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Kakehi T, Zenta M, Ishimori T, Tamura N, Wada H, Bessho M, Kakuda W. Association between Caregivers' Fear of Post-fracture Patients Falling and a Decline in Patients' Activities. Prog Rehabil Med 2023; 8:20230046. [PMID: 38162288 PMCID: PMC10752753 DOI: 10.2490/prm.20230046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives To evaluate caregivers' fear of post-fracture patients falling, we previously developed the Caregivers' Fear of Falling Index (CFFI). In this study, we investigated the relationship between patient performance in activities of daily living (ADLs) and CFFI. Methods We surveyed 55 patients receiving home-visit rehabilitation after fall-related fracture and their primary caregivers. Participants (patient and caregiver pair) were divided into two groups based on patient performance in basic ADLs (BADLs) and instrumental ADLs (IADLs). ROC analysis was conducted to assess the usefulness of CFFI and Falls Efficacy Scale-International (FES-I) in determining declines in performance in BADLs and IADLs. Multivariate logistic regression analysis was performed to examine the association between CFFI and declining performance in BADLs and IADLs. Results ROC analysis showed that CFFI exhibited a higher accuracy than FES-I (AUC: 0.73 in BADLs, 0.77 in IADLs) as an indicator of reduced ADL performance. Multivariate logistic analysis adjusted for age, sex, and physical function showed that CFFI was associated with a decline in patients' performance in IADLs (odds ratio, 0.92; 95% confidence interval, 0.85-0.99). Conclusions Caregivers' fear of post-fracture patients falling was associated with a decline in patients' performance in IADLs. These findings may serve as a guide for supporting caregivers of post-fracture patients.
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Affiliation(s)
- Tomohiro Kakehi
- Department of Rehabilitation Medicine, Graduate School of
Medicine, International University of Health and Welfare, Narita, Japan
- School of Health and Sciences at Narita, International
University of Health and Welfare, Narita, Japan
| | - Masashi Zenta
- Division of Rehabilitation Medicine, International
University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
| | - Takuya Ishimori
- Department of Rehabilitation, Institute of Brain and Blood
Vessels, Mihara Memorial Hospital, Isesaki, Japan
| | - Naoki Tamura
- Rehabilitation Center, Ushiku Aiwa General Hospital, Ushiku,
Japan
| | - Hiromu Wada
- Home-visit Nursing Station of Ryugasaki, Ryugasaki,
Japan
| | - Masahiko Bessho
- Department of Orthopaedic Surgery, International University
of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
- Department of Orthopaedic Surgery, School of Medicine,
International University of Health and Welfare, Narita, Japan
| | - Wataru Kakuda
- Department of Rehabilitation Medicine, Graduate School of
Medicine, International University of Health and Welfare, Narita, Japan
- Division of Rehabilitation Medicine, International
University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
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Kakehi T, Zenta M, Ishimori T, Tamura N, Wada H, Bessho M, Kakuda W. Reliability and Validity of Caregivers' Fear of Falling Index When Caring for Home-Based Rehabilitation Patients With Fall-Related Fractures. Ann Rehabil Med 2023; 47:300-306. [PMID: 37644719 PMCID: PMC10475813 DOI: 10.5535/arm.23052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/22/2023] [Accepted: 06/30/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE To evaluate the reliability and validity of this new measure, called the caregivers' fear of falling index (CFFI). METHODS The study surveyed home-based rehabilitation patients with fall-related fracture, and their primary caregivers. The characteristics of these patients were evaluated, and the caregivers were surveyed using the CFFI and Falls Efficacy Scale-International (FES-I). The reliability of the CFFI was assessed using item-total correlation, while the validity of the CFFI was evaluated through correlation coefficients calculated between the CFFI and the FES-I. RESULTS The participants were 51 patient-caregiver pairs. The internal consistency of the CFFI showed an alpha coefficient of 0.904. No items were excluded in the corrected item-total correlations. The CFFI showed a moderate correlation with FES-I (r=0.432, p=0.002). CONCLUSION This study found the CFFI to be a reliable and valid tool for measuring the primary caregivers' fear. The CFFI may be a useful tool for healthcare professionals to identify and supporting these primary caregivers.
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Affiliation(s)
- Tomohiro Kakehi
- Department of Rehabilitation Medicine, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan
- Department of Occupational Therapy, School of Health and Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Masashi Zenta
- Division of Rehabilitation Medicine, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
| | - Takuya Ishimori
- Department of Rehabilitation, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Isesaki, Japan
| | - Naoki Tamura
- Rehabilitation Center, Ushiku Aiwa General Hospital, Ushiku, Japan
| | - Hiromu Wada
- A Home-Visit Nursing Station of Ryugasaki, Ryugasaki, Japan
| | - Masahiko Bessho
- Department of Orthopaedic Surgery, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Wataru Kakuda
- Department of Rehabilitation Medicine, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan
- Division of Rehabilitation Medicine, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
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Kakehi T, Tamura N, Zenta M, Suzuki Y, Nakajima K, Wada H, Ishimori T, Bessho M, Kakuda W. Proposal of index to evaluate caregivers' fear of care recipient falls. Int J Rehabil Res 2022; 45:366-369. [PMID: 35942635 DOI: 10.1097/mrr.0000000000000543] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to identify evaluation items that can be used to create an index to evaluate caregivers' fear of care recipient falls. A three-round Delphi method was conducted with medical professionals engaged in discharge support for patients with fall-related fractures. In the first round, a working group brainstormed evaluation items. In the second and third rounds, opinions of medical professionals were quantified and evaluation items were refined. The Delphi method showed convergence of opinion with Kendall's W of 0.561 in the third round. Of the 109 evaluation items pooled in the first round, the consensus was reached on the importance of 19 items and one more item was additionally included. The 20 items may be useful for creating an index that sensitively measures caregivers' fear of care recipient falls.
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Affiliation(s)
- Tomohiro Kakehi
- Department of Rehabilitation Medicine, Graduate School of Medicine, International University of Health and Welfare
- Department of Occupational Therapy, School of Health and Sciences at Narita, International University of Health and Welfare, Chiba
| | - Naoki Tamura
- Department of Rehabilitation, Ushiku Aiwa General Hospital, Ibaraki
| | - Masashi Zenta
- Division of Rehabilitation Medicine, International University of Health and Welfare Ichikawa Hospital, Chiba
| | - Yasunari Suzuki
- Department of Occupational Therapy, School of Health and Sciences at Narita, International University of Health and Welfare, Chiba
| | - Kyoko Nakajima
- Division of Rehabilitation Medicine, International University of Health and Welfare Ichikawa Hospital, Chiba
| | - Hiromu Wada
- Department of Rehabilitation, Home-visit Nursing Station of Ryugasaki, Ibaraki
| | - Takuya Ishimori
- Department of Rehabilitation, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Gunma
| | - Masahiko Bessho
- Department of Orthopaedic Surgery, International University of Health and Welfare Ichikawa Hospital
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Wataru Kakuda
- Department of Rehabilitation Medicine, Graduate School of Medicine, International University of Health and Welfare
- Division of Rehabilitation Medicine, International University of Health and Welfare Ichikawa Hospital, Chiba
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Fukawa Y, Kakuda W, Yoshida S, Zenta M, Itano O, Kiko R, Tani H, Kubo A. Clinical Impact of the Introduction of an Early Rehabilitation Protocol on Infectious Complications in Patients after Gastrointestinal Cancer Surgery. Prog Rehabil Med 2019; 4:20190005. [PMID: 32789252 DOI: 10.2490/prm.20190005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/27/2019] [Indexed: 11/09/2022] Open
Abstract
Background The clinical importance of postoperative rehabilitation for cancer patients has recently attracted much attention. However, it remains uncertain whether early rehabilitation can prevent infectious complications in patients undergoing gastrointestinal cancer surgery. Methods The study group consisted of 259 patients who underwent laparoscopic or open surgery for gastrointestinal cancer at our institution between December 2012 and November 2016. Our department proposed a new early rehabilitation protocol for such patients to encourage physical activity after surgery. The protocol was clinically introduced on July 21, 2015. We divided the study subjects into two groups: those who were admitted before the introduction of the new protocol and those admitted after. The frequency of infectious complications, including respiratory infections, and the length of hospital stay after surgery were compared between the two groups. Results No adverse cardiovascular event associated with the early rehabilitation protocol was experienced. After the protocol was introduced, more than 80% of patients started exercising on the first day after surgery. For patients undergoing open surgery, the frequency of infectious complications was significantly reduced with the introduction of the protocol (p<0.05). Moreover, when open surgery was performed, the protocol significantly shortened the length of hospital stay (p<0.05). Conclusion Our proposed early rehabilitation protocol for patients who have undergone gastrointestinal cancer surgery was considered to be safe and feasible. The protocol may prevent infectious complications and shorten the hospital stay after such surgery.
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Affiliation(s)
- Yasuhisa Fukawa
- Department of Rehabilitation Medicine, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Chiba, Japan
| | - Wataru Kakuda
- Department of Rehabilitation Medicine, International University of Health and Welfare School of Medicine, Narita, Chiba, Japan
| | - Seiya Yoshida
- Department of Rehabilitation Medicine, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Chiba, Japan
| | - Masashi Zenta
- Department of Rehabilitation Medicine, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Chiba, Japan
| | - Osamu Itano
- Department of Hepato-Biliary-Pancreatic Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Narita, Chiba, Japan
| | - Risa Kiko
- Department of Rehabilitation Medicine, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Chiba, Japan
| | - Hiroaki Tani
- Department of Physical Therapy, Faculty of Health Science, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, Faculty of Health Science, International University of Health and Welfare, Otawara, Tochigi, Japan
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