Abstract
Health research has begun to pay increasing attention to inactivity in its broadest sense as lack of meaningful activity and boredom. Few studies however have taken a critical look at this phenomenon. We explore (in)activity drawing on ethnographic data from observations in an acute stroke unit and post-discharge interviews with stroke survivors and their families. Four themes emerged that explain patients’ (in)activity: (i) planned activities; (ii) ‘doing nothing’, (iii) the material environment of the unit; (iv) interactions with staff. Considering these themes, we seek to problematise received conceptual and methodological approaches to understanding (in)activity. We argue that (in)activity is best conceived not as lack of action or meaning, but as a situated practice encompassing both bodily and mental activities that reflect and reproduce the way in which life is collectively organised within a specific healthcare setting.
Highlights
Concerns about inactivity among stroke survivors have been raised for more than three decades, with studies consistently showing that patients in acute stroke units spend most of their time inactive and alone (Barrett et al, 2018; Bernhardt et al, 2004, 2008; De Weerdt et al, 2000; Ellul et al, 1993; Esmonde et al, 1997; Keith, 1980; Keith and Cowell, 1987; Langhorne et al, 2011)
If health research has traditionally focused on sedentariness, a growing body of literature has recently begun to consider the problem of boredom, drawing attention to how the hospital environment can unintentionally deprive patients of opportunities to engage in activities that meet their needs and preferences (Steele and Linsley, 2015)
The emerging literature on boredom is contributing to broaden the definition of inactivity beyond the narrow focus on physical activity
Summary
Concerns about inactivity among stroke survivors have been raised for more than three decades, with studies consistently showing that patients in acute stroke units spend most of their time inactive and alone (Barrett et al, 2018; Bernhardt et al, 2004, 2008; De Weerdt et al, 2000; Ellul et al, 1993; Esmonde et al, 1997; Keith, 1980; Keith and Cowell, 1987; Langhorne et al, 2011). Considered the preserve of philosophical enquiry (Goodstein, 2005; Heidegger, 1995), boredom is increasingly recognised as a problem affecting patients’ experience and outcomes (Burns, 2017; Steele and Linsley, 2015) It is an experience shared across patients suffering from diverse conditions, from psychiatric disorders (Binnema, 2004; Bowser et al, 2018; Newell et al, 2012; Todman, 2003), to cancer (Inman et al, 2003; Passik et al, 2003), brain injuries (Kenah et al, 2017), end of life conditions (Britton and Shipley, 2010) and stroke (Luker et al, 2015). Placing emphasis on the (lack of) meaning, the concept of boredom re-directs attention to the question of how patients spend time outside of planned care and to the mutual relationship between patients’ actions and emotions
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