de Vos A J B M, Asmus-Szepesi K J E, Bakker T J E M, de Vreede P L, van Wijngaarden J D H, Steyerberg E W, Mackenbach J P, Nieboer A P
Instituut Beleid & Management Gezondheidszorg, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands,
Tijdschr Gerontol Geriatr. 2015 Feb;46(1):12-27. doi: 10.1007/s12439-014-0100-6.
Hospital related functional decline in older patients is an underestimated problem. Thirty-five procent of 70-year old patients experience functional decline during hospital admission in comparison with pre-illness baseline. This percentage increases considerably with age.
METHODS/DESIGN: To address this issue, the Vlietland Ziekenhuis in The Netherlands has implemented the Prevention and Reactivation Care Programme (PReCaP), an innovative program aimed at reducing hospital related functional decline among elderly patients by offering interventions that are multidisciplinary, integrated and goal-oriented at the physical, social, and psychological domains of functional decline.
This paper presents a detailed description of the intervention, which incorporates five distinctive elements: (1) Early identification of elderly patients with a high risk of functional decline, and if necessary followed by the start of the reactivation treatment within 48 h after hospital admission; (2) Intensive follow-up treatment for a selected patient group at the prevention and Reactivation Centre; (3) Availability of multidisciplinary geriatric expertise; (4) Provision of support and consultation of relevant professionals to informal caregivers; (5) Intensive follow-up throughout the entire chain of care by a casemanager with geriatric expertise. Outcome and process evaluations are ongoing and results will be published in a series of forthcoming papers. This article is an edited translation of the previously published article 'Integrated approach to prevent functional decline in hospitalized elderly: the Prevention and Reactivation Care Program (PReCaP), BMC Geriatrics 2012;12:7, AJBM de Vos, KJE Asmus-Szepesi, TJEM Bakker, PL de Vreede, JDH van Wijngaarden, EW Steyerberg, JP Mackenbach, AP Nieboer.
老年患者中与医院相关的功能衰退是一个被低估的问题。与患病前的基线相比，35%的70岁患者在住院期间出现功能衰退。这一比例会随着年龄的增长而大幅上升。
方法/设计：为解决这一问题，荷兰的弗利特兰医院实施了预防与恢复护理计划（PReCaP），这是一项创新计划，旨在通过提供多学科、综合且针对功能衰退的身体、社会和心理领域的干预措施，减少老年患者中与医院相关的功能衰退。
本文详细描述了该干预措施，它包含五个独特要素：（1）早期识别有功能衰退高风险的老年患者，如有必要，在入院后48小时内开始恢复治疗；（2）在预防与恢复中心对选定患者群体进行强化后续治疗；（3）提供多学科老年医学专业知识；（4）为非正式护理人员提供相关专业人员的支持和咨询；（5）由具有老年医学专业知识的个案管理员在整个护理链中进行强化跟进。结果和过程评估正在进行，结果将在一系列即将发表的论文中公布。本文是对先前发表的文章《预防住院老年人功能衰退的综合方法：预防与恢复护理计划（PReCaP）》的编辑翻译，BMC老年医学2012；12：7，AJBM德沃斯、KJE阿斯穆斯 - 塞佩斯、TJEM巴克、PL德弗里德、JDH范维恩加登、EW斯泰尔伯格、JP麦肯巴赫、AP尼伯尔。
