to see a benefit (n = 29) and reported enjoyment from attending the
programme (n = 27). Finding the programme sufficiently challenging
was considered a facilitator with barriers to engagement when
participants find the programme too easy. Medically related issues
(n = 30), participants requiring close supervision (n = 16) and fatigue
(n = 12) were the most commonly reported barriers requiring modi-
fication of the programme.
CBE programmes need to be individually tailored to
ensure older adults can perceive an individual benefit and that the
programme is delivered at a challenging level for all participants,
whilst acknowledging medical conditions and fatigue.
Risk factors for falling, benzodiazepines and fear of falling: is there
C. Roqueta, I. Arnau-Barrés, N. Ronquillo, M. Martín, O. Vázquez,
Geriatric Medicine Department. Parc de Salut Mar. Centre
Fòrum. Hospital de la Esperança. Hospital del Mar.
To assess relationship between fear of falling and risk factors
for falling. Patients and method: prospective and observational
study of 62 patients (72.6% women); mean age 81.5 ± 7.9 years,
admitted in an intermediate care unit. The following risk factors for
falling were registered: orthostatic hypotension, intake benzo-
diazepines, visual and hearing impairment, delirium and depression.
Fear of falling was assessed by the Falls Efficacy Scale (FES) when
patients began walking in the rehabilitation ward. It was considered
to have fear of falling when the score in the FES was more than
Mean value of FES was 54.8 ± 21.7. Of the 16 patients with
FES> 70, 12 (75%) were treated with benzodiazepines and 4 (25%)
were not (p < 0.005). Of the 46 patients with FES
70, 8 (17.4%) had
hearing impairment and 38 (82.6%) had not (p = 0.002). There was no
relationship between FES > 70 points and others risk factors for falling
(1) Intake benzodiazepine was significantly associated
with a greater fear of falling. (2) Absence of hearing impairment was
significantly associated with lower fear of falling. (3) No relationship
between increased fear of falling and other risk factors was found.
Fear of falling and functional gain in patients admitted to an
intermediate care unit
, N. Ronquillo
, I. Arnau-Barres
, M. Martín
, R. Miralles
Geriatric Medicine Department. Parc de Salut Mar. Centre
Fòrum. Hospital del Mar. Hospital de l
Esperança. Barcelona, Spain
to assess the relationship between the fear of falling and the
prospective and observational study of 60 patients (73.3%
women); mean age: 81.5 ± 7.9 years. Main diagnosis, functional status
at admission [Barthel index (BIA)] and at discharge (BID) were
registered. Functional gain (FG) was calculated by the difference
between BID and BIA (in two patients FG was not calculated because
they did not complete the rehabilitation program because of medical
complications). The fear of falling was evaluated by the Falls Efficacy
Scale (FES) when patients began walking in the rehabilitation ward.
The relationship between a functional gain
20 points and the FES was
Main diagnosis: 46 (76.7%) fracture, 5 (8.3%) neurological, 3
(5%) cardiorespiratory and 6 (10%) others. The mean score of FES in 55
patients with a functional gain
20 points was 51.8 ± 20.7 and in the
remaining 3 was 82.3 ± 4.7 (p = 0.0169).
Fear of falling at the beginning of the rehabilitation
program was significantly lower in patients who achieved greater
functional gain during admission.
Quality improvement project to develop and implement a self-
management strategy into a rapid response and rehabilitation
, J. Fitzpatrick
, S. Gregory
Hounslow and Richmond
Community Healthcare NHS Trust,
Kings College London,
Richmond Community Healthcare NHS Trust, London, United Kingdom
Despite a national policy focus on supported self-
management, within a community rapid response and rehabilitation
team, an internal audit identified that there were minimal structured
health promotion and self-management plans developed with service
users. The aim of this quality improvement project was to implement
a self-management strategy for adult service users engaged with the
Rapid Response and Rehabilitation Team.
The quality improvement intervention, based on the
plan, do. study, act (PDSA) model included: PDSA 1- the development
of a self-management plan (based on the principles of personalised
care planning, incorporating goal setting, problem solving and regular
reviews). PDSA 2- staff education focused on supporting service
users to self-manage using motivational interviewing techniques.
PDSA 3- piloting the self-management plan with three service users.
PDSA 4- roll out of the self-management plan and PDSA 5- monthly
audit and feedback.
The evaluation involved an audit of the number and
quality of self-management plans developed with service users, and
measurement of staff self-reported knowledge and confidence to
support service users to self-manage pre and post intervention.
This quality improvement project demonstrates that
service user self-management can be successfully incorporated into
a rapid response and rehabilitation model and staff can adapt
motivational interviewing techniques to support individualised goal
setting and action planning.
The prevalence of vitamin D deficiency and functional capacity in
elderly patients undergoing cardiac surgery
, S. Miguel
, F. Pereira
, M. Ramalhinho
, D. Morais
, G. Araújo
, A. Amaro
, N. Alegria
Department of Physical
and Rehabilitation Medicine, Hospital Pulido Valente, Centro Hospitalar
Lisboa Norte, Lisbon, Portugal
The prevalence of vitamin D deficiency is common
among the elderly, as well as the increase of diseases associated with
lack of vitamin D. The muscle weakness, gait instability, fatigue and
depression are symptoms of vitamin D deficiency affecting functional
capacity. Some studies have demonstrated a relationship between
vitamin D deficiency and increased mortality associated with
cardiovascular events. The purpose of this study is to evaluate the
prevalence of vitamin D deficiency in patients over 65 years old
undergoing cardiac surgery before starting the cardiac rehabilitation
program (CRP), and to analyze the correlation between vitamin D
levels and functional capacity.
Were included prospectively 35 patients over 65 years old
(24 males, 11 females, mean age 72). Serumvitamin D was assessed by
quantitative determination of serum 25-hydroxyvitamin D (25(OH)D),
and levels <20 ng/mL were considered as vitamin D deficiency.
Vitamin D was checked on admission at CRP and functional capacity
assessment instruments in the elderly where applied: Timed Up and
Go Test (TUG), 6-minute walk test (6MWT) and International Physical
Activity Questionnaire (IPAQ).
28 patients (80%) had 25(OH)D <20 ng/mL. Higher 25(OH)D
concentrations were associated with higher functional scores.
We found high prevalence of vitamin D deficiency in the
sample. Patients with vitamin D deficiency had lower functional
scores. Follow-up studies are needed to demonstrate whether the
increase in functional capacity, provided by the CRP, is higher in
patients with vitamin D normalized levels. Important limitation is a
small sized sample which comprises only surgical patients.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29