Background
The COVID-19 pandemic caused drastic changes in the lives of the general population. People with physical disabilities, who commonly encounter daily challenges such as barriers to community mobility, reduced access to healthcare services and higher risk of suffering from depression, may face additional challenges in the context of the pandemic.
Objective
This study aims to review the impact of the COVID-19 pandemic, and associated isolation and protective measures, among people with physical disabilities.
Methods
A rapid review of the published literature was conducted on August 10, 2020 through a search in six online databases to synthesize results from original studies regarding the impact of the COVID-19 pandemic on people with physical disabilities. The International Classification of Functioning, Disability and Health was used to describe the population and the personal and environmental factors with a unified and standard health language.
Results
Eleven records were extracted from 1621 individual papers retrieved from the search strategy. Various impacts on daily functioning such as a decrease in access to healthcare have been noted during the pandemic. Changes in social and lifestyle habits, mood changes and decreased levels of physical activity were also noted.
Conclusions
Our results highlighted the lack of early research about the impacts of COVID-19 experienced by people with physical disabilities. Future studies should focus on specific consequences and needs of this vulnerable population to ensure their inclusion in public health recommendations and consideration by policy makers.
ObjectiveWe aim to determine the incidence of delirium and describe its impacts on hospital length of stay (LOS) among non-delirious community-dwelling older adults with an 8-hour exposure to the emergency department (ED) environment.DesignThis is a prospective observational multicentre cohort study (March–July 2015). Patients were assessed two times per day during their entire ED stay and up to 24 hours on hospital ward.SettingThe study took place in four Canadian EDs.Participants338 included patients: (1) aged ≥65 years; (2) who had an ED stay ≥8 hours; (3) were admitted to hospital ward and (4) were independent/semi-independent.Main outcome(s) and measure(s)The primary outcomes of this study were incident delirium in the ED or within 24 hours of ward admission and ED and hospital LOS. Functional and cognitive status were assessed using validated Older Americans Resources and Services and the modified Telephone Interview for Cognitive Status tools. The Confusion Assessment Method was used to detect incident delirium. Univariate and multivariate analyses were conducted to evaluate outcomes.ResultsMean age was 76.8 (±8.1), 17.7% were aged >85 years old and 48.8% were men. The mean incidence of delirium was 12.1% (n=41). Median IQR ED LOS was 32.4 (24.5–47.9) hours and hospital LOS was 146.6 (75.2–267.8) hours. Adjusted mean hospital LOS was increased by 105.4 hours (4.4 days) (95% CI 25.1 to 162.0, P<0.001) for patients who developed an episode of delirium compared with non-delirious patient.ConclusionsAn incident delirium was observed in one of eight independent/semi-independent older adults after an 8-hour ED exposure. An episode of delirium increases hospital LOS by 4 days and therefore has important implications for patients and could contribute to ED overcrowding through a deleterious feedback loop.
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