Mobilizing older adults: A multi-site, exploratory and observational study on patients enrolled in the Hospital Elder Life Program (HELP)

Babine, Rhonda L.; Hyrkäs, Kristiina; Mckenzie, Caitlin G.; Wierman, Heidi R.

doi:10.1016/j.gerinurse.2018.10.005

Cited by 5 publications

(5 citation statements)

References 35 publications

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“…Of the 56 studies, 32 used a qualitative study design [ 14 – 20 , 38 , 42 , 44 – 46 , 49 – 54 , 57 , 61 , 67 , 68 , 70 , 72 – 76 , 78 – 80 , 83 ], seven a quantitative study design [ 21 , 37 , 39 , 63 , 66 , 69 , 82 ], and 17 a mixed-methods study design [ 11 , 36 , 43 , 47 , 48 , 55 , 56 , 58 – 60 , 62 , 64 , 65 , 71 , 77 , 81 , 84 ]. Nineteen studies reported barriers and enablers as perceived by patients [ 14 , 20 , 36 , 37 , 39 , 48 , 51 , 61 , 63 – 65 , 67 , 70 , 73 , 78 , 79 , 81 , 83 ], 23 reported those perceived by HCPs [ 16 – 18 , 21 , 38 , 42 , 43 , 47 , 50 , 52 –…”

Section: Resultsmentioning

confidence: 99%

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Barriers and enablers to physical activity in patients during hospital stay: a scoping review

et al. 2021

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Background Low levels of physical activity are common during the hospital stay and have been associated with negative health outcomes. Understanding barriers and enablers to physical activity during a hospital stay can improve the development and implementation of tailored interventions aimed at improving physical activity. Previous studies have identified many barriers and enablers, but a comprehensive overview is lacking. This study aimed to identify and categorize all published patient- and healthcare professional-reported barriers and enablers to physical activity during a hospital stay for acute care, using the Theoretical Domains Framework (TDF). Methods We conducted a scoping review of Dutch and English articles using MEDLINE, CINAHL Plus, EMBASE, PsycINFO, and Cochrane Library (inception to September 2020), which included quantitative, qualitative, and mixed-methods studies reporting barriers and enablers to physical activity during a hospital stay for acute care, as perceived by patients or healthcare professionals. Two reviewers systematically extracted, coded, and categorized all barriers and enablers into TDF domains. Results Fifty-six articles were included in this review (32 qualitative, 7 quantitative, and 17 mixed-methods). In total, 264 barriers and 228 enablers were reported by patients, and 415 barriers and 409 enablers by healthcare professionals. Patient-reported barriers were most frequently assigned to the TDF domains Environmental Context & Resources (ECR, n = 148), Social Influences (n = 32), and Beliefs about Consequences (n = 25), while most enablers were assigned to ECR (n = 67), Social Influences (n = 54), and Goals (n = 32). Barriers reported by healthcare professionals were most frequently assigned to ECR (n = 210), Memory, Attention and Decision Process (n = 45), and Social/Professional Role & Identity (n = 31), while most healthcare professional-reported enablers were assigned to the TDF domains ECR (n = 143), Social Influences (n = 76), and Behavioural Regulation (n = 54). Conclusions Our scoping review presents a comprehensive overview of all barriers and enablers to physical activity during a hospital stay and highlights the prominent role of the TDF domains ECR and Social Influences in hospitalized patients’ physical activity behavior. This TDF-based overview provides a theoretical foundation to guide clinicians and researchers in future intervention development and implementation. Scoping review registration No protocol was registered for this review.

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Section: Resultsmentioning

confidence: 99%

“…Sample sizes varied between n = 6 and n = 345 patients and between n = 5 and n = 261 HCPs. Two studies did not specify the sample size [ 11 , 77 ], and one study only specified the number of included sites [ 47 ]. Further descriptions of the populations and settings included are provided in Additional file 4 .…”

Section: Resultsmentioning

confidence: 99%

Barriers and enablers to physical activity in patients during hospital stay: a scoping review

et al. 2021

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“…The methodological quality scores of the included quantitative studies ranged from no score to a maximum score of 5 (Additional file 6 ). Of the 19 quantitative studies, 13 studies were categorized as low quality [ 42 , 46 – 49 , 53 , 55 , 57 , 58 , 64 , 69 , 73 , 74 ]. Six quantitative studies were categorized as high quality [ 44 , 45 , 50 , 51 , 56 , 85 ].…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, and commonly reported, HCPs lacked knowledge, including mobilization techniques [ 62 , 68 ], patient mobility status and safety assessment [ 68 , 78 , 80 ], patients’ psychosocial needs, and how to inform or motivate them [ 62 , 81 ]. In addition, on theme 10, barriers were fear of patient falling [ 62 , 82 ] and safety concerns regarding staff or patient injury [ 64 , 68 , 69 , 85 ].…”

Section: Resultsmentioning

confidence: 99%

Facilitators and barriers to enhancing physical activity in older patients during acute hospital stay: a systematic review

Dijkstra

Sluis

Jager‐Wittenaar

et al. 2022

Int J Behav Nutr Phys Act

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Background To improve older patients’ physical activity (PA) behavior, it is important to identify facilitators and barriers to enhancing PA in older patients (≥ 65 years) during hospitalization from the perspectives of patients, caregivers, and healthcare professionals (HCPs). Methods In this systematic review, a search of PubMed, CINAHL, PsycINFO, EMBASE, and Web of Science (January 2000–May 2021) was performed, and quantitative, qualitative, and mixed-methods studies were included. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Identified facilitators and barriers were categorized using the social ecological model at the intrapersonal, interpersonal, and institutional levels. Results The 48 included articles identified 230 facilitators and 342 barriers. The main facilitators at the intrapersonal level included: knowledge, awareness, and attitudes; interpersonal level: social support, including encouragement and interdisciplinary collaboration; and institutional level: stimulating physical environment, patient activities and schedules, and PA protocols. The main barriers at the intrapersonal level included: physical health status, having lines or drains, patients’ fear, and HCPs’ safety concerns; interpersonal level: patient-HCP relation and HCPs’ unclear roles; and institutional level: lack of space and resources, including time and equipment. Best evidence synthesis provided moderate level of evidence for three barriers: patients’ unwillingness or refusal to move, patients having symptoms, and patients having lines or drains. No moderate level of evidence was found for facilitators. Conclusion The PA behavior of older adults during hospitalization is multidimensional. Our overview highlights facilitators and barriers on multilevel scale (intrapersonal, interpersonal, and institutional levels) that guides patients, caregivers, HCPs, and researchers in future clinical practice, and intervention development and implementation.

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“…Maintaining ambulation, walking approximately 50 meters three times a day, is an important part of preventing delirium. Therefore, future studies should clarify the distances that patients travel while performing daily activities in UUE contexts (Babine et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Modified Hospital Elder Life Program in the emergency department of a public university hospital: a multicomponent intervention program for preventing delirium

Assis

Pinto

Moraes

et al. 2022

Cad. Bras. Ter. Ocup.

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Objective To evaluate the feasibility of implementing an adaptation of the Hospital Elder Life Program (HELP) with the participation of family caregivers in a public university hospital. Method Descriptive exploratory pilot study developed with 30 hospitalized patients and their caregivers. Registration Forms were applied to identify risk factors for delirium, to select intervention protocols, and track implementation. Participants' level of satisfaction and barriers to implementing the program were assessed through qualitative interviews. Secondary results were collected from medical records. Descriptive statistical analysis was performed to characterize the sample and content analysis was used to analyze qualitative data. Results Most patients were female (60%), with a mean age of 74.3 years, incomplete elementary school (60%), widowed/divorced (56.7%) and living with family members (83.3%) at home (93.3%). 56.7% had been hospitalized in the last year and 93.3% had at least one risk factor for delirium. Food assistance and fluid replacement was the protocol with the highest adherence (96.2%) and guidance (76.5%) with the lowest. Participants were satisfied and believe that HELP contributed to improving patient outcomes. The reasons for not performing the proposed intervention were related to the hospital structure or organization, the patient and the companion. Conclusion Our results suggest that having family members act as “volunteers” is a viable strategy to implement HELP. This strategy can promote its implementation in public hospitals in low and middle-income countries.

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Mobilizing older adults: A multi-site, exploratory and observational study on patients enrolled in the Hospital Elder Life Program (HELP)

Cited by 5 publications

References 35 publications

Barriers and enablers to physical activity in patients during hospital stay: a scoping review

Barriers and enablers to physical activity in patients during hospital stay: a scoping review

Facilitators and barriers to enhancing physical activity in older patients during acute hospital stay: a systematic review

Modified Hospital Elder Life Program in the emergency department of a public university hospital: a multicomponent intervention program for preventing delirium

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