Literature review published
As described in our earlier blog post, gathering existing knowledge is a critical part of any project. In order to improve the design of stroke rehabilitation environments we need to make sure that we’re aware of all the relevant past research. This past year, the NOVELL team has conducted a review of the academic literature to collate all the international research relevant to the built environment and design of inpatient stroke rehabilitation facilities.
This review has now been published and, in keeping with open research practices and our Living Lab framework, it can be downloaded free of charge by anyone who would like to read it by following this link. We’ve also summarised our review in an infographic which you’ll find at the bottom of this blog post.
Systematic and scientific research methods are core to the NOVELL project, so we made sure to use rigorous methods for our review. After conducting numerous searches and weeding out the irrelevant or less applicable research we found 24 research articles to include in our final review.
Image: The number of published research articles that were found, screened, excluded, and included in the systematic literature review, Lipson-Smith et al., 2021.
These research articles all used many varied methods to investigate stroke rehabilitation environments including comparative studies, behaviour mapping and observation, and qualitative interviews. Some of the researchers had focused on a particular aspect of the built environment - such as the design of communal spaces, bedrooms, or therapy spaces - while others had instead explored the impact of the built environment as a whole. Some researchers had looked specifically at how the built environment impacted the clinical outcomes and recovery of stroke survivors, while other researchers had focused on whether the environment impacted physical, cognitive, or social activity, emotional well-being, or staff practices.
With so many different variables studied, and so many different methods used, it was difficult to synthesise results from the 24 research studies. There did appear to be some important repeated findings that we can use to guide our designs for NOVELL. For example, there was clear evidence that attractive and accessible communal areas are important for patient activity and well-being.
Some of the differences between the results of the 24 research studies revealed important areas of contention. For example, there were mixed results about the impact of single-bed rooms in stroke rehabilitation with some studies finding that they were beneficial and others suggesting that they may have some negative impacts. Bedroom design, and the relative strengths and limitations of single and shared bedrooms, will therefore be a central consideration in our NOVELL research.
Our review also revealed some clear evidence gaps - aspects of the built environment that had not been investigated thoroughly in the published research. For example, we found no research specific to the impact of outdoor spaces in inpatient stroke rehabilitation facilities. This is surprising as outdoor spaces and access to nature have been investigated in other healthcare settings and found to be very important. There was also very little research to suggest how the environment may impact the safety of stroke survivors, family/visitors, and staff, which is clearly an important consideration.
We in the NOVELL team found this review incredibly useful and informative, and we hope that you do too. It has confirmed for us the importance of conducting more targeted, unified research to continue to strengthen the evidence-based for inpatient stroke rehabilitation environment design.
Below is an infographic summary of the review which you are welcome to share.
