Assessment for incipient hospital-acquired deconditioning in acute hospital settings: A systematic literature review

• Published in: Journal of rehabilitation medicine 2019-06, Vol.51 (6), p.397-404
• Main Authors: Gordon, Susan, Grimmer, Karen A, Barras, Sarah
• Format: Article
• Language: English
• Subjects: Acquired; Activities of Daily Living; acute hospital admission; assessment; Disability Evaluation; discharge planning; Evaluation; Evidence-based medicine; frailty; functional decline; Gait; HAD; Health care; hospital-acquired deconditioning; Hospitalization; Hospitals - statistics & numerical data; Humans; Inpatient care; Inpatients - psychology; Inpatients - statistics & numerical data; inter-professional practice; Literature reviews; Measurement; Mobility; older people; Outcome Assessment, Health Care - methods; Patient admissions; Patient Care - methods; Patient Care - psychology; Patient Care - statistics & numerical data; psychometric properties; Psychometrics; quality care; Quantitative psychology; Questionnaires; Recovery of Function; Rehabilitation; Rehabilitation Research; Reliability; Reproducibility of Results; systematic evidence scan; utility
• ISSN: 1650-1977; 1651-2081
• DOI: 10.2340/16501977-2546

To systematically identify literature reporting on assessment instruments relevant for incipient hospital-acquired deconditioning during acute hospital admissions; evaluate their psychometric properties; and identify individual assessment items to form the basis of a comprehensive acute hospital test battery for hospital-acquired deconditioning. Systematic evidence scan of MEDLINE, CINAHL, PubMed and Google Scholar from database inception to January 2018. Papers reporting psychometric properties of assessment instruments to detect change in body function and structure, relevant to hospital-acquired deconditioning were selected. Included instruments should assess one or more elements of hospital-acquired deconditioning, reflect the short time-frame constraints of acute hospital admissions, and be able to be applied by any healthcare provider. Quality evaluation: Evidence of psychometric properties and utility were assessed using a validated instrument. Hospital-acquired deconditioning assessment items. Eight potentially-relevant instruments were identified, with moderate-to-good validity and utility, but limited evidence of reliability. These instruments reported a total of 53 hospital-acquired deconditioning assessment items. Seventeen items with measurement periods greater than 3 days were excluded. The remaining items measured anthropometrics, gait, balance, mobility, activities of daily living, and skin integrity. These assessment items provide the basis of a multifaceted evidence-based test battery to comprehensively and repeatedly assess acute hospital inpatient function for incipient hospital-acquired deconditioning.