Functional trajectories of older patients admitted to an Acute Care Unit for Elders
| Autor: | Fabiana Butrogno, Diane Morin, Andreina D'Onofrio, Rubli E, Christophe Büla |
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| Rok vydání: | 2016 |
| Předmět: |
Gerontology
Male medicine.medical_specialty Activities of daily living Psychological intervention Nursing assessment 03 medical and health sciences Nursing care 0302 clinical medicine Quality of life (healthcare) Risk Factors Acute care Activities of Daily Living Medicine Humans 030212 general & internal medicine Risk factor Geriatric Assessment Nursing Assessment Aged Inpatients 030504 nursing business.industry Delirium Quality of Life Female medicine.symptom 0305 other medical science business Hospital Units Switzerland |
| Zdroj: | International journal of older people nursing. 13(1) |
| ISSN: | 1748-3743 |
| Popis: | Aims and objectives To describe the functional trajectories of older medical inpatients and to identify factors associated with overall and in-hospital functional decline. Background Functional decline during a hospital stay is an important clinical outcome because independence remains a major determinant of older persons’ quality of life and health care demands. Design and methods Participants (n = 189) were admitted to the Acute Care Unit for Elders of a Swiss academic hospital and were aged 65 years and older. Performance in basic activities of daily living at home (self-reported), at hospital admission (observed) and at discharge (observed) was collected. Differences in scores for basic activities daily living between baseline and admission, between admission and discharge, and between baseline and discharge were used to define pre-admission, in-hospital and overall functional decline. Predictors of in-hospital and overall decline were identified using bivariate and multivariate logistic regression analyses. Results Pre-admission, in-hospital and overall functional decline occurred in 56.1%, 17.5% and 43.4% of the participants, respectively. In contrast, in-hospital functional improvement occurred in 40.2% of the participants. No predictors of pre-admission decline were identified, whereas pre-admission performance in instrumental activities of daily living was associated with in-hospital decline. Male gender and in-hospital delirium were associated with overall functional decline. Conclusions Most older inpatients experienced functional decline before their hospital admission, but only a minority experienced decline during their stay. Importantly, delirium was a strong predictor of overall functional decline. Implications for practice Low performance in instrumental activities of daily living prior to admission and delirium occurrence identified older patients at higher risk for in-hospital and overall functional decline. Gerontological nurses should play a key role in identifying these patients to provide preventative interventions and recovery care to preserve or restore their functional independence. |
| Databáze: | OpenAIRE |
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