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La Porta F, Valpiani G, Lullini G, Negro A, Pellicciari L, Bassi E, Caselli S, Pecoraro V, Govoni E. A novel multistep approach to standardize the reported risk factors for in-hospital falls: a proof-of-concept study. Front Public Health 2024; 12:1390185. [PMID: 38932769 PMCID: PMC11199548 DOI: 10.3389/fpubh.2024.1390185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Background Uncertainty and inconsistency in terminology regarding the risk factors (RFs) for in-hospital falls are present in the literature. Objective (1) To perform a literature review to identify the fall RFs among hospitalized adults; (2) to link the found RFs to the corresponding categories of international health classifications to reduce the heterogeneity of their definitions; (3) to perform a meta-analysis on the risk categories to identify the significant RFs; (4) to refine the final list of significant categories to avoid redundancies. Methods Four databases were investigated. We included observational studies assessing patients who had experienced in-hospital falls. Two independent reviewers performed the inclusion and extrapolation process and evaluated the methodological quality of the included studies. RFs were grouped into categories according to three health classifications (ICF, ICD-10, and ATC). Meta-analyses were performed to obtain an overall pooled odds ratio for each RF. Finally, protective RFs or redundant RFs across different classifications were excluded. Results Thirty-six articles were included in the meta-analysis. One thousand one hundred and eleven RFs were identified; 616 were linked to ICF classification, 450 to ICD-10, and 260 to ATC. The meta-analyses and subsequent refinement of the categories yielded 53 significant RFs. Overall, the initial number of RFs was reduced by about 21 times. Conclusion We identified 53 significant RF categories for in-hospital falls. These results provide proof of concept of the feasibility and validity of the proposed methodology. The list of significant RFs can be used as a template to build more accurate measurement instruments to predict in-hospital falls.
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Affiliation(s)
- Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Giorgia Valpiani
- Research and Innovation Unit, Biostatistics and Clinical Trial Area, University Hospital of Ferrara, Ferrara, Italy
| | - Giada Lullini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Antonella Negro
- Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Emilia-Romagna, Italy
| | | | - Erika Bassi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Serena Caselli
- Unità Operativa Complessa di Medicina Riabilitativa, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Valentina Pecoraro
- Department of Laboratory Medicine and Pathology, AUSL Modena, Modena, Italy
| | - Erika Govoni
- Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Emilia-Romagna, Italy
- Unità Organizzativa Riabilitazione Ospedaliera, Dipartimento Assistenziale Tecnico e Riabilitativo, Ausl Bologna, Bologna, Italy
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Hong S, Kim JS, Choi YA. Predictive Validity of the Johns Hopkins Fall Risk Assessment Tool for Older Patients in Stroke Rehabilitation. Healthcare (Basel) 2024; 12:791. [PMID: 38610213 PMCID: PMC11011889 DOI: 10.3390/healthcare12070791] [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: 02/21/2024] [Revised: 03/21/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
The aim of this retrospective, cross-sectional, observational study was to assess the frequency of falls and evaluate the predictive validity of the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) among patients aged ≥65 years, transferred to the rehabilitation ward of a university hospital. The predictive ability was assessed using receiver operating characteristic curve analysis, and the optimal threshold was established using the Youden index. We analyzed the overall cohort (N = 175) with subacute stroke and the subgroup with a low unaffected handgrip strength (HGS; men: <28 kg, women: <18 kg). Overall, 135/175 patients (77.1%) had a low HGS. The fall rate was 6.9% overall and 5.9% for patients with a low HGS. The JHFRAT predictive value was higher for patients with a low HGS than that for the overall cohort, but acceptable in both. The optimal cutoff score for the overall cohort was 11 (sensitivity, 67%; specificity, 68%), whereas that for the subgroup was 12 (sensitivity, 75%; specificity: 72%). These results are expected to aid nurses working in rehabilitation wards in more effectively utilizing JHFRAT outcomes for post-stroke older patients with a low HGS and contribute to the development of more appropriate fall prevention strategies for high-risk patients in the future.
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Affiliation(s)
- Seungho Hong
- Department of Rehabilitation Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Ji-Sook Kim
- Department of Nursing, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon 21431, Republic of Korea
| | - Young-Ah Choi
- Department of Rehabilitation Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Kitamura S, Otaka Y, Murayama Y, Ushizawa K, Narita Y, Nakatsukasa N, Matsuura D, Kondo K, Sakata S. Differences in the difficulty of subtasks comprising the toileting task among patients with subacute stroke: A cohort study. J Stroke Cerebrovasc Dis 2023; 32:107030. [PMID: 36709731 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107030] [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: 08/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Toileting comprises multiple subtasks, and the difficulty of each is critical to determining the target and priority of intervention. The study aimed to examine the difficulty of subtasks that comprise toileting upon admission and the reacquisition of skills of subtasks during hospitalization. MATERIALS AND METHODS This was a single-center prospective cohort study. We enrolled 101 consecutive stroke patients (mean age: 69.3 years) admitted to subacute rehabilitation wards. The independence in each of the 24 toileting subtasks was assessed using the Toileting Tasks Assessment Form (TTAF) every two or four weeks. The number of patients who were independent upon admission, as well as those who were not independent upon admission but became independent during hospitalization, was examined in each subtask. RESULTS The most difficult subtask upon admission was "Lock the wheelchair brakes" (16.8% of patients were independent), followed by "Turn while standing (before urination/defecation)" (17.8%), "Pull the lower garments down" (18.0%), "Turn while standing (after urination/defecation)" (18.8%), "Pull the lower garments up and adjust them" (18.8%), and "Maintain a standing position (before urination/defecation)" (18.8%). The most difficult subtask for those who were not independent but became independent was "Dispose of incontinence pad/sanitary items" (19.3%), followed by "Press the nurse call button (after urination/defecation)" (28.3%), "Take the foot off the footrest and place it on the ground" (28.6%), and "Clean up after urination/defecation" (29.0%). CONCLUSIONS The difficult subtasks upon admission and those for reacquired skills were different. The most difficult subtasks upon admission were main tasks, and the difficult subtasks in reacquiring skills were preparatory tasks.
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Affiliation(s)
- Shin Kitamura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan.
| | - Yudai Murayama
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Kazuki Ushizawa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Yuya Narita
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Naho Nakatsukasa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Daisuke Matsuura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Sachiko Sakata
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
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Hoedl M, Eglseer D, Bernet N, Everink I, Gordon AL, Lohrmann C, Osmancevic S, Saka B, Schols JMGA, Thomann S, Bauer S. Which factors influence the prevalence of institution-acquired falls? Results from an international, multi-center, cross-sectional survey. J Nurs Scholarsh 2021; 54:462-469. [PMID: 34919335 PMCID: PMC9542022 DOI: 10.1111/jnu.12758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Falls are a highly prevalent problem in hospitals and nursing homes with serious negative consequences such as injuries, increased care dependency, or even death. The aim of this study was to provide a comprehensive insight into institution-acquired fall (IAF) prevalence and risk factors for IAF in a large sample of hospital patients and nursing home residents among five different countries. DESIGN This study reports the outcome of a secondary data analysis of cross-sectional data collected in Austria, Switzerland, the Netherlands, Turkey, and the United Kingdom in 2017 and 2018. These data include 58,319 datapoints from hospital patients and nursing home residents. METHODS Descriptive statistics, statistical tests, logistic regression, and generalized estimating equation (GEE) models were used to analyze the data. FINDINGS IAF prevalence in hospitals and nursing homes differed significantly between the countries. Turkey (7.7%) had the highest IAF prevalence rate for hospitals, and Switzerland (15.8%) had the highest IAF prevalence rate for nursing homes. In hospitals, our model revealed that IAF prevalence was associated with country, age, care dependency, number of medical diagnoses, surgery in the last two weeks, and fall history factors. In nursing homes, care dependency, diseases of the nervous system, and fall history were identified as significant risk factors for IAF prevalence. CONCLUSIONS This large-scale study reveals that the most important IAF risk factor is an existing history of falls, independent of the setting. Whether a previous fall has occurred within the last 12 months is a simple question that should be included on every (nursing) assessment at the time of patient or resident admission. Our results guide the development of tailored prevention programs for persons at risk of falling in hospitals and nursing homes.
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Affiliation(s)
- Manuela Hoedl
- Medical University of Graz, Institute of Nursing Science, Graz, Austria
| | - Doris Eglseer
- Medical University of Graz, Institute of Nursing Science, Graz, Austria
| | - Niklaus Bernet
- Division of Nursing, Department of Health, Bern University of Applied Sciences, Bern, Switzerland
| | - Irma Everink
- Department Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Adam L Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK.,East Midlands Academic Health Sciences Network Patient Safety Collaborative, Nottingham, UK.,NIHR Applied Research Collaboration - East Midlands (ARC-EM), Nottingham, UK
| | - Christa Lohrmann
- Medical University of Graz, Institute of Nursing Science, Graz, Austria
| | | | - Bülent Saka
- Istanbul Faculty of Medicine, Department Internal Medicine, İstanbul Tıp Fakültesi Çapa - Fatih, Istanbul University, LIstanbul, Turkey
| | - Jos M G A Schols
- Department Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Silvia Thomann
- Division of Nursing, Department of Health, Bern University of Applied Sciences, Bern, Switzerland
| | - Silvia Bauer
- Medical University of Graz, Institute of Nursing Science, Graz, Austria
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Persson CU, Hansson PO. Determinants of falls after stroke based on data on 5065 patients from the Swedish Väststroke and Riksstroke Registers. Sci Rep 2021; 11:24035. [PMID: 34911990 PMCID: PMC8674218 DOI: 10.1038/s41598-021-03375-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 12/01/2021] [Indexed: 11/09/2022] Open
Abstract
We aimed to identify determinants in acute stroke that are associated with falls during the stroke unit stay. In order to enable individualized preventive actions, this knowledge is fundamental. Based on local and national quality register data on an unselected sample of 5065 stroke patients admitted to a stroke unit at a Swedish university hospital, univariable and multivariable logistic regression analyses were performed. The dependent variable was any fall during stroke unit stay. The independent variables related to function, activity, personal factors, time to assessment, comorbidities and treatments. Determinants of falls were: being male (odds ratio (OR) 2.25, 95% confidence interval (95% CI) 1.79–2.84), haemorrhagic stroke (OR 1.39, 95% CI 1.05–1.86), moderate stroke symptoms according to the National Institutes of Health Stroke Scale (NIHSS score 2–5 vs. NIHSS score 0–1) (OR 1.43, 95% CI 1.08–1.90), smoking (OR 1.70, 95% CI 1.29–2.25), impaired postural control in walking (OR 4.61, 95% CI 3.29–6.46), impaired postural control in standing (OR 1.60, 95% CI 1.25–2.05), stroke-related arm- and hand problems, OR 1.45, 95% CI 1.11–1.91), impaired cognition (OR 1.43, 95% CI 1.04–1.95), and urinary tract infection (OR 1.91, 95% CI 1.43–2.56). The findings from this study are useful in clinical practice and might help to improve patient safety after stroke.
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Affiliation(s)
- Carina U Persson
- Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Fl, Gothenburg, Sweden. .,Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital/Östra, Gothenburg, Region Västra Götaland, Sweden.
| | - Per-Olof Hansson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Region Västra Götaland, Sweden
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6
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Tarvonen-Schröder S, Niemi T, Hurme S, Koivisto M. Fall assessment in subacute inpatient stroke rehabilitation using clinical characteristics and the most preferred stroke severity and outcome measures. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2021. [DOI: 10.1080/21679169.2021.1960600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sinikka Tarvonen-Schröder
- Neurocenter, Turku University Hospital, Turku, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
| | - Tuuli Niemi
- Department of Expert Services, Turku University Hospital, Turku, Finland
| | - Saija Hurme
- Department of Biostatistics, University of Turku, Turku, Finland
| | - Mari Koivisto
- Department of Biostatistics, University of Turku, Turku, Finland
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7
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Bat-Erdene BO, Saver JL. Automatic Acute Stroke Symptom Detection and Emergency Medical Systems Alerting by Mobile Health Technologies: A Review. J Stroke Cerebrovasc Dis 2021; 30:105826. [PMID: 33932749 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105826] [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: 12/27/2020] [Revised: 03/28/2021] [Accepted: 04/07/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To survey recent advances in acute stroke symptom automatic detection and Emergency Medical Systems (EMS) alerting by mobile health technologies. MATERIALS AND METHODS Narrative review RESULTS: Delayed activation of EMS for stroke symptoms by patients and witnesses deprives patients of rapid access to brain-saving therapies and occurs due to public unawareness of stroke features, cognitive and motor deficits produced by the stroke itself, and sleep onset. A promising emerging approach to overcoming the inherent biologic constraints of patient capacity to self-detect and respond to stroke symptoms is continuous monitoring by mobile health technologies with wireless sensors and artificial intelligence recognition systems. This review surveys 11 sensing technologies - accelerometers, gyroscopes, magnetometers, pressure sensors, touch screen and keyboard input detectors, artificial vision, and artificial hearing; and 10 consumer device form factors in which they are increasingly implemented: smartphones, smart speakers, smart watches and fitness bands, smart speakers/voice assistants, home health robots, smart clothing, smart beds, closed circuit television, smart rings, and desktop/laptop/tablet computers. CONCLUSIONS The increase in computing power, wearable sensors, and mobile connectivity have ushered in an array of mobile health technologies that can transform stroke detection and EMS activation. By continuously monitoring a diverse range of biometric parameters, commercially available devices provide the technologic capability to detect cardinal language, motor, gait, and sensory signs of stroke onset. Intensified translational research to convert the promise of these technologies to validated, accurate real-world deployments are an important next priority for stroke investigation.
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Affiliation(s)
- Bat-Orgil Bat-Erdene
- Comprehensive Stroke Center and Department of Neurology, David Geffen School of Medicine at UCLA, Sukhbaatar District, Khoroo-1, 42-55, 11000 Ulaanbaatar, Mongolia.
| | - Jeffrey L Saver
- Comprehensive Stroke Center and Department of Neurology, David Geffen School of Medicine at UCLA, Sukhbaatar District, Khoroo-1, 42-55, 11000 Ulaanbaatar, Mongolia
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8
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Purnamasari AA, Arafat R, Sabriyati WONI, Erfina E. Risk factors of falls among hospitalized stroke patients. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.07.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Sex disparities within the field of stroke, including subarachnoid hemorrhages (SAHs), have been in focus during the last 2 decades. It is clear that stroke incidence is higher in men, and also that men have their first stroke earlier than women. On the other hand, women have more severe strokes, mainly because cardioembolic strokes are more common in women. This leads to higher case fatality and worse functional outcome in women. It has often been pointed out that women more often have nontraditional stroke symptoms, and therefore may seek medical help later. After discharge from the hospital, female stroke survivors live alone in many cases and are dependent on external care. Therefore, these women frequently rate their quality of life (QoL) lower than men do. Female spouses more often provide help to their male stroke survivors than the reverse, and they accept a heavier burden. These caregivers are at high risk for depression, low QoL, and low psychologic wellbeing. SAH is a special form of stroke, often caused by a ruptured aneurysm. It is about 20% more common in women. The case fatality is high, but does not differ between the sexes.
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Affiliation(s)
- Peter Appelros
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - Signild Åsberg
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Marzolini S, Robertson AD, Oh P, Goodman JM, Corbett D, Du X, MacIntosh BJ. Aerobic Training and Mobilization Early Post-stroke: Cautions and Considerations. Front Neurol 2019; 10:1187. [PMID: 31803129 PMCID: PMC6872678 DOI: 10.3389/fneur.2019.01187] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 10/25/2019] [Indexed: 12/14/2022] Open
Abstract
Knowledge gaps exist in how we implement aerobic exercise programs during the early phases post-stroke. Therefore, the objective of this review was to provide evidence-based guidelines for pre-participation screening, mobilization, and aerobic exercise training in the hyper-acute and acute phases post-stroke. In reviewing the literature to determine safe timelines of when to initiate exercise and mobilization we considered the following factors: arterial blood pressure dysregulation, cardiac complications, blood-brain barrier disruption, hemorrhagic stroke transformation, and ischemic penumbra viability. These stroke-related impairments could intensify with inappropriate mobilization/aerobic exercise, hence we deemed the integrity of cerebral autoregulation to be an essential physiological consideration to protect the brain when progressing exercise intensity. Pre-participation screening criteria are proposed and countermeasures to protect the brain from potentially adverse circulatory effects before, during, and following mobilization/exercise sessions are introduced. For example, prolonged periods of standing and static postures before and after mobilization/aerobic exercise may elicit blood pooling and/or trigger coagulation cascades and/or cerebral hypoperfusion. Countermeasures such as avoiding prolonged standing or incorporating periodic lower limb movement to activate the venous muscle pump could counteract blood pooling after an exercise session, minimize activation of the coagulation cascade, and mitigate potential cerebral hypoperfusion. We discuss patient safety in light of the complex nature of stroke presentations (i.e., type, severity, and etiology), medical history, comorbidities such as diabetes, cardiac manifestations, medications, and complications such as anemia and dehydration. The guidelines are easily incorporated into the care model, are low-risk, and use minimal resources. These and other strategies represent opportunities for improving the safety of the activity regimen offered to those in the early phases post-stroke. The timeline for initiating and progressing exercise/mobilization parameters are contingent on recovery stages both from neurobiological and cardiovascular perspectives, which to this point have not been specifically considered in practice. This review includes tailored exercise and mobilization prescription strategies and precautions that are not resource intensive and prioritize safety in stroke recovery.
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Affiliation(s)
- Susan Marzolini
- KITE, Toronto Rehab-University Health Network, Toronto, ON, Canada
- Department of Exercise Sciences, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- Canadian Partnership for Stroke Recovery, Toronto, ON, Canada
| | - Andrew D. Robertson
- Schlegel-University of Waterloo Research Institute for Aging, University of Waterloo, Waterloo, ON, Canada
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Paul Oh
- KITE, Toronto Rehab-University Health Network, Toronto, ON, Canada
- Department of Exercise Sciences, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- Canadian Partnership for Stroke Recovery, Toronto, ON, Canada
| | - Jack M. Goodman
- KITE, Toronto Rehab-University Health Network, Toronto, ON, Canada
- Department of Exercise Sciences, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Dale Corbett
- Canadian Partnership for Stroke Recovery, Toronto, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Xiaowei Du
- KITE, Toronto Rehab-University Health Network, Toronto, ON, Canada
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Bradley J. MacIntosh
- Canadian Partnership for Stroke Recovery, Toronto, ON, Canada
- Sunnybrook Health Sciences Center, Toronto, ON, Canada
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Bowden V, Bradas C, McNett M. Impact of level of nurse experience on falls in medical surgical units. J Nurs Manag 2019; 27:833-839. [DOI: 10.1111/jonm.12742] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 11/19/2018] [Accepted: 12/13/2018] [Indexed: 11/28/2022]
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12
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Takeda E, Yamaguchi T, Mizuguchi H, Fujitani J, Liu M. Development of a toileting performance assessment test for patients in the early stroke phase. Disabil Rehabil 2018; 41:2826-2831. [PMID: 29958010 DOI: 10.1080/09638288.2018.1479455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Purpose: The study aimed to develop a toileting performance assessment test to measure the toileting performance ability of patients in the early phase after stroke.Methods: In this study, 214 stroke patients were enrolled. Cronbach's α, Spearman's rank correlations (ρ values) with the toileting-related items of the functional independence measure and Barthel Index, interrater reliability (weighted κ), and responsiveness (standardized response mean) were evaluated. Receiver operating characteristic and the area under the curves were utilized to determine the cutoff scores for the significance of the independence of toilet ability with the functional independence measure and Barthel Index.Results: Cronbach's α was ≥0.90. The p values between toileting performance assessment test and Barthel Index and between toileting performance assessment test and functional independence measure were 0.88 and 0.86, respectively. The weighted κ for each item was ≥0.61. The standardized response means were 0.81 for the functional independence measure, 0.70 for the Barthel Index, and 0.93 for the toileting performance assessment test. Cutoff scores of the toileting performance assessment test were 18 points.Conclusions: The toileting performance assessment test has acceptable psychometric properties and proved useful in assessing toileting performance ability of patients in the early phase after stroke.Implications for rehabilitationToileting performance assessment test demonstrated acceptable psychometric properties, and it can be useful for assessing the toileting ability of patients in the early phase after stroke.Toileting performance assessment test should provide information that leads to lowered risk of falls while toileting, and the information gathered can assist patients in achieving early toileting independence after stroke.As the development of toileting performance assessment test excluded patients with cognitive disabilities, the item for cognitive function should be developed as well.
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Affiliation(s)
- Eriko Takeda
- Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tomofumi Yamaguchi
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark.,JSPS Overseas Research Fellow, Japan Society for the Promotion of Science, Tokyo, Japan.,Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Hiroko Mizuguchi
- Department of Rehabilitation, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Junko Fujitani
- Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Meigen Liu
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
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