Optimizing patients' functional status during daily nursing care interventions: A systematic review

Abstract

Patients often experience a functional decline due to physical inactivity during illness. Nurses can influence the physical activity of patients while assisting them with activities of daily living. The purpose of this study was to identify effective interventions that are embedded in daily nursing care (irrespective of care setting) that aim to optimize the functional status of patients by increasing their physical activity. A systematic review was performed and reported following the preferred reporting items for systematic reviews and meta‐analyses. PubMed, CINAHL, and Cochrane were searched for studies from January 2002 to March 2019. The critical appraisal tools from the Joanna Briggs Institute were used to assess the risk of bias in individual studies. Study characteristics, intervention key components, and reported effects of included studies were extracted, summarized narratively, and compared. Twenty studies, evaluating nine different interventions were included. In these interventions, eight key components were identified. Four components were included in all six interventions with a positive effect on mobility, physical activity, or functional status. These components were: assessment of patient's functionality; goal setting with the patient; establishment of an individualized plan; and engagement of patients in physical and daily activity. The effects were limited due to the risk of bias in the studies, small sample sizes, limited clinical meaning of the effects, and variability of the adherence to the interventions. Multicomponent interventions were the most promising to enhance the functional status of patients. Future research should evaluate these interventions using research methods aiming at producing more rigorous evidence.

Effect, economic and process-evaluation of a generic function focused care program for long-term care; study protocol of a multicenter cluster–randomized trial

“…Recent reviews show that current FFC-based programs across various care settings show mixed effects on improving either care professionals’ FFC-enhancing behavior and clients’ engagement in physical and functional activity [ 25 , 54 ]. Based on suggestions from these reviews and synthesized findings from process evaluations of the previously developed and tested Dutch FFC-based programs, several lessons and implications have been formulated to optimize future programs and develop an advanced generic FFC-program (SELF) accordingly [ 31 ].…”

“…Although current Dutch programs are based on the principles of the FFC-philosophy or similar care concepts, not all aspects considered relevant are addressed in conjunction. Multicomponent interventions are considered most promising in enhancing the functional abilities of clients [ 54 ], thereby building on a comprehensive and interactive educational component as a core element to facilitate staff training [ 55 ]. To address the uniformity, which seems to be lacking given the wide variety of available interventions nationally and internationally, a generic function focused care program was developed to be applicable in long-term care.…”

“…Consequently, it is advocated to include a broader spectrum of behavior change determinants by using integrative behavior change models such as the one addressed in the SELF-program [ 32 ]. In addition, we adhere to the suggestions addressed by Lee and colleagues and Verstraten and colleagues to conduct thorough evaluations of FFC-based programs and to use research methods aimed at producing more rigorous burdens of proof [ 25 , 54 ]. Limitations of the study include the subjective approach of data-collection, i.e., using self-report questionnaires.…”

The Role of GeneXpert MTB/RIF in Reducing Treatment Delay Among Multidrug Resistance Tuberculosis Patients: A Propensity Score Matched Analysis

“…On the other hand, socio-demographic characteristics of patients like age group, residence, gender, TB treatment supporter, and clinical factors like the form of TB, complications, Functional status at admission: Classified based activity daily living (ADL) (eg, ambulating, feeding, dressing and keeping personal hygiene) as working, ambulatory, and bedridden. 15 Treatment supporter: A family member (FM) or any person who is willing to help and is accepted by the patient and answerable to the health services can also be a treatment supporter. 16 TB/HIV confection: A patient having HIV infection and TB disease at the same time.…”

“…Functional status at admission: Classified based activity daily living (ADL) (eg, ambulating, feeding, dressing and keeping personal hygiene) as working, ambulatory, and bedridden. 15 …”