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Adsett JA, Mcrae PJ, Mudge AM. Staff perceived barriers to patient mobilisation vary by hospital, discipline and experience: a multisite cross- sectional survey. Arch Phys Med Rehabil 2024:S0003-9993(24)01254-1. [PMID: 39332514 DOI: 10.1016/j.apmr.2024.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 09/08/2024] [Accepted: 09/11/2024] [Indexed: 09/29/2024]
Abstract
OBJECTIVE To describe staff-perceived barriers to progressive patient mobilisation. DESIGN Cross-sectional staff survey SETTING: 10 internal medicine wards in 4 hospitals in a large Australian health service. PARTICIPANTS Nursing, medical and allied health staff INTERVENTIONS: Not applicable MAIN MEASURES: Patient Mobilization Attitudes and Beliefs Survey. An overall barriers score, and subscale scores for knowledge, attitudes and behaviours were calculated and compared between hospitals, discipline and years of clinical experience. RESULTS The survey was completed by 208 participants (123 nurses, 27 medical and 58 allied health), of whom 104 (50%) had less than 5 years' experience. Greatest perceived barriers included nursing workload, medical orders not being in place and patient and family resistance to mobilisation. Overall barrier scores differed between hospitals, discipline (nursing mean score 50 [SD 7] medical 51 [SD 7], and allied health 43 [SD 7]) and years of clinical experience (<5 years mean score 50 [SD 7], 5-9 years 47 [SD 7], 10 or more years 46 [SD 8]); significant differences by hospital and discipline persisted in multivariate analysis. The behaviour subscale had the highest barriers score and knowledge the lowest across all subgroups. CONCLUSION Staff perceived nursing workload, lack of medical orders and patient and family resistance to be the greatest barriers to patient mobilisation. Barrier scores differed between disciplines, experience levels and across hospitals within a single health service. Lower scores on the knowledge subscale highlight the need for multi-component strategies beyond education that address culture and systems; education may particularly benefit medical staff.
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Affiliation(s)
- Julie A Adsett
- Physiotherapy Department, Royal Brisbane and Women's Hospital Brisbane, Queensland, Australia; Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
| | - Prue J Mcrae
- Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Alison M Mudge
- Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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Adsett JA, Mudge AM. Interventions to Promote Physical Activity and Reduce Functional Decline in Medical Inpatients: An Umbrella Review. J Am Med Dir Assoc 2024; 25:105052. [PMID: 38830596 DOI: 10.1016/j.jamda.2024.105052] [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] [Received: 08/09/2023] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVES Physical inactivity in hospitals is common and is associated with poor patient and clinical outcomes. This review was undertaken to identify and describe the effectiveness of interventions implemented at the ward or system level for improving physical activity and reducing functional decline in general medical inpatients. The secondary aim was to describe the effects on length of stay, discharge destination, falls, and hospital costs. DESIGN Umbrella review. SETTING AND PARTICIPANTS Systematic reviews that evaluated ward- or system-level interventions aiming to improve physical activity or reduce functional decline in medical inpatients. METHODS PubMed, EMBASE, Cochrane Database, CINAHL, JBI, and Web of Science databases were searched for English-language reviews published between 2000 and 2023. AMSTAR 2 was used to assess methodologic quality. Two reviewers independently assessed eligibility and methodologic quality and completed data abstraction, with results presented as a narrative synthesis. RESULTS The search yielded 568 systematic reviews of which 12 met criteria, half of which were published since 2020. Reviews included 76 unique primary studies with 72,645 participants. Most reviews were of low quality. Interventions that focused on progressive mobilization likely increased physical activity participation, reduced functional decline, and improved discharge home. Multicomponent interventions that employed multiple strategies targeting a broader range of barriers likely improved functional decline and discharge home and may have been associated with shorter length of stay. No interventions were associated with increased frequency of falls. Few studies reported costs. CONCLUSIONS AND IMPLICATIONS Progressive mobilization interventions and multicomponent interventions appear to be effective for improving physical activity participation and reducing functional decline in medical inpatients. Further high-quality studies may help to determine the most important aspects of multicomponent interventions. Standardized terminology related to inpatient physical activity may help promote a shared understanding and purpose across professions.
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Affiliation(s)
- Julie A Adsett
- Physiotherapy Department, Royal Brisbane and Women's Hospital Brisbane, Brisbane, Queensland, Australia; Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital Brisbane, Brisbane, Queensland, Australia.
| | - Alison M Mudge
- Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital Brisbane, Brisbane, Queensland, Australia
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King B, Hook M, Brown R, Mahoney J, Steege L. Implementation of MOVIN by a Nurse-Led Clinical Team: A Multiple Methods Evaluation Using the RE-AIM Framework. Res Gerontol Nurs 2024; 17:189-201. [PMID: 39047229 DOI: 10.3928/19404921-20240621-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
PURPOSE To evaluate the implementation of MOVIN, a multicomponent mobility intervention, by a nurse-led team and measure the effectiveness on unit-level outcomes. METHOD A pragmatic quasi-experimental study was conducted on an inpatient adult medical unit. Evaluation was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Interviews with 13 organizational partners were conducted to understand barriers and facilitators to adoption. Thematic analysis was used to analyze the data. Quantitative data to determine effectiveness on distance of patient ambulation and percent of patients ambulated by nursing staff were analyzed using an interrupted time series. RESULTS A significant increase in total weekly distances for patient ambulation and percent of patients ambulated by nursing staff occurred between preintervention, intervention, and postintervention periods. Themes for adoption included: Value, Immediate Feedback, Inclusive Implementation, Resource Needs, and Lack of Organizational Evidence. The nurse-led team demonstrated high fidelity to maintaining the core components of MOVIN. CONCLUSION A nurse-led team can successfully launch a multicomponent mobility intervention and sustain impact. RE-AIM supported assessments of key partners at multiple organizational levels, capturing critical unit level outcomes. Multiple methods for data collection and analysis yielded rich results to inform future dissemination of MOVIN. [Research in Gerontological Nursing, 17(4), 189-201.].
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van Grootel JWM, Bor P, Veenhof C, Valkenet K. Development of a goal-directed movement intervention (GOAL) using a movement sensor for hospitalized patients: An intervention mapping approach. Clin Rehabil 2024; 38:251-262. [PMID: 37644843 PMCID: PMC10725127 DOI: 10.1177/02692155231198173] [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: 05/03/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE To describe the development of a goal-directed movement intervention in two medical wards, including recommendations for implementation and evaluation. DESIGN Implementation Research. SETTING Pulmonology and nephrology/gastroenterology wards of the University Medical Centre Utrecht, The Netherlands. PARTICIPANTS Seven focus groups were executed including 28 nurses, 7 physical therapists and 15 medical specialists. Patients' perceptions were repeatedly assessed during the iterative steps of the intervention development. INTERVENTION Interventions were targeted to each ward's specific character, following an Intervention Mapping approach using literature and research meetings. Main measures: Intervention components were linked to Behavior Change Techniques and implementation strategies will be selected using the Expert Recommendation Implementing Change tool. Evaluation outcomes like number of patients using the movement intervention will be measured, based on the taxonomy of Proctor. RESULTS The developed intervention consists of: insight in patients movement behavior (monitoring & feedback), goal setting (goals & planning) and adjustments to the environment (associations & antecedents). The following implementation strategies are recommended: to conduct educational meetings, prepare & identify champions and audit & provide feedback. To measure service and client outcomes, the mean level of physical activity per ward can be evaluated and the Net Promoter Score can be used. CONCLUSION(S) This study shows the development of a goal-directed movement intervention aligned with the needs of healthcare professionals. This resulted in an intervention consisting of feedback & monitoring of movement behavior, goal setting and adjustments in the environment. Using a step-by-step iterative implementation model to guide development and implementation is recommended.
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Affiliation(s)
- JWM van Grootel
- HU University of Applied Sciences Utrecht, Research Center of Healthy and Sustainable Living, Research Group Innovation of Movement Care, Utrecht, The Netherlands
- University Medical Centre Utrecht, Department of Rehabilitation Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - P Bor
- University Medical Centre Utrecht, Department of Rehabilitation Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - C Veenhof
- HU University of Applied Sciences Utrecht, Research Center of Healthy and Sustainable Living, Research Group Innovation of Movement Care, Utrecht, The Netherlands
- University Medical Centre Utrecht, Department of Rehabilitation Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - K Valkenet
- HU University of Applied Sciences Utrecht, Research Center of Healthy and Sustainable Living, Research Group Innovation of Movement Care, Utrecht, The Netherlands
- University Medical Centre Utrecht, Department of Rehabilitation Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
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Burkhalter H, Zimmermann H. [The development of kinaesthetic competence in acute inpatient care: a feasibility study with a pre-posttest design]. Pflege 2024; 37:265-274. [PMID: 38204328 DOI: 10.1024/1012-5302/a000973] [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: 01/12/2024]
Abstract
The development of kinaesthetic competence in acute inpatient care: a feasibility study with a pre-posttest design Abstract: Background: Most patients in acute care hospitals experience movement limitations due to surgery or a general deterioration of their condition. Therefore, nurses need a high level of competence in movement promotion. Aim: The aim of this study was to evaluate the feasibility of a three-day advanced kinaesthetics training course followed by six months of practical support to promote kinaesthetic competence in inpatient acute care and the competence development achieved as a result. Methods: The evaluation of the nurses' effectiveness was conducted using a pre- and post-measurement of kinaesthetic competence through a self-assessment questionnaire and an observation protocol. The evaluation of feasibility was done through a semi-structured questionnaire. Results: Eight nurses rated their kinaesthetics competence as good before (mean: 10,8 on a scale of 4-16) and very good after the intervention (mean: 13,2). The kinaesthetics trainer assessed the competence before as sufficient (mean: 9,4 on a scale of 4-16) and very good (mean: 14,5) after the practical support. The need to make practical support more flexible is highlighted in the qualitative data. Conclusion: The results demonstrate that a three-day training followed by six months of practical support has a positive impact on nurses' kinaesthetic competence.
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Affiliation(s)
- Hanna Burkhalter
- Pflegeentwicklung, Departement Pflege und Fachsupport, Kantonsspital Graubünden, Chur, Schweiz
| | - Hubert Zimmermann
- Fachverantwortlicher Kinästhetik, Departement Pflege und Fachsupport, Kantonsspital Graubünden, Chur, Schweiz
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Mooser B, Bergsma D, Liechti FD, Baumgartner C, Gentizon J, Méan M, Wertli MM, Mancinetti M, Schmidt-Leuenberger J, Aubert CE. Impact of an INtervention to increase MOBility in older hospitalized medical patients (INTOMOB): Study protocol for a cluster randomized controlled trial. BMC Geriatr 2023; 23:705. [PMID: 37907858 PMCID: PMC10617203 DOI: 10.1186/s12877-023-04285-3] [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: 05/23/2023] [Accepted: 09/06/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Low mobility during an acute hospitalization is frequent and associated with adverse effects, including persistent functional decline, institutionalization and death. However, we lack effective interventions to improve mobility that are scalable in everyday practice. The INTOMOB trial - INtervention to increase MOBility in older hospitalized medical patients - will test the effect of a multilevel intervention to improve mobility of older hospitalized patients on functional mobility. METHODS The INTOMOB multicenter superiority parallel cluster randomized controlled trial will enroll in total 274 patients in Swiss hospitals. Community-dwelling adults aged ≥ 60 years, admitted to a general internal medicine ward with an anticipated length of hospital stay of ≥ 3 days, will be eligible for participation. Unit of randomization will be the wards. A multilevel mobility intervention will be compared to standard of care and target the patients (information and exercise booklets, mobility diary, iPad with exercise videos), healthcare professionals (e-learning, oral presentation, mobility checklist), and environment (posters and pictures on the wards). The primary outcome will be life-space level, measured by the University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA), at 30 days after enrollment. The LSA is a measure of functional mobility, i.e., how far participants move from bedroom to outside town. Secondary outcomes include, among others, LSA at 180 days, mobility and falls during hospitalization, muscle strength at discharge, and falls, emergency room visits, readmissions, and death within 180 days. DISCUSSION This study has the potential to improve outcomes of older hospitalized patients through an intervention that should be scalable in clinical practice because it fosters patient empowerment and does not require additional resources. The tools provided to the patients can help them implement better mobility practices after discharge, which can contribute to better functional outcomes. The choice of a functional patient-reported outcome measure as primary outcome (rather than a "simple" objective mobility measure) reinforces the patient-centeredness of the study. TRIAL REGISTRATION clinicaltrials.gov (NCT05639231, released on December 19 2022); Swiss National Clinical Trial Portal (SNCTP000005259, released on November 28 2022).
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Affiliation(s)
- Blandine Mooser
- 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
| | - Dominique Bergsma
- 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
| | - Fabian D Liechti
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christine Baumgartner
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jenny Gentizon
- Institute of Higher Education and Research Healthcare, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie Méan
- Department of Medicine, Internal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Maria M Wertli
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Internal Medicine, Baden Cantonal Hospital, Baden, Switzerland
| | - Marco Mancinetti
- Department of General Internal Medicine, Fribourg Cantonal Hospital, Fribourg, 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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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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Byrnes A, McRae P, Mudge AM. 'Life is about movement-everything that is alive moves': a mixed methods study to understand barriers and enablers to inpatient mobility from the older patient's perspective. Age Ageing 2023; 52:afad111. [PMID: 37463284 PMCID: PMC10353760 DOI: 10.1093/ageing/afad111] [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: 12/14/2022] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Mobility in hospital is important to maintain independence and prevent complications. Our multi-centre study aimed to measure mobility and identify barriers and enablers to mobility participation from the older patient's perspective. METHODS Mixed methods study including direct observation of adult inpatients on 20 acute care wards in 12 hospitals and semi-structured interviews with adults aged 65 years or older on each of these wards. Interviews were undertaken by trained staff during the inpatient stay. Quantitative data were analysed descriptively. Qualitative data were initially coded deductively using the theoretical domains framework (TDF), with an inductive approach then used to frame belief statements. RESULTS Of 10,178 daytime observations of 503 adult inpatients only 7% of time was spent walking or standing. Two hundred older patient interviews were analysed. Most (85%) patients agreed that mobilising in hospital was very important. Twenty-three belief statements were created across the eight most common TDF domains. Older inpatients recognised mobility benefits and were self-motivated to mobilise in hospital, driven by goals of maintaining or recovering strength and health and returning home. However, they struggled with managing pain, other symptoms and new or pre-existing disability in a rushed, cluttered environment where they did not wish to trouble busy staff. Mobility equipment, meaningful walking destinations and individualised programmes and goals made mobilising easier, but patients also needed permission, encouragement and timely assistance. CONCLUSION Inpatient mobility was low. Older acute care inpatients frequently faced a physical and/or social environment which did not support their individual capabilities.
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Affiliation(s)
- Angela Byrnes
- Eat Walk Engage Program, Metro North Health, Herston, QLD, Australia
- Internal Medicine Research Unit, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Prue McRae
- Eat Walk Engage Program, Metro North Health, Herston, QLD, Australia
- Internal Medicine Research Unit, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Alison M Mudge
- Address correspondence to: Alison M. Mudge, Eat Walk Engage Program, 6th floor block 7, Royal Brisbane and Women’s Hospital, Butterfield St, Herston, 4029 QLD, Australia. Tel: 61736460854.
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Bergsma D, Panait C, Leist P, Mooser B, Pantano L, Liechti FD, Gentizon J, Baumgartner C, Mancinetti M, Méan M, Schmidt Leuenberger JM, Aubert CE. Feasibility and Acceptability of an INtervention TO Increase MOBility in Older Hospitalized Medical Patients (INTOMOB): A Mixed-Methods Pilot Study. Gerontol Geriatr Med 2023; 9:23337214231202148. [PMID: 37790194 PMCID: PMC10542323 DOI: 10.1177/23337214231202148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/24/2023] [Accepted: 09/01/2023] [Indexed: 10/05/2023] Open
Abstract
Background: To reduce adverse outcomes of low hospital mobility, we need interventions that are scalable in everyday practice. This study assessed the feasibility and acceptability of the INTOMOB multilevel intervention addressing barriers to hospital mobility without requiring unavailable resources. Methods: The INTOMOB intervention, targeting older patients, healthcare professionals (HCPs) and the hospital environment, was implemented on acute general internal medicine wards of three hospitals (12/2022-03/2023). Feasibility and acceptability of the intervention were assessed and two types of accelerometers compared in a mixed methods study (patient and HCP surveys and interviews). Quantitative data were analyzed descriptively and qualitative data using a deductive approach. Results were integrated through meta-inferences. Results: Of 20 patients (mean age 74.1 years), 90% found the intervention helpful and 82% said the environment intervention (posters) stimulated mobility. The majority of 44 HCPs described the intervention as clear and helpful. There was no major implementation or technical issue. About 60% of patients and HCPs preferred a wrist-worn over an ankle-worn accelerometer. Conclusions: The INTOMOB intervention is feasible and well accepted. Patients' and HCPs' feedback allowed to further improve the intervention that will be tested in a cluster randomized trial and provides useful information for future mobility-fostering interventions.
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Affiliation(s)
- Dominique Bergsma
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudia Panait
- Department of Internal Medicine, Fribourg Cantonal Hospital, Fribourg, Switzerland
| | - Pascal Leist
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Blandine Mooser
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
| | - Lynn Pantano
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabian D. Liechti
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jenny Gentizon
- Institute of Higher Education and Research in Healthcare, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Christine Baumgartner
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marco Mancinetti
- Department of Internal Medicine, Fribourg Cantonal Hospital, Fribourg, Switzerland
| | - Marie Méan
- Department of Medicine, Internal medicine, Lausanne University hospital, University of Lausanne, 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, Switzerland
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