Assessment for incipient hospital-acquired deconditioning in acute hospital settings: A systematic literature review
Authors:
Gordon, S., Grimmer, K. A., and Barras, S.
Abstract:
OBJECTIVES: To systematically identify literature reporting on assessment instruments relevant for incipient hospital-acquired deconditioning during acute hospital admissions; evaluate their psychometric properties; and identify individual assessment items to form the basis of a comprehensive acute hospital test battery for hospital-acquired deconditioning.
DESIGN AND DATA SOURCES: Systematic evidence scan of MEDLINE, CINAHL, PubMed and Google Scholar from database inception to January 2018.
STUDY SELECTION: Papers reporting psychometric properties of assessment instruments to detect change in body function and structure, relevant to hospital-acquired deconditioning were selected. Included instruments should assess one or more elements of hospital-acquired deconditioning, reflect the short time-frame constraints of acute hospital admissions, and be able to be applied by any healthcare provider. Quality evaluation: Evidence of psychometric properties and utility were assessed using a validated instrument.
DATA EXTRACTION: Hospital-acquired deconditioning assessment items.
RESULTS: Eight potentially-relevant instruments were identified, with moderate-to-good validity and utility, but limited evidence of reliability. These instruments reported a total of 53 hospital-acquired deconditioning assessment items. Seventeen items with measurement periods greater than 3 days were excluded. The remaining items measured anthropometrics, gait, balance, mobility, activities of daily living, and skin integrity.
CONCLUSION: These assessment items provide the basis of a multifaceted evidence-based test battery to comprehensively and repeatedly assess acute hospital inpatient function for incipient hospital-acquired deconditioning.
Physical functioning Role functioning Social functioning
General health perceptions / HRQoL:
Self-rated health
Age:
Adults (18-65) Seniors (65+)
Disease:
Certain infections and parasitic diseases and related symptoms Codes for special purposes Diseases of and symptoms related to the blood and blood-forming organs and certain disorders involving the immune mechanism Diseases of and symptoms related to the digestive system Diseases of and symptoms related to the ear and mastoid process Diseases of and symptoms related to the eye and adnexa Diseases of and symptoms related to the genitourinary system Diseases of and symptoms related to the musculoskeletal system and connective tissue Diseases of and symptoms related to the respiratory system Diseases of and symptoms related to the skin and subcutaneous tissue Endocrine, nutritional and metabolic diseases and related symptoms External causes of morbidity and mortality Injury, poisoning and certain other consequences of external causes Mental and behavioural disorders and related symptoms Pregnancy, childbirth and puerperium and related symptom Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified