PMID- 23279450
OWN - NLM
STAT- MEDLINE
DCOM- 20131206
LR  - 20150522
IS  - 1365-2702 (Electronic)
IS  - 0962-1067 (Linking)
VI  - 22
IP  - 9-10
DP  - 2013 May
TI  - Trajectories and predictors of functional decline of hospitalised older patients.
PG  - 1322-31
LID - 10.1111/jocn.12055 [doi]
AB  - AIMS AND OBJECTIVES: To delineate the trajectories of functional status over four 
      time points and to examine predictors of functional decline (FD) in hospitalised 
      older patients. BACKGROUND: About 30-60% of the older patients develop new 
      dependence in activities of daily living (ADL) during a hospital stay, which 
      results in progressive disability after discharge. The functional trajectories 
      and risk factors of FD among hospitalised older patients require identification. 
      DESIGN: A cohort study. METHODS: The study consecutively recruited 273 patients 
      aged 65 and older admitted to a medical centre in southern Taiwan. Functional 
      trajectory, by ADL score, was observed at four time points: two weeks before 
      admission, admission, discharge and three months after discharge. The ADL score 
      two weeks before admission was used as a baseline functional status. RESULTS: 
      Eighty-three (30.4%) patients experienced FD at three months after discharge. 
      Functional trajectory as shown by ADL scores indicated that all 273 patients 
      dropped steeply at admission and that two-thirds were gradually restored three 
      months after discharge. Logistic regression revealed that the number of falls in 
      the past year, Instrument Activities of Daily Living (IADL) status before 
      admission, comorbidity and ADL decline between preadmission and discharge were 
      significant predictors of FD three months after discharge. The ADL score decline 
      during hospitalisation was the mediator of FD three months after discharge. 
      CONCLUSIONS: Findings indicate that the ADL function of those hospitalised older 
      patients who reported having fallen more often in the previous year had more 
      comorbidity, had a lower IADL score, and had more ADL score decline before 
      admission and discharge would continue to decline after discharge. RELEVANCE TO 
      CLINICAL PRACTICE: Clinical nurses can integrate the finding of this study with 
      Comprehensive Geriatric Assessment to tailor intervention to restore older 
      patient's physical function during hospitalisation.
CI  - (c) 2013 Blackwell Publishing Ltd.
FAU - Huang, Hui-Tzu
AU  - Huang HT
AD  - Institute of Allied Health Sciences, College of Medicine, National Cheng Kung 
      University, Taiwan.
FAU - Chang, Chia-Ming
AU  - Chang CM
FAU - Liu, Li-Fan
AU  - Liu LF
FAU - Lin, Huey-Shyan
AU  - Lin HS
FAU - Chen, Ching-Huey
AU  - Chen CH
LA  - eng
PT  - Journal Article
DEP - 20130102
PL  - England
TA  - J Clin Nurs
JT  - Journal of clinical nursing
JID - 9207302
CIN - J Clin Nurs. 2015 Jan;24(1-2):312-3. PMID: 25832822
MH  - *Activities of Daily Living
MH  - Aged
MH  - Female
MH  - Geriatric Assessment
MH  - *Hospitalization
MH  - Humans
MH  - Male
MH  - Taiwan
EDAT- 2013/01/03 06:00
MHDA- 2013/12/16 06:00
CRDT- 2013/01/03 06:00
PHST- 2012/08/28 00:00 [accepted]
PHST- 2013/01/03 06:00 [entrez]
PHST- 2013/01/03 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - 10.1111/jocn.12055 [doi]
PST - ppublish
SO  - J Clin Nurs. 2013 May;22(9-10):1322-31. doi: 10.1111/jocn.12055. Epub 2013 Jan 2.