Gerbrandij, E. (2015) Mobiliteit van geriatrische patiënten tijdens een ziekenhuisopname en de rol van de fysiotherapeut. thesis, Medicine.
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Abstract
Objective We know little of the mobility of hospitalized geriatric patients in the Netherlands, as well as of the relationship between mobility and functionality. The objective of this study was to obtain more insight into the mobility of hospitalized geriatric patients and the role the physiotherapist. The goal was to stimulate and improve the mobility of hospitalized geriatric patient in collaboration with the physiotherapist. We also investigated the relationship between mobility and outcomes, namely: functional status, length of stay, discharge destination and mortality. Methods This was a retrospective study of patient files conducted with a database consisting of two cohorts with data from hospitalized geriatric patients. For the first cohort we used an existing database. A second cohort was added to this database and contained the same type of data that were collected for the first cohort, namely socio-demographic characteristics, reason of admission, length of stay, functional status, mortality and discharge destination. For both cohorts, we collected data from files of the physiotherapist. With these data we investigated the mobility of patients on admission and at discharge. With the same data we also mapped the applied treatment options of the physiotherapist. Results A total of 230 patients were enrolled. The number of bedridden patients decreased from 20% at the time of admission to 6% at discharge (p = 0.000). The use of walking devices increased from 68% at admission to 86% at discharge (p = 0.001). Other parameters that could be used to measure mobility were not registered by the physiotherapist in 58% to 95% of cases. We found a relationship between being bedridden and functional status (ADL en BDL). At admission patients showed more often loss of function when they were bedridden at admission (p = 004, χ2 = 11.253). Regarding to the role of the physiotherapist, patients received physiotherapy treatment once a day. Of all the applied treatment options, gait training was the most applied treatment, which took place at 79% of the patients. Other treatment options were training of strength, mobility and balance, and training of transfers from bed or chair. Conclusion There is still inconclusive insight in the mobility of hospitalized geriatric patients. On the other hand, we gained more insight in how mobility can be measured, and what physiotherapy treatment options exist. For further research towards mobility, the first important step is to define ‘mobility’ in collaboration with the physiotherapist. To measure mobility, we suggest to develop a new ‘mobilitytool’, what enables the physiotherapist to observe a number of basic skills that are important to the patients ability to cope independently. These basic skills consists of the ability to get out of bed, rising from a chair and walk a few metres, all in a way that is independent and safe. A new ‘mobility tool’ gives the physiotherapist also the possibility to more materialise the treatment and perhaps limit the range of treatment options.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Asselt, dr. D.Z.B. van and Klinische Geriatrie and Medisch Centrum Leeuwarden |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:44 |
| Last Modified: | 25 Jun 2020 10:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/572 |
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