ABSTRACT
PURPOSE: WHO recommends integrating rehabilitation into palliative care when providing services for people with life-threatening conditions. Recently, there has been increasing interest in exploring how rehabilitation and palliative care approaches could be combined. The aim of this study was to map and discuss the goals of intervention programmes that combine rehabilitation and palliative care. METHODS: A scoping review was performed. The electronic databases MEDLINE, EMBASE, and CINAHL were searched for papers published between January 2014 and September 2022. Papers were considered eligible if the participants in question had a life-threatening disease and if interventions included both rehabilitation and palliative care. All study types were included. RESULTS: Ten papers describing five interventions were included. Qualitative goals were narratively described, and quantitative goals were analysed according to the International Classification of Functioning, Disability and Health, and the Total Pain framework. Findings showed an overall focus on functioning and quality of life. Further analysis indicated an emphasis on physical and psychological dimensions. Social participation, and the social and spiritual dimensions were rarely evaluated. CONCLUSION: This review indicates that goals relative to social participation, the social and spiritual dimensions, and the patient's own goals may well be overlooked as points of orientation for interventions.
There is an increasing interest in combining palliative care and rehabilitation approaches in clinical work.When rehabilitation and palliative care are combined, goals may be overlooked, and the patient's own goals can be used as a point of orientation for interventions.Future practice should pay special attention to subjective goals, social participation, and the social and spiritual dimensions when combining rehabilitation and palliative care.
ABSTRACT
BACKGROUND AND AIMS: Falls among older people are associated with injury, functional decline, fear of falling, and depression. This study aims to evaluate the effect of multifactorial fall prevention on function, fear of falling, health-related quality of life and psychological well-being. METHODS: 392 older people > or =65 years sustaining a fall, leading to treatment in the emergency room or hospitalization, were included in a randomized, controlled intervention study on multifactorial fall prevention. The intervention consisted of systematic assessment and personalized treatment aimed at reducing risk factors for falls, and was performed at the geriatric outpatient department of a university hospital. The control group received usual care. Outcome measures were functional ability (Barthel Index and Frenchay Activity Index), fear of falling (Activities Balance Confidence Scale), health-related quality of life (SF- 36), and psychological well-being (SCL-92), and were recorded at interviews 6 and 12 months after inclusion. RESULTS: Only the physical function of SF-36 was slightly positively affected by the intervention (p=0.04). There were no effects on general health (p=0.49) or mental health (p=0.39) items, Barthel Index (p=0.10), Frenchay Activity Index (p=0.71), balance confidence (p=0.77), anxiety (p=0.92), depression (p=0.90) or somatization (p=0.13). CONCLUSIONS: This program of multifactorial fall prevention may have an effect on the physical function item of health-related quality of life in favor of the intervention group, but none on other measures of health-related quality of life, daily function, fear of falling or psychological well-being.
