Hunter Kathleen F, Butler Jeffrey I, Shrestha Shovana, Jones C Allyson, Wagg Adrian, Millar Nick, Carr Frances, Dahlke Sherry
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
PLoS One. 2025 Jun 16;20(6):e0324953. doi: 10.1371/journal.pone.0324953. eCollection 2025.
Hospitalized older adults are at risk for both physical and cognitive functional decline. To support the implementation of interventions optimizing their function, both healthcare professional knowledge and other factors that may impact practice change should be addressed. The objective of this study was to examine the characteristics and type of interventions supporting the translation of gerontological evidence into practice to optimize functional outcomes for hospitalized older adults.
This scoping review used the guidelines recommended by Peters et al. Six electronic databases were searched from database inception to 2024. Included studies were primary research studies that 1) described an educational intervention for healthcare professionals as part of an initiative to promote practice change and 2) assessed functional outcomes (physical and/or cognitive).
Thirty-eight studies were deemed eligible. Numerous interventions to support implementation of knowledge to improve functional outcomes were identified. In addition to educational strategies, other interventions addressed care processes, changes to the built environment, administration/management support, leadership support/facilitation, and discharge/transition planning. Studies employed a range of measures to assess functional outcomes among hospitalized older adults.
Older studies tended to focus on nurse-driven interventions, and newer ones on interprofessional interventions. Knowledge gaps were highlighted in terms of theory, research designs, intervention descriptions, country representation, policy, environmental changes, and leadership roles. Future evaluations of interventions to enhance older adults' functioning should examine effectiveness and compare single- and multi-intervention programs. Strategies based on implementation science theory are needed to ensure successful uptake of effective interventions, while also addressing real-world issues in hospital units, such as short staffing, resource constraints, and overcrowding.
住院老年人面临身体和认知功能衰退的风险。为支持实施优化其功能的干预措施，医疗专业知识以及可能影响实践变革的其他因素都应予以考虑。本研究的目的是探讨支持将老年医学证据转化为实践以优化住院老年人功能结局的干预措施的特征和类型。
本范围综述采用了彼得斯等人推荐的指南。从数据库创建到2024年，检索了六个电子数据库。纳入的研究为原发性研究，这些研究：1）将针对医疗专业人员的教育干预描述为促进实践变革举措的一部分；2）评估功能结局（身体和/或认知方面）。
38项研究被认为符合条件。确定了许多支持知识实施以改善功能结局的干预措施。除教育策略外，其他干预措施涉及护理流程、建筑环境变化、行政/管理支持、领导支持/促进以及出院/过渡计划。研究采用了一系列措施来评估住院老年人的功能结局。
早期研究倾向于关注护士主导的干预措施，而近期研究则侧重于跨专业干预措施。在理论、研究设计、干预描述、国家代表性、政策、环境变化和领导角色方面存在知识空白。未来对增强老年人功能的干预措施的评估应考察有效性，并比较单一干预和多干预项目。需要基于实施科学理论的策略来确保有效干预措施的成功应用，同时解决医院科室中的实际问题，如人员短缺、资源限制和过度拥挤。
