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: 1. Be interviewed once so that a patient-centred communication care plan can be made 2. Do sit to stand activity 3. Walk as part of a walking program.
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. For patients in the Long-Term Care Stream or Rehab Stream Arm, 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. For patients in the Reactivation Stream Intervention Arm, the dose of the intervention is: up to 45 minutes per session, five sessions per week, for three 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.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
26
Communication Care Plan, Sit to Stand Activity, Walking Program
Abbeylawn Retirement Home Transitional Care Unit (Operated by Bayshore Health Care)
Pickering, Ontario, Canada
RECRUITINGCedarbrook Lodge Retirement Home Transitional Care Unit (Operated by Bayshore Health Care)
Scarborough Village, Ontario, Canada
RECRUITINGRecruitment rate
Recruitment rate will be calculated as the percentage of participants who enroll in the study out of the total number of eligible participants
Time frame: From start of recruitment to end of recruitment (6 months)
Retention rate
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)
Time frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Adherence (Level of engagement with the treatment [percentage]).
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)
Time frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Adherence (Average number of treatment sessions attended)
Average number of treatment sessions attended
Time frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Adherence (Average duration of each intervention session)
The average duration of each intervention session (in minutes)
Time frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Adherence (Average duration of each walking session)
The average duration of each walking session (in minutes)
Time frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Adherence (Average number of sit to stands done per session)
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)
Adherence (Level of engagement with sit to stands [percentage])
Percentage = number of sit to stands done per session, divided by the goal number of sit to stands.
Time frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)
Participant Satisfaction (for Long-Term Care Stream or Rehab Stream Arm)
8-Item Client Satisfaction Questionnaire (CSQ-8) + 3 Open-Ended Questions. The CSQ-8 has a minimum value is 8, the maximum value is 32. Higher scores mean a better outcome.
Time frame: Posttest (Immediately after 6-week intervention) (Time 3)
Participant Satisfaction (for Reactivation Stream Intervention Arm)
8-Item Client Satisfaction Questionnaire (CSQ-8) + 3 Open-Ended Questions. The CSQ-8 has a minimum value is 8, the maximum value is 32. Higher scores mean a better outcome.
Time frame: Posttest (Immediately after 3-week intervention) (Time 3)
Lower extremity muscle strength (for Long-Term Care Stream or Rehab Stream Arm)
time to perform one sit-to-stand
Time frame: 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)
time to perform one sit-to-stand
Time frame: 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)
2-minute walk test
Time frame: 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)
2-minute walk test
Time frame: 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)
Barthel Index (BI). The BI has a minimum value of 0 and a maximum value of 20. Higher scores mean a better outcome.
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Time frame: 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)
Barthel Index (BI). The BI has a minimum value of 0 and a maximum value of 20. Higher scores mean a better outcome.
Time frame: 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)
The Quality of Life-AD Measure (QOL-AD). The QOL-AD is a 13-item questionnaire. Participants rate each item on a 4-point scale, with 1 being poor and 4 being excellent. The minimum score is 13 and the maximum score is 52. Higher scores mean a better outcome.
Time frame: 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)
Discharge destination after TCP
Time frame: 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)
Discharge destination after TCP
Time frame: At the time of discharge from the TCU or within 60 days of admission to TCP, whichever comes first.
Intervention fidelity (percentage)
Intervention fidelity will also be measured through the interventionist's self-report of 12 intervention items. The percentage will be calculated as the number of items done divided by the 12 items on the intervention fidelity checklist. Minimum value is 0%, maximum value is 100%. A higher percentage means a better outcome (greater intervention fidelity).
Time frame: Calculated at the end of the study (6 months + 6 weeks from the start of recruitment)