Article

OBJECTIVE: To determine the impact of a restorative model of home care on social
support and physical function among community-dwelling older people. DESIGN:
Cluster-randomized controlled trial. SETTING: Home care in an urban area.
PARTICIPANTS: Participants (N=205) were randomly assigned to an intervention
group (n=108; mean age, 79.1y; 71.3% women; 81.5% New Zealand European [NZE];
50.8% residing in areas of the highest levels of social deprivation) or a usual
care group (n=97; mean age, 76.9y; 60.8% women; 73.2% NZE; 53.5% in the highest
levels of social deprivation). INTERVENTION: Participants randomly assigned to
the intervention group completed a goal facilitation tool with a needs assessor
to determine their needs and to establish the aims for the episode of care.
Services were structured according to the principles of restorative home care
(independence focused with individually tailored activity programs). Usual care
participants received a standard needs assessment that informed the delivery of
home care services. MAIN OUTCOME MEASURES: Short Physical Performance Battery
(SPPB), Dukes Social Support Index (DSSI). RESULTS: There was greater change over
time in physical function (measured by SPPB: F=8.30, P=.003) but no associated
increase in social support (as determined by DSSI: F=2.58, P=.09). CONCLUSIONS:
Significant improvements in physical function were observed after a period of
restorative home care services. The absence of an associated change in social
support may have been the result of a combination of factors, including the
threshold of physical function required for community ambulation, the low rate of
allied health service provision, and the time required to reestablish social
ties. The findings contribute to a greater understanding of factors necessary to
refocus home-based services to emphasize improvements in physical function and
independence.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS