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老年人的物理治疗活动能力检查:基于离散选择实验的可行性及参与者偏好

A Physical Therapy Mobility Checkup for Older Adults: Feasibility and Participant Preferences From a Discrete Choice Experiment.

作者信息

Lieberz Dalerie, Borgeson Hannah, Dobson Steven, Ewings Lindsey, Johnson Karen, Klaysmat Kori, Schultz Abby, Tasson Rachel, Borstad Alexandra L

机构信息

Department of Physical Therapy, The College of St. Scholastica, Duluth, MN.

St. Luke's Medical Clinic, Mountain Iron, MN.

出版信息

J Patient Cent Res Rev. 2022 Jan 17;9(1):24-34. doi: 10.17294/2330-0698.1874. eCollection 2022 Winter.

Abstract

PURPOSE

Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment.

METHODS

Adults over 55 years of age were recruited from the community. In the study's first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the second phase, a new sample of older adults (>55 years old) were educated about the Mobility Checkup and then completed a discrete choice experiment to determine their preferences regarding 4 attributes of this care model: cost, visit duration, desired education topic, and style of educational graphic.

RESULTS

Each study phase was completed by 31 participants. Of the 6 feasibility criteria, 5 were met. Visit duration exceeded the 60-minute criteria for 13 of the 31 participants. Still, 91% of participants were very satisfied with the Mobility Checkup. Ability to transition positions identified preclinical mobility disability most frequently. A 30-minute visit with no out-of-pocket cost was deemed preferred.

CONCLUSIONS

Older adults value knowing what physical performance measurements predict about their general health. Transitions should be evaluated as part of a Mobility Checkup for older adults. Clearly conveyed cost of health care service is important to older adult consumers.

摘要

目的

身体机能指标,如步行速度,可识别并预测临床前的行动能力障碍,但在常规医疗护理中很少使用。一种名为“行动能力检查”的预防性护理模式正在设计中,旨在减少老年人的行动能力障碍。本研究有两个目的:1)确定“行动能力检查”的可行性和结果,2)通过离散选择实验确定老年人对这种护理模式的偏好。

方法

从社区招募55岁以上的成年人。在研究的第一阶段,参与者完成一次“行动能力检查”,使用6项标准评估可行性。在第二阶段,对一组新的老年人样本(>55岁)介绍“行动能力检查”,然后完成一项离散选择实验,以确定他们对这种护理模式的4个属性的偏好:成本、就诊时长、期望的教育主题和教育图表风格。

结果

每个研究阶段均由31名参与者完成。6项可行性标准中,有5项得到满足。31名参与者中有13名的就诊时长超过了60分钟的标准。尽管如此,91%的参与者对“行动能力检查”非常满意。体位转换能力最常识别出临床前的行动能力障碍。一次30分钟且无需自付费用的就诊被认为是首选。

结论

老年人重视了解身体机能测量结果对其总体健康状况的预测。对于老年人的“行动能力检查”,应将体位转换作为评估的一部分。清晰传达医疗服务的成本对老年消费者很重要。

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