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Effects of a Modified Hospital Elder Life Program on Frailty in Individuals Undergoing Major Elective Abdominal Surgery
Author(s) -
Chen Cheryl ChiaHui,
Chen ChiungNien,
Lai IRue,
Huang GuanHua,
Saczynski Jane S.,
Inouye Sharon K.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12651
Subject(s) - medicine , psychological intervention , odds ratio , hospital discharge , physical therapy , intervention (counseling) , statistical significance , abdominal surgery , emergency medicine , gerontology , surgery , nursing
Objectives To test the effects of a modified H ospital E lder L ife P rogram (m HELP ) on frailty. Design Matched and unmatched analyses of data from a before‐and‐after study. Setting Hospital, inpatient. Participants Participants aged 65 and older (n = 189) undergoing major elective abdominal surgery at a medical center in Taiwan. Intervention The m HELP included three nursing interventions: early mobilization, oral and nutritional assistance, and orienting communication. Measurements Frailty rate and transitions between frailty states from hospital discharge to 3 months after discharge using Fried's phenotype criteria categorized as nonfrail (0 or 1 criteria present), prefrail (2 or 3 criteria present), and frail (4 or 5 criteria present). Results In matched pairs, participants who received the m HELP interventions were significantly less likely to be frail at discharge (19.2%) than matched controls (65.4%) (adjusted odds ratio ( AOR ) = 0.10, 95% CI = 0.02–0.39). Transitions to states of greater frailty during hospitalization were more common for participants in the control group. Three months after discharge, participants who received the m HELP intervention during hospitalization were less likely to be frail (17.3%) than matched controls (23.1%) ( AOR = 0.73, 95% CI = 0.21–2.56), although this difference did not achieve statistical significance. Conclusion The m HELP intervention is effective in reducing frailty by hospital discharge, but the benefit is diminished by 3 months after discharge. Thus, the m HELP provides a useful approach to manage in‐hospital frailty for older adults undergoing major abdominal surgery.