Strategies Used by Older Patients to Prevent Functional Decline During Hospitalization

Abstract

Almost one third of older patients hospitalized for acute care suffer functional decline. Few studies have investigated the point of view of older patients on prevention of this decline. Within the framework of a descriptive qualitative study, the perceptions of 30 hospitalized older adults were collected regarding their personal prevention strategies, the barriers to implementing these, and nursing staff interventions deemed useful. Results show that participants are sensitive to the risk of functional decline and utilize various preventive strategies particularly to maintain their physical abilities, maintain good spirits, keep a clear mind, and foster nutrition and sleep. Their strategies are difficult to implement on account of internal and external barriers. Nursing interventions deemed useful are good relational approach, strong basic care, appropriate assessment, and respect for level of autonomy. The study underscores that older hospitalized patients are applying strategies to prevent functional decline, but some nursing interventions may thwart their efforts.

Mobility bridges a gap in care: Findings from an early mobilisation quality improvement project in acute care

“…Patients were not unaware of the risks of immobility during hospitalisation but reported being overwhelmed with early physical struggles and feelings of dependence. Patients' perceptions of their conditions and awareness of risk in developing functional decline appeared to precede the implementation of strategies to maintain physical abilities and autonomy during hospitalisation, which is consistent with past research (Lafrenière, Folch, Dubois, Bédard, & Ducharme, ).…”

Patients' and nurses' experiences of fundamental nursing care: A systematic review and qualitative synthesis

“…Of the 16 high‐quality studies, study designs were reported as grounded theory (3), ethnography (2), phenomenology (1), soft systems approach (1) and interpretative description (1), or reported as content analysis (3), thematic analysis (2), or framework analysis (1) or did not name the methodological orientation (2). Papers reported qualitative data for observational studies ( n = 12) (Boltz et al, ; Bourret, Bernick, Cott, & Kontos, ; Coyer, O'Sullivan, & Cadman, ; Gaspard & Cox, ; Kitson, et al, 2013b; Kneafsey, Clifford, & Greenfield, ; Lafreniére, Folch, & Bèdard, ; Lomborg et al, ; Sjögren Forss, Nilsson, & Borglin, ; Taylor, Sims, & Haines, , ; Wardh, Hallberg, Berggren, Andersson, & Sorensen, ) and experimental studies ( n = 4) where new practices were introduced (French et al, ; Jensen et al, ; Robison et al, ; Thomas et al, ). Of these, two papers included patient data about a new nursing care method.…”

“…Of these, two papers included patient data about a new nursing care method. Nine studies included patient's perspectives of experience of care (Bourret et al, ; Jensen et al, ; Kitson et al, 2013b; Lafreniére et al, ; Lomborg et al, ; Robison et al, ; Sjögren Forss et al, ; Taylor, Sims, & Haines, ; Thomas et al, ).…”

“…In this section, the two high‐quality papers that described more than one care area (Kitson, Conroy, et al, ; Lafreniére et al, ) are discussed in the relevant care sections.…”

“…Patients reported valuing mobility and independence (Boltz et al, ; Bourret et al, ; Kitson et al, 2013b; Lafreniére et al, ; Taylor, Sims, & Haines, ; Taylor et al, ) and being assisted and encouraged to move according to abilities (Lafreniére et al, ). Patients appreciated actions to prevent falls (Lafreniére et al, ). Nurses noticed patients associating self‐worth with mobility (Bourret et al, ).…”