| 1. |
- Asplin, Gillian, et al.
(författare)
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Concurrent validity and responsiveness of Traffic Light System-BasicADL (TLS-BasicADL)
- 2022
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 24:6, s. 372-380
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To test validity and responsiveness of Traffic Light System-BasicADL (TLS-BasicADL). Method: Validity: Data according to TLS-BasicADL, modified Functional Independence Measure (FIM) and Barthel Index (BI) were collected from 50 patients with mixed medical diagnoses. Responsiveness: 106 patients following hip fracture assessed according to TLS-Basic ADL and modified Katz Index. Percentage change in TLS-BasicADL from pre-fracture status, to post-operatively, discharge and 1 month follow-up was calculated. TLS-BasicADL and modified Katz Index were also correlated at discharge and 1 month. For analysis of responsiveness, Spearman's rho coefficient (rs) was used and for distribution at item level, percentage change and sign test. Results: Validity: Strong-excellent correlations between TLS-BasicADL and modified FIM (0.65-0.95), TLS-BasicADL and modified BI (0.77-0.97) for individual items. Analysis of total scores revealed excellent correlations between instruments (0.96-0.98). Responsiveness: Significant differences between assessments for each item of TLS-BasicADL except upper hygiene, dressing and eating. Excellent correlation was found between TLS-BasicADL and modified Katz Index between pre-fracture - discharge (0.897) and moderate-strong (0.597) discharge - 1 month. Conclusion: TLS-BasicADL is shown to have acceptable concurrent validity for measuring basic mobility and self-care in elderly patients with mixed medical diagnoses and responsive for patients following hip fracture surgery.
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| 2. |
- Asplin, Gillian, et al.
(författare)
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Early coordinated rehabilitation in acute phase after hip fracture - a model for increased patient participation
- 2017
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Ingår i: Bmc Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 17:240
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies have shown that patients with hip fracture treated in a Comprehensive Geriatric Care (CGC) unit report better results in comparison to orthopaedic care. Furthermore, involving patients in their healthcare by encouraging patient participation can result in better quality of care and improved outcomes. To our knowledge no study has been performed comparing rehabilitation programmes within a CGC unit during the acute phase after hip fracture with focus on improving patients' perceived participation and subsequent effect on patients' function. Methods: A prospective, controlled, intervention performed in a CGC unit and compared with standard care. A total of 126 patients with hip fracture were recruited who were prior to fracture; community dwelling, mobile indoors and independent in personal care. Intervention Group (IG): 63 patients, mean age 82.0 years and Control Group (CG): 63 patients mean age 80.5 years. Intervention: coordinated rehabilitation programme with early onset of patient participation and intensified occupational therapy and physiotherapy after hip fracture surgery. The primary outcome measure was self-reported patient participation at discharge. Secondary outcome measures were: TLS-BasicADL; Bergs Balance Scale (BBS); Falls Efficacy Scale FES(S); Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG) at discharge and 1 month and ADL staircase for instrumental ADL at 1 month. Results: At discharge a statistically significant greater number of patients in the IG reported higher levels of participation (p < 0.05) and independence in lower body hygiene (p < 0.05) and dressing (p < 0.001). There were however no statistically significant differences at discharge and 1 month between groups in functional balance and confidence, performance measures or risk for falls. Conclusion: This model of OT and PT coordinated inpatient rehabilitation had a positive effect on patients' perceived participation in their rehabilitation and ADL at discharge but did not appear to affect level of recovery or risk for future falls at 1 month. A large proportion of patients remained at risk for future falls at 1 month in both groups highlighting the need for continued rehabilitation after discharge.
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| 3. |
- Asplin, Gillian, et al.
(författare)
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See me, teach me, guide me, but it’s up to me! Patients’ experiences of recovery during the acute phase after hip fracture
- 2021
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 23:3, s. 135-143
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore patients’ experiences of their recovery after hip fracture surgery and the use of Traffic Light System-BasicADL in their rehabilitation process. Method: Nineteen patients (13 females and 6 males), aged 66–94, were interviewed. A qualitative content analysis method was used for analysis of data. Results: Two categories were identified: ‘Being seen as a person’ with subcategories; Interaction affects trust and security; Information is key to understanding; and Encouragement is essential to promote activity. And ‘Striving for Independence’, with subcategories; Accepting the situation while trying to remain positive; The greener the better, but it’s up to me; Ask me, I have goals; and Uncertainties concerning future. Conclusion: The findings of this study mirror clinical reality. There is a continued need for organisations to reflect over existing practise and question routines and procedures. In order to improve services and provide better quality of care, it is essential to acknowledge the patients’ experiences, needs and preferences and make efforts to accommodate these where possible. Health care professionals must recognise that patients with hip fracture are individuals, with varying needs that change across the continuum of recovery.
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| 4. |
- Asplin, Gillian, et al.
(författare)
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TLS-BasicADL: development and reliability of a new assessment scale to measure basic mobility and self-care
- 2014
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Ingår i: International Journal of Therapy and Rehabilitation. - : Mark Allen Group. - 1741-1645 .- 1759-779X. ; 21:9, s. 421-6
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe the development and test reliability of a new assessment scale for measuring basic mobility and self-care: the Traffic Light System-BasicADL (TLS-BasicADL). Subjects: Eighteen occupational and physiotherapists took part in inter-rater, and 25 in intra-rater, reliability testing. Thirty inpatients admitted to an acute geriatric/orthopaedic unit, aged ≥70 years participated in inter-rater testing, 5 of whom were included in intra-rater testing. Methods: TLS-BasicADL was constructed by members of the interdisciplinary team at a geriatric unit. Items were generated from existing instruments, pilot testing and consensus meetings. Inter-rater testing was performed by two therapists simultaneously. Intra-rater reliability was examined using video-taped films of 5 patients. Therapists viewed and assessed 5 patients, then retested 4 weeks later. For inter-rater testing percentage agreement (PA) and intra-class correlation coefficient (ICC) were used, and for intra-rater reliability, PA. Results: Analysis of reliability showed high inter-rater (PA=86%; ICC=0.90) and fair intra-rater reliability (PA=≥72%) for mobility items. Conclusion: The new interdisciplinary assessment, TLS-BasicADL for measuring function in older persons in the acute hospital setting is shown to have high inter-rater and fair intra-rater reliability.
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| 5. |
- Asplin, Gillian
(författare)
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Traffic Light System-BasicADL (TLS-BasicADL) Development, reliability, validity, clinical utility and patient perspective
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To describe the development of Traffic Light System-BasicADL (TLS-BasicADL), and procedures to establish properties of reliability, validity, clinical utility and patient perspective. TLS-BasicADL measures the patient’s ability to perform basic activities of daily living. Methods: Study I describes the development process and testing of inter- and intra-rater reliability in 30 patients (orthopaedic diagnoses). Study II investigates criterion validity in 50 patients (mixed diagnoses), and responsiveness in 106 patients following hip fracture surgery. Study III, evaluation of a coordinated rehabilitation programme with focus on patient participation, including use of TLS-BasicADL and enhanced occupational therapy and physiotherapy in 126 patients after hip fracture. Study IV, to gain a better understanding of patients’ experiences of recovery following hip fracture, including use of TLS-BasciADL. Twenty patients were interviewed and the data was analysed using qualitative content analysis. Results: Study I: High inter-and fair intra-rater reliability was reported. Study II: Strong to excellent correlations were found between TLS-BasicADL and modified Functional Independence Measure, and TLS-BasicADL and modified Barthel Index. Responsiveness: Significant differences were found between the assessment time points for each item of TLS-BasicADL, except upper hygiene, dressing and eating. Excellent correlation between TLS-BasicADL and modified Katz Index between pre-fracture – discharge, and moderate to strong from discharge - one month. Study III: The intervention group reported higher levels of participation and independence in lower body hygiene, and dressing. No statistically significant differences at discharge and one month post-discharge between groups in functional balance and confidence, performance measures or risk for falls. At one month post-discharge 40-80% of all patients remained at risk for falls. Study IV: Two categories were found: ‘Being seen as a person’ with subcategories; Interaction affects trust and security; Information is key to understanding; and Encouragement is essential to promote activity. And ‘Striving for Independence’, with subcategories; Accepting the situation whilst trying to remain positive; The greener the better, but it’s up to me; Ask me, I have goals; and Uncertainties concerning future. Conclusions: TLS-BADL provides a simple and practical team instrument for assessing basic ADL in older patients in the acute hospital setting, a visual aid to highlight level of independence and promotes communication between team members and patient. TLS-BasicADL has shown fair to high reliability, strong to excellent concurrent validity and moderate to strong responsiveness. More intensive training and enhanced collaboration with patients following hip fracture leads to increased patient perceived participation and independence in ADL at discharge. At one month post-discharge, patients continue to experience low levels of balance confidence and remain at risk for future falls, highlighting the need for improved discharge planning and rehabilitation services post-discharge. Following hip fracture patients experience a need to be taken seriously and seen as a person by the health care personnel. All patients described personal goals, but these were not always identified by the physiotherapists. TLS-BasicADL was described by patients as simple and easy to understand. Monitoring progress through the colour-coding changing was described satisfying and fun to see, as well as stimulating and promoting feelings of increased self-confidence.
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