Schafthuizen Laura, van Dijk Monique, van Rosmalen Joost, Ista Erwin
Department of Internal Medicine, section Nursing Science, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands.
BMC Nurs. 2024 Jan 2;23(1):11. doi: 10.1186/s12912-023-01648-4.
Although stimulating patients' mobility is considered a component of fundamental nursing care, approximately 35% of hospitalized patients experience functional decline during or after hospital admission. The aim of this study is to assess mobility level and to identify factors affecting mobility status in hospitalized patients admitted in single-occupancy patient rooms (SPRs) on general wards.
Mobility level was quantified with the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) and EQ-5D-3L. GENEActiv accelerometer data over 24 h were collected in a subset of patients. Data were analyzed using generalized ordinal logistic regression analysis. The STROBE reporting checklist was applied.
Wearing pajamas during daytime, having pain, admission in an isolation room, and wearing three or more medical equipment were negatively associated with mobilization level. More than half of patients (58.9%) who were able to mobilize according to the EQ-5D-3L did not achieve the highest possible level of mobility according to the JH-HLM. The subset of patients that wore an accelerometer spent most of the day in sedentary behavior (median 88.1%, IQR 85.9-93.6). The median total daily step count was 1326 (range 22-5362).
We found that the majority of participating hospitalized patients staying in single-occupancy patient rooms were able to mobilize. It appeared, however, that most of the patients who are physically capable of walking, do not reach the highest possible level of mobility according to the JH-HLM scale. Nurses should take their responsibility to ensure that patients achieve the highest possible level of mobility.
尽管促进患者活动被视为基础护理的一部分,但约35%的住院患者在住院期间或出院后出现功能衰退。本研究的目的是评估普通病房单人病房(SPRs)住院患者的活动水平,并确定影响其活动状态的因素。
使用约翰·霍普金斯最高活动量表(JH-HLM)和EQ-5D-3L对活动水平进行量化。在部分患者中收集了24小时的GENEActiv加速度计数据。使用广义有序逻辑回归分析对数据进行分析。应用了STROBE报告清单。
白天穿睡衣、疼痛、入住隔离病房以及佩戴三种或更多医疗设备与活动水平呈负相关。根据EQ-5D-3L能够活动的患者中,超过一半(58.9%)根据JH-HLM未达到最高可能的活动水平。佩戴加速度计的患者子集一天中的大部分时间处于久坐行为(中位数88.1%,四分位距85.9 - 93.6)。每日总步数中位数为1326(范围22 - 5362)。
我们发现,大多数入住单人病房的参与研究的住院患者能够活动。然而,似乎大多数有行走能力的患者根据JH-HLM量表未达到最高可能的活动水平。护士应负责确保患者达到最高可能的活动水平。