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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group of patients | No Intervention | Patients hospitalized after thoracic or abdominal surgery in a conventional in-hospital environment (not modified, before the implementation of the Culture Care program). Patients will receive standard of care, including early mobilization prescribed by the physician according to the ERAS guidelines. | |
| Culture Care group of patients | Experimental | Patients hospitalized after thoracic or abdominal surgery in an in-hospital environment modernized by the Culture Care program. As with control patients, patients in the Culture Care group will receive the similar standard of care, including early mobilization prescribed by the physician according to the ERAS guidelines. |
|
| Control group of healthcare workers | No Intervention | Healthcare workers working in the surgical units, with a conventional in-hospital environment (before implementation of the Culture Care program) | |
| Culture Care group of healthcare workers | Experimental | Healthcare workers working in the surgical units, with an in-hospital environment modernized by the Culture Care program |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Culture Care program | Other | 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. These posters will be interactive, so that a QR code can be scanned to access musical content and audio podcasts (interviews and documentaries) accessible via bone-conduction headphones. The Culture Care program is likely to reduce the sedentary behavior of hospitalized patients, by providing an attractive in-hospital environment that is likely to produce both physical and psychological benefits. |
| Measure | Description | Time Frame |
|---|---|---|
| Daily time spent out of bed | This outcome will be assessed by accelerometry | From postoperative day 1 to postoperative day 3. |
| Daily steps number | This outcome will be assessed by accelerometry | From postoperative day 1 to postoperative day 3. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients mobilized on the day of surgery | Out of bed: sitting in the chair, standing, walking, etc. This outcome will be assessed by accelerometry. | The day of surgery (Day 0) |
| Daily steps number |
| Measure | Description | Time Frame |
|---|---|---|
| Patients experience of the Culture Care intervention | Semi-structured interview (for the intervention group) | Interviews will start after the end of the quantitative study, for a anticipated duration from 1 to 5 months, maximum 8 months). Interviews will be conducted with patients between postoperative day 2 and postoperative day 5. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jonathan Dugernier, PhD | Contact | 0783057932 | +41 | jonathan.dugernier@he-arc.ch |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital de Neuchâtel | Recruiting | Neuchâtel | 2000 | Switzerland |
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The first part of this project is a quantitative monocentric, non-randomized controlled study comparing a group of participants before implementation of the Culture Care program (control group) with a group of participants after implementation of the Culture Care program (Culture Care group). Participants are hospitalized patients and the healthcare workers.
The second part of this project is a qualitative study once the Culture Care program is implemented.
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|
| From postoperative day 1 to postoperative day 5. |
| Mean daily duration of physical inactivity, light physical activity and moderate-to-vigorous physical activity | From postoperative day 1 to postoperative day 5. |
| Quality of recovery after surgery | This outcome will be assessed using the Quality of Recovery in 15 questions questionnaire (QoR-15) with a 11-point numerical rating scale with a minimum score of 0 (very poor recovery) and a maximum score of 150 (excellent recovery) | At postoperative day 2 and at discharge (maximum 1 day before) |
| Psychological well-being | This outcome will be assessed using the Hospital Anxiety and Depression scale to measure anxiety and depression, with a score of 0 to 7 considered normal, 8 to 10 indicate mild symptoms, 11 to 14 indicate moderate symptoms and 15 to 21 indicate severe symptoms. | At postoperative day 2 |
| Experience of in-hospital mobility | This outcome will be assessed using a survey with Likert scale questions with seven point scale to express how much they agree or disagree with different statements about barriers and facilitators to mobility during the hospital stay. In addition, patients will be asked to rate their satisfaction about the in-hospital environment (with 0 being the lowest and 10 being the highest). | At postoperative day 2 |
| Postoperative complications rate | This outcome will be assessed using the Comprehensive Complications Index (CCI®), a score ranging from 0 (no complication) to 100 (death). | From the day of surgery to hospital discharge (from maximum 1 day before discharge to 2 days after discharge) |
| Length of hospital stay | At hospital discharge (from maximum 1 day before discharge to 2 days after discharge) |
| Number of patients with adverse events | Adverse events related to early mobilization of patients in the postoperative phase up to discharge, i.e. number of falls or loss of consciousness, accidental removal of drains or catheters | At hospital discharge (from maximum 1 day before discharge to 2 days after discharge) |
| Number of adverse events per patients | Adverse events related to early mobilization of patients in the postoperative phase up to discharge, i.e. number of falls or loss of consciousness, accidental removal of drains or catheters | 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 | This outcome will be assessed among the healthcare workers via a survey. | 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. |
| Healthcare workers experience of the Culture Care intervention |
Semi-structured interview (for the intervention group only) conducted with the healthcare workers working in the units modernized with the Culture Care program. |
| Interviews will start after the end of the quantitative study, for an anticipated duration from 1 to 5 months, maximum 8 months) |
| ID | Term |
|---|---|
| D051346 | Mobility Limitation |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |
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