https://scholars.lib.ntu.edu.tw/handle/123456789/461872
標題: | Modified hospital elder life program: Effects on abdominal surgery patients | 作者: | CHERYL CHIA-HUI CHEN MING-TSAN LIN YU-WEN TIEN CHUNG-JEN YEN Huang G.-H. Inouye S.K. |
公開日期: | 2011 | 出版社: | Elsevier Inc. | 卷: | 213 | 期: | 2 | 起(迄)頁: | 245-252 | 來源出版物: | Journal of the American College of Surgeons | 摘要: | Background: Postsurgical functional decline is common in older patients and can lead to frailty and increased mortality. Comprehensive interventions such as the Hospital Elder Life Program (HELP) have been shown to be effective, but modifying the HELP to include only 3 key interventions might prove cost-effective for surgical patients. Study Design: Consecutive patients from August 2007 through April 2009 (n = 179) were enrolled if they had undergone common elective abdominal surgical procedures, such as gastrectomy, cholecystectomy, and Whipple surgery. A modified HELP intervention consisting of early mobilization, nutritional assistance, and therapeutic (cognitive) activities implemented by a trained nurse was introduced on a surgical ward in May 2008. Patients enrolled before May 2008 received usual care and served as controls (n = 77). Those enrolled after the modified HELP intervention constituted the experimental group (n = 102). Changes in performance of activities of daily living, nutritional status, and cognitive function between admission and discharge were the primary end points. Results: Independent of baseline functions, education, periampullary diagnosis, comorbidity, surgical procedure, and duration of surgery, patients in the HELP group declined significantly less on activities of daily living performance and nutritional status (p < 0.001) than controls. The delirium rate was also significantly lower in the HELP group (0%) than in the control group (16.7%) (p < 0.001). Conclusions: The modified HELP intervention effectively reduced older surgical patients' functional decline and delirium rates by hospital discharge. This program, conducted by a trained nurse, was not costly but did require commitment and ongoing cooperation between physician and nursing leadership to achieve compliance with the protocols. ? 2011 American College of Surgeons. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-79960844315&doi=10.1016%2fj.jamcollsurg.2011.05.004&partnerID=40&md5=daa5e82760c019f37c816c07c45ee93b https://scholars.lib.ntu.edu.tw/handle/123456789/461872 |
ISSN: | 1072-7515 | DOI: | 10.1016/j.jamcollsurg.2011.05.004 | SDG/關鍵字: | abdominal surgery; aged; article; cholecystectomy; cognition; cognitive therapy; comorbidity; controlled study; cost effectiveness analysis; daily life activity; delirium; educational status; elderly care; elective surgery; female; functional assessment; gastrectomy; health program; human; male; mobilization; modified hospital elder life program; nurse; nutritional status; nutritional support; operation duration; pancreaticoduodenectomy; priority journal; surgical patient; surgical ward |
顯示於: | 醫學系 |
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