完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.author | Chen, Cheryl Chia-Hui | en_US |
dc.contributor.author | Yang, Yi-Ting | en_US |
dc.contributor.author | Lai, I-Rue | en_US |
dc.contributor.author | Lin, Been-Ren | en_US |
dc.contributor.author | Yang, Ching-Yao | en_US |
dc.contributor.author | Huang, John | en_US |
dc.contributor.author | Tien, Yu-Wen | en_US |
dc.contributor.author | Chen, Chiung-Nien | en_US |
dc.contributor.author | Lin, Ming-Tsan | en_US |
dc.contributor.author | Liang, Jin-Tung | en_US |
dc.contributor.author | Li, Hsiu-Ching | en_US |
dc.contributor.author | Huang, Guan-Hua | en_US |
dc.contributor.author | Inouye, Sharon K. | en_US |
dc.date.accessioned | 2019-06-03T01:08:33Z | - |
dc.date.available | 2019-06-03T01:08:33Z | - |
dc.date.issued | 2019-05-01 | en_US |
dc.identifier.issn | 1525-8610 | en_US |
dc.identifier.uri | http://dx.doi.org/10.1016/j.jamda.2018.09.016 | en_US |
dc.identifier.uri | http://hdl.handle.net/11536/151929 | - |
dc.description.abstract | Objective: To evaluate the effects of the modified Hospital Elder Life Program (mHELP) comprising 3 nurse-administered protocols in older patients undergoing gastrointestinal (GI) surgery. Design: Cluster randomized trial. Setting: Two 36-bed GI wards at a university-affiliated medical center in Taiwan. Participants: Older patients (>= 65 years, N = 377) were recruited if they were scheduled for elective GI surgery with an expected length of hospital stay > 6 days. After transferring to the GI ward after surgery, participants were randomly assigned to the mHELP or control group (1: 1) by room rather than individually because most patient units are double-or triple-occupancy rooms. Intervention: The mHELP protocols (early mobilization, oral and nutritional assistance, and orienting communication) were administered daily with usual care by a trained nurse until hospital discharge. The control group received usual care only. Measures: Outcomes were in-hospital nutritional decline, measured by body weight and Mini-Nutritional Assessment (MNA) scores, and Fried's frailty phenotype. Return of GI motility was examined as a potential mechanism contributing to observed outcomes. Results: Participants (mean age = 74.5 years; 56.8% male) primarily underwent colorectal (56.5%), gastric (21.2%), and pancreatobiliary (13.8%) surgery. Participants who received the mHELP [for a median of 7 days (interquartile range = 6-10 days)] had significantly lower in-hospital weight loss and decline in MNA scores (weight -2.1 vs -4.0 lb, P = .002; score -3.2 vs -4.0, P =.03) than the control group. The mHELP group also had significantly lower rates of incident frailty during hospitalization (12.0% vs 21.7%, P = .022), and persistent frailty (50.0% vs 92.9%, P = .03). Participants in the mHELP group had trends toward an accelerated return of GI motility. Conclusion and Implications: The mHELP effectively reduced nutritional decline, prevented new frailty, and promoted recovery of frailty present before admission. These nurse-administered protocols might be useful in other settings, including conditions managed at home or in nursing facilities. (C) 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine. | en_US |
dc.language.iso | en_US | en_US |
dc.subject | Frailty | en_US |
dc.subject | Hospital Elder Life Program | en_US |
dc.subject | Ileus | en_US |
dc.subject | nutritional status | en_US |
dc.subject | surgery | en_US |
dc.title | Three Nurse-administered Protocols Reduce Nutritional Decline and Frailty in Older Gastrointestinal Surgery Patients: A Cluster Randomized Trial | en_US |
dc.type | Article | en_US |
dc.identifier.doi | 10.1016/j.jamda.2018.09.016 | en_US |
dc.identifier.journal | JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION | en_US |
dc.citation.volume | 20 | en_US |
dc.citation.issue | 5 | en_US |
dc.citation.spage | 524 | en_US |
dc.citation.epage | 0 | en_US |
dc.contributor.department | 統計學研究所 | zh_TW |
dc.contributor.department | Institute of Statistics | en_US |
dc.identifier.wosnumber | WOS:000466101300003 | en_US |
dc.citation.woscount | 0 | en_US |
顯示於類別: | 期刊論文 |