European Geriatric Medicine - Supplement 1 - Volume 7

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.

Conclusions:

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.

P-471

Risk factors for falling, benzodiazepines and fear of falling: is there

any relationship?

C. Roqueta, I. Arnau-Barrés, N. Ronquillo, M. Martín, O. Vázquez,

R. Miralles.

Geriatric Medicine Department. Parc de Salut Mar. Centre

Fòrum. Hospital de la Esperança. Hospital del Mar.

Aim:

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

70 points.

Results:

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

registered.

Conclusions:

(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.

P-472

Fear of falling and functional gain in patients admitted to an

intermediate care unit

C. Roqueta

, N. Ronquillo

, I. Arnau-Barres

, M. Martín

, R. Miralles

O. Vázquez

Geriatric Medicine Department. Parc de Salut Mar. Centre

Fòrum. Hospital del Mar. Hospital de l

’

Esperança. Barcelona, Spain

Objective:

to assess the relationship between the fear of falling and the

functional gain.

Methods:

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

evaluated.

Results:

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).

Conclusions:

Fear of falling at the beginning of the rehabilitation

program was significantly lower in patients who achieved greater

functional gain during admission.

P-473

Quality improvement project to develop and implement a self-

management strategy into a rapid response and rehabilitation

model

J. Sanders

, J. Fitzpatrick

, S. Gregory

Hounslow and Richmond

Community Healthcare NHS Trust,

Kings College London,

Hounslow and

Richmond Community Healthcare NHS Trust, London, United Kingdom

Introduction:

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.

Methodology:

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.

Evaluation:

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.

Conclusions:

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.

P-474

The prevalence of vitamin D deficiency and functional capacity in

elderly patients undergoing cardiac surgery

O. Santos

, S. Miguel

, F. Pereira

, M. Ramalhinho

, D. Morais

G. Afonso

, G. Araújo

, A. Amaro

, N. Alegria

Department of Physical

and Rehabilitation Medicine, Hospital Pulido Valente, Centro Hospitalar

Lisboa Norte, Lisbon, Portugal

Introduction:

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.

Methods:

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).

Results:

28 patients (80%) had 25(OH)D <20 ng/mL. Higher 25(OH)D

concentrations were associated with higher functional scores.

Conclusions:

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

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