Johansen Lea Kromann, Larsen Trine Schifter, Kirk Jeanette Wassar, Pedersen Britt Staevnsbo, Nielsen Barbara Rubek, Kallemose Thomas, Bandholm Thomas, Pedersen Mette Merete
Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegård Alle 30, Hvidovre, 2650, Denmark.
Physical Medicine & Rehabilitation Research- Copenhagen (PMR-C), Copenhagen University Hospital Amager and Hvidovre, Kettegård Alle 30, Hvidovre, 2650, Denmark.
BMC Geriatr. 2025 May 13;25(1):330. doi: 10.1186/s12877-025-05976-9.
It is well-established that mobility is very limited among older hospitalized patients and associated with several negative outcomes. Therefore, this mixed-methods study aimed to quantify 24-hour mobility levels in acutely admitted older adults and simultaneously explore clinical practice with regards to mobilization and mobility through an ethnographic field study.
Over a 6-week period, hospital mobility was assessed in 44 geriatric patients by SENS motion activity sensors that the patients wore continuously for 24 h a day during their hospitalization. An ethnographic field study was conducted alongside the cohort study. It included participant observation on the ward and situated conversations with staff, patients, and relatives 2-3 times a week for 4-5 h at different times of the day. The observations were noted in field notes. Activity data were aggregated into a per day measure based on the mean of all available days for a given patient. Also, the per day measures were stratified by walking dependency (walking with or without a walking aid). The field notes were analyzed through a thematic analysis.
During hospitalization, the patients spent most of their time (22.8 h/per day) in sedentary behavior and only 1.2 h/per day in uptime (walking and standing), including 43 min walking, and took less than 1200 steps daily. The field study revealed that most staff consider mobilization and mobility important tasks. However, mobilizing patients to a chair and performing functional level assessments are prioritized over patient mobility. Also, the patients' perceived mobility opportunities are limited by the physical environment (e.g., congested hallways) and lack of purposeful activities to engage in.
This study found low levels of mobility in geriatric inpatients during hospitalization. While mobility is considered important, mobilization to a chair and functional assessments are prioritized over patient mobility, which becomes dependent on the patient's own initiative. Therefore, environmental adjustment, enhanced interprofessional collaboration, and targeted strategies for integrating mobility into daily care practices are warranted to enhance in-hospital mobility. ClincalTrials.Gov identifier NCT06421246.
众所周知，老年住院患者的活动能力非常有限，且与多种负面结果相关。因此，这项混合方法研究旨在量化急性入院老年人的24小时活动水平，并同时通过人种学实地研究探索有关活动动员和活动能力的临床实践。
在为期6周的时间里，通过SENS运动活动传感器对44名老年患者的医院活动情况进行评估，患者在住院期间每天连续佩戴该传感器24小时。在队列研究的同时进行了人种学实地研究。包括在病房进行参与观察，并在一天中的不同时间每周与工作人员、患者和亲属进行2至3次、每次4至5小时的现场交谈。观察结果记录在实地笔记中。活动数据根据给定患者所有可用天数的平均值汇总为每日测量值。此外，每日测量值按行走依赖程度（使用或不使用助行器行走）进行分层。通过主题分析对实地笔记进行分析。
住院期间，患者大部分时间（每天22.8小时）处于久坐状态，每天只有1.2小时处于活动状态（行走和站立），其中包括43分钟的行走时间，且每天步数少于1200步。实地研究表明，大多数工作人员认为活动动员和活动能力是重要任务。然而，将患者转移到椅子上并进行功能水平评估比患者的活动能力更受重视。此外，患者感知到的活动机会受到物理环境（如拥挤的走廊）和缺乏有目的活动的限制。
本研究发现老年住院患者住院期间活动水平较低。虽然活动能力被认为很重要，但将患者转移到椅子上和功能评估比患者的活动能力更受重视，而患者的活动能力依赖于患者自身的主动性。因此，有必要进行环境调整、加强跨专业协作，并制定有针对性的策略将活动能力融入日常护理实践中，以提高住院期间的活动能力。临床试验注册编号NCT06421246。
