Students of Florey Stroke: Ruby Lipson-Smith
Name: Ruby Lipson-Smith
Role, Group: PhD student, Stroke
Supervisor(s): Prof Julie Bernhardt, The Florey (primary supervisor), Prof Heidi Zeeman, Griffith University (co-supervisor)
Email: ruby.lipson-smith@florey.edu.au
Phone: +61 3 9035 7130
Location: MBC Austin
Twitter: @RubyLipsonSmith
https://www.linkedin.com/in/ruby-lipson-smith-5b7a32104/
https://www.researchgate.net/profile/Ruby_Lipson-Smith
Ruby Lipson-Smith is a PhD student in the Stroke department at The Florey Institute of Neuroscience and Mental Health. Her PhD research focuses on how the design of inpatient rehabilitation facilities may influence patients’ behaviour, mood, and recovery after a stroke. More broadly, she is interested in human/environment interactions and how they apply to health psychology, brain repair, mood, and cognition (memory, perception, executive functions).
Ruby is also a Research Officer in Cancer Experience Research at Peter MacCallum Cancer Centre where her research focuses on understanding and improving patients’ care and treatment experiences.
She has a Bachelor of Science (honours) in Psychology and Neuroscience, and a Bachelor of Arts in History. Ruby collaborates with researchers and architects at the Melbourne School of Design, and has received seed funding from the Hallmark Ageing Research Initiative to explore the concept of stroke rehabilitation facilities as learning environments.
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| Ruby Lipson-Smith |
Tell us about your research.
I use mixed methods to investigate how the environment of inpatient rehabilitation facilities may interact with patients’ behaviour, mood, and recovery after a stroke. I analyse the designs of the facilities and use systematic observation (behavioural mapping), activity tracking, questionnaires, and qualitative ‘walkthrough’ patient interviews to consider the relationship between stroke patients’ experiences, their behaviour, and their environment. I have also used Value-Focused Thinking expert-elicitation methodologies to explore what various experts (clinicians, architects, patients, academics, etc.) think is important in the design of inpatient stroke rehabilitation facilities. By using a variety of research techniques, and speaking with people who have had a stroke, I hope to gain a broad understanding of the complex interactions between the environment, behaviour, and brain repair.
Why is your research important?
Stroke incidence is increasing, and many people who have a stroke require a period of inpatient rehabilitation to re-learn skills or abilities that were compromised as a result of the stroke. Re-learning after a stroke is incredibly difficult. Patients often experience fatigue, depression, boredom, and a lack of motivation which makes it very hard to participate in the goal-directed therapy and incidental practice (physical, cognitive, and social activity) that are necessary for re-learning. It’s therefore essential that the design of inpatient rehabilitation buildings facilitates practice and promotes patient activity and motivation. However, rehabilitation wards are unfortunately often located in refurbished acute medical wards, or have been designed following a model that promotes bed rest and isolation – behaviours which are detrimental to stroke recovery. Results from my research may be used to optimise new buildings and refurbishments for re-learning and recovery after stroke.
What would you like to do in the future?
I would like to continue to explore connections between the brain and the environment, and to conduct research at the juncture where the arts and the sciences meet.
What is your favourite thing about the Florey?
My favourite thing about the Florey is the variety of topics and techniques that are researched at the institute – from molecular and cellular to clinical – and the generosity with which this expertise is shared.
What inspired you to pursue stroke research?
My grandmother had a stroke when I was 9 and I was struck by both the sudden devastation and the gradual improvements (and later, age-related decline) that happened to her brain and mind. The complexity of those changes, and the difficulties that she experienced have always stayed with me. I find this area of research challenging, but hopeful: the sudden onset of stroke is a humbling reminder of the delicate vulnerability and complexity of our brain, but our ability to re-learn and recover after a stroke, whether completely or minutely, is an encouraging reminder of our brain’s plasticity and ability to improve.
Research Projects:
A survey of rehabilitation facility design in Victoria
The aim of this study is to survey all of the inpatient rehabilitation facility in Victoria in order to broadly describe the buildings that house these facilities (including their age, original purpose, layout, and features). Knowing the current state of these buildings, and whether they were purpose-built, will help in planning and prioritising future research. This is a descriptive study, with data collected via telephone questionnaire and publicly available websites.
Reframing stroke rehabilitation spaces: The role of learning in recovery and its implications for design
The aim of this study is to use a Value-Focused Thinking expert-elicitation approach to determine what experts think is important in the design of inpatient stroke rehabilitation facilities. Most previous research about the physical environment and hospital design relates to the acute healthcare setting. While these findings are important, rehabilitation facilities are unique because they are both a healthcare space and a re-learning space. The priorities for the design of stroke inpatient rehabilitation facilities are therefore likely to be distinct from that of acute healthcare settings. To understand these priorities, many perspectives need to be considered, including those that may come from learning environments research. This study was funded by the Hallmark Aging Research Initiative and is a collaborative project between The Florey and The Learning Environments Applied Research Network (LEaRN) at the Melbourne School of Design.
The Value-Focused Thinking methodology will be carried out over a series of workshops and will result in a structured framework to describe what is important in the design of inpatient stroke rehabilitation facilities. The workshops will be attended by a variety of experts, including: Past stroke patients; clinicians with experience in stroke rehabilitation; healthcare environments academics; learning environments academics; architects, designers, and wayfinders with experience of designing healthcare environments or learning environments; and health policy-makers. Understanding what is important in the design of these spaces will provide a structure for design evaluation of existing facilities, and can be used to inform the design of new facilities and refurbishments.
The ENVIRONS (ENVironments for Inpatient RehabilitatiON of Stroke patients) study: A multiple-case study to understand how the built environment of inpatient stroke rehabilitation facilities may best promote efficiency, effectiveness, emotional well-being, and safety.
The ENVIRONS study will build on the framework that was developed in the ‘reframing stroke rehabilitation spaces’ study and complement the expert opinion with data collected on site at rehabilitation facilities. The ENVIRONS study is a multiple-case study, where 2 inpatient rehabilitation facilities in Victoria are considered as separate 'cases'. The aim of the ENVIRONS study is to understand how the built environment may best meet the criteria that have been defined as important for the design of inpatient stroke rehabilitation spaces, namely: efficiency, effectiveness, emotional well-being, and safety. The study will follow a Convergent Mixed-Methods study design. The built environments of the participating sites will be described (floor plans, written description, photos). Staff at each site will be asked to participate in a structured interview. A sample of stroke patients at each site will also be asked to participate. Patient participation will involve behavioural mapping (observing patient behaviour and levels of physical, cognitive, and social activity), a 'walkthrough' interview, and a selection of questionnaires. Results from this study could increase the evidence-base behind design choices that are made in new and refurbished inpatient rehabilitation facilities.
The aim of this study is to survey all of the inpatient rehabilitation facility in Victoria in order to broadly describe the buildings that house these facilities (including their age, original purpose, layout, and features). Knowing the current state of these buildings, and whether they were purpose-built, will help in planning and prioritising future research. This is a descriptive study, with data collected via telephone questionnaire and publicly available websites.
Reframing stroke rehabilitation spaces: The role of learning in recovery and its implications for design
The aim of this study is to use a Value-Focused Thinking expert-elicitation approach to determine what experts think is important in the design of inpatient stroke rehabilitation facilities. Most previous research about the physical environment and hospital design relates to the acute healthcare setting. While these findings are important, rehabilitation facilities are unique because they are both a healthcare space and a re-learning space. The priorities for the design of stroke inpatient rehabilitation facilities are therefore likely to be distinct from that of acute healthcare settings. To understand these priorities, many perspectives need to be considered, including those that may come from learning environments research. This study was funded by the Hallmark Aging Research Initiative and is a collaborative project between The Florey and The Learning Environments Applied Research Network (LEaRN) at the Melbourne School of Design.
The Value-Focused Thinking methodology will be carried out over a series of workshops and will result in a structured framework to describe what is important in the design of inpatient stroke rehabilitation facilities. The workshops will be attended by a variety of experts, including: Past stroke patients; clinicians with experience in stroke rehabilitation; healthcare environments academics; learning environments academics; architects, designers, and wayfinders with experience of designing healthcare environments or learning environments; and health policy-makers. Understanding what is important in the design of these spaces will provide a structure for design evaluation of existing facilities, and can be used to inform the design of new facilities and refurbishments.
The ENVIRONS (ENVironments for Inpatient RehabilitatiON of Stroke patients) study: A multiple-case study to understand how the built environment of inpatient stroke rehabilitation facilities may best promote efficiency, effectiveness, emotional well-being, and safety.
The ENVIRONS study will build on the framework that was developed in the ‘reframing stroke rehabilitation spaces’ study and complement the expert opinion with data collected on site at rehabilitation facilities. The ENVIRONS study is a multiple-case study, where 2 inpatient rehabilitation facilities in Victoria are considered as separate 'cases'. The aim of the ENVIRONS study is to understand how the built environment may best meet the criteria that have been defined as important for the design of inpatient stroke rehabilitation spaces, namely: efficiency, effectiveness, emotional well-being, and safety. The study will follow a Convergent Mixed-Methods study design. The built environments of the participating sites will be described (floor plans, written description, photos). Staff at each site will be asked to participate in a structured interview. A sample of stroke patients at each site will also be asked to participate. Patient participation will involve behavioural mapping (observing patient behaviour and levels of physical, cognitive, and social activity), a 'walkthrough' interview, and a selection of questionnaires. Results from this study could increase the evidence-base behind design choices that are made in new and refurbished inpatient rehabilitation facilities.
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