Title: Towards a common definition of Hospital-Acquired Deconditioning in Adults: A Scoping Review

Westlake, Meri; Cowley, A; Robinson, K; Gordon, A L

Abstract

Background: Hospital-acquired deconditioning is a term utilised in clinical practice, describing a loss of physical and/or cognitive function associated with hospitalisation. Previous reviews have addressed interventions, its prevalence in older adults and potential assessment tools. However, each review has reported a core limitation, the need for an agreed-upon definition and diagnostic criteria for hospital-acquired deconditioning.

Objective: We aimed to identify key components used to define hospital-acquired deconditioning in adults. We sought to do this by : identifying diagnostic criteria; ,describing how authors operationalised HAD; and describing differences between HAD and other immobility-linked syndromes. This article focuses on how hospital-acquired deconditioning is understood and operationalised.

Design: A scoping review using the Joanna Briggs Institute methodology for evidence synthesis.

Eligibility Criteria: Published in English after 1st January 1990, investigating adults over 18, set in inpatient rehabilitation or acute care settings, and including either a definition or description of hospital-acquired deconditioning or an outline of strategies to assess, prevent or manage hospital-acquired deconditioning.

Sources of Evidence: Published and grey literature, no restriction was placed on study design

Charting methods: Relevant data, where available, was extracted from each source using a proprietary data extraction template.

Results: Ninety-eight articles were included from 2163 retrieved results. Thirty-two were from rehabilitation or post-acute care settings, 49 from acute care, 15 from intensive care, and 2 from other settings. The literature was diverse in methodology and research question addressed. Hospital-acquired deconditioning was poorly defined, no consistent patterns were identified in aetiology and sequelae; diagnostic criteria were not fully agreed upon.

Conclusions: The literature on hospital acquired deconditioning is large, diverse and incomplete. Further work is required to develop a shared definition of hospital-acquired deconditioning; enabling researchers to coalesce for better understanding of the phenomenon, and clinicians, in turn, to better treat and mitigate against it

Citation

Westlake, M., Cowley, A., Robinson, K., & Gordon, A. L. (in press). Title: Towards a common definition of Hospital-Acquired Deconditioning in Adults: A Scoping Review. BMJ Open,

• Journal Article Type: Article
• Acceptance Date: Nov 12, 2024
• Deposit Date: Nov 15, 2024
• Publicly Available Date: Nov 15, 2024
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Keywords: Hospital-Acquired Deconditioning; Scoping Review; Concept; Diagnosis; Adults Word Count: 4357
• Public URL: https://nottingham-repository.worktribe.com/output/41922635
• Publisher URL: https://bmjopen.bmj.com/