Construct validity and inter-rater reliability of the Dutch activity measure for post-acute care “6-clicks” basic mobility form to assess the mobility of hospitalized patients

Geelen, Sven J G; Valkenet, Karin; Veenhof, Cindy

doi:10.1080/09638288.2018.1471525

Cited by 17 publications

(12 citation statements)

References 36 publications

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“…The AM-PAC demonstrated to be reliable and valid for assessing patients’ basic mobility in acute care settings. 28 , 29 Handgrip strength was measured to get insight into the overall muscle strength and level of physical function. Handgrip strength was measured with the Jamar hydraulic hand dynamometer, which is an easily accessible tool with excellent psychometric characteristics.…”

Section: Methodsmentioning

confidence: 99%

The Effectiveness of Hospital in Motion, a Multidimensional Implementation Project to Improve Patients’ Movement Behavior During Hospitalization

et al. 2020

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Objective Hospital in Motion is a multidimensional implementation project aiming to improve movement behavior during hospitalization. The purposed of this study was to investigate the effectiveness of Hospital in Motion on movement behavior. Methods This prospective study used a pre-implementation and post-implementation design. Hospital in Motion was conducted at 4 wards of an academic hospital in the Netherlands. In each ward, multidisciplinary teams followed a 10-month step-by-step approach, including the development and implementation of a ward-specific action plan with multiple interventions to improve movement behavior. Inpatient movement behavior was assessed before the start of the project and 1 year later, using a behavioral mapping method in which patients were observed between 9:00 am and 4:00 pm. The primary outcome was the percentage of time spent lying down. In addition, sitting and moving, immobility-related complications, length of stay, discharge destination home, discharge destination rehabilitation setting, mortality, and 30-day readmissions were investigated. Differences between pre-implementation and post-implementation conditions were analyzed using the chi-square test for dichotomized variables, the Mann Whitney test for nonnormal distributed data, or independent samples t test for normally distributed data. Results Patient observations demonstrated that the primary outcome, the time spent lying down, changed from 60.1% to 52.2%. For secondary outcomes, the time spent sitting increased from 31.6% to 38.3%, and discharges to a rehabilitation setting reduced from 6 (4.4%) to 1 (0.7%). No statistical differences were found in the other secondary outcome measures. Conclusion The implementation of the multidimensional project Hospital in Motion was associated with patients who were hospitalized spending less time lying in bed and with a reduced number of discharges to a rehabilitation setting. Impact Inpatient movement behavior can be influenced by multidimensional interventions. Programs implementing interventions that specifically focus on improving time spent moving, in addition to decreasing time spent lying, are recommended.

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Section: Methodsmentioning

confidence: 99%

The Effectiveness of Hospital in Motion, a Multidimensional Implementation Project to Improve Patients’ Movement Behavior During Hospitalization

et al. 2020

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“…To determine the relationship between the bedside nurses LOF and the Activity Measure for Post‐Acute Care (AM‐PAC) 6‐Clicks basic mobility score, we included a sample of patients in the CICU over a nonconsecutive 5‐day period who received both LOF and AM‐PAC 6‐Clicks score assessment. The 6‐Clicks mobility score has been validated and is reliable in acute hospitalised patients (Geelen, Valkenet, & Veenhof, ; Jette et al, ). It has been shown to have very good discrimination at predicting hospital discharge destination (receiver operating characteristic scores of 0.86 for basic mobility and 0.85 for daily activity) (Jette et al, , ).…”

Section: Methodsmentioning

confidence: 99%

Level of function mobility scale for nurse‐driven early mobilisation in people with acute cardiovascular disease

Dima

Valiquette

Berube-Dufour

et al. 2019

Journal of Clinical Nursing

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Background There are currently no validated tools that are reliable and easy to use for nurses to assess mobility in people with acute cardiovascular disease in the Cardiovascular Intensive Care Unit (CICU). Methods A multidisciplinary team at an academic tertiary care centre developed the Level of Function (LOF) Mobility Scale for use in a nurse‐driven early progressive mobilisation in the CICU. To determine inter‐rater reliability, the prehospital and admission LOF were assessed independently by two CICU nurses. Pairwise comparisons between raters were evaluated using Cohen's kappa statistic. To determine convergence validity, the LOF and Activity Measure for Post‐Acute Care 6‐Clicks score upon admission were compared with Spearman's correlation. To determine feasibility, a 9‐item mobility scale questionnaire was distributed to CICU nurses with and without experience using the LOF Mobility Scale. The STROBE reporting guidelines were used. Results The LOF Mobility Scale had good inter‐rater reliability for assessment of LOF prior to hospitalisation (N = 131, kappa = 0.66, p < .001) and at the time of CICU admission (N = 131, kappa = 0.71, p < .001). There was a moderate correlation (N = 79 observations; correlation coefficient = 0.525; p < .01) between the bedside nurses LOF and the 6‐Clicks score. All nurses surveyed (N = 54; 100%) thought that the LOF Mobility Scale was clear and unambiguous, the LOFs were well‐defined and the scale was an appropriate length. Nearly all of the nurses with experience using the scale (N = 22/24; 92%) felt that the scale took less than one minute to complete, compared with about half (N = 14/30; 47%) in the group of nurses without experience using the scale. Conclusion The LOF Mobility Scale is reliable and feasible for mobility assessment in a nurse‐driven early progressive mobilisation programme in patients with acute cardiovascular disease in the CICU. Relevance to clinical practice A nurse‐driven EM programme can be implemented in the CICU.

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“…In this study, the AM-PAC “6-Clicks” measures of basic mobility and daily activity in acute care will be used. These short forms have shown to be valid for assessing patients’ activity limitations in acute care settings [34,35]. Handgrip strength can indicate the overall strength of an individual and can provide insight into the level of physical function [36,37].…”

Section: Methodsmentioning

confidence: 99%

Hospital in Motion, a Multidimensional Implementation Project to Improve Patients’ Physical Behavior During Hospitalization: Protocol for a Mixed-Methods Study

Delft¹,

Bor²,

Valkenet³

et al. 2019

JMIR Res Protoc

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Background Despite the evidence of the adverse consequences of immobility during hospitalization, patients spend most of the time in bed. Although physical activity is a modifiable factor that can prevent in-hospital functional decline, bed rest is deeply rooted in the hospital culture. To attack this, a multidimensional approach is needed. Therefore, Hospital in Motion, a multidimensional implementation project, was designed to improve physical behavior during hospitalization. Objective The primary objective of this study is to investigate the effectiveness of Hospital in Motion on inpatient physical behavior. Secondary objectives are to investigate the effectiveness on length of hospital stay and immobility-related complications of patients during hospitalization and to monitor the implementation process. Methods For this study, Hospital in Motion will be implemented within 4 wards (cardiology, cardiothoracic surgery, medical oncology, and hematology) in a Dutch University Medical Center. Per ward, multidisciplinary teams will be composed who follow a step-by-step multidimensional implementation approach including the development and implementation of tailored action plans with multiple interventions to stimulate physical activity in daily care. A prepost observational study design will be used to evaluate the difference in physical behavior before and 1 year after the start of the project, including 40 patients per time point per ward (160 patients in total). The primary outcome measure is the percentage of time spent lying, measured with the behavioral mapping method. In addition, a process evaluation will be performed per ward using caregivers’ and patient surveys and semistructured interviews with patients and caregivers. Results This study is ongoing. The first participant was enrolled in October 2017 for the premeasurement. The postmeasurements are planned for the end of 2018. The first results are expected to be submitted for publication in autumn 2019. Conclusions This study will provide information about the effectiveness of the Hospital in Motion project on physical behavior and about the procedures of the followed implementation process aimed to incorporate physical activity in usual care. These insights will be useful for others interested in changing physical behavior during hospitalization. Trial Registration Netherlands Trial Register NTR7109; https://www.trialregister.nl/trial/6914 (Archived by WebCite at http://www.webcitation.org/76dyhdjdd) International Registered Report Identifier (IRRID) DERR1-10.2196/11341

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Construct validity and inter-rater reliability of the Dutch activity measure for post-acute care “6-clicks” basic mobility form to assess the mobility of hospitalized patients

Cited by 17 publications

References 36 publications

The Effectiveness of Hospital in Motion, a Multidimensional Implementation Project to Improve Patients’ Movement Behavior During Hospitalization

The Effectiveness of Hospital in Motion, a Multidimensional Implementation Project to Improve Patients’ Movement Behavior During Hospitalization

Level of function mobility scale for nurse‐driven early mobilisation in people with acute cardiovascular disease

Hospital in Motion, a Multidimensional Implementation Project to Improve Patients’ Physical Behavior During Hospitalization: Protocol for a Mixed-Methods Study

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