Effects of Unstructured Mobility Programs in Older Hospitalized General Medicine Patients: A Systematic Review and Meta-Analysis

Reynolds, Courtney D.; Brazier, Kaitlyn V.; Burgess, Evelyn A.A.; Golla, Jonathan A.; Le, Jayson; Parks, Brenna A.; O’Hoski, Sachi; Beauchamp, Marla K.

doi:10.1016/j.jamda.2020.12.008

Cited by 8 publications

(2 citation statements)

References 27 publications

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“…Patients perceiving clinician stress and lack of time did not dare asking for help. However, while adding staff resources improved mobility in studies [ 8 , 9 , 24 – 26 ], it is unlikely to modify practices in a context of staff shortage and rising healthcare costs. Conversely, focusing on optimizing the use of time and staff resources, for example by clarifying staff roles, ways to communicate and mobility task planning, could be a way to address these barriers.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, interventions that succeeded to improve hospital mobility in strict study conditions have not been implemented in clinical practice on a large scale [ 5 , 8 , 9 ]. This might be due to a lack of comprehensive consideration of barriers, facilitators, and real-life resources, and of active stakeholder involvement (“participatory research”) [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Perspectives of patients and clinicians on older patient mobility on acute medical wards: a qualitative study

Herzog,

Herzog-Zibi,

Mattmann

et al. 2023

BMC Geriatr

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Background Low mobility during an acute care medical hospitalization is frequent and associated with adverse outcomes, particularly among older patients. Better understanding barriers and facilitators to improve mobility during hospitalization could help develop effective interventions. The goal of this study was to assess barriers and facilitators to older medical patients’ hospital mobility, from the point of view of patients and clinicians, to develop a framework applicable in clinical practice. Methods We conducted a qualitative study in one university and two non-university hospitals of two different language and cultural regions of Switzerland, including 13 focus groups (FGs; five with patients, eight with clinicians). We included 24 adults aged 60 years or older hospitalized on an acute general internal medicine ward of one of the three participating hospitals during the previous years, and 34 clinicians (15 physicians, nine nurses/nursing assistants, 10 physiotherapists) working on those wards. The FG guides included open-ended questions exploring mobility experiences, expectations, barriers and facilitators to mobility, consequences of low mobility and knowledge on mobility. We applied an inductive thematic analysis. Results We identified four themes of barriers and facilitators to mobility: 1) patient-related factors; 2) clinician-related factors; 3) social interactions; and 4) non-human factors. Clinician-related factors were only mentioned in clinician FGs. Otherwise, subthemes identified from patient and clinician FGs were similar and codes broadly overlapped. Subthemes included motivation, knowledge, expectations, mental and physical state (theme 1); process, knowledge – skills, mental state – motivation (theme 2); interpersonal relationships, support (theme 3); hospital setting – organization (theme 4). Conclusions From patients’ and clinicians’ perspectives, a broad spectrum of human and structural factors influences mobility of older patients hospitalized on an acute general internal medicine ward. New factors included privacy issues and role perception. Many of those factors are potentially actionable without additional staff resources. This study is a first step in participatory research to improve mobility of older medical inpatients.

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Section: Discussionmentioning

confidence: 99%