Clinical trial NCT06893848: Influence of the Culture Care Program on Patient Mobility After Thoracic or Abdominal Surgery: a Mixed-methods Study
Official title: Culture Care Program: a Mixed-methods Study Evaluating the Effect of an Innovative In-hospital Experience on Patient Mobility After Thoracic or Abdominal Surgery
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Thoracic Surgery
Abdominal Surgery Patients
Hospital Mobility
Mobility Limitation
Keywords: Physical activity
Postoperative recovery
Accelerometer
Early mobilization
Lead sponsor: Haute Ecole ARC Sante
Sponsor class: OTHER
First posted: 2025-03-25
Enrollment: 204
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Intervention model description: 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.
Primary purpose: PREVENTION

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.


Eligibility criteria: Inclusion Criteria:

* 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.

Exclusion Criteria:

* 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.

Primary outcomes:
measure: Daily time spent out of bed
timeFrame: From postoperative day 1 to postoperative day 3.
measure: Daily steps number
timeFrame: From postoperative day 1 to postoperative day 3.
Secondary outcomes:
measure: Number of patients mobilized on the day of surgery
timeFrame: The day of surgery (Day 0)
measure: Daily steps number
timeFrame: From postoperative day 1 to postoperative day 5.
measure: Mean daily duration of physical inactivity, light physical activity and moderate-to-vigorous physical activity
timeFrame: From postoperative day 1 to postoperative day 5.
measure: Quality of recovery after surgery
timeFrame: At postoperative day 2 and at discharge (maximum 1 day before)
measure: Psychological well-being
timeFrame: At postoperative day 2
measure: Experience of in-hospital mobility
timeFrame: At postoperative day 2
measure: Postoperative complications rate
timeFrame: From the day of surgery to hospital discharge (from maximum 1 day before discharge to 2 days after discharge)
measure: Length of hospital stay
timeFrame: At hospital discharge (from maximum 1 day before discharge to 2 days after discharge)
measure: Number of patients with adverse events
timeFrame: At hospital discharge (from maximum 1 day before discharge to 2 days after discharge)
measure: Number of adverse events per patients
timeFrame: At hospital discharge (from maximum 1 day before discharge to 2 days after discharge)
measure: Perception of the work environment and readiness to stimulate the mobility of hospitalized patients after surgery
timeFrame: 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.
Other outcomes:
measure: Patients experience of the Culture Care intervention
timeFrame: 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.
measure: Healthcare workers experience of the Culture Care intervention
timeFrame: Interviews will start after the end of the quantitative study, for an anticipated duration from 1 to 5 months, maximum 8 months)
Locations:
city: Neuchâtel
country: Switzerland
facility: Hôpital de Neuchâtel
Study officials:
References: