hospital discharge (from maximum 1 day before discharge to 2 days after discharge)]
• Number of adverse events per patients [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 [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.]

Eligibility criteria

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.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Non-randomized

Model

Single group

Masking

Single blind

Primary purpose

Prevention

Study locations

Switzerland · 1 center

• Hôpital de Neuchâtel — Neuchâtel

Identifiers

NCT: NCT06893848 · Study 2024-02620

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗