None listed
Conditions
Brief summary
For hospitalized older adults, every day of immobility is associated with reduced muscle mass and strength, leading to a host of negative outcomes, including short- and long-term functional decline. Despite the established knowledge of the deleterious effects of immobility, older adults, even those able to ambulate independently, spend most of their hospital stay lying in bed. Emergent evidence suggests that in-hospital immobility is a complex phenomenon affected by a wide range of factors, such as personal predisposing characteristics, intrinsically related to patients’ clinical, physical, mental, and emotional condition; and hospitalization process factors, related to the care processes, the characteristics of the healthcare organization, and the assistance of informal caregiving. Nonetheless, a comprehensive model postulating the relative contribution of and interrelations between these risk factors has yet to be proposed and empirically tested. Moreover, despite increasing realization of the importance of tailoring mobility recommendations that account for patients’ predisposing clinical and functional conditions, specific mobility thresholds are yet to be established. To achieve this goal, we will conduct a prospective multi-center study of 1,200 hospitalized older adults nested in 40 internal medical units in nine hospitals across Israel and a sample of 340 nurses, nurse aides, and physicians from these units. Data will be collected in five phases: (1) prior to patients’ recruitment, on the hospital setting and on staff knowledge and attitudes; (2) at admission, on personal risk factors including physical, medical, and cognitive function; (3) during the hospitalization period, on healthcare and caregiving-related factors (from patient-survey and electronic health record data) and on actual mobility levels (assessed up to 5 hospitalization days using accelerometers); (4) at discharge, on physical, medical, and cognitive function; (5) and 1 month post-discharge via a telephone interview, on hospitalization outcomes. Analysis will employ multiple linear regressions and structural equation modeling, accounting for the multilevel design.
Interventions
The exposure is acute hospitalization. Each participants is followed up to five days during the hospitalization period and after month via a phone call.
Sponsors
University of Haifa
Eligibility
Sex/Gender
All
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(1) age 70 or older, (2) self-reported pre-admission ability to walk with or without personal or assistive device, (3) cognitively intact or having available caregivers willing to participate based on intermediary reporting, and (4) the patient or the caregiver speaks Hebrew, Arabic, or Russian
Exclusion criteria
(1) Admission diagnosis of acute Cerbro Vascular Accident (CVA) (2) need for mechanical ventilation, (3) patient admitted for end-of-life care, (4) prescribed mobility restriction for 24 hours or longer, or (5) patient in prescribed isolation.
Outcome results
None listed