The Effect of Caregiver-Mediated Mobility Interventions in Hospitalized Patients on Patient, Caregiver, and Health System Outcomes: A Systematic Review

Objective: To synthesize the evidence examining caregiver-mediated mobility interventions in a hospital setting and whether they improve patient, caregiver, or health system outcomes. Data Sources: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus databases from inception to September 7, 201...

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Main Authors: Israt Yasmeen, MBT, Karla D. Krewulak, PhD, Christopher Grant, MD, FRCPC, Henry T. Stelfox, MD, PhD, Kirsten M. Fiest, PhD
Format: Article
Language:English
Published: Elsevier 2020-09-01
Series:Archives of Rehabilitation Research and Clinical Translation
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2590109520300185
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spelling doaj-15fd3b8675834eaf80bb4fa00fe7007f2020-11-25T03:44:07ZengElsevierArchives of Rehabilitation Research and Clinical Translation2590-10952020-09-0123100053The Effect of Caregiver-Mediated Mobility Interventions in Hospitalized Patients on Patient, Caregiver, and Health System Outcomes: A Systematic ReviewIsrat Yasmeen, MBT0Karla D. Krewulak, PhD1Christopher Grant, MD, FRCPC2Henry T. Stelfox, MD, PhD3Kirsten M. Fiest, PhD4Department of Critical Care Medicine, Alberta Health Services and Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartment of Critical Care Medicine, Alberta Health Services and Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartment of Critical Care Medicine, Alberta Health Services and Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartment of Critical Care Medicine, Alberta Health Services and Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences and O’Brien Institute for Public Health, University of Calgary, Calgary, AB, CanadaDepartment of Critical Care Medicine, Alberta Health Services and Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences and O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada; Department of Psychiatry and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Corresponding author Kirsten M. Fiest, PhD, Department of Critical Care Medicine, Alberta Health Services and Cumming School of Medicine, University of Calgary, Ground Floor, McCaig Tower, 3134 Hospital Drive NW, Calgary, AB, Canada T2N 5A1.Objective: To synthesize the evidence examining caregiver-mediated mobility interventions in a hospital setting and whether they improve patient, caregiver, or health system outcomes. Data Sources: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus databases from inception to September 7, 2018. Study Selection: Two reviewers independently selected original research in inpatient settings that reported on an intervention delivered by a caregiver (eg, family, friend, paid worker) and directed to the patient’s mobility. Mobility interventions were categorized based on the level of caregiver engagement using a 3-category framework: inform (provision of education on patient’s condition and management), activate (prompting caregivers to take action in patient care), and collaborate (encouraging interaction with providers or other caregivers). Data Extraction: One reviewer extracted data, and another checked the data. Quality was assessed using the Cochrane Collaboration’s risk of bias tool and Grading of Recommendations, Assessment, Development and Evaluation approach. Data Synthesis: Forty studies met the inclusion criteria; most were randomized controlled trials (n=16/40, 40.0%) and investigated older adults (n=18/40, 45.0%) with stroke (n=20/40, 50.0%). Inform (n=2) and activate (n=4) interventions and combined inform-activate (n=5/6, 83.3%) and inform-activate-collaborate (n=6/10, 60.0%) interventions were reported to improve patient mobility. Inform-activate and inform-collaborate interventions were reported to improve caregiver outcomes (eg, burden) (n=13/19, 68.4%). Studies that engaged caregivers in all 3 strategies (inform-activate-collaborate) were reported to improve health system outcomes (eg, hospital readmission) (n=4/6, 66.7%). Most studies were of unclear (n=22/40, 55.0%) or low risk of bias (n=11/40, 27.5%) for most domains. Conclusions: Engaging caregivers in mobility of hospitalized patients may improve patient mobility as well as caregiver and health system outcomes.http://www.sciencedirect.com/science/article/pii/S2590109520300185Activities of daily livingCaregiversHospitalQuality of lifeRehabilitationSystematic review
collection DOAJ
language English
format Article
sources DOAJ
author Israt Yasmeen, MBT
Karla D. Krewulak, PhD
Christopher Grant, MD, FRCPC
Henry T. Stelfox, MD, PhD
Kirsten M. Fiest, PhD
spellingShingle Israt Yasmeen, MBT
Karla D. Krewulak, PhD
Christopher Grant, MD, FRCPC
Henry T. Stelfox, MD, PhD
Kirsten M. Fiest, PhD
The Effect of Caregiver-Mediated Mobility Interventions in Hospitalized Patients on Patient, Caregiver, and Health System Outcomes: A Systematic Review
Archives of Rehabilitation Research and Clinical Translation
Activities of daily living
Caregivers
Hospital
Quality of life
Rehabilitation
Systematic review
author_facet Israt Yasmeen, MBT
Karla D. Krewulak, PhD
Christopher Grant, MD, FRCPC
Henry T. Stelfox, MD, PhD
Kirsten M. Fiest, PhD
author_sort Israt Yasmeen, MBT
title The Effect of Caregiver-Mediated Mobility Interventions in Hospitalized Patients on Patient, Caregiver, and Health System Outcomes: A Systematic Review
title_short The Effect of Caregiver-Mediated Mobility Interventions in Hospitalized Patients on Patient, Caregiver, and Health System Outcomes: A Systematic Review
title_full The Effect of Caregiver-Mediated Mobility Interventions in Hospitalized Patients on Patient, Caregiver, and Health System Outcomes: A Systematic Review
title_fullStr The Effect of Caregiver-Mediated Mobility Interventions in Hospitalized Patients on Patient, Caregiver, and Health System Outcomes: A Systematic Review
title_full_unstemmed The Effect of Caregiver-Mediated Mobility Interventions in Hospitalized Patients on Patient, Caregiver, and Health System Outcomes: A Systematic Review
title_sort effect of caregiver-mediated mobility interventions in hospitalized patients on patient, caregiver, and health system outcomes: a systematic review
publisher Elsevier
series Archives of Rehabilitation Research and Clinical Translation
issn 2590-1095
publishDate 2020-09-01
description Objective: To synthesize the evidence examining caregiver-mediated mobility interventions in a hospital setting and whether they improve patient, caregiver, or health system outcomes. Data Sources: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus databases from inception to September 7, 2018. Study Selection: Two reviewers independently selected original research in inpatient settings that reported on an intervention delivered by a caregiver (eg, family, friend, paid worker) and directed to the patient’s mobility. Mobility interventions were categorized based on the level of caregiver engagement using a 3-category framework: inform (provision of education on patient’s condition and management), activate (prompting caregivers to take action in patient care), and collaborate (encouraging interaction with providers or other caregivers). Data Extraction: One reviewer extracted data, and another checked the data. Quality was assessed using the Cochrane Collaboration’s risk of bias tool and Grading of Recommendations, Assessment, Development and Evaluation approach. Data Synthesis: Forty studies met the inclusion criteria; most were randomized controlled trials (n=16/40, 40.0%) and investigated older adults (n=18/40, 45.0%) with stroke (n=20/40, 50.0%). Inform (n=2) and activate (n=4) interventions and combined inform-activate (n=5/6, 83.3%) and inform-activate-collaborate (n=6/10, 60.0%) interventions were reported to improve patient mobility. Inform-activate and inform-collaborate interventions were reported to improve caregiver outcomes (eg, burden) (n=13/19, 68.4%). Studies that engaged caregivers in all 3 strategies (inform-activate-collaborate) were reported to improve health system outcomes (eg, hospital readmission) (n=4/6, 66.7%). Most studies were of unclear (n=22/40, 55.0%) or low risk of bias (n=11/40, 27.5%) for most domains. Conclusions: Engaging caregivers in mobility of hospitalized patients may improve patient mobility as well as caregiver and health system outcomes.
topic Activities of daily living
Caregivers
Hospital
Quality of life
Rehabilitation
Systematic review
url http://www.sciencedirect.com/science/article/pii/S2590109520300185
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