Measurement of function in older adults transitioning from hospital to home: an integrative review

Liebzeit, Daniel; King, Barbara; Bratzke, Lisa C.

doi:10.1016/j.gerinurse.2017.11.003

Cited by 25 publications

(21 citation statements)

References 79 publications

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“…Despite the importance of both BADLs and IADLs in older adults transitioning back home, assessment of functional status in this group is also focused primarily on BADLs. In order to highlight how functional status has been assessed, we examined forty publications cited in a recent review that included functional status as a primary study variable for older adults transitioning from hospital to home (Liebzeit et al, 2017). Table 1 summarizes the items included as a part of the functional status assessments.…”

Section: How We Assess Functional Status In Older Adultsmentioning

confidence: 99%

“…One major barrier in research on older adults functioning during the transition from hospital to home is that the instruments used to measure that functioning have limitations (Liebzeit, King, & Bratzke, 2017). For instance, we do not have sufficient evidence documenting the instruments’ validity and reliability for use by self-report in this group (Liebzeit et al, 2017). Despite this limitation, the instruments are largely administered by self-report and often by telephone.…”

Section: Introductionmentioning

confidence: 99%

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Improving Functional Assessment in Older Adults Transitioning From Hospital to Home

Liebzeit

King

Bratzke

et al. 2018

Professional Case Management

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Purpose/Objectives The purpose of this article is to highlight how scientists have assessed all components of functional status in older adults transitioning from hospital to home to date, discuss ways of improving assessment of functional status, and discuss implications for case management research and practice. Primary Practice Setting(s) This article focuses on case management of older adults transitioning from hospital to home. Findings/Conclusions There any many ways to assess functional status, including BADLs, IADLs, and other non-physical domains of function such as leisure, social, and productive activities. However, assessment of function in older adults transitioning from hospital to home is primarily limited to BADLs. Non-physical domains of functional status have been linked to important outcomes in community-dwelling older adults and could give clinicians and researchers a better understanding of how older adults are functioning, as well as allow for earlier recognition of those who are beginning to experience functional decline. Implications for Case Management Practice In case management, it is important to ask older adults about goals regarding their functional status and how they think about their functioning in the hospital and at home. Early identification of older adults’ functional goals while in the hospital is the first step towards regaining their ideal or premorbid function after discharge to home. In order to best determine baseline functional status, we may need to consider assessments that can measure multiple domains of functioning in older adults, such as the Sickness Impact Profile (SIP). Gaining a more comprehensive understanding and assessment of functional status for hospitalized older adults would help to inform discharge destinations and improve transitions in care.

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Section: How We Assess Functional Status In Older Adultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving Functional Assessment in Older Adults Transitioning From Hospital to Home

Liebzeit

King

Bratzke

et al. 2018

Professional Case Management

Self Cite

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“…They regard the Katz Index or other specifically focused tool as better options for the assessment of patients with physical disabilities. These tools are traditionally used in elder-care homes (nursing homes), and their reliability and validity have been tested many times; no better tool has been found for the assessment of independence [ 31 ]. A study by Roedl et al expresses equally positive opinions regarding independence assessment using the Barthel Index and Katz Index.…”

Section: Discussionmentioning

confidence: 99%

Use of Standardized and Non-Standardized Tools for Measuring the Risk of Falls and Independence in Clinical Practice

Neugebauer

Tóthová

Doležalová

2021

IJERPH

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(1) Background: The use of standardized tools is regarded as the basis for an evidence-based assessment. The tools enable monitoring of complex events and the effectiveness of adopted interventions. Some healthcare facilities use standardized tools such as the Morse Fall Scale, but many use non-standardized tools created based on patient needs. Our study question was, why are non-standardized tools used when standardized tools are more beneficial and can be statistically evaluated and compared to other results; (2) Methods: We used a quantitative, non-standardized questionnaire to survey 1200 nurses, which was representative sample for the entire Czech Republic. All questionnaires were assessed in two phases (a) the frequency evaluation and descriptive analysis, and (b) hypotheses testing and correlation analyses; (3) Results: We found that the Conley Scale, Barthel test, and IADL test were preferred by many nurses. Furthermore, we found that nurses using standardized assessment scales noticed risk factors significantly more frequently but regarded the increased complexity of care to be psychologically demanding. (4) Conclusions: In patients with physical disabilities, both types of tools (internal non-standardized and standardized) are used to assess the risk of falls and independence; nurses generally welcomed the increase use of standardized tools in their facilities.

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“…Several models have been proposed to predict the location of discharge or the level of supportive services required after discharge. However, there is only one review of tools to predict location of discharge and it only used qualitative synthesis to describe them [5]. No review has compared validated models that predict the need for supportive services after discharge to home or an institutional setting.…”

Section: Introductionmentioning

confidence: 99%

Predicting the need for supportive services after discharged from hospital: a systematic review

Kobewka

Mulpuru

Chassé

et al. 2020

BMC Health Serv Res

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Background Some patients admitted to acute care hospital require supportive services after discharge. The objective of our review was to identify models and variables that predict the need for supportive services after discharge from acute care hospital. Methods We performed a systematic review searching the MEDLINE, CINAHL, EMBASE, and COCHRANE databases from inception to May 1st 2017. We selected studies that derived and validated a prediction model for the need for supportive services after hospital discharge for patients admitted non-electively to a medical ward. We extracted cohort characteristics, model characteristics and variables screened and included in final predictive models. Risk of bias was assessed using the Quality in Prognostic Studies tool. Results Our search identified 3362 unique references. Full text review identified 6 models. Models had good discrimination in derivation (c-statistics > 0.75) and validation (c-statistics > 0.70) cohorts. There was high quality evidence that age, impaired physical function, disabilities in performing activities of daily living, absence of an informal care giver and frailty predict the need for supportive services after discharge. Stroke was the only unique diagnosis with at least moderate evidence of an independent effect on the outcome. No models were externally validated, and all were at moderate or higher risk of bias. Conclusions Deficits in physical function and activities of daily living, age, absence of an informal care giver and frailty have the strongest evidence as determinants of the need for support services after hospital discharge. Trial registration This review was registered with PROSPERO #CRD42016037144.

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Measurement of function in older adults transitioning from hospital to home: an integrative review

Cited by 25 publications

References 79 publications

Improving Functional Assessment in Older Adults Transitioning From Hospital to Home

Improving Functional Assessment in Older Adults Transitioning From Hospital to Home

Use of Standardized and Non-Standardized Tools for Measuring the Risk of Falls and Independence in Clinical Practice

Predicting the need for supportive services after discharged from hospital: a systematic review

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