Promoting inpatients' physical activity : From the development of a family participation intervention to the implementation of a multidimensional action plan

Abstract

In order to prevent physical decline it is necessary that patients remain physically active as much as possible during hospitalization. In this thesis, two intervention projects aiming to increase physical activity in hospitalized patients have been investigated. In part 1, an intervention for family participation in physiotherapy-related tasks in patients admitted to the Intensive Care Unit has been developed. The developed intervention contains three components: 1) brochure including a menu of activities divided into simple activities to calm the patient (e.g. reading a book) and physiotherapy-related tasks such as passive movements, active limb exercises, and functional exercises; 2) poster in patient room demonstrating what family wants/can do; and 3) instruction moment with physiotherapist. Subsequently, its feasibility was investigated in a pilot study. The findings of this study demonstrate that family participation in physiotherapy-related tasks in patients admitted to the Intensive Care Unit is feasible. Part 2 focused on the implementation and evaluation of Hospital in Motion, a multidisciplinary implementation project aiming to improve movement behavior of hospitalized patients. During one year, an action plan, consisting of multidimensional 'exercise interventions', was implemented in four different wards. Results show that the percentage of time spent in bed (during the day) decreased. In addition, experienced factors of influence on the implementation of Hospital in Motion were investigated. Findings demonstrate that interventions must be multidimensional and tailored to the target group in order to bring about effective and sustainable changes. Subsequently, these interventions must be implemented and evaluated step-by-step for each individual intervention.