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Optimizing the mobility of residents with dementia: a pilot study promoting healthcare aide uptake of a simple mobility innovation in diverse nursing home settings.

Slaughter SE, Estabrooks CA - BMC Geriatr (2013)

Bottom Line: Residents who more frequently completed the sit-to-stand activity were more likely to maintain or improve mobility compared with those who completed it less frequently (F=4.46; p=0.046, after adjustment for age).The audit-and-feedback intervention was associated with increased uptake of the activity from pre-intervention to post-intervention (t-score=-2.48; p=0.02).More context domains correlated significantly with aides' use of conceptual research and information sources in one site than the other.

View Article: PubMed Central - HTML - PubMed

Affiliation: Edmonton Clinic Health Academy, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. susan.slaughter@ualberta.ca.

ABSTRACT

Background: Almost 90 percent of nursing home residents have some type of mobility limitation. Many spend most of their waking hours lying in bed or sitting. Such inactivity can negatively affect residents' health and general well-being. This pilot study aimed to assess (1) the effect of the sit-to-stand activity on mobility outcomes of nursing home residents, (2) the effect of an audit-and-feedback intervention on uptake of the sit-to-stand activity by healthcare aides, and (3) the contextual factors influencing uptake of the sit-to-stand activity by healthcare aides.

Methods: This quasi-experimental pilot study was conducted in two nursing homes in western Canada. Twenty-six residents with dementia completed the sit-to-stand activity with 56 healthcare aides during daily care; separately, 71 healthcare aides completed a research use and context survey. Preliminary mobility feedback was presented to healthcare aides in one site. Resident mobility was measured using the 30-second sit-to-stand test. Healthcare aide uptake of the activity was measured using documentation flowsheets and a survey-based measure. Context was measured using the Alberta Context Tool. Mobility and uptake outcomes were analyzed over time and by site with analysis of covariance. Spearman and Pearson correlations were used to correlate context data with research use.

Results: Residents who more frequently completed the sit-to-stand activity were more likely to maintain or improve mobility compared with those who completed it less frequently (F=4.46; p=0.046, after adjustment for age). Uptake for one site was significantly different from the other (t-score=2.67; p=0.01, after adjustment for resident covariates). The audit-and-feedback intervention was associated with increased uptake of the activity from pre-intervention to post-intervention (t-score=-2.48; p=0.02). More context domains correlated significantly with aides' use of conceptual research and information sources in one site than the other.

Conclusions: The sit-to-stand activity is a promising means to maintain or improve transfer ability of nursing home residents with dementia. In the nursing home with initially weak uptake, strengthened uptake followed an audit-and-feedback intervention. Activity participation was higher in the site with stronger correlations between context and measured research use. Results are sufficiently promising to warrant proceeding with a full clinical trial.

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Related in: MedlinePlus

Mean uptake of sit-to-stand activity with 95% confidence intervals by time and site. Note: audit-and-feedback intervention introduced to Site 1 in March.
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Figure 3: Mean uptake of sit-to-stand activity with 95% confidence intervals by time and site. Note: audit-and-feedback intervention introduced to Site 1 in March.

Mentions: Table 4 reports the means for uptake of the sit-to-stand activity. In December 2009 the range in the number of occasions of completing the sit-to-stand activity in Site 1 was 0 to 40 while the range in Site 2 was 6 to 75. Results of the two-way analysis of covariance are reported in Table 5. To summarize, a significant main effect for time (p=0.01) indicates a change in uptake over time. As well, a significant main effect for site (p=0.01) indicates that the uptake for site 1 was significantly different than the uptake for site 2. There was a significant interaction effect such that the site 1 mean uptake increased over time from 12.9 to 26.2 occasions, while the site 2 mean uptake stayed relatively constant over time from 31.6 to 32 occasions (p=0.02). The covariates age (p=0.16), CHESS (p=0.95), CPS (p=0.65) and DRS (p=0.92) did not have a significant influence on the findings. The changes in uptake over time by site are graphically displayed in Figure 3.


Optimizing the mobility of residents with dementia: a pilot study promoting healthcare aide uptake of a simple mobility innovation in diverse nursing home settings.

Slaughter SE, Estabrooks CA - BMC Geriatr (2013)

Mean uptake of sit-to-stand activity with 95% confidence intervals by time and site. Note: audit-and-feedback intervention introduced to Site 1 in March.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016510&req=5

Figure 3: Mean uptake of sit-to-stand activity with 95% confidence intervals by time and site. Note: audit-and-feedback intervention introduced to Site 1 in March.
Mentions: Table 4 reports the means for uptake of the sit-to-stand activity. In December 2009 the range in the number of occasions of completing the sit-to-stand activity in Site 1 was 0 to 40 while the range in Site 2 was 6 to 75. Results of the two-way analysis of covariance are reported in Table 5. To summarize, a significant main effect for time (p=0.01) indicates a change in uptake over time. As well, a significant main effect for site (p=0.01) indicates that the uptake for site 1 was significantly different than the uptake for site 2. There was a significant interaction effect such that the site 1 mean uptake increased over time from 12.9 to 26.2 occasions, while the site 2 mean uptake stayed relatively constant over time from 31.6 to 32 occasions (p=0.02). The covariates age (p=0.16), CHESS (p=0.95), CPS (p=0.65) and DRS (p=0.92) did not have a significant influence on the findings. The changes in uptake over time by site are graphically displayed in Figure 3.

Bottom Line: Residents who more frequently completed the sit-to-stand activity were more likely to maintain or improve mobility compared with those who completed it less frequently (F=4.46; p=0.046, after adjustment for age).The audit-and-feedback intervention was associated with increased uptake of the activity from pre-intervention to post-intervention (t-score=-2.48; p=0.02).More context domains correlated significantly with aides' use of conceptual research and information sources in one site than the other.

View Article: PubMed Central - HTML - PubMed

Affiliation: Edmonton Clinic Health Academy, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. susan.slaughter@ualberta.ca.

ABSTRACT

Background: Almost 90 percent of nursing home residents have some type of mobility limitation. Many spend most of their waking hours lying in bed or sitting. Such inactivity can negatively affect residents' health and general well-being. This pilot study aimed to assess (1) the effect of the sit-to-stand activity on mobility outcomes of nursing home residents, (2) the effect of an audit-and-feedback intervention on uptake of the sit-to-stand activity by healthcare aides, and (3) the contextual factors influencing uptake of the sit-to-stand activity by healthcare aides.

Methods: This quasi-experimental pilot study was conducted in two nursing homes in western Canada. Twenty-six residents with dementia completed the sit-to-stand activity with 56 healthcare aides during daily care; separately, 71 healthcare aides completed a research use and context survey. Preliminary mobility feedback was presented to healthcare aides in one site. Resident mobility was measured using the 30-second sit-to-stand test. Healthcare aide uptake of the activity was measured using documentation flowsheets and a survey-based measure. Context was measured using the Alberta Context Tool. Mobility and uptake outcomes were analyzed over time and by site with analysis of covariance. Spearman and Pearson correlations were used to correlate context data with research use.

Results: Residents who more frequently completed the sit-to-stand activity were more likely to maintain or improve mobility compared with those who completed it less frequently (F=4.46; p=0.046, after adjustment for age). Uptake for one site was significantly different from the other (t-score=2.67; p=0.01, after adjustment for resident covariates). The audit-and-feedback intervention was associated with increased uptake of the activity from pre-intervention to post-intervention (t-score=-2.48; p=0.02). More context domains correlated significantly with aides' use of conceptual research and information sources in one site than the other.

Conclusions: The sit-to-stand activity is a promising means to maintain or improve transfer ability of nursing home residents with dementia. In the nursing home with initially weak uptake, strengthened uptake followed an audit-and-feedback intervention. Activity participation was higher in the site with stronger correlations between context and measured research use. Results are sufficiently promising to warrant proceeding with a full clinical trial.

Show MeSH
Related in: MedlinePlus