Can in-hospital or post discharge caregiver involvement increase functional performance of older patients? A systematic review

Dijk, Margaretha van; Vreven, Jasmien; Verheyden, Geert; Tournoy, Jos; Flamaing, Johan

doi:10.1186/s12877-020-01769-4

Cited by 13 publications

(7 citation statements)

References 41 publications

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“…13 Healthcare environments can impact staff efficiency, well-being Open access and retention, 1 with flow-on effects for patient care. Family and caregiver involvement can improve patient outcomes, 57 yet caregivers often feel ignored or alienated in inpatient stroke rehabilitation environments. 58 Future research should consider the impact of the built environment on staff and family/caregivers and how the environmental needs and priorities of these groups can be balanced with patients' needs.…”

Section: Discussionmentioning

confidence: 99%

Built environments for inpatient stroke rehabilitation services and care: a systematic literature review

et al. 2021

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ObjectivesTo identify, appraise and synthesise existing design evidence for inpatient stroke rehabilitation facilities; to identify impacts of these built environments on the outcomes and experiences of people recovering from stroke, their family/caregivers and staff.DesignA convergent segregated review design was used to conduct a systematic review.Data sourcesOvid MEDLINE, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature were searched for articles published between January 2000 and November 2020.Eligibility criteria for selecting studiesQualitative, quantitative and mixed-methods studies investigating the impact of the built environment of inpatient rehabilitation facilities on stroke survivors, their family/caregivers and/or staff.Data extraction and synthesisTwo authors separately completed the title, abstract, full-text screening, data extraction and quality assessment. Extracted data were categorised according to the aspect of the built environment explored and the outcomes reported. These categories were used to structure a narrative synthesis of the results from all included studies.ResultsTwenty-four articles were included, most qualitative and exploratory. Half of the included articles investigated a particular aspect of the built environment, including environmental enrichment and communal areas (n=8), bedroom design (n=3) and therapy spaces (n=1), while the other half considered the environment in general. Findings related to one or more of the following outcome categories: (1) clinical outcomes, (2) patient activity, (3) patient well-being, (4) patient and/or staff safety and (5) clinical practice. Heterogeneous designs and variables of interest meant results could not be compared, but some repeated findings suggest that attractive and accessible communal areas are important for patient activity and well-being.ConclusionsStroke rehabilitation is a unique healthcare context where patient activity, practice and motivation are paramount. We found many evidence gaps that with more targeted research could better inform the design of rehabilitation spaces to optimise care.PROSPERO registration numberCRD42020158006.

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Section: Discussionmentioning

confidence: 99%

Built environments for inpatient stroke rehabilitation services and care: a systematic literature review

et al. 2021

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“…Additionally, the program led to greater satisfaction among relatives regarding the provided care [ 27 , 28 ]. Also, if cognitive dysfunction is recognised, relatives can be more intensively involved in the medical treatment during the admission, which can improve hospital outcomes [ 34 ]. Involving relatives in the care process may even reduce the number of readmissions [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Recognition of cognitive dysfunction in hospitalised older patients: a flash mob study

Visser,

van Eersel,

Hempenius

et al. 2024

BMC Geriatr

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Background It is important that healthcare professionals recognise cognitive dysfunction in hospitalised older patients in order to address associated care needs, such as enhanced involvement of relatives and extra cognitive and functional support. However, studies analysing medical records suggest that healthcare professionals have low awareness of cognitive dysfunction in hospitalised older patients. In this study, we investigated the prevalence of cognitive dysfunction in hospitalised older patients, the percentage of patients in which cognitive dysfunction was recognised by healthcare professionals, and which variables were associated with recognition. Methods A multicentre, nationwide, cross-sectional observational study was conducted on a single day using a flash mob study design in thirteen university and general hospitals in the Netherlands. Cognitive function was assessed in hospitalised patients aged ≥ 65 years old, who were admitted to medical and surgical wards. A Mini-Cog score of < 3 out of 5 indicated cognitive dysfunction. The attending nurses and physicians were asked whether they suspected cognitive dysfunction in their patient. Variables associated with recognition of cognitive dysfunction were assessed using multilevel and multivariable logistic regression analyses. Results 347 of 757 enrolled patients (46%) showed cognitive dysfunction. Cognitive dysfunction was recognised by attending nurses in 137 of 323 patients (42%) and by physicians in 156 patients (48%). In 135 patients (42%), cognitive dysfunction was not recognised by either the attending nurse or physician. Recognition of cognitive dysfunction was better at a lower Mini-Cog score, with the best recognition in patients with the lowest scores. Patients with a Mini-Cog score < 3 were best recognised in the geriatric department (69% by nurses and 72% by physicians). Conclusion Cognitive dysfunction is common in hospitalised older patients and is poorly recognised by healthcare professionals. This study highlights the need to improve recognition of cognitive dysfunction in hospitalised older patients, particularly in individuals with less apparent cognitive dysfunction. The high proportion of older patients with cognitive dysfunction suggests that it may be beneficial to provide care tailored to cognitive dysfunction for all hospitalised older patients.

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“…Studies showed that family involvement has the potential to optimize patient outcomes, such as illness and recovery experience, as well as redirecting family psychological distress into an active participatory role, and supporting HCPs with the constraints of time and staffing [ 95 – 97 ]. Moreover, caregiver involvement may lead to better functional performance after discharge [ 98 ]. However, due to limited research on family participation in inpatient mobilization, the evidence on the effects of interventions that include family participation is low, and it is therefore difficult to draw strong conclusions.…”

Section: Discussionmentioning

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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Can in-hospital or post discharge caregiver involvement increase functional performance of older patients? A systematic review

Cited by 13 publications

References 41 publications

Built environments for inpatient stroke rehabilitation services and care: a systematic literature review

Built environments for inpatient stroke rehabilitation services and care: a systematic literature review

Recognition of cognitive dysfunction in hospitalised older patients: a flash mob study

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

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