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OBJECTIVES: The aim of this study was to determine if being unable to stand at ICU discharge was associated with an increased probability of ICU readmission. DESIGN: A multicenter retrospective cohort study was conducted using the Toronto Intensive Care Observational Registry (iCORE) project. SETTING: Nine tertiary academic ICUs in Toronto, Canada, affiliated with the University of Toronto. PATIENTS: All patients admitted to ICUs participating in iCORE from September 2014 to January 2020 were included. Patients had to be mechanically ventilated for more than 4 hours to be included in iCORE. Exclusion criteria were death during the initial ICU stay, transfer to another institution not included in iCORE at ICU discharge, and a short ICU stay defined as less than 2 days. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The main exposure in this study was the inability of the patient to stand at ICU discharge, documented daily in the database within the ICU Mobility Scale. The primary outcome of this study was readmission to the ICU. After adjusting for potential confounders, being unable to stand at ICU discharge was associated with increased odds of readmission (odds ratio, 1.85; 95% CI, 1.31–2.62; p < 0.001). CONCLUSIONS: In patients with an ICU stay of 2 days or more, being unable to stand at ICU discharge is associated with increased odds of readmission to the ICU. [ABSTRACT FROM AUTHOR]

Understanding the relationships between comorbidity, disability, and home health‐care services aids in user‐centered care design. This study identifies patterns of these factors among older adults with physical disability living at home and explores their associations. This cross‐sectional study included community‐dwelling older adults assessed for Long‐term Care Insurance from September 1 to December 31, 2018, in Yiwu, Zhejiang, China. We analyzed deidentified data on sociodemographics, physical disability, chronic conditions, and care plans for 1882 participants using latent class analysis and multinomial logistic regression. Five comorbidity patterns (other sporadic diseases, cancer comorbidity, other sporadic comorbidities, coronary atherosclerotic heart disease, and fracture) and four home health‐care service patterns (assistance & facilitation of elimination, bedridden assistance & stoma care, bedside assistance & stoma care, and assistance & tube feeding) were identified. Four disability patterns emerged (bedridden without incontinence, bedridden & with upper limb mobility, off‐bed & ADLs limited, and bedridden with incontinence). Complex associations between these patterns were observed. The study highlights the heterogeneity and complexity of the above patterns, emphasizing the importance of person‐centered home health‐care services and technology‐supported care strategies. [ABSTRACT FROM AUTHOR]

Most residents of long-term care facilities (LTCFs) are patients with chronic diseases requiring long-term care. Unplanned hospitalization of older and frailer residents from LTCFs reduces their mobility and increases the number of infections, complications, and falls that might lead to severe disability or death. This study aimed to identify the critical risk factors associated with unplanned hospitalization among LTCF residents in Taiwan, providing insights that could inform better care practices in similar settings globally. A retrospective study was conducted using inpatient data from a medical center in central Taiwan, covering the period from 2011 to 2019. A total of 1220 LTCF residents were matched with general patients using propensity score matching. Multiple logistic regression analyses were performed to identify factors associated with unplanned hospitalization, controlling for relevant variables. LTCF residents had a significantly higher risk of unplanned hospitalization compared to general patients (OR = 1.44, 95% CI = 1.21–1.73). Key risk factors included advanced age (≥85 years, OR = 1.25, 95% CI = 1.02–1.54), the presence of comorbidities such as diabetes (OR = 1.17, 95% CI = 1.03–1.33) and renal failure (OR = 1.63, 95% CI = 1.42–1.86), high fall risk (OR = 2.67, 95% CI = 2.30–3.10), and being bedridden (OR = 6.55, 95% CI = 5.48–7.85). The presence of a tracheostomy tube also significantly increased hospitalization risk (OR = 1.73, 95% CI = 1.15–2.59). LTCF residents are at a higher risk of unplanned hospitalization, particularly those with specific comorbidities, physical limitations, and indwelling medical devices. These findings underscore the need for targeted interventions to manage these risks, potentially improving care outcomes for LTCF residents globally. [ABSTRACT FROM AUTHOR]

Purpose. Sarcopenia is an advancing and widespread skeletal muscle condition characterized by the depletion of skeletal muscle mass. The (pro)renin receptor ((P)RR) is a multifaceted protein with both pathophysiological and physiological functions. (P)RR is cleaved to generate soluble (P)RR, whose blood concentration may reflect the expression level of tissue (P)RR. We have discovered that the expression of (P)RR was elevated in the atrophied skeletal muscles of aged mice and humans. Methods. In this study, we examined the correlation between muscle atrophy and serum soluble (P)RR levels in bedridden patients with sarcopenia. Results. In total, 45 subjects were enrolled. Their ages were 81 (59–89) y.o., and serum soluble (P)RR levels were 30.5 ± 7.3 ng/ml. Lean body mass ratio (lean body mass/body weight), an index of muscle mass, was independently significantly and negatively correlated with serum soluble (P)RR concentrations in all patients. In addition, the lean body mass ratio was independently significantly and negatively correlated with serum soluble (P)RR concentrations in older patients (≥82 y.o.) but not in younger patients (<82 y.o.). Conclusion. These data suggested that patients with sarcopenia, especially in elderly patients, may be associated with increased (P)RR expression. The serum soluble (P)RR level could be a biomarker of sarcopenia although this issue should be investigated by future studies. [ABSTRACT FROM AUTHOR]

Objective: The most recent edition of the International Clinical Practice Guideline for the Prevention and Treatment of Pressure Ulcers/Injuries was released in 2019. Shortly after, in 2020, the first edition of the SECURE Prevention expert panel report, focusing on device-related pressure ulcers/injuries, was published as a special issue in the Journal of Wound Care. A second edition followed in 2022. This article presents a comprehensive summary of the current understanding of the causes of pressure ulcers/injuries (PU/Is) as detailed in these globally recognised consensus documents. Method: The literature reviewed in this summary specifically addresses the impact of prolonged soft tissue deformations on the viability of cells and tissues in the context of PU/Is related to bodyweight or medical devices. Results: Prolonged soft tissue deformations initially result in cell death and tissue damage on a microscopic scale, potentially leading to development of clinical PU/Is over time. That is, localised high tissue deformations or mechanical stress concentrations can cause microscopic damage within minutes, but it may take several hours of continued mechanical loading for this initial cell and tissue damage to become visible and clinically noticeable. Superficial tissue damage primarily stems from excessive shear loading on fragile or vulnerable skin. In contrast, deeper PU/Is, known as deep tissue injuries, typically arise from stress concentrations in soft tissues at body regions over sharp or curved bony prominences, or under stiff medical devices in prolonged contact with the skin. Conclusion: This review promotes deeper understanding of the pathophysiology of PU/Is, indicating that their primary prevention should focus on alleviating the exposure of cells and tissues to stress concentrations. This goal can be achieved either by reducing the intensity of stress concentrations in soft tissues, or by decreasing the exposure time of soft tissues to such stress concentrations. [ABSTRACT FROM AUTHOR]

In this article, we present findings from a qualitative study examining how young women experience being long‐term bedridden with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), during childhood and adolescence. The aim is to explore how young women who fell ill with ME/CFS during childhood and adolescence look back on their lived experience of being long‐term bedridden from the vantage point of being fully or partially recovered. Informed by a phenomenological theoretical perspective, the researchers applied a narrative methodological approach involving the analysis of interviews with 13 women, aged 16–29 years at the time of the interview. Attention was particularly paid to how participants structured their narratives and to the events (telling moments) they identified as important. Four major storylines were developed: Ambivalent responses to the presence of others; A body on the edge of life; An eternity in the dark; and Recasting painful memories of being bedridden and alone. Based on our findings, we argue that the experience of being long‐term bedridden with ME/CFS during childhood and adolescence can be understood and communicated as a plot in which individuals find themselves pushed to the extreme limit of suffering and loneliness. [ABSTRACT FROM AUTHOR]

Prescribers often face the challenge of predicting creatinine clearance (CrCl) in elderly patients who are 65 years or older and have serum creatinine (SCr) concentrations below 1 mg/dL. Studies have shown that utilizing rounded SCr would underestimate CrCl in this population, which could lead to the under-dosing of some medications like vancomycin. The current study aimed to compare the accuracy of vancomycin dosing using actual SCr versus rounded SCr to 1 mg/dL in elderly patients. A total of 245 patients were included. The therapeutic trough level (10–20 mg/L) was achieved in 138 (56.3%) patients using actual SCr. Sub-therapeutic (<10 mg/L) and supra-therapeutic (>20 mg/L) trough levels were observed in 32 (13.1%) and 75 (30.6%) patients, respectively. The predictive performance of different vancomycin doses based on actual SCr and rounded SCr compared to the targeted maintenance dose (TMD) showed a stronger correlation of dosing based on actual SCr with TMD (r = 0.55 vs. 0.31) compared to rounded SCr dosing; both doses showed similar precision, with ranges of ±552 mg/day for the dosing based on actual SCr and ±691 mg/day for the dosing based on rounded SCr. Furthermore, the dosing based on actual SCr showed a lower error percentage (69%) and a higher accuracy rate (57.6%) within ±10% of the TMD compared to the dosing based on rounded SCr, which had an error percentage of (92.3%) and an accuracy rate of (40%). The prevalence of vancomycin-associated nephrotoxicity (VAN) was seen in 44 (18%) patients. Patients between 75 and 84 years of age, those who were bedridden, and those with vancomycin trough concentrations greater than 20 mg/L had a higher risk of developing VAN. In conclusion, in elderly patients, estimating vancomycin dosing based on actual SCr was more accurate compared to rounded SCr to 1 mg/dL. The efficacy of vancomycin could be negatively affected by rounding up SCr, which could underestimate CrCl and result in the under-dosing of vancomycin. [ABSTRACT FROM AUTHOR]

Abstract Background Frailty pervades the demographic of individuals afflicted by chronic kidney disease (CKD) and exhibits a robust correlation with a less favorable prognosis. Nonetheless, the evaluation and prognostication of frailty within the incipient stages of dialysis initiation remain shrouded in ambiguity. The necessity arises for an uncomplicated metric that holistically assesses frailty among aged CKD patients, one which lends itself to pragmatic clinical application. Methods In our prospective endeavor, we conducted assessments using the “KIHON checklist (KCL),” a questionnaire comprising 25 points, thoughtfully crafted by the Japanese Ministry of Health, Labour and Welfare to provide a thorough evaluation of the elderly population. This assessment was administered at the commencement of hemodialysis in patients aged 65 years or older. Subsequently, we analyzed the prognostic ramifications of the initial KCL scores on the composite primary endpoint, which encompassed the undesirable outcomes of either being bedridden or succumbing to mortality. Results A total of 24 patients (median age 76 years, 20 men) were included. The median KCL score was 6 [4, 10] points, and it was significantly correlated with the number of components in the revised Japanese Cardiovascular Health Study, which is a diagnostic criterion for frailty (p

Purple urine bag syndrome (PUBS) is a rare entity first described by Barlow and Dickinson in 1978 characterized by purple discoloration of urine in long-term debilitated patients with chronic indwelling urinary catheters. This syndrome is a result of a breakdown of indole into indoxyl sulfate and further metabolic degradation into indigo by the bacteria in the urinary tract resulting in the characteristic purple hue of the urine. We describe the case of a 60-year-old male, bedridden due to traumatic paraplegia, presenting to us with lower abdominal pain and purple discoloration of urine due to Proteus mirabilis. [ABSTRACT FROM AUTHOR]

Background: Health care provided by youth can support homebound and bedridden older adults. The purpose of this study was to develop a program for homebound and bedridden older adults in rural areas of northeastern Thailand. Methods: The methodology was a mixed method, including 1) exploration of the current situation through qualitative method, 2) development of a training program, and 3) implementation and evaluation of the program developed through a quasi-experimental method from February to June 2020 in Ta-Muang Subdistrict, Selaphum District, Roi Et Province, Thailand. Data were collected through focus group discussions, in-depth interviews, Thai version of the brief form of the World Health Organization Quality of Life (WHOQOL-BREF-THAI), and Srithanya Stress Test (ST-5) questionnaires. Quantitative data were analyzed using percentages, means, SDs, and paired t tests, while qualitative data were analyzed using content analysis. Results: The qualitative method showed 4 major themes, including 1) lack of caregivers, 2) lack of knowledge, 3) loneliness and stress, and 4) under the poverty line. The training program involved 6 activities: 1) providing knowledge in caring for older adults to educate and support youth, 2) demonstrating and practicing in caring for older adults to educate and support youth, 3) caring for older adults with love and care, 4) providing hygiene care to older adults, 5) promoting self-worth and self-confidence in youth, and 6) enhancing community participation. The quantitative method showed after the implementation of this training program. Findings showed that quality of life had higher mean scores, and stress had lower mean scores compared to the prior implementation. Conclusion: This training program could promote bonding among youth and homebound and bedridden older adults through peer support from health volunteers.

The study explores the impact of predictive nursing interventions on pressure ulcers (PUs) in elderly bedridden patients. A total of 120 elderly bedridden patients from the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture between August 2019 and August 2023 were selected as the subjects of the study and were randomly divided into an observation group and a control group using a random number table method. The control group received conventional nursing care, while the observation group received predictive nursing interventions. The study compared the incidence of PUs, Braden scale scores, the onset time of PUs, self‐rating anxiety scale (SAS) scores, self‐rating depression scale (SDS) scores, and nursing satisfaction between the two groups. In elderly bedridden patients, the application of predictive nursing interventions significantly reduced the incidence of PUs (p < 0.001), significantly lowered the SAS and SDS scores (p < 0.001), and also significantly increased Braden scale scores (p < 0.001) and delayed the onset time of PUs (p < 0.001). Additionally, it improved patients' nursing satisfaction (p = 0.008). Predictive nursing interventions in elderly bedridden patients have good application effects, reducing the occurrence of PUs, delaying the time of onset in patients, improving patients' negative emotions and enhancing nursing satisfaction rates. It is worthy of widespread use. [ABSTRACT FROM AUTHOR]

Pressure ulcers are one of the leading complications in bedridden patients that result in multiple burdens on healthcare systems and patients (11 billion dollars/year). The prevalence of pressure ulcers in traumatic brain injury patients is 1.5‐fold compared with the other bedridden patients. Moreover, critical traumatic brain injury patients who are admitted to the intensive care unit experience severe pressure ulcers and further complications. The motor/sensory disabilities and low supplementation and oxygenation to the pressured side were the main mechanisms of the typical pressure ulcers. Intellectual evaluation is the first essential step to prevent the development of pressure ulcers in high‐risk patients. Till now, different scales, including Injury Scale Score and Braden Scale Score, have been provided to assess the pressure ulcer. Since low stages of pressure ulcers heal rapidly, traumatic brain injury patients require a periodical assessment to prevent further developments timely. Alongside different procedures provided to prevent and treat any pressure ulcer, traumatic brain injury patients required additional specific protections. For the first line, fast and efficient rehabilitation repairs motor/sensory disabilities and decreases the chance of pressure ulcer. Our review indicated that pressure ulcer in traumatic brain injury had several complex mechanisms that demand special care. Therefore, further studies are required to address these mechanisms and prevent their progression to typical and atypical pressure ulcers. [ABSTRACT FROM AUTHOR]

To evaluate the effect of predictive nursing interventions on pressure ulcers in elderly bedridden patients by meta‐analysis. Applied computer searches of PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for randomised controlled trials (RCTs) on the effect of predictive nursing in preventing pressure ulcers in elderly bedridden patients from the database inception to November 2023. Two researchers independently screened the literature, extracted data and performed quality assessment based on inclusion and exclusion criteria. Stata 17.0 software was utilised for data analysis. Eighteen RCTs involving 6504 patients were finally included. The analysis revealed the implementation of predictive nursing interventions had a significant advantage in reducing the incidence of pressure ulcers in elderly bedridden patients compared with conventional nursing (odds ratio [OR] = 0.20, 95% confidence interval [CI]: 0.15–0.28, p < 0.001), while the patients' satisfaction with nursing care was higher (OR = 3.70, 95% CI: 2.99–4.57, p < 0.001). This study shows that the implementation of a predictive nursing interventions for elderly bedridden patients can effectively reduce the occurrence of pressure ulcers and significantly improve patients' satisfaction with nursing care, which is worthy of clinical promotion and application. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to demonstrate whether the care burden of caregivers of bedridden patients, who experience feeding difficulties, decreases according to the Hospital Anxiety and Depression Scale (HADS) (1) after the patient has undergone PEG (Percutaneous Endoscopic Gastrostomy). The hypothesis of the study was that the levels of anxiety and depression of caregivers for patients fed via PEG decrease more than those for caregivers of patients fed through other enteral methods. Based on this, the goal is to recommend to palliative care and home care professionals the type of feeding method for bedridden patients that will create less burden on their relatives. Methods: A comparison was made of the Hospital Anxiety and Depression Scale (HADS) scores among caregivers of patients receiving PEG and other enteral nutrition, focusing on changes between hospital admission and discharge. These changes were analyzed based on the caregiver's age, gender, and the duration of the patient's hospital stay. Methods: This study conducted a comparative analysis of the Hospital Anxiety and Depression Scale (HADS) scores among caregivers of patients receiving Percutaneous Endoscopic Gastrostomy (PEG) versus other forms of enteral nutrition. The focus was on the variation in these scores from the time of the patients' hospital admission to their discharge. This analysis incorporated an examination of how these changes correlated with the caregiver's age and gender, as well as the duration of the patient's hospitalization. Results: Despite longer hospital stays, a decrease in anxiety and depression was observed in caregivers of patients receiving PEG compared to the other group (p = 0.078). It was found that the decrease in anxiety and depression levels was less pronounced with increasing age of the caregiver (r=-0.202, p = 0.038). Hospital stay duration for patients receiving PEG was significantly longer than for those receiving other enteral nutrition methods (p = 0.017). Conclusions: We believe that Percutaneous Endoscopic Gastrostomy (PEG) should be the preferred method for long-term enteral nutrition due to its facilitation of effective and comfortable feeding and medication administration by caregivers. In palliative care services, for patients requiring long-term nutrition, PEG should be considered more prominently than other enteral feeding methods to reduce the anxiety of caregivers. [ABSTRACT FROM AUTHOR]

Identify and characterize bedridden users who live at home in the community and assess caregiver’s burden. Cross-sectional observational study. It was applied: a sociodemographic and health profile questionnaire; Katz index; Coelho and Savassi Family Risk Scale; ABEP socioeconomic classification scale; and reduced Zarit Scale. Descriptive analysis with categorical data expressed as frequency and percentage, and continuous data, as mean and standard deviation, with the confidence interval. A total of 23 bedridden patients were evaluated, most of them elderly males, with some reported family dysfunction and who lived in masonry houses without accessibility or adequate adaptations. The 27 caregivers were mostly informal, almost all female family members, with care overload considered severe. These issues must be faced by health professionals, so can offer adequate responses to the needs of this population, which is still very neglected and unassisted. To make the invisible visible is to humanize care and provide access to health. [ABSTRACT FROM AUTHOR]

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Background Due to aging characteristics such as dry, loose and inelastic skin, and decreased skin tolerance, the elderly are more vulnerable to injuries caused by pressure. An appropriate decompression mattress is the key to preventing pressure injury. Objective To compare the decompression effects of two types of mattresses by analyzing the pressures and temperatures of sacrococcygeal skin in bedridden elderly patients in the supine position. Methods By convenience sampling, 45 bedridden elderly patients who were admitted to Cadre Internal Medicine Ward, General Hospital of Eastern Theater Command from January 2021 to March 2022 were selected as the participants (all of them were male since most of the patients in the ward were male) . They were assigned to group A (n=23, use of gel mattress, repositioned every two hours for seven days) or group B (n=22, use of air mattress, repositioned every two hours for seven days) according to their willingness. The maximal sacrococcygeal pressure and skin temperature were measured at three fixed defined time points every day during supine position〔at the beginning (baseline) , and at one and two hours in the position〕. Maximal sacrococcygeal pressure was measured using a continuous bedside pressure mapping system, and the skin temperature in the same location was measured using a hand-held thermometer. The linear mixed-effects model was used to analyse the changes in sacrococcygeal pressure and skin temperature of the elderly bedridden patients and compare the decompression effects of the two mattresses. Results There were no pressure injuries in both groups during the intervention. The interaction effect between group and day was not statistically significant on the changes in sacrococcygeal pressure (Fgroup*day=0.07, Pgroup*day=0.999) , while the interaction effect between group and time on them was statistically significant (Fgroup*time =6.45, Pgroup*time=0.012) . Therefore, the mixed-effects model analysis was conducted again after removing the interaction between the group and day. The results indicated that the sacrococcygeal pressures in the gel mattress group were lower than those in the air mattress group after one and two hours after the supine position (P

Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To evaluate the clinical effectiveness and health economic benefits of a novel indwelling lattice-based device for fecal management in bedridden patients. Materials and methods: This nonrandomized, two-arm study included 70 bedridden patients (≥18 years exhibiting liquid stool) referred from the ICU of surgery and medicine units of a 2000-bed tertiary care referral hospital, assigned to the intervention and control groups. About 35 patients were eligible to be included in the intervention group while 35 patients with contraindications to the intervention device were included in the usual care control group. Assessments were made before and every 24 hours during the study, and all patients were closely monitored for development of incontinence-associated dermatitis (IAD) and hospital-acquired pressure injury. Results: The test device was successfully deployed on the first attempt and effectively diverted fecal matter in all 35 patients, with no adverse events. In the control group, 83% of the patients developed IAD, which resulted in prolonged hospitalization and increased expenses. Overall, the control group (with adult diapers) required greater time, resources, and efforts for fecal management and resulted in increased patient morbidity. Conclusion: The patient management time, resource consumption, overall cost of hospital admission, and the complication rates are significantly lower with the use of the novel lattice-based device than with the use of adult diapers for fecal management. [ABSTRACT FROM AUTHOR]

Pressure injury (PI) mainly occurs in bedridden older adults or those with physical limitations. Here, we aimed to determine the appropriate timing to conduct flap reconstruction in patients with PIs and identify factors affecting surgical outcomes. We retrospectively reviewed the data of all patients who received debridement or flap reconstruction surgery for PIs in our hospital from January 2016 to December 2021. The extracted data included patient demographics, surgical records, blood test results, vital signs, and flap outcomes. In total, 484 surgical procedures (364 debridements and 120 flaps) were performed on 216 patients. Serum albumin level of ≥2.5 g/dL remarkably increased the likelihood of complete wound healing (odds ratio [OR] = 4.12, P =.032) and reduced the risk of postoperative complications (OR = 0.26, P =.040). In contrast, advanced age (OR = 1.04, P =.045) and serum creatinine level ≥2 mg/dL (OR = 5.07, P =.016) increased the risk of postoperative complications. Thus, patients with a favourable nutrition status have a higher likelihood of achieving complete wound healing. By contrast, patients who are older and have serum creatinine ≥2 mg/dL and serum albumin <2.5 g/dL tend to develop more postoperative complications. Overall, thorough correction for patient inflammation, infection, anaemia, and malnutrition status can provide optimal flap surgery outcomes. [ABSTRACT FROM AUTHOR]

Bedridden patients risk presenting several problems caused by prolonged immobility, leading to a long recovery process. There is thus a need to develop solutions that ensure the implementation of physical rehabilitation programs in a controlled and interactive way. In this context, the ABLEFIT project aims to develop a medical device to physically rehabilitate bedridden patients with prolonged immobility. A partnership was established between the school of nursing, business enterprises and an engineering institute to develop a prototype. After creating the prototype, a pre-clinical experimental usability study was created using the user-centred multi-method approach (User and Human-Centered Design) to assess the device’s functionality, ergonomics and safety. The pre-clinical stage was initiated with a sample of 12 health professionals (that manipulated the device’s functionalities) and 10 end-users (who used the device). During the pre-clinical stage, the need to incorporate in the final version joint stabilizers was observed. Another important finding was the importance of the continuous monitorization of vital signs on Ablefit, namely, heart rate and SPO2. Therefore, the development of the Ablefit system allows the monitoring of a set of variables and conditions inherent to immobility. At the same time, this device will be a dynamic solution (using gamification and simulation technologies) by generating personalized rehabilitation plans.

Prolonged bed rest causes a multitude of deleterious physiological changes in the human body that require interventions even during immobilization to prevent or minimize these negative effects. In addition to other interventions such as physical and nutritional therapy, non-physical interventions such as cognitive training, motor imagery, and action observation have demonstrated efficacy in mitigating or improving not only cognitive but also motor outcomes in bedridden patients. Recent technological advances have opened new opportunities to implement such non-physical interventions in semi- or fully-immersive environments to enable the development of bed rest countermeasures. Extended Reality (XR), which covers augmented reality (AR), mixed reality (MR), and virtual reality (VR), can enhance the training process by further engaging the kinesthetic, visual, and auditory senses. XR-based enriched environments offer a promising research avenue to investigate the effects of multisensory stimulation on motor rehabilitation and to counteract dysfunctional brain mechanisms that occur during prolonged bed rest. This review discussed the use of enriched environment applications in bedridden patients as a promising tool to improve patient rehabilitation outcomes and suggested their integration into existing treatment protocols to improve patient care. Finally, the neurobiological mechanisms associated with the positive cognitive and motor effects of an enriched environment are highlighted. [ABSTRACT FROM AUTHOR]

Pressure injuries (PIs) are a major public health problem and can be used as quality-of-care indicators. An incipient development in the field of medical devices takes the form of Smart Health Textiles, which can possess innovative properties such as thermoregulation, sensing, and antibacterial control. This protocol aims to describe the process for the development of a new type of smart clothing for individuals with reduced mobility and/or who are bedridden in order to prevent PIs. This paper's main purpose is to present the eight phases of the project, each consisting of tasks in specific phases: (i) product and process requirements and specifications; (ii and iii) study of the fibrous structure technology, textiles, and design; (iv and v) investigation of the sensor technology with respect to pressure, temperature, humidity, and bioactive properties; (vi and vii) production layout and adaptations in the manufacturing process; (viii) clinical trial. This project will introduce a new structural system and design for smart clothing to prevent PIs. New materials and architectures will be studied that provide better pressure relief, thermo-physiological control of the cutaneous microclimate, and personalisation of care. [ABSTRACT FROM AUTHOR]

Aim: Analysis of the concepts and development of a conceptual definition of being wheelchair‐bound and being bedridden. Design: Concept analysis. Methods: Walker and Avant´s concept analysis method was used. A thematic analysis guided the determination of the attributes, antecedents and consequences. Results: Being wheelchair‐bound and being bedridden are defined as permanent states in which people are bound to an object. Being passively bound to a wheelchair and being bedridden both mean an increasing restriction of the life‐space. Being passive wheelchair‐bound often represents a preliminary stage to being bedridden. Both concepts have six attributes: in need of help, powerlessness, life‐space confinement, mobility limitation, endurance and weakness. They differ in the main feature maintaining an independent sitting position. Physical immobility and physiological instability are antecedents with the following influencing factors: illness, complexity, burden, endogenous/exogenous booster. The consequences are the progression of inactivity and all related physical and psycho‐social problems. [ABSTRACT FROM AUTHOR]

Abstract The use of a pocked-sized, wireless-Bluetooth ultrasound portable system with display images presented on a tablet facilitated the work of our radiologists during the first wave of coronavirus disease 2019 (COVID-19) to perform diagnostic and interventional procedures in bedridden patients. The device is equipped with a battery-powered probe without cables that transmits images to a tablet (or a cell phone) through a dedicated App. We hypothesise in future to extend diagnostic and low-complexity interventional procedures from hospitalised patients to at-home patients who are not able to mobilise out of bed or are difficult to transport. This domiciliary service might also reduce the overhead of hospital accesses.

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bedridden patients risk presenting several problems caused by prolonged immobility, leading to a long recovery process. There is thus a need to develop solutions that ensure the implementation of physical rehabilitation programs in a controlled and interactive way. In this context, the ABLEFIT project aims to develop a medical device to physically rehabilitate bedridden patients with prolonged immobility. A partnership was established between the school of nursing, business enterprises and an engineering institute to develop a prototype. After creating the prototype, a pre-clinical experimental usability study was created using the user-centred multi-method approach (User and Human-Centered Design) to assess the device's functionality, ergonomics and safety. The pre-clinical stage was initiated with a sample of 12 health professionals (that manipulated the device's functionalities) and 10 end-users (who used the device). During the pre-clinical stage, the need to incorporate in the final version joint stabilizers was observed. Another important finding was the importance of the continuous monitorization of vital signs on Ablefit, namely, heart rate and SPO2. Therefore, the development of the Ablefit system allows the monitoring of a set of variables and conditions inherent to immobility. At the same time, this device will be a dynamic solution (using gamification and simulation technologies) by generating personalized rehabilitation plans. [ABSTRACT FROM AUTHOR]

Background The purpose of this study is to examine the association between physical activity and contracture in older patients confined to bed in long-term care (LTC) facilities. Methods Patients wore ActiGraph GT3X+ for 8 hours on their wrists, and vector magnitude (VM) counts were obtained as the amount of activity. The passive range of motion (ROM) of joints was measured. The severity of ROM restriction classified, as the tertile value of the reference ROM of each joint, was scored 1-3 points. Spearman's rank correlation coefficients (Rs) were used to measure the association between the VM counts per day and ROM restrictions. Results The sample comprised 128 patients with a mean (SD) age of 84.8 (8.8) years. The mean (SD) of VM was 84574.6 (115195.2) per day. ROM restriction was observed in most joints and movement directions. ROMs in all joints and movement directions, except wrist flexion and hip abduction, were significantly correlated with VM. Furthermore, the VM and ROM severity scores showed a significant negative correlation (Rs = -0.582, p < .0001). Conclusions A significant correlation between the physical activity and ROM restrictions indicates that a decrease in the amount of physical activity could be one of the causes of contracture. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Pressure ulcers (PUs) are highly prevalent and challenging wounds. In this study, patients with either tetraplegia or paraplegia, all of whom had multiple grade 4 PUs and who underwent single-session surgical treatment were included. In order to increase the mobility of the musculocutaneous flap, the gluteus maximus muscle, which cannot be used by immobile patients, was detached and inserted into the flap. Method: This was a retrospective case series and all PUs were reconstructed within the same surgical session. Results: A total of nine patients participated in the study, all of whom were male. Mean age was 33 years (range: 20–42 years). Mean follow-up period was 14.3 months (range: 9–24 months). All patients had a successful single-session repair of all PUs. Total or partial flap losses were not observed. Mean and total number of reconstructed PUs were 2.55 and 23, respectively. The mean area of reconstructed open wounds per patient was 174.6cm2 and the mean operation duration was 253 minutes. The level of blood loss was acceptable as the decrease in haemoglobin levels was not more than 2g/dl for each patient. Conclusion: Multiple PUs can be repaired in one session using gluteus maximus musculocutaneous flaps in immobile patients. Based on the fact that the gluteus maximus is an essential muscle for ambulation, our approach can only be used in the treatment of patients with irreversible paraplegia or tetraplegia. When all prerequsities are met, the amount of blood loss and operation duration are acceptable, and returning the patient to a wound-free state can be achieved more quickly compared to multi-session repairs. Air-fluidised beds are vital tools for accomplishing single session repairs of multiple PUs. The data shows that the approach is safe and can be used in patients with multiple PUs. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the use of multilayered silicone foam dressings for preventing pressure injury recurrence by reducing friction, pressure, and shear force at skin sites where previous pressure injuries closed. Methods: A bench‐to‐clinical bedside investigation was conducted. In the bench, three multilayered silicone foam dressings were assessed. The simulated skin‐shearing test consisted of a weight, a polyurethane‐based skin model containing a three‐axis tactile sensor, dressings, a table covered with bedsheets, and a mechanical tester. The mechanical tester simultaneously measured the interface friction force and internal shear force and pressure continuously during skin model movements. No‐dressing was used as a negative control. In clinical bedside assessments, a multilayered silicone foam dressing with lower friction and shear force was applied to two bedridden patients. Photographs and ultrasound images were used to assess the recurrence of pressure injury. Results: The dressings significantly reduced friction, pressure, and shear force compared with these parameters in the negative control. No significant differences in the shear forces between the dressings were observed. One clinical case did not develop a new pressure injury reaching the dermis. However, the second case developed a new pressure injury within one month after the first pressure injury closed. Conclusion: Our bench‐to‐clinical bedside study revealed that multilayered silicone foam dressings can potentially prevent pressure injury recurrence. [ABSTRACT FROM AUTHOR]

Objective: To assess the quality of life of family caregivers and their relationship with socioeconomic, health and care conditions. Methods: a cross-sectional and analytical study carried out in the city of Palmas/TO, in the period of 2020-2022, with a sample of 49 family caregivers of bedridden older adults. Quality of life was assessed by the instrument "12-Item- Short- Form Health Survey" (SF-12). To verify the relationship between physical and mental components and independent variables, the t-test was used. Results: Caregivers presented mean values of the physical component of 43.26 points (95% CI: 39.87 – 46.64) and the mental component of 50.98 points (95% CI: 47.96 – 54.00). Significant differences were found between the scores of the mental component for family dysfunction, alcohol consumption and overload, and between the physical component for multimorbidity, polypharmacy, body mass index and overload. Conclusion: The findings of this study demonstrated a relationship between social conditions, health, care and quality of life, thus granting knowledge to health professionals to guide them in planning actions aimed at improving caregivers' quality of life. [ABSTRACT FROM AUTHOR]

In this paper, we propose a multi-sensor IoT system-based smart predictive analytics care and movement monitoring model that can be applied to various diapers and solve these problems for the bedridden elderly. A multisensor is designed to monitor the condition of the diaper and the movement of the bedridden elderly, in addition, to know the use condition of the diaper and the attitude of the bedridden elderly. In addition, through the changed pattern of the time series data acquired from the multi-sensor, a model that can know not only the presence or absence of urine/feces/farts but also the attitude of bedridden people is constructed and compared to this, it detects urine/feces/farts, care sensing to know the diaper usage status and the bedridden elderly's attitude duration. We propose smart predictive analytics care monitoring model based on multi sensor IoT system: management of diaper and attitude for the bedridden elderly. The design and proposed method are tested and the results are derived through an accredited certification body for an objective evaluation method. [ABSTRACT FROM AUTHOR]

Copyright of Fenerbahce University Journal of Health Sciences (FBU-JOSH) / Fenerbahçe Üniversitesi Sağlık Bilimleri Dergisi is the property of Fenerbahce University Journal of Health Sciences (FBU-JOSH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: An increasing number of individuals aged 60 and older will rely on healthcare services, particularly due to increased physical limitations and mobility restrictions. This implies an increase in permanently immobile, often bedridden people who require targeted care. Mobility impairments progress gradually, leading to loss of autonomy and self-care skills, physical decline, functional deterioration, disability, etc. This review synthesises research findings on the implications of becoming and being bedridden for nursing care of older people in long-term care., Objectives: The aim of this scoping review was to explore the current state of research on the topic of bedriddenness in older people in the context of long-term care and to identify research gaps., Methods: We analysed English and German language peer-reviewed publications from the electronic databases MEDLINE (PubMed), CINAHL, LIVIO and Scopus. Publications from 1998 to 2023 were included if they addressed 'bedriddenness', the 'process of becoming bedridden', 'prevention' and the 'consequences of bedriddenness', and the 'care of bedridden people'. The PRISMA-ScR guidelines were used., Results: We identified 250 publications based on the defined inclusion criteria. We included 47 in detail condensing their content and organising them according to developed categories, bedriddenness and its prevention, development, consequences and care, which were the subject of intensive research. Although researchers have focused on risk factors for the development of immobility and its negative consequences for those affected, they paid little attention to self-determination and the organisation of life in bed, which enables those affected to participate. Different ideas regarding the term 'bedriddenness' indicate the need for a consensus definition., Conclusion: Our review shows that articles strongly focus on the process of becoming bedridden. Many publications examine bedridden people's care by emphasising the perspective of (informal) caregivers and the challenges they face. The perspective of bedridden people, together with the consideration of psychosocial dimensions of bedriddenness and the promotion of opportunities for participation, should be focused on in further research. Appropriate concepts for training and nursing practice would be helpful., Implications for Practice: Bedriddenness is a phenomenon that mainly affects older people, particularly those living in nursing homes. Concepts should be developed that reflect the reality of bedridden people's lives. Targeted interventions to improve the mobility of people with severe mobility impairments are important. Therefore, it is essential to establish educational modules for (informal) caregivers that consider mobility and rehabilitative practices as an integral part of care., (© 2025 The Author(s). International Journal of Older People Nursing published by John Wiley & Sons Ltd.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study is to explore the concept of dignity from the experience of older people with limited mobility and confined to beds while living in a nursing home. Background: Nursing staff have an important impact on the dignity of those older people confined to beds in nursing homes. Individuals' uniqueness with respecting dignity should be ensured. Methods: A qualitative descriptive study was conducted. The study was carried out with 19 older people who were immobile and confined to bed and living in nursing homes. The individual in‐depth interviews were conducted between July and October 2021. Inductive thematic analysis was used to synthesize data. Results: The main theme 'Dignity of older people confined to bed' emerged from subthemes 'Emotions', 'Lived experience' and 'Failure to maintain care'. The participants expressed their dissatisfaction towards the nursing staff's disrespectful care, which evoked feelings of insignificance and inferiority. Conclusion: Undignified and disrespectful nursing care can cause feelings of suffering, sadness and anger in older people confined to their beds. Nurses must listen to this group of older people and learn from their experiences. Compassionate, person‐centred care with kindness and empathy should be provided by all those providing and receiving care in nursing homes. Implications for Nursing Management: To provide dignified care, nursing staff must understand the importance of person‐centred, individually oriented nursing care for older people living with immobility in nursing homes. [ABSTRACT FROM AUTHOR]

Primary spinal infection is a challenge for neurosurgeons. Here, for the first time, we introduced the vacuum sealing drainage (VSD) sponge into the intervertebral space for the primary thoracolumbar infection treatment. This study included 6 bedridden patients with thoracolumbar spondylodiscitis without deformity formation. All 6 patients were treated with the VSD in our hospital from June 30, 2018, to August 31, 2019. All 6 cases of thoracolumbar infection achieved clinical cure at 3-month follow-up, and no surgical-related mortalities occurred in our series. One patient died of acute cerebral infarction 5 months after surgery, and the remaining 5 patients completed a 12-month follow-up without recurrence. The JOA score of all 6 cases improved significantly after VSD treatment. VSD is feasible for safe and effective treatment for primary thoracolumbar infection. The short-term follow-up effect is definite. [ABSTRACT FROM AUTHOR]

Introduction: Pressure Ulcers (PU) are a major problem in public health because they increase the morbidity and amount of care required and, at the same time, deprive individuals of their autonomy and independence. In the current era of technological advancement, new methods of health provision need to be developed and evaluated. This investigational study examines the validation of a Mobile Application (MA) which supports the Informal Caregiver (IC), in preventing PU of bedridden people within the community. Method and Materials: The validation control is divided into two (2) phases. In the first phase, the MA was evaluated by nine (9) experts who examined the Content Validity, whilst in the second phase, the Face Validity was evaluated by fifteen (15) IC. Results: Testing the validity of the MA, the specialist participants of the study evaluated the content as superior material (SAM=84.09%) whilst the Technological Validity was considered to be acceptable (S-CVI/UA = 0.42; S-CVI/Ave = 0.83). The Validity of Clarity was also considered acceptable by the IC (S-CVI/Ave 0.83) who also revealed a high intention in using the MA as shown by the Ease-of-Use scale (91.7%±2.6%) and the Utility-scale (89.3%±4.2%). Conclusions: The creation of a MA was attempted, to support the knowledge of IC, so that they are better able to promote the quality of life of the patient in a technologically functional framework. The MA has been validated both for its Content Validity and for its Face Validity. Further research, however, on the evaluation of MA in practice, is highly recommended. [ABSTRACT FROM AUTHOR]

Background To examine the relationship between an institutionally prepared standardized patient evaluation form and the Edmonton Frail Scale (EFS) in patients receiving home health care. Material and Methods Our prospective, observational study included 200 patients over the age of 18 who requested home health care, regardless of gender. The EFS and institutional data collection forms were applied consecutively on the same day to all patients included in the study. Results Among the 200 individuals recruited for the study, 59% were female and 41% were male; the overall average age was 80 years. According to the EFS results, 4.5% of the patients were classified as non-frail, 6% were vulnerable, and 89.5% had varying degrees of frailty (mild, moderate and severe). There was a significant positive correlation between EFS score and age (p<0.001). There was no significant relationship between EFS score and confinement to bed; however, EFS scores were higher in bedridden patients (p=0.017). The EFS score was higher in those with chronic disease (p<0.001). A >9 threshold for EFS score could identify those in need of home health care services, with a sensitivity of 80.34% and a specificity of 90.91%. Conclusion Age is an important risk factor for frailty, and the presence of chronic illness and confinement to bed may potentiate its effects. On the contrary, the level of personal care, pain conditions and pressure sores/ulcers were unassociated with frailty. It was determined that the EFS score could be supportive in distinguishing patients in need of home health care services. [ABSTRACT FROM AUTHOR]

Introduction: Repositioning practice is an essential pressure ulcer prevention intervention that has emerged in the history of nursing. Numerous terms are employed to indicate its meaning, such as turning, positioning, or posturing. However, there is no available analysis that distinguishes these terms or analyzes repositioning practice attributes. Objective: To analyze repositioning practice as a concept of bedridden patients in hospitals by combining methods from Foucault's archeology of knowledge and Rodger's concept analysis. Concept Description: Repositioning practice passes through three eras: classical, modern, and research. The repositioning practice is "turn a bedridden patient in a harmonized way and ends with anchor and documentation." The analysis concludes seven attributes for the repositioning practice: pre-turn, assessment, turn, harmonization, anchor, documentation, and time. The analysis assumes bedridden patients, and assigned nurses on duty are the antecedents. Moreover, the main consequence is pressure ulcer prevention, while patient safety and quality of care are the secondary consequences. Discussion: Repositioning practice understanding has grown with time. Each era has added to or removed from nursing's understanding for repositioning practice until it appears as it now. The current analysis expects further development in repositioning practice understanding and applications. Conclusion: Repositioning practice is an important nursing intervention and has shown a dynamic movement over history. It is expected that this dynamic will continue in the future. [ABSTRACT FROM AUTHOR]

The use of a pocked-sized, wireless-Bluetooth ultrasound portable system with display images presented on a tablet facilitated the work of our radiologists during the first wave of coronavirus disease 2019 (COVID-19) to perform diagnostic and interventional procedures in bedridden patients. The device is equipped with a battery-powered probe without cables that transmits images to a tablet (or a cell phone) through a dedicated App. We hypothesise in future to extend diagnostic and low-complexity interventional procedures from hospitalised patients to at-home patients who are not able to mobilise out of bed or are difficult to transport. This domiciliary service might also reduce the overhead of hospital accesses. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Despite data supporting the reduction of interactions with patients during nighttime, bed bathing is sometimes performed within this period in sedated patients unable to manage their own hygiene care. Objectives: To compare patient physiologic variables and adverse effect incidence between night and day bed baths. Methods : This was a single-center prospective observational study in a 12-bed intensive care unit during 2 months. Night period was defined to run from 10 PM to 6 AM. Night bed baths were provided to sedated ventilated patients whatever their sedation, if their Richmond Agitation Sedation Scale score was -2 or deeper. Bed bath-induced changes in physiological variables, treatments, and related unscheduled events were registered during both night and day bed baths. Results : Twenty-one patients (aged 62.9 [52.5-73.2] years, 14 male patients) were included. We registered 97 night bed baths and 95 day bed baths. Heart rate increased only after day bed baths (85 beats/min [bpm] [69-97 bpm] vs 88 bpm [73-98 bpm], P =.02). Increase in Richmond Agitation Sedation Scale score occurred, respectively, during 13 (13.4%) and 8 (8.4%) night and day bed baths, without significant differences. Body temperature significantly decreased during both night and day bed baths (respectively, 37[degrees]C [36.6[degrees]C-37.4[degrees]C] vs 36.6[degrees]C [36.2[degrees]C-37.2[degrees]C], P <.0001; and 36.9[degrees]C [36.5[degrees]C-37.2[degrees]C] vs 36.7[degrees]C [36.2[degrees]C-37.2[degrees]C], P =.0006). Overall, unscheduled events, whether physiologic changes, pain, or calling a physician in rescue occurred in 97 procedures (50.5%), irrespective of their timing (night vs day, respectively 53% [54.6%] vs 44% [46.3%], P =.31). Discussion : Although unscheduled events occurred in half of bed baths, differences evidenced between nighttime and daytime bed baths were scarce. The appropriateness of nighttime bed bathing remains questionable. [ABSTRACT FROM AUTHOR]

Patients undergoing hematopoietic stem cell transplantation are isolated and commonly bedridden. Our aim was to investigate whether a nursing intervention is feasible to increase physical activity after a stem cell transplantation, compared to standard care. A secondary aim was to compare quality of life between the groups. A non-equivalent group pretest-posttest design was applied. Twenty-two patients were included in the standard care group and 21 in the intervention group. The intervention comprised physical activity support pre transplantation, daily during hospital stay, and 14 days post discharge. An activity diary, metabolic equivalent of tasks, the six-minute walking test and the FACT-Anaemia Scale were used for evaluation. This study is reported in accordance with the CONSORT statement. The intervention group was more physically active, walked further in six minutes and seemed to have a slightly better quality of life compared to patients receiving standard care. The nursing intervention increased physical activity and may be associated with a better quality of life in patients undergoing hematopoietic stem cell transplantation. [ABSTRACT FROM AUTHOR]