Challenging rehabilitation environment for older patients
Lian MJ Tijsen,1–3 Els WC Derksen,4 Wilco P Achterberg,1 Bianca I Buijck2,31Department Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands; 2Oktober, Bladel, The Netherlands; 3De Zorgboog, Bakel, The Netherlands; 4Department Primary and Community Care,...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-08-01
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| Series: | Clinical Interventions in Aging |
| Subjects: | |
| Online Access: | https://www.dovepress.com/challenging-rehabilitation-environment-for-older-patients-peer-reviewed-article-CIA |
| _version_ | 1818899539543719936 |
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| author | Tijsen LMJ Derksen EWC Achterberg WP Buijck BI |
| author_facet | Tijsen LMJ Derksen EWC Achterberg WP Buijck BI |
| author_sort | Tijsen LMJ |
| collection | DOAJ |
| description | Lian MJ Tijsen,1–3 Els WC Derksen,4 Wilco P Achterberg,1 Bianca I Buijck2,31Department Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands; 2Oktober, Bladel, The Netherlands; 3De Zorgboog, Bakel, The Netherlands; 4Department Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The NetherlandsIntroduction: After hospitalization, 11% of the older patients are referred to rehabilitation facilities. Nowadays, there is a trend to formalize the rehabilitation process for these patients in a Challenging Rehabilitation Environment (CRE). This concept involves the comprehensive organization of care, support and the environment on a rehabilitation ward. However, since literature on the principles of CRE is scarce, this review aimed to explore and describe the principles of CRE.Methods: A search was made in PubMed for relevant literature concerning CRE. Then, articles were hand searched for relevant keywords (ie, task-oriented training, therapy intensity, patient-led therapy, group training), references were identified, and topics categorized.Results: After evaluating 51 articles, 7 main topics of CRE were identified: 1) Therapy time; ie, the level of (physical) activity; the intensity of therapy and activity is related to rehabilitation outcomes, 2) group training; used to increase practice time and can be used to achieve multiple goals (eg, activities of daily living, mobility), 3) patient-regulated exercise; increases the level of self-management and practice time, 4) family participation; may lead to increased practice time and have a positive effect on rehabilitation outcomes, 5) task-oriented training; in addition to therapy, nurses can stimulate rehabilitants to perform meaningful tasks that improve functional outcomes, 6) enriched environment; this challenges rehabilitants to be active in social and physical activities, and 7) team dynamics; shared goals during rehabilitation and good communication in a transdisciplinary team improve the quality of rehabilitation.Discussion: This is the first description of CRE based on literature; however, the included studies discussed rehabilitation mainly after stroke and for few other diagnostic groups.Conclusion: Seven main topics related to CRE were identified that may help patients to improve their rehabilitation outcomes. Further research on the concept and effectivity of CRE is necessary.Keywords: geriatric rehabilitation, postacute care, care process, aging |
| first_indexed | 2024-12-19T19:49:34Z |
| format | Article |
| id | doaj.art-147399750f8940849d281713d6f5590a |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-12-19T19:49:34Z |
| publishDate | 2019-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-147399750f8940849d281713d6f5590a2022-12-21T20:08:02ZengDove Medical PressClinical Interventions in Aging1178-19982019-08-01Volume 141451146047804Challenging rehabilitation environment for older patientsTijsen LMJDerksen EWCAchterberg WPBuijck BILian MJ Tijsen,1–3 Els WC Derksen,4 Wilco P Achterberg,1 Bianca I Buijck2,31Department Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands; 2Oktober, Bladel, The Netherlands; 3De Zorgboog, Bakel, The Netherlands; 4Department Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The NetherlandsIntroduction: After hospitalization, 11% of the older patients are referred to rehabilitation facilities. Nowadays, there is a trend to formalize the rehabilitation process for these patients in a Challenging Rehabilitation Environment (CRE). This concept involves the comprehensive organization of care, support and the environment on a rehabilitation ward. However, since literature on the principles of CRE is scarce, this review aimed to explore and describe the principles of CRE.Methods: A search was made in PubMed for relevant literature concerning CRE. Then, articles were hand searched for relevant keywords (ie, task-oriented training, therapy intensity, patient-led therapy, group training), references were identified, and topics categorized.Results: After evaluating 51 articles, 7 main topics of CRE were identified: 1) Therapy time; ie, the level of (physical) activity; the intensity of therapy and activity is related to rehabilitation outcomes, 2) group training; used to increase practice time and can be used to achieve multiple goals (eg, activities of daily living, mobility), 3) patient-regulated exercise; increases the level of self-management and practice time, 4) family participation; may lead to increased practice time and have a positive effect on rehabilitation outcomes, 5) task-oriented training; in addition to therapy, nurses can stimulate rehabilitants to perform meaningful tasks that improve functional outcomes, 6) enriched environment; this challenges rehabilitants to be active in social and physical activities, and 7) team dynamics; shared goals during rehabilitation and good communication in a transdisciplinary team improve the quality of rehabilitation.Discussion: This is the first description of CRE based on literature; however, the included studies discussed rehabilitation mainly after stroke and for few other diagnostic groups.Conclusion: Seven main topics related to CRE were identified that may help patients to improve their rehabilitation outcomes. Further research on the concept and effectivity of CRE is necessary.Keywords: geriatric rehabilitation, postacute care, care process, aginghttps://www.dovepress.com/challenging-rehabilitation-environment-for-older-patients-peer-reviewed-article-CIAgeriatric rehabilitationpostacute carecare processaging |
| spellingShingle | Tijsen LMJ Derksen EWC Achterberg WP Buijck BI Challenging rehabilitation environment for older patients Clinical Interventions in Aging geriatric rehabilitation postacute care care process aging |
| title | Challenging rehabilitation environment for older patients |
| title_full | Challenging rehabilitation environment for older patients |
| title_fullStr | Challenging rehabilitation environment for older patients |
| title_full_unstemmed | Challenging rehabilitation environment for older patients |
| title_short | Challenging rehabilitation environment for older patients |
| title_sort | challenging rehabilitation environment for older patients |
| topic | geriatric rehabilitation postacute care care process aging |
| url | https://www.dovepress.com/challenging-rehabilitation-environment-for-older-patients-peer-reviewed-article-CIA |
| work_keys_str_mv | AT tijsenlmj challengingrehabilitationenvironmentforolderpatients AT derksenewc challengingrehabilitationenvironmentforolderpatients AT achterbergwp challengingrehabilitationenvironmentforolderpatients AT buijckbi challengingrehabilitationenvironmentforolderpatients |