Outcome of Rehabilitation of Older People in Primary Health Care

Study Overview
=================
Brief Summary
-----------------
The Outcome of Multi-Disciplinary, Structured Rehabilitation of Older People in a District Inpatient Rehabilitation Centre is better than in a Standard Primary Health Care Rehabilitation Programme in Short Term Beds in Nursing Homes.

Official Title
-----------------
Outcome of Multi-Disciplinary, Structured Rehabilitation of Older People in an Inpatient District Rehabilitation Centre Versus Standard Primary Health Care Rehabilitation - An Open Comparative Observational Stdy

Conditions
-----------------
Chronic Disease, Stroke, Hip Fractures, Osteoarthritis

Intervention / Treatment
-----------------
* Other: Rehabilitation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Both Genders Age=>65 Years Diagnoses: Stroke, Hip Fractures, Osteoarthritis, Chronic, slowly progressing Diseases, Functional Decline due to Old Age, Functional Decline due to Long Hospital Stay Assessed to have a Rehabilitation Potential Exclusion Criteria: Age<65 Years Patietns with Highly Progressive Diseases Sunnaas ADL Index<10 MMSE<18 Deeply Depressed Patients with no Initiative Patients with Speech Dyspnoea Patients with unstable Angina Pectoris Patients with not diagnosed Cardiac Arrythmias

Ages Eligible for Study
-----------------
Minimum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| District Rehabilitation Centre (Model 1)<br>Patients admitted to Primary Health Care Rehabilitation, either Post-Acute from the Same District General Hospital or Directly from their Homes. They were recruited continuously at Entrance to the Rehabilitation Centre. | Other: Rehabilitation<br>* Model 1: Regular Assessment of Rehabilitation Goal, Rehabilitation Plan, Weekly Multi-Disciplinary Evaluation and Adjustment of Plan, Regular use of Measurement Scales, Regular Dialog between Personnel, Patient and Relatives. Model 2: More Occasional use of the Listed Activities. Model 1 and Model 2: Physical Training and Functional ADL Training, in Groups, One by One or Self-Training.<br>|
| Standard PHC Rehabilitation (Model 2)<br>Patients admitted to Standard Primary Health Care (PHC) Rehabilitation, either Post-Acute from the Same District General Hospital or Directly from their Homes. They were recruited Continuously at Entrance to the Short Term Rehabilitation Beds in Nursing Homes or at the Beginning of Rehabilitation in their Own Homes. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Sunnaas ADL Index | Sunnaas ADL Index measures 12 Activities of Daily Life. Each Activity has a Score from 0-3, where 0=totally dependent and 3=independent. The Total Max Score of 36 means Totally Independent. | Change from Baseline in Sunnaas ADL Index at End of Rehabilitation. Change from End of Rehabilitation in Sunnaas ADL Index at 3 months. Change from End of Rehabilitation in Sunnaas ADL Index at 18 Months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Umea Life Satisfaction Checklist | A Simple and Validated Questionnaire, testing Life Satisfaction. We chose Two of the Questions: LSCa: How satisfied are you with your Life in general? LSCb: How satisfied are you with your Ability to manage your Self-Care? The Scores are 1-3=not satisfied and 4-6=satisfied | Change from End of Rehabilitation in Umea Life Satisfaction Checklist at 3 Months after Rehabilitation. | 
| Mini Mental Status Evaluation=MMSE | MMSE measures Cognitive Function. Scores are from 0-30, where 30 indicates no Cognitive Problems. | MMSE Recorded Two Weeks into Rehabilitation | 
| Symptom Check List 10=SCL10 | SCL10 is a Questionnaire mapping Emotional Health during the Previous Week, particularly Anxiety and Depression. SCL-10 comprises Ten Questions with Scores from 1-4. The Final Score is the Total Score sum divided by Ten. Scores>1.85 indicate Severe Emotional Problems | SCL10 recorded at two Weeks into Rehabilitation | 
| Home Care Services | The care scores were: 1:0 hour/week, 2:>0-3 hours/week, 3:>3-6 hours/week, 4:>6-9 hours/week, and 5:>9 hours/week. | Change from End of Rehabilitation in Home Care Services at Three Months after Rehabilitation | 
| Informal Care from Relatives | Care Scores: 1:0 Hour/Week, 2:>0-3 Hours/Week, 3:>3-6 Hours/Week, 4:>6-9 Hours/Week, and 5:>9 Hours/Week. | Change in Informal Care from relatives from End of Rehabilitation at Three Months after Rehabilitation | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Rehabilitation outcome, Aged, Aged, 80 and over, Activities of daily living