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Wen P, Sun L, Shen T, Wang Z. Factors impeding physical activity in older hospitalised patients: A qualitative meta-synthesis. J Clin Nurs 2024. [PMID: 38572996 DOI: 10.1111/jocn.17158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/25/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Older hospitalised patients have low levels of physical activity and multiple impairing factors. AIMS To systematically evaluate the perceived barriers to physical activity among older patients during hospitalisation, and provide reference for future intervention programs. DESIGN Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. METHODS An exhaustive exploration was conducted across the CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Embase, Cochrane Library and Web of Science from their inception until August, 2023 to identify qualitative research on obstacles to physical activity among older hospital patients. The quality of the literature was evaluated using the Joanna Briggs Institute's critical appraisal tool for qualitative research. Meta-synthesis method was used to integrate the results. RESULTS In total, 8 literatures were included, 43 themes were extracted, and analogous research results were amalgamated to generate 10 categories and 3 syntheses: individual level, interpersonal influencing factors and hospital environment and resources level. CONCLUSION Older inpatients are faced with multiple barriers to physical activity. Medical staff should pay attention to changes in physical activity during hospitalisation, identify barriers to physical activity in older inpatients and provide references for promoting physical activity programs for the older. NO PATIENT OR PUBLIC CONTRIBUTION This study is a meta-synthesis and does not require relevant contributions from patients or the public. WHAT IS ALREADY KNOWN Older patients are at low physical activity levels during hospitalisation. Older inpatients are faced with multiple barriers to physical activity. WHAT THIS PAPER ADDS Factors of physical activity impairment in hospitalised older patients should be considered in the context of health status, psychological factors, motivation and social support. Disease-induced psychological fallout has a greater impact on physical activity in the older.
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Affiliation(s)
- Peiting Wen
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Lili Sun
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - TianTian Shen
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhaodi Wang
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Serrano-Guerrero J, Bani-Doumi M, Chiclana F, Romero FP, Olivas JA. How satisfied are patients with nursing care and why? A comprehensive study based on social media and opinion mining. Inform Health Soc Care 2024; 49:14-27. [PMID: 38178275 DOI: 10.1080/17538157.2023.2297307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
To assess the overall experience of a patient in a hospital, many factors must be analyzed; nonetheless, one of the key aspects is the performance of nurses as they closely interact with patients on many occasions. Nurses carry out many tasks that could be assessed to understand the patient's satisfaction and consequently, the effectiveness of the offered services. To assess their performance, traditionally, expensive, and time-consuming methods such as questionnaires and interviews have been used; nevertheless, the development of social networks has allowed the patients to convey their opinions in a free and public manner. For that reason, in this study, a comprehensive analysis has been performed based on patients' opinions collected from a feedback platform for health and care services, to discover the topics about nurses the patients are more interested in. To do so, a topic modeling technique has been proposed. After this, sentiment analysis has been applied to classify the topics as satisfactory or unsatisfactory. Finally, the results have been compared with what the patients think about doctors. The results highlight what topics are most relevant to assess the patient satisfaction and to what extent. The results remark that the opinion about nurses is, in general, more positive than about doctors.
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Affiliation(s)
- Jesus Serrano-Guerrero
- Department of Information Technologies and Systems, University of Castilla-La Mancha, Escuela Superior de Informatica, Ciudad Real, Spain
| | - Mohammad Bani-Doumi
- Department of Information Technologies and Systems, University of Castilla-La Mancha, Escuela Superior de Informatica, Ciudad Real, Spain
| | - Francisco Chiclana
- School of Computer Science and Informatics, De Montfort University, Institute of Artificial Intelligence, Leicester, UK
| | - Francisco P Romero
- Department of Information Technologies and Systems, University of Castilla-La Mancha, Escuela Superior de Informatica, Ciudad Real, Spain
| | - Jose A Olivas
- Department of Information Technologies and Systems, University of Castilla-La Mancha, Escuela Superior de Informatica, Ciudad Real, Spain
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Goonan R, Mohandoss E, Marston C, Kay J, De Silva AP, Maier AB, Reijnierse E, Klaic M. Is there a relationship between 'getting up and dressed' and functional and physical outcomes in geriatric rehabilitation inpatients? A quasi-experimental study. Clin Rehabil 2024; 38:119-129. [PMID: 37644886 DOI: 10.1177/02692155231197510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVES To evaluate the physical and functional outcomes of the 'Ending Pyjama Paralysis' intervention in an inpatient geriatric rehabilitation unit. DESIGN Quasi-experimental mixed-methods design nested within the 'REStORing health of acutely unwell adulTs' (RESORT) prospective, observational, longitudinal cohort of geriatric rehabilitation inpatients study. SETTING Geriatric rehabilitation wards in a major metropolitan public hospital between June 2019 and March 2020. INTERVENTION The 'Ending Pyjama Paralysis' movement originated in the UK. Its aim was to encourage patients to 'Get up, Get dressed and Get moving' to reduce hospital-associated functional decline. However, the physical and functional benefits of this campaign have not yet been evaluated. The 'Ending Pyjama Paralysis' was adopted as an integrated intervention on two out of four geriatric rehabilitation wards. The two control wards received usual care. MAIN MEASURES Physical measures included the Short Physical Performance Battery, and functional measures included the Katz Index of Independence in Activities of Daily Living and Lawton and Brody's Instrumental Activities of Daily Living, which were completed on admission and discharge. A linear mixed-effects model was used to analyse the results. RESULTS A total of 833 admissions were included in this study. Of these, 512 patients were in the control group, and 321 were in the intervention group. There were no significant differences in both physical and functional measures between the intervention and control groups. CONCLUSION The 'Ending Pyjama Paralysis' campaign did not result in enhanced functional or physical benefits in geriatric rehabilitation inpatients in this setting when applied in addition to usual care.
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Affiliation(s)
- Rose Goonan
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
| | - Edward Mohandoss
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
| | - Celia Marston
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Jaqueline Kay
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
| | - Anurika Priyanjali De Silva
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- MISCH (Methods and Implementation Support for Clinical and Health research Hub), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Department of Internal Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, Singapore
| | - Esmee Reijnierse
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
| | - Marlena Klaic
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
- Melbourne School of Health Science, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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4
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Alsop T, Woodforde J, Rosbergen I, Mahendran N, Brauer S, Gomersall S. Perspectives of health professionals on physical activity and sedentary behaviour in hospitalised adults: A systematic review and thematic synthesis. Clin Rehabil 2023; 37:1386-1405. [PMID: 37070142 PMCID: PMC10426259 DOI: 10.1177/02692155231170451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/02/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE To explore health professionals' perspectives on physical activity and sedentary behaviour of hospitalised adults to understand factors that contribute to these behaviours in this environment. DATA SOURCES Five databases (PubMed, MEDLINE, Embase, PsycINFO and CINAHL) were searched in March 2023. REVIEW METHODS Thematic synthesis. Included studies explored perspectives of health professionals on the physical activity and/or sedentary behaviour of hospitalised adults using qualitative methods. Study eligibility was assessed independently by two reviewers and results thematically analysed. Quality was assessed using the McMaster Critical Review Form and confidence in findings assessed using GRADE-CERQual. RESULTS Findings from 40 studies explored perspectives of over 1408 health professionals from 12 health disciplines. The central theme identified was that physical activity is not a priority in this setting due to the complex interplay of multilevel influences present in the interdisciplinary inpatient landscape. Subthemes, the hospital is a place for rest, there are not enough resources to make movement a priority, everyone's job is no one's job and policy and leadership drives priorities, supported the central theme. Quality of included studies was variable; critical appraisal scores ranged from 36% to 95% on a modified scoring system. Confidence in findings was moderate to high. CONCLUSION Physical activity in the inpatient setting is not a priority, even in rehabilitation units where optimising function is the key. A shift in focus towards functional recovery and returning home may promote a positive movement culture that is supported by appropriate resources, leadership, policy, and the interdisciplinary team.
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Affiliation(s)
- Tahlia Alsop
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Ingrid Rosbergen
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Department of Physiotherapy & Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Niruthikha Mahendran
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sandra Brauer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sjaan Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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Herzog PJ, Herzog-Zibi RDL, Mattmann M, Möri C, Mooser B, Inauen J, Aubert CE. Perspectives of patients and clinicians on older patient mobility on acute medical wards: a qualitative study. BMC Geriatr 2023; 23:558. [PMID: 37704950 PMCID: PMC10500927 DOI: 10.1186/s12877-023-04226-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/08/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Low mobility during an acute care medical hospitalization is frequent and associated with adverse outcomes, particularly among older patients. Better understanding barriers and facilitators to improve mobility during hospitalization could help develop effective interventions. The goal of this study was to assess barriers and facilitators to older medical patients' hospital mobility, from the point of view of patients and clinicians, to develop a framework applicable in clinical practice. METHODS We conducted a qualitative study in one university and two non-university hospitals of two different language and cultural regions of Switzerland, including 13 focus groups (FGs; five with patients, eight with clinicians). We included 24 adults aged 60 years or older hospitalized on an acute general internal medicine ward of one of the three participating hospitals during the previous years, and 34 clinicians (15 physicians, nine nurses/nursing assistants, 10 physiotherapists) working on those wards. The FG guides included open-ended questions exploring mobility experiences, expectations, barriers and facilitators to mobility, consequences of low mobility and knowledge on mobility. We applied an inductive thematic analysis. RESULTS We identified four themes of barriers and facilitators to mobility: 1) patient-related factors; 2) clinician-related factors; 3) social interactions; and 4) non-human factors. Clinician-related factors were only mentioned in clinician FGs. Otherwise, subthemes identified from patient and clinician FGs were similar and codes broadly overlapped. Subthemes included motivation, knowledge, expectations, mental and physical state (theme 1); process, knowledge - skills, mental state - motivation (theme 2); interpersonal relationships, support (theme 3); hospital setting - organization (theme 4). CONCLUSIONS From patients' and clinicians' perspectives, a broad spectrum of human and structural factors influences mobility of older patients hospitalized on an acute general internal medicine ward. New factors included privacy issues and role perception. Many of those factors are potentially actionable without additional staff resources. This study is a first step in participatory research to improve mobility of older medical inpatients.
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Affiliation(s)
- Philippe J Herzog
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Rose D L Herzog-Zibi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Charlotte Möri
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Blandine Mooser
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Jennifer Inauen
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Carole E Aubert
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
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Drazich BF, Resnick B, Boltz M, Galik E, Kim N, McPherson R, Ellis J, Phun J, Kuzmik A. Factors Associated With Physical Activity in Hospitalized Patients With Dementia. J Aging Phys Act 2023; 31:658-665. [PMID: 36746152 PMCID: PMC10517697 DOI: 10.1123/japa.2022-0210] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/11/2022] [Accepted: 11/12/2022] [Indexed: 02/08/2023]
Abstract
Older adults continue to spend little time engaged in physical activity when hospitalized. The purpose of this study was to (a) describe activity among hospitalized older adults with dementia and (b) identify the association between specific factors (gender, ambulation independence, comorbidities, race, and hospital setting) and their physical activity. This descriptive study utilized baseline data on the first 79 participants from the Function Focused Care for Acute Care using the Evidence Integration Triangle. Multiple linear regression models were run using accelerometry data from the first full day of hospitalization. The participants spent an average of 83.7% of their time being sedentary. Male gender, ambulation independence, and hospital setting (the hospital in which the patient was admitted) were associated with greater activity. This study reports on the limited time spent in activity for older adults with dementia when hospitalized and highlights patient profiles that are particularly vulnerable to sedentary behavior in the hospital setting.
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Affiliation(s)
| | - Barbara Resnick
- School of Nursing, University of Maryland Baltimore, Baltimore, MD,USA
| | - Marie Boltz
- School of Nursing, Penn State University, College State, PA,USA
| | - Elizabeth Galik
- School of Nursing, University of Maryland Baltimore, Baltimore, MD,USA
| | - Nayeon Kim
- School of Nursing, University of Maryland Baltimore, Baltimore, MD,USA
| | - Rachel McPherson
- School of Nursing, University of Maryland Baltimore, Baltimore, MD,USA
| | - Jeanette Ellis
- School of Nursing, University of Maryland Baltimore, Baltimore, MD,USA
| | - Jasmine Phun
- School of Medicine, Thomas Jefferson University, Philadelphia, PA,USA
| | - Ashley Kuzmik
- School of Nursing, Penn State University, College State, PA,USA
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7
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Frederiksen KO, Nørgaard B, Bruun IH. How to Improve Hospitalized Older Adults’ Activity Level: A Mixed Methods Study. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2121884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Inge Hansen Bruun
- Department of Physical and Occupational Therapy, Lillebaelt Hospital, Kolding, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Dijkstra F, van der Sluis G, Jager-Wittenaar H, Hempenius L, Hobbelen JSM, Finnema E. Facilitators and barriers to enhancing physical activity in older patients during acute hospital stay: a systematic review. Int J Behav Nutr Phys Act 2022; 19:99. [PMID: 35908056 PMCID: PMC9338465 DOI: 10.1186/s12966-022-01330-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/06/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To improve older patients' physical activity (PA) behavior, it is important to identify facilitators and barriers to enhancing PA in older patients (≥ 65 years) during hospitalization from the perspectives of patients, caregivers, and healthcare professionals (HCPs). METHODS In this systematic review, a search of PubMed, CINAHL, PsycINFO, EMBASE, and Web of Science (January 2000-May 2021) was performed, and quantitative, qualitative, and mixed-methods studies were included. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Identified facilitators and barriers were categorized using the social ecological model at the intrapersonal, interpersonal, and institutional levels. RESULTS The 48 included articles identified 230 facilitators and 342 barriers. The main facilitators at the intrapersonal level included: knowledge, awareness, and attitudes; interpersonal level: social support, including encouragement and interdisciplinary collaboration; and institutional level: stimulating physical environment, patient activities and schedules, and PA protocols. The main barriers at the intrapersonal level included: physical health status, having lines or drains, patients' fear, and HCPs' safety concerns; interpersonal level: patient-HCP relation and HCPs' unclear roles; and institutional level: lack of space and resources, including time and equipment. Best evidence synthesis provided moderate level of evidence for three barriers: patients' unwillingness or refusal to move, patients having symptoms, and patients having lines or drains. No moderate level of evidence was found for facilitators. CONCLUSION The PA behavior of older adults during hospitalization is multidimensional. Our overview highlights facilitators and barriers on multilevel scale (intrapersonal, interpersonal, and institutional levels) that guides patients, caregivers, HCPs, and researchers in future clinical practice, and intervention development and implementation.
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Affiliation(s)
- F Dijkstra
- Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, P.O. Box 1080, 8900, CB, Leeuwarden, The Netherlands.
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
- Department of Health Science, Section of Nursing Research & Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- FAITH research, Groningen/Leeuwarden, The Netherlands.
| | - G van der Sluis
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Department of Health Strategy and Innovation, Nij Smellinghe Hospital Drachten, Drachten, The Netherlands
| | - H Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L Hempenius
- Geriatric Center, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - J S M Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E Finnema
- Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, P.O. Box 1080, 8900, CB, Leeuwarden, The Netherlands
- Department of Health Science, Section of Nursing Research & Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands
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Ramsey KA, Loveland P, Rojer AGM, Denehy L, Goonan R, Marston C, Kay JE, Brenan J, Trappenburg MC, Lim WK, Reijnierse EM, Meskers CGM, Maier AB. Geriatric Rehabilitation Inpatients Roam at Home! A Matched Cohort Study of Objectively Measured Physical Activity and Sedentary Behavior in Home-Based and Hospital-Based Settings. J Am Med Dir Assoc 2021; 22:2432-2439.e1. [PMID: 34022152 DOI: 10.1016/j.jamda.2021.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/10/2021] [Accepted: 04/14/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES This study aimed to describe objectively measured physical activity and sedentary behavior in geriatric rehabilitation patients receiving care in the home-based compared to the hospital-based setting. DESIGN Observational matched cohort study. SETTING AND PARTICIPANTS Home-based (patient's home) or hospital-based (ward) geriatric rehabilitation was delivered to inpatients within the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort of the Royal Melbourne Hospital (Melbourne, Victoria, Australia). METHODS Patients were asked to wear ActivPAL4 accelerometers for 1 week and were assessed by a comprehensive geriatric assessment at admission, discharge, and followed up after 3 months. Hospital-based patients were matched to home-based patients for sex and baseline physical function [Short Physical Performance Battery (SPPB), activities (instrumental) of daily living, and Clinical Frailty Scale]. Differences in patient characteristics and physical activity (total, standing and walking durations, number of steps and sit-to stand transitions) and sedentary behavior (total, sitting and lying durations) were assessed. RESULTS A total of 159 patients were included: 18 home-based [mean age: 81.9 ± 8.6 years, 38.9% female, median (interquartile range [IQR]) SPPB: 7.0 (5.0-9.0)] and 141 hospital-based [mean age: 82.9 ± 7.8 years, 57.4% female, median (IQR) SPPB: 1.0 (0.0-4.0)] patients, of whom 18 were matched [mean age: 80.1 ± 7.4 years, 38.9% female, median (IQR) SPPB: 6.5 (4.8-10.0)]. Median physical activity measures were consistently higher in home-based patients compared to the total group of hospital-based patients. After matching, physical activity measures remained >2.4 times higher and were significantly different for all measures (total physical activity, standing and walking durations, and steps) except for sit-to-stand transitions. Sedentary behaviors were similar with home-based patients spending non-significantly more time sitting but significantly less time lying than hospital-based patients (matched and total). CONCLUSIONS AND IMPLICATIONS Home-based inpatients are more physically active than hospital-based inpatients independent of matching for sex and baseline physical function, which supports home-based geriatric rehabilitation.
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Affiliation(s)
- Keenan A Ramsey
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Paula Loveland
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Anna G M Rojer
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Linda Denehy
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Victoria, Australia
| | - Rose Goonan
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Celia Marston
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jacqueline E Kay
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jacinta Brenan
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Marijke C Trappenburg
- Department of Internal Medicine, Amstelland Hospital, Amstelveen, the Netherlands; Department of Internal Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Wen Kwang Lim
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Carel G M Meskers
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Centre for Healthy Longevity, National University Health System, Singapore.
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10
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Scheerman K, Schoenmakers AHC, Meskers CGM, Maier AB. Physical, motivational and environmental factors influencing physical activity promotion during hospitalization: Older patients' perspective. Geriatr Nurs 2021; 42:599-604. [PMID: 33714636 DOI: 10.1016/j.gerinurse.2021.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 10/21/2022]
Abstract
Better understanding of older patients' perspective on physical, motivational and environmental barriers and enablers in physical activity promotion during hospitalization contributes to the development of strategies to increase in hospital physical activity. Using a mixed method approach, barriers and enablers from patients (in)dependent in physical activity (Functional Ambulation Categories ≥4 versus <4) were identified. Forty-nine patients (median age 77 years IQR:75-83, female: n = 25) were interviewed. Barriers reported as most important were feeling weak (n = 10), having lines/drains (n = 9) and pain (n = 7) and enablers reported as most important were feeling physically independent (n = 19), sense of importance of physical activity (n = 12), and maintaining physical strength (n = 10). Physically dependent patients were more frequently encouraged by professionals to be physically active compared to independent patients. Focus on physical barriers and motivational enablers for older patients may help to increase their physical activity during hospitalization and encouragement by health care professionals should also encompass physically independent patients.
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Affiliation(s)
- Kira Scheerman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Section of Gerontology and Geriatrics, De Boelelaan 1117, 1081, HV Amsterdam, the Netherlands.; Amsterdam Movement Sciences, Van der Boechorststraat 9, 1081, BT Amsterdam, the Netherlands
| | - Amber Hendrica Cornelia Schoenmakers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Section of Gerontology and Geriatrics, De Boelelaan 1117, 1081, HV Amsterdam, the Netherlands
| | - Carel Gerardus Maria Meskers
- Amsterdam Movement Sciences, Van der Boechorststraat 9, 1081, BT Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, the Netherlands, De Boelelaan 1117, 1081, HV Amsterdam, the Netherlands
| | - Andrea Britta Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081, BT Amsterdam, the Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Royal Parade, Parkville Victoria, 3010 Melbourne, Australia; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.
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