Effects of a Supervised Inpatient Gratitude Walking Program on Rural Veteran Populations
Abstract: Objectives: To determine if there will be a change in quality care metrics using a supervised inpatient gratitude walking program. Also, to investigate if implementation of this program could improve early detection of mood disorders. Design: Correlational, Cross-sectional. Setting: Hospitalized Care. Participants: Hospitalized Veterans (N=54) from May 2022 to March 2023 who scored between 7 to 16 on the Tinetti Gait/Balance assessment tool and agreed to daily 20-minute walks during admission. Interventions: Daily 20-minute gratitude walk with hospitalized patients who qualified. Main outcome measures: Impact of gratitude walks on Internal State Scale Version 2 (ISS-2) score during hospitalization and 2 weeks after hospitalization. Length of stay, and Readmission Rates. Results: Data shows that 54 of 189 veterans met program inclusion criteria. The impact of gratitude walks on ISS-2 scores improved both the well-being scores and the depression scores. The ISS-2 tool correlates a greater well-being score as better, at time of admission the average score was 188 and the average score 2-weeks post discharge was 216 (ARR = 0.51, RRR = 12.9%, NNT = 1.9). The ISS-2 tool correlates a lower depression score as better, at the time of admission the average score was 207 and the average score 2-weeks post discharge was 162 (ARR = 0.83, RRR = 21.7%, NNT = 1.2). However, there was no significant change in length of stay (6.4 days vs. 6.8 days) for the facility compared to previous scores. Hospital wide readmissions were improved for some specific disease process like COPD and pneumonia but worse for congestive heart failure. A direct correlation of readmission metrics to the intervention could not be concluded. Conclusions: Initiation of daily early mobilization program in combination with gratitude exercises can decrease the risk of post-hospital depression and improve well-being. Contributing to better health outcomes and mental health at all stages of recovery.