Movement behavior might serve as a crucial factor in the clinical decision-making processes of health care professionals, influencing matters such as post-hospital destination, medical discharge, functional independence, and treatment adjustments. This study explored how health care practitioners in a hospital setting use patient movement behavior (physical activity, sedentary behavior and sleep) in their clinical decision making.
A qualitative thematic analysis approach was used to develop a theoretical framework. Purposive sampling was used to recruit doctors, nurses and physiotherapists across different wards and different levels of seniority from the University Medical Centre Utrecht (the Netherlands). Between January 2024 and August 2024 observations and semi structured -interviews were conducted. Observations and interviews were transcribed and analysis moved from initial coding to focus coding resulting in the production of subthemes, themes and finally theory development. Qualitative thematic analysis approach was used to develop a theoretical framework.
In total, 45 participants (16 physiotherapist, 15 nurses and 14 doctors) were included in the study. Four main themes were derived from the data.(1): ‘Enhancing the objectiveness of movement’ (2): ‘Engaging the patients in physical activity’ (3)’Multidisciplinary involvement and working process’.4) ‘’. These four concepts fall under the same theory; movement behavior influences treatment and discharge location. Health care professionals believe that patients require certain levels of physical activity in order to receive certain treatments and require that, aside from medical considerations, the patient be functionally prepared for the next location after discharge. Patients preferences and motivations have a huge importance in shared medical decisions, especially when movement behavior is involved. A theoretical framework was developed which identifies factors that explain clinical decision making among health care professionals in the hospital setting.
Theoretical findings identified factors related to movement behavior, and how do they affect clinical decision making. Furthermore, results demonstrate that health care practitioners have different roles, duties and responsibilities across different hospital wards. This study shows that movement behavior assessment is used for treatment selection, movement goals setting, treatment guidelines, and location of discharge selection.
Theory development over the transition from implicit understanding and decision making to explicit theory understanding of different health care practitioners perspectives can lead to improve multidisciplinary decisions regarding medical and functional aspects of patients during admission
Movement Behavior
Clinical Decision Making
