What affects physical activity in a rehabilitation centre? Voices of patients, nurses, therapists, and activity trackers

Abstract

Purpose

In the context of rehabilitation, research shows a close connection between patients’ physical activity, care culture, and the built environment. As these three impact on patients’ rehabilitation process, we aim to understand what affects physical activity in a particular rehabilitation centre.

Materials and methods

We combine insights from literature with a qualitative study informed by quantitative data. Semi-structured and walking interviews with 16 patients were informed by output from activity trackers. Two focus-group interviews with respectively four nurses and two therapists provided extra perspectives.

Results

We found that patients interpret physical activity rather narrowly, equating it with therapy. Yet, the data of the activity trackers show that daily activities are often as active as therapy, as confirmed by nurses and therapists. Motivation to be physically active was found in setting clear goals, social interaction, allowing choice and control to achieve a sense of normality, and the built environment. How patients act in and interact with the built environment are closely related to how staff approaches and communicates care.

Conclusions

The focus on what affects – defines, hampers, or supports – physical activity in a rehabilitation centre allowed developing a better understanding of how care culture and the built environment interrelate.

Implications for rehabilitation

• How physical activity is perceived by patients reflects the goals they like to achieve through rehabilitation.

• The built environment is a third factor in the relation between care culture and patients’ physical activity.

• Fully supporting patients to be physically active with respect to their personality and capabilities requires differentiating between patients both in how they are approached (patient- or person-centred) and in how they are spatially facilitated.

Keywords:

• Built environment
• care
• physical activity
• rehabilitation
• patient experience
  

Acknowledgements

The authors thank all participating patients and staff members for sharing their time and insights, the management of the care organisation for the support, and Erik Verbeke for the support in programming the MATLAB code.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Research Foundation Flanders (FWO) under Grant Number 12Y6519N.