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Merimee S, Ali A, Downes K, Mullins J, Sajid MI, Mir H. Lost in the Shuffle: Low Health Literacy in Geriatric Fracture Patients and Families Regarding Post-Acute Care-A Prospective Study. J Am Acad Orthop Surg Glob Res Rev 2024; 8:01979360-202404000-00012. [PMID: 38569089 PMCID: PMC10994444 DOI: 10.5435/jaaosglobal-d-24-00062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION This study aims to evaluate health literacy (HL) in geriatric orthopaedic trauma patients and their families as it relates to their post-acute care (PAC) in skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs). METHODS This nonrandomized controlled clinical trial included patients aged 65 years and older treated for acute fracture at a Level 1 trauma center and discharged to either IRF or SNF. First 106 patients enrolled served as the control group and received standard discharge instructions. The second 101 patients were given a set of oral and written instructions regarding PAC detailing important questions to ask upon arrival to their facility. RESULTS The mean HL score for all patients/families was 2.4 out of 5. No significant difference was noted in HL scores (2.4 versus 2.3) or median LOS (22 versus 28 days) between the control and intervention groups. Family involvement (68%) slightly improved HL scores (2.6 versus 1.9, P < 0.001). Patients discharged to IRF had better HL scores (3.4 versus 2.3, P < 0.001), shorter LOS (median 15 vs 30 days, P < 0.001), and trended toward improved knowledge of discharge goals (48.1% versus 35.6%) than those in SNF. CONCLUSION System-wide solutions are necessary to improve geriatric HL and optimize outcomes in orthopaedic trauma.
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Affiliation(s)
- Stephanie Merimee
- From the Department of Orthopaedic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL (Dr. Merimee and Dr. Ali), and the Florida Orthopaedic Institute, Tampa, FL (Dr. Downes, Dr. Mullins, Dr. Sajid, and Dr. Mir)
| | - Ashley Ali
- From the Department of Orthopaedic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL (Dr. Merimee and Dr. Ali), and the Florida Orthopaedic Institute, Tampa, FL (Dr. Downes, Dr. Mullins, Dr. Sajid, and Dr. Mir)
| | - Katheryne Downes
- From the Department of Orthopaedic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL (Dr. Merimee and Dr. Ali), and the Florida Orthopaedic Institute, Tampa, FL (Dr. Downes, Dr. Mullins, Dr. Sajid, and Dr. Mir)
| | - Joanna Mullins
- From the Department of Orthopaedic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL (Dr. Merimee and Dr. Ali), and the Florida Orthopaedic Institute, Tampa, FL (Dr. Downes, Dr. Mullins, Dr. Sajid, and Dr. Mir)
| | - Mir Ibrahim Sajid
- From the Department of Orthopaedic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL (Dr. Merimee and Dr. Ali), and the Florida Orthopaedic Institute, Tampa, FL (Dr. Downes, Dr. Mullins, Dr. Sajid, and Dr. Mir)
| | - Hassan Mir
- From the Department of Orthopaedic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL (Dr. Merimee and Dr. Ali), and the Florida Orthopaedic Institute, Tampa, FL (Dr. Downes, Dr. Mullins, Dr. Sajid, and Dr. Mir)
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Wasilewski M, Vijayakumar A, Szigeti Z, Sathakaran S, Wang KW, Saporta A, Hitzig SL. Barriers and Facilitators to Delivering Inpatient Cardiac Rehabilitation: A Scoping Review. J Multidiscip Healthc 2023; 16:2361-2376. [PMID: 37605772 PMCID: PMC10440091 DOI: 10.2147/jmdh.s418803] [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: 05/24/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Objective The purpose of this scoping review was to summarize the literature on barriers and facilitators that influence the provision and uptake of inpatient cardiac rehabilitation (ICR). Methods A literature search was conducted using PsycINFO, MEDLINE, EMBASE, CINAHL and AgeLine. Studies were included if they were published in English after the year 2000 and focused on adults who were receiving some form of ICR (eg, exercise counselling and training, education for heart-healthy living). For studies meeting inclusion criteria, descriptive data on authors, year, study design, and intervention type were extracted. Results The literature search resulted in a total of 44,331 publications, of which 229 studies met inclusion criteria. ICR programs vary drastically and often focus on promoting physical exercises and patient education. Barriers and facilitators were categorized through patient, provider and system level factors. Individual characteristics and provider knowledge and efficacy were categorized as both barriers and facilitators to ICR delivery and uptake. Team functioning, lack of resources, program coordination, and inconsistencies in evaluation acted as key barriers to ICR delivery and uptake. Key facilitators that influence ICR implementation and engagement include accreditation and professional associations and patient and family-centred practices. Conclusion ICR programs can be highly effective at improving health outcomes for those living with CVDs. Our review identified several patient, provider, and system-level considerations that act as barriers and facilitators to ICR delivery and uptake. Future research should explore how to encourage health promotion knowledge amongst ICR staff and patients.
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Affiliation(s)
- Marina Wasilewski
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada
| | - Abirami Vijayakumar
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Zara Szigeti
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sahana Sathakaran
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Adam Saporta
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sander L Hitzig
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
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Plys E, Levy CR, Brenner LA, Vranceanu AM. Let’s Integrate! The Case for Bringing Behavioral Health to Nursing Home–Based Post-Acute and Subacute Care. J Am Med Dir Assoc 2022; 23:1461-1467.e7. [DOI: 10.1016/j.jamda.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022]
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Conic RRZ, Geis C, Vincent HK. Social Determinants of Health in Physiatry: Challenges and Opportunities for Clinical Decision Making and Improving Treatment Precision. Front Public Health 2021; 9:738253. [PMID: 34858922 PMCID: PMC8632538 DOI: 10.3389/fpubh.2021.738253] [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: 07/08/2021] [Accepted: 10/11/2021] [Indexed: 11/15/2022] Open
Abstract
Physiatry is a medical specialty focused on improving functional outcomes in patients with a variety of medical conditions that affect the brain, spinal cord, peripheral nerves, muscles, bones, joints, ligaments, and tendons. Social determinants of health (SDH) play a key role in determining therapeutic process and patient functional outcomes. Big data and precision medicine have been used in other fields and to some extent in physiatry to predict patient outcomes, however many challenges remain. The interplay between SDH and physiatry outcomes is highly variable depending on different phases of care, and more favorable patient profiles in acute care may be less favorable in the outpatient setting. Furthermore, SDH influence which treatments or interventional procedures are accessible to the patient and thus determine outcomes. This opinion paper describes utility of existing datasets in combination with novel data such as movement, gait patterning and patient perceived outcomes could be analyzed with artificial intelligence methods to determine the best treatment plan for individual patients in order to achieve maximal functional capacity.
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Affiliation(s)
- Rosalynn R Z Conic
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States
| | - Carolyn Geis
- Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, United States
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, United States
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Gustavson AM, Malone DJ, Boxer RS, Forster JE, Stevens-Lapsley JE. Application of High-Intensity Functional Resistance Training in a Skilled Nursing Facility: An Implementation Study. Phys Ther 2020; 100:1746-1758. [PMID: 32750132 PMCID: PMC7530575 DOI: 10.1093/ptj/pzaa126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 08/20/2019] [Accepted: 04/24/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Rehabilitation in skilled nursing facilities (SNFs) is under scrutiny to deliver high-quality care and superior outcomes in less time. High-intensity resistance training demonstrates functional improvements in community-dwelling and long-term care populations but has not been generalized to the SNF population. The purpose of this study was to evaluate implementation issues including safety and feasibility and to provide preliminary information on effectiveness of rehabilitation focused on high-intensity functional resistance training in an SNF. METHODS The implementation study design consisted of 2 nonrandomized independent groups (usual care and high intensity) that were staged within a single SNF. The i-STRONGER program (IntenSive Therapeutic Rehabilitation for Older Skilled NursinG HomE Residents) integrates principles of physiologic tissue overload into rehabilitation. Physical therapists administered the Short Physical Performance Battery and gait speed at evaluation and discharge. Reach, Effectiveness, Adoption, Implementation, and Maintenance was used to evaluate the implementation process. An observational checklist and documentation audits were used to assess treatment fidelity. Regression analyses evaluated the response of functional change by group. RESULTS No treatment-specific adverse events were reported. Treatment fidelity was high at >99%, whereas documentation varied from 21% to 50%. Patient satisfaction was greater in i-STRONGER, and patient refusals to participate in therapy sessions trended downward in i-STRONGER. Patients in i-STRONGER exhibited a 0.13 m/s greater change in gait speed than in the usual care group. Although not significant, i-STRONGER resulted in a 0.64-point greater change in the Short Physical Performance Battery than usual care, and average SNF length of stay was 3.5 days shorter for i-STRONGER patients. CONCLUSION The findings from this study indicate that implementation of a high-intensity resistance training framework in SNFs is safe and feasible. Furthermore, results support a signal effectiveness of improving function and satisfaction, although the heterogeneity of the population necessitates a larger implementation study to confirm. IMPACT STATEMENT This pragmatic study demonstrates that high-intensity resistance training in medically complex older adults is safe and favorable in SNFs. This work supports the need to fundamentally change the intensity of rehabilitation provided to this population to promote greater value within post-acute care. Furthermore, this study supports the application of implementation science to rehabilitation for rapid and effective translation of evidence into practice.
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Affiliation(s)
- Allison M Gustavson
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado
| | - Daniel J Malone
- CCS, Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado
| | - Rebecca S Boxer
- Division of Geriatric Medicine, Department of Medicine, University of Colorado, and Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, Colorado
| | - Jeri E Forster
- Rocky Mountain Regional Veterans Affairs Medical Center, Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora; Department of Physical Medicine and Rehabilitation, University of Colorado; and Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado
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Passias PG, Poorman GW, Bortz CA, Qureshi R, Diebo BG, Paul JC, Horn SR, Segreto FA, Pyne A, Jalai CM, Lafage V, Bess S, Schwab FJ, Hassanzadeh H. Predictors of adverse discharge disposition in adult spinal deformity and associated costs. Spine J 2018; 18:1845-1852. [PMID: 29649611 DOI: 10.1016/j.spinee.2018.03.022] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 02/09/2018] [Accepted: 03/26/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT With advances in the understanding of adult spinal deformity (ASD), more complex osteotomy and fusion techniques are being implemented with increasing frequency. Patients undergoing ASD corrections infrequently require extended acute care, longer inpatient stays, and are discharged to supervised care. Given the necessity of value-based health care, identification of clinical indicators of adverse discharge disposition in ASD surgeries is paramount. PURPOSE Using the nationwide and surgeon-created databases, the present study aimed to identify predictors of adverse discharge disposition after ASD surgeries and view the corresponding differences in charges. STUDY DESIGN/SETTING This is a retrospective analysis of patients on the National Surgical Quality Improvement Program (NSQIP) database and of cost data from Medicare PearlDiver Database. PATIENT SAMPLE Patients undergoing thoracolumbar surgery for correction of ASD were included in the study. OUTCOME MEASURES Primary analysis was performed to compare patients discharged to home with patients who either expired or were discharged to locations other than home. Secondary analysis was performed to determine the cost differences across discharge groups. METHODS Patients on NSQIP undergoing thoracolumbar ASD-corrective surgery with a primary diagnosis of scoliosis (ICD-9 code 737.x) and over the age of 18 were isolated. Predictors (demographic, clinical, and complications) of not-home (NH; rehab or skilled nursing facility) discharge were analyzed using binary logistic regression controlling for levels fused, decompressions, osteotomies, and revisions. Average 30- and 90-day costs of care were reported in home, rehab, and skilled nursing facility discharge groups in patients undergoing 8+ level thoracolumbar fusion. RESULTS A total of 1,978 patients undergoing lumbar ASD-corrective surgery were included for analysis (average age: 59.3 years, sex: 64% female). Average length of stay was 6.58 days. On multivariate regression analysis, age over 60 years (odds ratio [OR]: 0.28, confidence interval [CI]: 0.22-0.34) and female sex (p=.003) were independent predictors of adverse discharge status. Partially dependent preoperational functional status, defined as reliance on another person to complete some activities of daily living, increased likelihood of adverse discharge disposition (OR: 0.57, CI: 0.35-0.90). Despite controlling for all clinical variables except for the ones specific to each analysis, Smith-Petersen osteotomy (OR: 0.51, CI: 0.40-0.64), interbody device placement (OR: 0.80, CI: 0.64-0.98), and fixation to the iliac (OR: 0.54, CI: 0.41-0.70) increased the likelihood of adverse discharge. Complications most associated with adverse discharge were urinary tract infections (OR: 0.34, CI: 0.21-0.57) and blood transfusions (OR: 0.42, CI: 0.34-0.52). Relative to home discharge, 30-day costs of care were +$21,061 more expensive in rehab discharges, but not different in skilled nursing facility discharges (+$5,791, p=.177). The 90-day costs of care were $23,815 in rehab discharges (p<.001), but again not different from skilled nursing facility discharges (+$6,091, p=.212). CONCLUSIONS Discharge destination to rehabilitation has a significant impact on the cost of thoracolumbar ASD surgeries. Patient selection can predict patients at higher risk of discharges to rehab or skilled nursing facility.
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Affiliation(s)
- Peter G Passias
- Division of Spine, Department of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NYU School of Medicine, 301 East 17th St, New York, NY, 10003, USA.
| | - Gregory W Poorman
- Division of Spine, Department of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NYU School of Medicine, 301 East 17th St, New York, NY, 10003, USA
| | - Cole A Bortz
- Division of Spine, Department of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NYU School of Medicine, 301 East 17th St, New York, NY, 10003, USA
| | - Rabia Qureshi
- Spine Division, Department of Orthopaedic Surgery, University of Virginia School of Medicine, 415 Ray C. Hunt Dr, Suite 3100, Charlottesville, VA 22908, USA
| | - Bassel G Diebo
- Department of Orthopaedic Surgery, SUNY Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY 11203, USA
| | - Justin C Paul
- Department of Orthopaedic Surgery, NYU Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Samantha R Horn
- Division of Spine, Department of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NYU School of Medicine, 301 East 17th St, New York, NY, 10003, USA
| | - Frank A Segreto
- Division of Spine, Department of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NYU School of Medicine, 301 East 17th St, New York, NY, 10003, USA
| | - Alexandra Pyne
- Division of Spine, Department of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NYU School of Medicine, 301 East 17th St, New York, NY, 10003, USA
| | - Cyrus M Jalai
- Division of Spine, Department of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NYU School of Medicine, 301 East 17th St, New York, NY, 10003, USA
| | - Virginie Lafage
- Department of Orthopaedic Surgery, NYU Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Shay Bess
- Rocky Mountain Scoliosis and Spine, 2055 North High St, Denver, CO 80205, USA
| | - Frank J Schwab
- Department of Orthopaedic Surgery, NYU Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Hamid Hassanzadeh
- Spine Division, Department of Orthopaedic Surgery, University of Virginia School of Medicine, 415 Ray C. Hunt Dr, Suite 3100, Charlottesville, VA 22908, USA
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Mitra R, Standaert CJ. The Value of Physical Medicine and Rehabilitation in the New Health Care Market. PM R 2018; 8:475-8. [PMID: 27173173 DOI: 10.1016/j.pmrj.2016.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 03/03/2016] [Indexed: 11/18/2022]
Affiliation(s)
- Raj Mitra
- Department of Rehabilitation Medicine, The University of Kansas, Medical Center Mail Stop 1046, 3901 Rainbow Blvd, Kansas City, KS 66160(∗).
| | - Christopher J Standaert
- Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine, and Neurological Surgery, University of Washington, Seattle, WA(†)
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Brusco NK, Taylor NF, Watts JJ, Shields N. Economic Evaluation of Adult Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials in a Variety of Settings. Arch Phys Med Rehabil 2014; 95:94-116.e4. [DOI: 10.1016/j.apmr.2013.03.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 03/14/2013] [Accepted: 03/14/2013] [Indexed: 12/01/2022]
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Hoyer EH, Needham DM, Miller J, Deutschendorf A, Friedman M, Brotman DJ. Functional status impairment is associated with unplanned readmissions. Arch Phys Med Rehabil 2013; 94:1951-8. [PMID: 23810355 DOI: 10.1016/j.apmr.2013.05.028] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 04/24/2013] [Accepted: 05/26/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine whether functional status on admission to a Comprehensive Integrated Inpatient Rehabilitation Program (CIIRP) is associated with unplanned readmission to acute care. DESIGN Retrospective cohort study. SETTING Academic hospital-based CIIRP. PARTICIPANTS Consecutive patients (N=1515) admitted to a CIIRP between January 2009 and June 2012. INTERVENTIONS Patients' functional status, the primary exposure variable, was assessed using tertiles of the total FIM score at CIIRP admission, with secondary analyses using the FIM motor and cognitive domains. A propensity score, consisting of 25 relevant clinical and demographic variables, was used to adjust for confounding in the analysis. MAIN OUTCOME MEASURES Readmission to acute care was categorized as (1) readmission before planned discharge from the CIIRP, (2) readmission within 30 days of discharge from the CIIRP, and (3) total readmissions from both groups, with total readmissions being the a priori primary outcome. RESULTS Among the 1515 patients, there were 347 total readmissions. Total readmissions were significantly associated with FIM scores, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the lowest and middle FIM tertiles versus the highest tertile (AOR=2.6; 95% CI, 1.9-3.7; P<.001 and AOR=1.7; 95% CI, 1.2-2.4; P=.002, respectively). There were similar findings for secondary analyses of readmission before planned discharge from the CIIRP (AOR=3.5; 95% CI, 2.2-5.8; P<.001 and AOR=2.1; 95% CI, 1.3-3.5l P=.002, respectively), and a weaker association for readmissions after discharge from the CIIRP (AOR=1.6; 95% CI, 1.0-2.4; P=.047 and AOR=1.3; 95% CI, 0.8-1.9; P=.28, respectively). The FIM motor domain score was more strongly associated with readmissions than the FIM cognitive score. CONCLUSIONS Functional status on admission to the CIIRP is strongly associated with readmission to acute care, particularly for motor aspects of functional status and readmission before planned discharge from the CIIRP. Efforts to reduce hospital readmissions should consider patient functional status as an important and potentially modifiable risk factor.
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Affiliation(s)
- Erik H Hoyer
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD.
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Shah S, Tartaro C, Chew F, Morris M, Wood C, Wuzzardo A. Rehabilitation Efficiency and Effectiveness in Medical-Surgical Conditions: A Pilot Study of 234 Patients. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2012. [DOI: 10.3109/02703181.2012.731481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Suryakumar Shah
- 1Occupational Therapy, School of Health, The Richard Stockton College of New Jersey, Galloway, NJ, USA
| | - Christine Tartaro
- 2Criminal Justice, Richard Stockton College of New Jersey, Galloway, NJ, USA
| | | | - Mike Morris
- 3Genesis Rehab Care, Kennett Square, PA, USA
| | - Christine Wood
- 4Occupational Therapy, Richard Stockton College of New Jersey, Galloway, NJ, USA
| | - Ashley Wuzzardo
- 4Occupational Therapy, Richard Stockton College of New Jersey, Galloway, NJ, USA
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Abizanda P, León M, Domínguez-Martín L, Lozano-Berrio V, Romero L, Luengo C, Sánchez-Jurado PM, Martín-Sebastiá E. Effects of a short-term occupational therapy intervention in an acute geriatric unit. A randomized clinical trial. Maturitas 2011; 69:273-8. [DOI: 10.1016/j.maturitas.2011.04.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 03/13/2011] [Accepted: 04/06/2011] [Indexed: 10/18/2022]
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