Bedriddenness and Local Confinement in long-term care facilities - prevalence and influencing factors
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1 Bedriddenness and Local Confinement in long-term care facilities - prevalence and influencing factors IOS World Congress 2012, 12 th May 2012 Session J: Dependent Care Sabine Schrank Departement of Nursing Science University of Vienna
2 Project outline Staff: Departement of Nursing Science, University of Vienna Univ.-Prof. Mag. Dr. Hanna Mayer Mag. Sabine Schrank Departement of Nursing Science, University of Witten/Herdecke Hon.-Prof. Mag. Dr. Angelika Zegelin Prof. Dr.rer.nat. Herbert Mayer Funded by Felix Mandl Fonds and SeneCura 2
3 Background Process of becoming bedridden (Zegelin 2005) Phase process: instability, incident, immobility, local confinement, bedriddenness Gradual local confinement switching between places of one`s own accord is no longer possible. People remain in one place and are dependent upon help if they are to be transferred. Bedriddenness means a longer state of existence in which the affected person spends the majority of the day (and night) in bed. 3
4 Forms of Bedriddenness Mild Out of bed for around 4-5 hours, sitting in a chair Mid-state People leave the bed briefly to carry out a few activities (going to the toilet, eating ) Complete In bed 24hours a day 4
5 Forms of Local Confinement Mild Movement independently as far as possible Need help with the transfer Mid-state Short distance with a wheelchair alone Limited in their motions Complete Remain in one place Dependent upon help until being transferred 5
6 Aim 1. Determine prevalence of bedriddenness and local confinement 2. More knowledge about the influcencing factors 6
7 Research questions How many persons, being taken care of in the investigated long term care facilities, are bedridden and local confined? Which main influencing factors on bedriddenness and local confinement can be defined? 7
8 Prevalence investigation Quantitative cross-sectional & comprehensive survey Complete survey 12 long-term care facilities (n= 3054) Standardised questionnaire 1.State of bedriddenness 2.State of local confinement 3.Temporary bed rest 4.Possible influencing factors At the time of the survey/ 6 months before due to illness or surgery Sex, body stature, length of stay, number of patients/ward 8
9 Characteristics of residents sex Body stature Length of stay Number of patients/ward Bed rest Female Male Light Middle Heavy Less than 6 months 6-12 months 1-2 years 2-4 years Longer than 4 years Up to 20 persons persons More than 30 persons No Due to illness Due to previous disease 72,9% 26,9% 27,8% 44,0% 28,1% 13,2% 10,6% 14,4% 23,0% 38,8% 13,3% 59,6% 27,2% 98,3% 1,6% 0,1% 9
10 Every second person is bedridden bedriddenness 49,8 mild form 19,1 mid-state form 7,9 complete form 22,8 n =
11 2 out of 3 persons are locally confined local confinement 61,8 mild form 9,5 mid-state form 9,5 complete form 42,8 n =
12 Every second person is bedridden and locally confined both 42,9 both complete form 18,6 n =
13 Bedriddenness/ Local Confinement Sex Number of patients Exist independently of Body Stature Lenght of stay 13
14 Conclusion Every second person is bedridden (49,8%) 2 out of 3 are locally confined (61,8%) Almost every second person is bedridden and locally confined (42,9%) No influence between the investigated factors and the phenomena 14
15 2. Influencing factors Case Study Design Participant observations (from January 2012 until now) Interviews (nursing staff, residents, family members ) Content analysis of nursing care plans and documentation 15
16 First impressions of the observations Attitude caregivers Rigid organizational strutures Spatial conditions Mobility low priority Transfer situation Missing incentives Bedriddenness Local Confinement 16
17 Implications 1. Change of attitude More attention on local confinement 2. Prevention of bedriddenness and local confinement Routine assessments Development of preventive programms for mild locally confined people Interventions for complete locally confined people to prevent complete bedriddenness 17
18 Sabine Schrank Departement of Nursing Science University of Vienna Research report download: 18
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