{"title":"对居家老人进行为期六个月的前瞻性干预研究。患者报告和观察结果。","authors":"Jeanette Kjernsholen MD , Inger Schou-Bredal PhD, RN, OUS , Rolf Kaaresen MD, PhD, OUS , Helene Lundgaard Soberg PhD , Aase Sagen PhD","doi":"10.1016/j.arrct.2023.100311","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate the effect of a reablement intervention (a person-centered, interdisciplinary rehabilitation approach) compared with usual care services in home-dwelling elderly experiencing functional declines in activities of daily living.</p></div><div><h3>Design</h3><p>A non-randomized controlled trial comparing a reablement intervention with usual care; outcomes were measured at baseline, after intervention, and at a 6-month from baseline in both groups.</p></div><div><h3>Setting</h3><p>Municipal public health service.</p></div><div><h3>Participants</h3><p>Sixty-five home-dwelling elderly with functional decline were assigned by the participants home care service zone to a reablement group (n=35), or a usual care group (n=30). The mean participant age was 80±11 years in the reablement group and 78±12 in the usual care group.</p></div><div><h3>Intervention</h3><p>The reablement group received a person-centered and tailored reablement program provided by an interdisciplinary team, consisting of a physiotherapist, an occupational therapist, and a nurse. The usual care group received standard home care services.</p></div><div><h3>Main Outcome Measures</h3><p>The dimension “Your health today” from the European Quality of Life-Visual Analog Scale (HRQOL), the patient-specific functional scale for goals in ADL (PSFS), the short physical performance battery (SPPB), and home care services in hours per week.</p></div><div><h3>Results</h3><p>There were significant differences over time in favor of the reablement group with between-group effect sizes of Cohen h<sup>2</sup>=0.36 (<em>P</em>=.001) for HRQOL, h<sup>2</sup>=0.60 (<em>P</em>=.001) for PSFS, h<sup>2</sup>=0.30 (<em>P</em>=.001) for SPPB, and h<sup>2</sup>=0.10 (<em>P=</em>.013) for hours of home care services per week. The within-group effect size for PSFS was h<sup>2</sup>=0.15 (<em>P=</em>.010) in favor of the reablement group. The mean number of hours of home care services per week was mean 0.38±1.07 (<em>P</em>=.001) in the reablement group and mean 30.38±64.13 (<em>P</em>=.023) in the usual care group.</p></div><div><h3>Conclusions</h3><p>The participants in the reablement group achieved and maintained better physical function, a higher HRQOL and needed considerably less home care services than the usual care group participants. Thus, reablement appears to be a more beneficial and sustainable approach than the usual care services for the home-dwelling elderly with functional decline.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000733/pdfft?md5=f307fb070aae2676db1f261e9d5ca0e2&pid=1-s2.0-S2590109523000733-main.pdf","citationCount":"0","resultStr":"{\"title\":\"A Prospective Intervention Study With 6 Months Follow-up of the Effect of Reablement in Home Dwelling Elderly: Patient-reported and Observed Outcomes\",\"authors\":\"Jeanette Kjernsholen MD , Inger Schou-Bredal PhD, RN, OUS , Rolf Kaaresen MD, PhD, OUS , Helene Lundgaard Soberg PhD , Aase Sagen PhD\",\"doi\":\"10.1016/j.arrct.2023.100311\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>To investigate the effect of a reablement intervention (a person-centered, interdisciplinary rehabilitation approach) compared with usual care services in home-dwelling elderly experiencing functional declines in activities of daily living.</p></div><div><h3>Design</h3><p>A non-randomized controlled trial comparing a reablement intervention with usual care; outcomes were measured at baseline, after intervention, and at a 6-month from baseline in both groups.</p></div><div><h3>Setting</h3><p>Municipal public health service.</p></div><div><h3>Participants</h3><p>Sixty-five home-dwelling elderly with functional decline were assigned by the participants home care service zone to a reablement group (n=35), or a usual care group (n=30). The mean participant age was 80±11 years in the reablement group and 78±12 in the usual care group.</p></div><div><h3>Intervention</h3><p>The reablement group received a person-centered and tailored reablement program provided by an interdisciplinary team, consisting of a physiotherapist, an occupational therapist, and a nurse. The usual care group received standard home care services.</p></div><div><h3>Main Outcome Measures</h3><p>The dimension “Your health today” from the European Quality of Life-Visual Analog Scale (HRQOL), the patient-specific functional scale for goals in ADL (PSFS), the short physical performance battery (SPPB), and home care services in hours per week.</p></div><div><h3>Results</h3><p>There were significant differences over time in favor of the reablement group with between-group effect sizes of Cohen h<sup>2</sup>=0.36 (<em>P</em>=.001) for HRQOL, h<sup>2</sup>=0.60 (<em>P</em>=.001) for PSFS, h<sup>2</sup>=0.30 (<em>P</em>=.001) for SPPB, and h<sup>2</sup>=0.10 (<em>P=</em>.013) for hours of home care services per week. The within-group effect size for PSFS was h<sup>2</sup>=0.15 (<em>P=</em>.010) in favor of the reablement group. The mean number of hours of home care services per week was mean 0.38±1.07 (<em>P</em>=.001) in the reablement group and mean 30.38±64.13 (<em>P</em>=.023) in the usual care group.</p></div><div><h3>Conclusions</h3><p>The participants in the reablement group achieved and maintained better physical function, a higher HRQOL and needed considerably less home care services than the usual care group participants. Thus, reablement appears to be a more beneficial and sustainable approach than the usual care services for the home-dwelling elderly with functional decline.</p></div>\",\"PeriodicalId\":72291,\"journal\":{\"name\":\"Archives of rehabilitation research and clinical translation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2590109523000733/pdfft?md5=f307fb070aae2676db1f261e9d5ca0e2&pid=1-s2.0-S2590109523000733-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of rehabilitation research and clinical translation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2590109523000733\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of rehabilitation research and clinical translation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590109523000733","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
A Prospective Intervention Study With 6 Months Follow-up of the Effect of Reablement in Home Dwelling Elderly: Patient-reported and Observed Outcomes
Objectives
To investigate the effect of a reablement intervention (a person-centered, interdisciplinary rehabilitation approach) compared with usual care services in home-dwelling elderly experiencing functional declines in activities of daily living.
Design
A non-randomized controlled trial comparing a reablement intervention with usual care; outcomes were measured at baseline, after intervention, and at a 6-month from baseline in both groups.
Setting
Municipal public health service.
Participants
Sixty-five home-dwelling elderly with functional decline were assigned by the participants home care service zone to a reablement group (n=35), or a usual care group (n=30). The mean participant age was 80±11 years in the reablement group and 78±12 in the usual care group.
Intervention
The reablement group received a person-centered and tailored reablement program provided by an interdisciplinary team, consisting of a physiotherapist, an occupational therapist, and a nurse. The usual care group received standard home care services.
Main Outcome Measures
The dimension “Your health today” from the European Quality of Life-Visual Analog Scale (HRQOL), the patient-specific functional scale for goals in ADL (PSFS), the short physical performance battery (SPPB), and home care services in hours per week.
Results
There were significant differences over time in favor of the reablement group with between-group effect sizes of Cohen h2=0.36 (P=.001) for HRQOL, h2=0.60 (P=.001) for PSFS, h2=0.30 (P=.001) for SPPB, and h2=0.10 (P=.013) for hours of home care services per week. The within-group effect size for PSFS was h2=0.15 (P=.010) in favor of the reablement group. The mean number of hours of home care services per week was mean 0.38±1.07 (P=.001) in the reablement group and mean 30.38±64.13 (P=.023) in the usual care group.
Conclusions
The participants in the reablement group achieved and maintained better physical function, a higher HRQOL and needed considerably less home care services than the usual care group participants. Thus, reablement appears to be a more beneficial and sustainable approach than the usual care services for the home-dwelling elderly with functional decline.
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