The OASIS Walking Study - Older Adults With Cognitive Impairment Performing Sit to Stands and Walking in Transitional Care Programs: A Feasibility Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cognitive Impairment
- Sponsor
- University Health Network, Toronto
- Enrollment
- 26
- Locations
- 2
- Primary Endpoint
- Retention rate
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
The goal of this intervention study is to test the effects of a nurse-led mobility intervention (known as the OASIS Walking Intervention (Older Adults performing Sit to Stands and Walking Intervention)) in older adults with cognitive impairment, such as dementia, in transitional care programs.
The main questions this study aims to answer are:
- Is the study doable and are older adults satisfied with the intervention?
- Does the intervention improve older adults' muscle strength, mobility, functional status and quality of life?
Participants will be asked to do the following:
- Be interviewed once so that a patient-centred communication care plan can be made
- Do sit to stand activity
- Walk as part of a walking program.
Detailed Description
The purpose of this study is to determine the feasibility of and satisfaction of participants with a novel intervention - the OASIS Walking Intervention (that is, the Older Adults with cognitive impairment performing Sit to Stands and Walking Intervention) in a facility-based TCPs. The second aim is to determine the efficacy of the OASIS Walking intervention on muscle strength, mobility, functional status, quality of life, and discharge destination. A feasibility study will be undertaken for this three-component intervention project. In terms of study design, a quasi-experimental one group time series design will be used. A sample size of 26 patient participants and their substitute decision makers will participate in the study. Participants will be older adults ≥65 years admitted to a facility-based transitional care unit in Ontario. The Older Adults with cognitive impairment performing the Sit to Stands and Walking Intervention is a nurse-led intervention that consists of three components: 1) Patient-Centered Communication Care Plan (informed by interviews with the participant and their care partner); 2) Sit to Stand Activity; and 3) Walking program. This intervention is grounded using a patient centered approach. The dose of the intervention is: up to 45 minutes per session, five sessions per week, for six weeks. Approximately up to 30 minutes will be spent walking with the participant and up to 15 minutes will be spent performing the sit-to-stand activity.
Investigators
Eligibility Criteria
Inclusion Criteria
- •aged 65 years and older;
- •have cognitive impairment (dementia, delirium, cognitive impairment, or unspecified cognitive impairment) as documented in the medical record or Quick Dementia Rating Scale (QDRS) score of ≥2)
- •admitted to a transitional care unit after a hospitalization
- •can speak English
- •has received clearance from the physiotherapist to participate in the study
- •has received clearance from the nurse practitioner to participate in the study
- •were community-dwelling (lived in a home or retirement home; not a nursing home) prior to hospitalization
- •were able to walk independently or with the assistance of one person (with or without a gait aid) prior to hospital admission
- •is currently able to ambulate either independently or with the assistance of one person (with or without a gait aid)
- •has a care partner (family member, friend) who is willing participate in an interview about the patient for the study.
Exclusion Criteria
- •Palliative (having \<six months prognosis as documented in the medical chart)
Outcomes
Primary Outcomes
Retention rate
Time Frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Retention rate will be calculated as the percentage of participants who complete the study (i.e., receive the full dose of the intervention and provided post-test outcome data) out of the number of participants who were enrolled (i.e., signed a consent form and provided baseline data)
Adherence (Average duration of each walking session)
Time Frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
The average duration of each walking session (in minutes)
Adherence (Average number of treatment sessions attended)
Time Frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Average number of treatment sessions attended
Recruitment rate
Time Frame: From start of recruitment to end of recruitment (6 months)
Recruitment rate will be calculated as the percentage of participants who enroll in the study out of the total number of eligible participants
Adherence (Level of engagement with the treatment [percentage]).
Time Frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
The level of engagement with the treatment (percentage). For this study, the planned number of sessions is five per week for 6 weeks for a total of 30 sessions. Percentage = the number of sessions attended divided by the total number of sessions (30 sessions)
Adherence (Average duration of each intervention session)
Time Frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
The average duration of each intervention session (in minutes)
Adherence (Level of engagement with sit to stands [percentage])
Time Frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Percentage = number of sit to stands done per session, divided by the goal number of sit to stands.
Adherence (Average number of sit to stands done per session)
Time Frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Average number of sit to stands done per session.
Secondary Outcomes
- Participant Satisfaction (for Long-Term Care Stream or Rehab Stream Arm)(Posttest (Immediately after 6-week intervention) (Time 3))
- Participant Satisfaction (for Reactivation Stream Intervention Arm)(Posttest (Immediately after 3-week intervention) (Time 3))
- Lower extremity muscle strength (for Long-Term Care Stream or Rehab Stream Arm)(Pretest Initial Assessment (Time 1); After 3 weeks of intervention (Time 2); Posttest (Immediately after 6-week intervention) (Time 3))
- Lower extremity muscle strength (for Reactivation Stream Intervention Arm)(Pretest Initial Assessment (Time 1); After 1.5 weeks of intervention (Time 2); Posttest (Immediately after 3-week intervention) (Time 3))
- Mobility (for Long-Term Care Stream or Rehab Stream Arm)(Pretest Initial Assessment (Time 1); After 3 weeks of intervention (Time 2); Posttest (Immediately after 6-week intervention) (Time 3))
- Mobility (for Reactivation Stream Intervention Arm)(Pretest Initial Assessment (Time 1); After 1.5 weeks of intervention (Time 2); Posttest (Immediately after 3-week intervention) (Time 3))
- Functional Status (for Long-Term Care Stream or Rehab Stream Arm)(Pretest Initial Assessment (Time 1); After 3 weeks of intervention (Time 2); Posttest (Immediately after 6-week intervention) (Time 3))
- Functional Status (for Reactivation Stream Intervention Arm)(Pretest Initial Assessment (Time 1); After 1.5 weeks of intervention (Time 2); Posttest (Immediately after 3-week intervention) (Time 3))
- Patient's Quality of Life (for Long-Term Care Stream or Rehab Stream Arm)(Pretest Initial Assessment (Time 1); After 3 weeks of intervention (Time 2); Posttest (Immediately after 6-week intervention) (Time 3))
- Discharge destination (for Long-Term Care Stream or Rehab Stream Arm)(At the time of discharge from the TCU or within 60 days of admission to TCP, whichever comes first.)
- Discharge destination (for Reactivation Stream Intervention Arm)(At the time of discharge from the TCU or within 60 days of admission to TCP, whichever comes first.)
- Intervention fidelity (percentage)(Calculated at the end of the study (6 months + 6 weeks from the start of recruitment))