Article

Environmental Enrichment (EE) is shown to facilitate recovery of
motor and cognitive function in animal models of stroke. The efficacy of EE in
the clinical setting with stroke survivors remains unknown. Successful
implementation of EE in a busy rehabilitation unit requires identification of
barriers and enablers which are best informed by staff feedback. AIM: To
qualitatively explore the experiences of nursing staff involved in a pilot study
investigating the feasibility of EE in a rehabilitation ward. METHODS: This was a
qualitative study consisting of analysis of semi-structured interviews with nine
nursing staff who were asked to reflect on "routine care" and their own
"experience of the EE study". An inductive thematic approach was used to collect
and analyse data using a process of constant comparison. RESULTS: Male and female
staff with varying years of experience working in stroke rehabilitation
participated in focus group and individual interviews. Three key themes were
identified concerning the implementation of EE including: (i) "Nurses are so
busy"--perceptions on routine work practice; (ii) "A better outlook"--perceptions
of the benefit of EE; (iii) "They're just not going to participate"--perceptions
of barriers to EE. Indeed, the challenges identified in this study align with
practice change literature, which indicates that staff workload, routine and
attitudes can influence the implementation of a new practice. DISCUSSION: Staff
perceived the use of an EE in their rehabilitation unit promoted
activity/participation and increased patient moral. The barriers and enablers
experienced by staff in this study may be used to inform the design and conduct
of future studies investigating the efficacy of EE during inpatient stroke
rehabilitation after stroke. IMPLICATIONS FOR REHABILITATION: Results from
animals models suggest that environmental enrichment (EE) is an important
paradigm for consideration in stroke rehabilitation. It is concerning that many
stroke survivors are inactive during their admission for inpatient stroke
rehabilitation. Preliminary results suggest that rehabilitation nurses perceive
that EE promoted patient activity/participation. Results highlight the importance
of social support and participation in the ward environment and potential
benefits for patient's mood levels.

Langue : ANGLAIS