Functional trajectories of older patients admitted to an Acute Care Unit for Elders.

Détails

ID Serval
serval:BIB_F583870C34A8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Functional trajectories of older patients admitted to an Acute Care Unit for Elders.
Périodique
International journal of older people nursing
Auteur(s)
D'Onofrio A., Büla C., Rubli E., Butrogno F., Morin D.
ISSN
1748-3743 (Electronic)
ISSN-L
1748-3735
Statut éditorial
Publié
Date de publication
03/2018
Peer-reviewed
Oui
Volume
13
Numéro
1
Pages
1-9
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Résumé
To describe the functional trajectories of older medical inpatients and to identify factors associated with overall and in-hospital functional decline.
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.
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.
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.
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.
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.
Mots-clé
Activities of Daily Living, Aged, Delirium/nursing, Female, Geriatric Assessment, Hospital Units, Humans, Inpatients, Male, Nursing Assessment, Quality of Life, Risk Factors, Switzerland, delirium, hospital-related functional decline, nursing care, risk factor
Pubmed
Web of science
Création de la notice
20/09/2017 13:43
Dernière modification de la notice
20/08/2019 16:22
Données d'usage