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在养老院居民中增加身体活动的可行性:养老院积极居民(ARCH)计划。

The feasibility of increasing physical activity in care home residents: Active Residents in Care Homes (ARCH) programme.

机构信息

Faculty of Health, Social Care and Education, St George's University of London and Kingston University, UK; Health Innovation Network, London, UK.

Faculty of Health, Social Care and Education, St George's University of London and Kingston University, UK.

出版信息

Physiotherapy. 2020 Jun;107:50-57. doi: 10.1016/j.physio.2019.06.007. Epub 2019 Jun 27.

Abstract

OBJECTIVES

Maintaining physical activity for older residents in care homes maximises their physical and mental health and wellbeing, independence, dignity and quality of life. Unfortunately, most residents do not participate in regular physical activity. Active Residents in Care Homes, ARCH, was designed to increase physical activity by facilitating whole-system change in a care home. We evaluated whether ARCH can be delivered, its effects on resident's physical activity, wellbeing and costs.

DESIGN

Feasibility study.

SETTING

Three residential care homes.

PARTICIPANTS

Care home residents and staff.

INTERVENTION

Occupational and physiotherapists implemented ARCH over 4 months with an 8-month follow-up.

MAIN OUTCOME MEASURES

Assessment of Physical Activity, Pool Activity Level, EQ5D-5L, Dementia Care Mapping, cost of implementing ARCH, health and social care utilisation.

RESULTS

After implementing ARCH, residents displayed more positive behaviours, better mood and engagement and higher physical activity levels, but these improvements were not sustained at 8-month follow-up. The cost (2016 prices) of implementing ARCH was £61,037, which equates to £1,650/resident. Healthcare utilisation was £295/resident (SD320) in the 4 months prior to ARCH, £308/resident (SD406) during the 4-month implementation and £676/resident (SD438) in the 8-month follow-up.

CONCLUSIONS

The ARCH programme can be delivered, it may have some short-term benefits and is affordable. Rather than have unrealistic increases in the health and longevity of older care home residents, ARCH may slow the decline in physical, mental and emotional well-being usually seen in older people in care homes, return some dignity and improve their quality of life in their last months or years.

摘要

目的

维持养老院中老年人的身体活动,可最大限度地提高他们的身心健康和生活质量、独立性、尊严和生活质量。不幸的是,大多数居民没有定期参加身体活动。积极居民在养老院,ARCH,旨在通过促进整个系统的变化来增加身体活动养老院。我们评估了 ARCH 是否可以交付,它对居民身体活动、福利和成本的影响。

设计

可行性研究。

设置

三个养老院。

参与者

养老院居民和工作人员。

干预措施

职业治疗师和物理治疗师在 4 个月内实施 ARCH,并进行 8 个月的随访。

主要结果测量

身体活动评估、泳池活动水平、EQ5D-5L、痴呆症护理映射、ARCH 实施成本、健康和社会保健利用。

结果

实施 ARCH 后,居民表现出更积极的行为、更好的情绪和参与度以及更高的身体活动水平,但这些改善在 8 个月的随访中并未持续。实施 ARCH 的成本(2016 年价格)为 61,037 英镑,相当于每个居民 1,650 英镑。ARCH 实施前的 4 个月内,医疗保健利用为每个居民 295 英镑(SD320),实施期间为每个居民 308 英镑(SD406),8 个月随访期间为每个居民 676 英镑(SD438)。

结论

ARCH 计划可以交付,它可能有一些短期的好处,并且负担得起。ARCH 可能不会使养老院中老年人的健康和寿命不切实际地增加,而是可能会减缓通常在养老院中老年人身体、精神和情感健康方面的下降,恢复一些尊严,并提高他们在最后几个月或几年的生活质量。

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