Purpose: This study investigated predictors of change in physical function in elderly patients admitted to a sub-acute nursing facility following lower extremity surgery.
Design and Methods: A predictive middle-range model was developed that used ten factors as potential predictors: nine factors from the Minimum Data Set (MDS) and the amount (total time) of rehabilitation therapy. This study used retrospective chart abstraction to investigate the model.
Results: Data were collected from the medical records of 131 subjects, mean age=77.1 years (SD=6.9) who were admitted to a sub-acute rehabilitation facility from January 2000 to December 2002. The mean length of stay was 18.7 days (SD=6.9). Controlling for age and co-morbidity, hierarchical multiple regression analyses found that Activities of Daily Living (ADL) on admission, history of falls, weight change, memory loss, and depressive mood were predictive of physical function at discharge (R2=.49, p < .001, post-hoc power=99%), with ADL function on admission the most significant predictor (b=.43, p < .001). Rehabilitation therapy significantly improved ADL functioning although patients experiencing urinary incontinence or weight change were at greater risk of functional decline (R2=.10, p=.02, post-hoc power=61%).
Implications: For nurses who practice in a sub-acute setting, these results provide additional support for the influence of admission factors on the patient's physical functioning in rehabilitation therapy. The study demonstrated the predictive capacity of the MDS factors for physical function in a sub-acute unit.
Session #1196 - Long Term Care
The 29th Annual MNRS Research Conference (April 1-4, 2005)