Ecological evaluation of a Rehabilitative Environment for spinal cord injured people: Behavioural mapping and feedback

Abstract

A behavioural mapping procedure was used to describe the behavioural profile, pattern of interaction and location of patients and staff in a rehabilitation unit for traumatically spinal cord injured people. Naturalistic observations were randomly obtained by trained observers during two observational periods, using 10 behavioural categories drafted from the observational literature. Feedback of the results was given to staff between the observational periods. Results suggested that patients spent a considerable proportion of their time in solitary and disengaged behaviours. Analysis of the behavioural profile of patients revealed little difference between the therapeutic day and the evening. Patients were also observed to spend large amounts of time in the ward area during the day. These results are at variance with the concept of active rehabilitation, and also raise questions concerning institutionalization. The efficacy of feedback in initiating institutional change is also examined. Comparison is made with previous research and strategies for change are suggested.