To test the effectiveness of a restorative care (Res-Care) intervention on function, muscle strength, contractures, and quality of life of nursing home residents, with secondary aims focused on strengthening self-efficacy and outcome expectations.
A randomized controlled repeated-measure design was used, and generalized estimating equations were used to evaluate status at baseline and 4 and 12 months after initiation of the Res-Care intervention.
Twelve nursing homes in Maryland.
Four hundred eighty-seven residents consented and were eligible: 256 from treatment sites and 231 from control sites. The majority were female (389, 80.1%) and white (325, 66.8%); 85 (17.4%) were married and the remaining widowed, single, or divorced/separated. Mean age was 83.8 +/- 8.2, and mean Mini-Mental State Examination score was 20.4 +/- 5.3.
Res-Care was a two-tiered self-efficacy-based intervention focused on motivating nursing assistants and residents to engage in functional and physical activities.
Barthel Index, Tinetti Gait and Balance, grip strength, Dementia Quality-of-Life Scale, self-efficacy, and Outcome Expectations Scales for Function.
Significant treatment-by-time interactions (P<.05) were found for the Tinetti Mobility Score and its gait and balance subscores and for walking, bathing, and stair climbing.
The findings provide some evidence for the utility and safety of a Res-Care intervention in terms of improving function in NH residents.
[Show abstract][Hide abstract] ABSTRACT: Function-focused care (FFC) is a rehabilitative philosophy of care with which nurses help patients engage in activities of daily living and physical activity with the goal of preventing avoidable functional decline. This prospective, observational study described the degree of FFC provided by nursing staff to Chinese American (n = 32) and non-Chinese American (n = 43) older adults in medical-surgical units of an urban hospital. In both groups, only a few ADLs were a focus of FFC. Loss of physical function occurred, and physical function did not return to baseline by discharge in both groups; however, FFC was associated with less decline. Results suggest that hospitalized elders, both Chinese American and non-Chinese American, can benefit from nurse-led FFC. FFC may help minimize functional decline and decrease the use of postacute care rehabilitation. The gerontological rehabilitation nurse can play an essential role, guiding a function-focused approach throughout the hospital stay, including with the transitional care plan.
Rehabilitation nursing: the official journal of the Association of Rehabilitation Nurses 11/2011; 36(6):233-40. DOI:10.1002/j.2048-7940.2011.tb00088.x · 1.15 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Comment on the paper by Sackley CM et al. Effects of a physiotherapy and occupational therapy intervention on mobility and activity in care home residents: a cluster randomised controlled trial. BMJ 2009, 3339: b3123
[Show abstract][Hide abstract] ABSTRACT: Rehabilitation treatments may be effective in improving the physical health of older people in long-term care. In 2010, 7.6% of the world's population were over 65 years old, and this is predicted to increase to 13% by 2035. It is expected that this will lead to a rise in demand for long-term residential care. This has increased interest in ways to prevent deterioration in health and activities of daily living, for example, walking and dressing, among care home residents. Physical rehabilitation (interventions based on exercising the body) may have a role, and this review examines the evidence available. This review included 67 trials, 36 of which were conducted in North America, 20 in Europe, and seven in Asia. In total, 6300 participants with an average age of 83 years were involved. Most interventions in some way addressed difficulties in activities of daily living. This review investigates the effects of physical rehabilitation on activities of daily living, strength, flexibility, balance, mood, cognition (memory and thinking), exercise tolerance, fear of falling, death, illness, and unwanted effects associated with the intervention, such as injuries. While variations between trials meant that we could not make specific recommendations, individual studies were often successful in demonstrating benefits to physical health from participating in different types of physical rehabilitation.
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