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

NCT06893848 | Recruiting

• 1 other identifier: Study 2024-02620
• Study Type: interventional
• Target: 204
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Thoracic Surgery; Abdominal Surgery Patients; Hospital Mobility; Mobility Limitation

Keywords

Physical activity; Postoperative recovery; Accelerometer; Early mobilization

Outcome Measures

Primary Outcomes (2)

• 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.

Secondary Outcomes (11)

• Number of patients mobilized on the day of surgery

  The day of surgery (Day 0)

• Daily steps number

  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

  At postoperative day 2 and at discharge (maximum 1 day before)

• Psychological well-being

  At postoperative day 2

Other Outcomes (2)

• Patients experience of the Culture Care intervention

  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.

• Healthcare workers experience of the Culture Care intervention

  Interviews will start after the end of the quantitative study, for an anticipated duration from 1 to 5 months, maximum 8 months)

Study Arms (4)

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.

Other: Culture Care program

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

Other: Culture Care program

Interventions

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.

Culture Care group of healthcare workers; Culture Care group of patients

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• Haute Ecole ARC Sante: lead

Study Sites (1)

Hôpital de Neuchâtel

Neuchâtel, 2000, Switzerland

RECRUITING

MeSH Terms

Conditions

Mobility Limitation; Motor Activity

Condition Hierarchy (Ancestors)

Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavior

Central Study Contacts

Jonathan Dugernier, PhD

CONTACT

0783057932; jonathan.dugernier@he-arc.ch

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr

Model Details: 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.

Study Record Dates

• First Submitted: March 7, 2025
• First Posted: March 25, 2025
• Study Start: March 10, 2025
• Primary Completion: May 1, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: March 25, 2025

Record last verified: 2025-03

Locations

CH (1)