Westlake Meri, Cowley Alison, Robinson Katie, Gordon Adam L
University of Nottingham, Nottingham, UK
Research & Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK.
BMJ Open. 2025 Jan 15;15(1):e086976. doi: 10.1136/bmjopen-2024-086976.
Hospital-acquired deconditioning is a term used in clinical practice, describing a loss of physical and/or cognitive function associated with hospitalisation. Previous reviews have addressed interventions, its prevalence in older adults and potential assessment tools. However, each review has reported a core limitation, the need for an agreed-upon definition and diagnostic criteria for hospital-acquired deconditioning.
We aimed to identify key components used to define hospital-acquired deconditioning in adults. We sought to do this by identifying diagnostic criteria, describing how authors operationalised Hospital- Acquired Deconditioning (HAD), and describing differences between HAD and other immobility-linked syndromes. This article focuses on how hospital-acquired deconditioning is understood and operationalised.
A scoping review using the Joanna Briggs Institute methodology for evidence synthesis.
Published in English after 1 January 1990, investigating adults over 18, set in inpatient rehabilitation or acute care settings, and including either a definition or description of hospital-acquired deconditioning or an outline of strategies to assess, prevent or manage hospital-acquired deconditioning.
Published and grey literature, no restriction was placed on study design.
Relevant data, where available, was extracted from each source using a proprietary data extraction template.
One hundred and three articles were included from 2403 retrieved results. Thirty-three were from rehabilitation or post-acute care settings, 53 from acute care, 15 from intensive care and two from other settings. The literature was diverse in methodology and research question addressed. Hospital-acquired deconditioning was poorly defined, no consistent patterns were identified in aetiology and sequelae; diagnostic criteria were not fully agreed on.
The literature on hospital-acquired deconditioning is large, diverse and incomplete. Further work is required to develop a shared definition of hospital-acquired deconditioning, enabling researchers to coalesce for better understanding of the phenomenon, and clinicians, in turn, to better treat and mitigate against it.
OSF: https://osf.io/b5sgw/.
医院获得性失能是临床实践中使用的一个术语，描述与住院相关的身体和/或认知功能丧失。以往的综述涉及干预措施、其在老年人中的患病率以及潜在的评估工具。然而，每篇综述都报告了一个核心局限性，即需要对医院获得性失能有一个商定的定义和诊断标准。
我们旨在确定用于定义成人医院获得性失能的关键要素。我们试图通过确定诊断标准、描述作者如何对医院获得性失能（HAD）进行操作化，以及描述HAD与其他与活动受限相关综合征之间的差异来实现这一目标。本文重点关注医院获得性失能是如何被理解和操作化的。
采用乔安娜·布里格斯研究所的证据综合方法进行范围综述。
1990年1月1日后以英文发表，研究对象为18岁以上成年人，研究背景为住院康复或急性护理环境，且包括医院获得性失能的定义或描述，或评估、预防或管理医院获得性失能的策略概述。
已发表文献和灰色文献，对研究设计无限制。
如有相关数据，使用专有数据提取模板从每个来源中提取。
从2403条检索结果中纳入了103篇文章。其中33篇来自康复或急性后期护理环境，53篇来自急性护理，15篇来自重症监护，2篇来自其他环境。文献在研究方法和所解决的研究问题方面各不相同。医院获得性失能的定义不明确，病因和后遗症方面未发现一致模式；诊断标准也未完全达成共识。
关于医院获得性失能的文献数量众多、内容多样且不完整。需要进一步开展工作，以制定医院获得性失能的共同定义，使研究人员能够凝聚力量，更好地理解这一现象，进而使临床医生能够更好地进行治疗和缓解。
开放科学框架（OSF）：https://osf.io/b5sgw/ 。
