Shaw Angela M, Robert Rhonda, Kresta Kimberly, Andersen Clark R, Lewis Betsy, Maetzold Brittni, Valderrama Raymund, Cion Ian, Tewari Priti
Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Children (Basel). 2022 Feb 2;9(2):186. doi: 10.3390/children9020186.
Pediatric, adolescent and young adult (PAYA) patients are less active than their healthy counterparts, particularly during inpatient stays.
We conducted a quality improvement initiative to increase activity levels in patients admitted to our pediatric oncology and cellular therapy unit using a Plan-Do-Study-Act (PDSA) model. An interdisciplinary team was assembled to develop an incentive-based inpatient exercise and activity program titled Totally Excited About Moving Mobility and Exercise (TEAM M). As part of the program, patients were encouraged by their care team to remain active during their inpatient stay. As an additional incentive, patients earned stickers to display on TEAM M door boards along with tickets that could be exchanged for prizes. Activity was assessed by documentation of physical therapy participation, tests of physical function, and surveys of staff perceptions of patient activity levels, motivations, and barriers.
Compared to baseline, patient refusals to participate in physical therapy decreased significantly (24% vs. 2%) ( < 0.02), and staff perceptions of patient motivation to stay active increased from 40% to 70% in the post implementation period. There were no changes in physical function tests.
An incentive-based exercise program for young oncology inpatients greatly improved patient activity levels, participation in physical therapy and influenced professional caregivers' beliefs.
儿科、青少年及青年（PAYA）患者的活动量低于健康同龄人，尤其是在住院期间。
我们开展了一项质量改进计划，采用计划-实施-研究-改进（PDSA）模型，提高入住我院儿科肿瘤与细胞治疗科患者的活动水平。组建了一个跨学科团队，制定了一项名为“完全热衷于移动、活动与锻炼”（TEAM M）的基于激励的住院患者运动和活动计划。作为该计划的一部分，护理团队鼓励患者在住院期间保持活跃。作为额外激励，患者可获得贴纸，贴在TEAM M的门板上，还可获得可兑换奖品的奖券。通过记录物理治疗参与情况、身体功能测试以及对工作人员对患者活动水平、动机和障碍的看法进行调查，来评估活动情况。
与基线相比，患者拒绝参加物理治疗的情况显著减少（24%对2%）（P<0.02），实施后工作人员对患者保持活跃的动机的看法从40%提高到了70%。身体功能测试没有变化。
一项针对年轻肿瘤住院患者的基于激励的运动计划极大地提高了患者的活动水平、物理治疗参与度，并影响了专业护理人员的看法。
