Exploring the potential impact of green spaces for in-patient stroke units: A mixed methods study

Abstract

Background: Research suggests green spaces can benefit in-patients, including improving mood and wellbeing. Recently, Chapel Allerton hospital installed two new green spaces for the benefit of stroke patients: The Stroke Association's “Garden for Recovery”, transplanted from the Chelsea Flower Show; and a therapy garden designed by LTHT Estates staff to provide an alternative setting for therapy. Other stroke units also have access to green space, yet little is known about the use of green space post-stroke.

Aims: To explore use of hospital-based green spaces for stroke in-patients, potential benefits, challenges, key elements and relevant contextual factors.

Methods: Mixed-methods multisite case study (three stroke units including at Chapel Allerton, each with access to green space designed and used for different purposes). Data collection: • contextual data to understand design, rationale, and maintenance; • behavioural mapping (10-day period, two seasons per site) to understand usage; • semi-structured interviews to understand experiences, with (per site): ---ten in-patients who are green-space users and their carers (twice: while hospitalised and again once discharged); ---five in-patients who have not used the space; ---ten multidisciplinary staff.

Interview data will be analysed using the Framework approach; mixed methods data synthesised, and programme theory and recommendations drafted. The latter will be refined by expert groups of stroke survivors, carers and staff in three other locations.

Results: The first round of behavioural mapping identified little green-space usage in winter (one group of visitors in ten days). Spring/Summer data will be available by July 2026. Initial interviews have been conducted; a preliminary analysis describing the experiences, benefits and challenges of green spaces for in-patient stroke care will be available in July 2026.

Conclusion: Our proposed project has the potential to transform stroke rehabilitation by examining how green spaces could improve patient outcomes, support staff well-being, and promote sustainable healthcare practices.