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Disentangling the complexity of mobility of older medical patients in routine practice: An ethnographic study in Denmark
Copenhagen Univ Hosp Hvidovre, Denmark.
Roskilde Municipal, Denmark.
Copenhagen Univ Hosp Hvidovre, Denmark.
Copenhagen Univ Hosp Hvidovre, Denmark; Clin Res Ctr, Denmark.
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 4, article id e0214271Article in journal (Refereed) Published
Abstract [en]

Aim Many older medical patients experience persistent functional limitations after hospitalization, such as dependency in activities of daily living, recurring fall incidents and increased mortality. Therefore, increased activity and mobilization during hospitalization are essential to prevent functional decline in older medical patients. No previous studies have explored how the social context influences how health professionals decide whether or not to mobilize patients. This qualitative study aimed to explore how social contextual circumstances affect the mobility of older medical patients in medical departments. Methods An ethnographic field study was conducted in six medical departments in three public hospitals in the capital region of Copenhagen, Denmark. Participant observations were carried out from January to June 2017. The researchers were present for up to 14 days (range, 8-14 days) in the six departments. A total of 210 pages of field notes were produced. The participants were health professionals involved in the care of older medical patients: physiotherapists, registered nurses, nursing assistants and physicians. A content analysis was conducted. Findings Five themes concerning mobility of patients emerged: (1) materialities; (2) professional roles; (3) encouraging moments; (4) patients and relatives; and (5) organization and management. Of these, professional roles seem to be the most important because it pervaded all themes. Different health professionals in the medical departments recognized, spoke and acted based on different cultural models. Conclusion It was found that mobility of older medical patients is entangled in a complex network of social contextual circumstances. Mobility of older medical patients is based on health professionals different cultural models, which shape distinct professional identities and lead to contradictions and blurring of the priorities and responsibilities among the health professionals involved in mobilization. The consequence is that no profession "owns" the responsibility for mobilization, thus restricting mobilization of the patients during hospitalization.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE , 2019. Vol. 14, no 4, article id e0214271
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Health Care Service and Management, Health Policy and Services and Health Economy
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URN: urn:nbn:se:liu:diva-157212DOI: 10.1371/journal.pone.0214271ISI: 000464696100007PubMedID: 30990802OAI: oai:DiVA.org:liu-157212DiVA, id: diva2:1324709
Note

Funding Agencies|Velux Foundation (Lauritz William Foundation) [00013449]

Available from: 2019-06-14 Created: 2019-06-14 Last updated: 2019-10-31

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