Authors (including presenting author) :
Cheng SY(1), Tang WK(1), Chan KKA(2), Leung SFE(3), Ng PLV(3), Hui NP (2), Wong CL(1), Tsang WY(1), SHA KY(1)
Affiliation :
(1) Medical and Geriatric Department, United Christian Hospital, (2) Occupational Therapy Department, United Christian Hospital, (3) Physiotherapy Department, United Christian Hospital.
Introduction :
Timely rehabilitation intervention have been documented in improve prognosis, maximize functional preservation and improve the quality of life of elderly patients suffering fracture hip & stroke. However, outpatient and day rehabilitation services were being scaled down or suspended under the impact of COVID-19 pandemic. MSC-HRT service (including nurse coordination, PT & OT home visits) may implement as a potential solution to address the barriers to deliver effective rehabilitation services during the pandemic.
Objectives :
This study aims to explore the effect of MSC-HRT service on functional outcomes, quality of life component and rehabilitation access of elderly patients during the COVID-19 pandemic.
Methodology :
Using a one group pre and post-test quasi-experimental design. From January 1, 2020 to October 31, 2020. Total 84 patients (mean age: 80.06, SD: 8.20) who were discharged from the hospital following a hip fracture surgery (N=56) or stroke event (N=28) and without any community rehabilitation service were recruited. The MSC-HRT service provides prompt appropriate community services referrals (mean waiting time for first visit for PT & OT respectively: 5.72 & 5.77 working days), and delivers no more than 12 weeks of nursing consultation and home rehabilitation training (mean number of visits by PT & OT: 15.61). Various functional performance evaluation scales and questionnaire were utilized to evaluate the functional outcomes and service satisfaction respectively.
Result & Outcome :
Significant improvement was found in various functional measures: The mean scores of Modified Functional Ambulation Classification (MFAC) 5.26 to 6.16 (p< 0.005), Timed Up and Go Test (TUGT) 27.91 to 22.38 (p< 0.005), Elderly Mobility Scale (EMS) (11.15 to 15.20 (p< 0.005), Modified Rivermead Mobility Index (MRMI) 33.68 to 36.82 (p< 0.005), Modified Barthel Index (MBI) 84.19 to 91.47 (p< 0.005) and Lawton Instrumental Activities of Daily Living Scale 10.61 to 12.55 (p< 0.005) respectively. In the qualitative questionnaire, 95% of patients felt better competency in community rehabilitation through an improved knowledge base (86% agreed), self-care ability (94% agreed) and individual care plan (93% agreed). Although 40% of participants were worried about the risk of contacting COVID 19, 79% of participants requested to maintain the service in the future. Overall, 93% of participants found the service had met their rehabilitation needs and expectations. Conclusion: MSC-HRT service can provide timely on-site home rehabilitation, improve patients' functional outcomes and enhance their quality of life. A more standardized service framework, workflow adn selection criteria can further enrich the service model and care delivery.
