Physical function in hospice patients and physiotherapy interventions: a profile of hospice physiotherapy.
OBJECTIVE
There is a dearth of international research on hospice physiotherapy. This study aims to profile hospice physiotherapy in an Irish setting in order to inform practice internationally.


METHODS
The study design consisted of a retrospective chart audit over 6 months.


METHODS
The study took place at a specialist palliative care inpatient unit (hospice) in Limerick, Ireland.


METHODS
All patients were discharged (through death or discharge onwards) from January to June 2010.


METHODS
The Edmonton Functional Assessment Tool (EFAT-2) was used as an outcome measure.


RESULTS
Sixty-five percent were referred for physiotherapy; 58% (n=144) were assessed and treated. A wide range of patients was referred (mean functional score 11, range 1-23, SD 5). Rehabilitation activities were widespread: 48% with more than one functional score recorded made improvements; 53% of physiotherapy patients were eventually discharged home; 47% of physiotherapy patients died, of whom 52% received physiotherapy in the last week of life. The median physiotherapy program lasted 11 days (range 1-186, SD 22) whereas the median number of treatments was four (range 1-99, SD 10). The most common interventions were gait re-education (67%), transfer training (58%), and exercises (53%). One third of treatment attempts were unsuccessful because of the unavailability/unsuitability of patients. Challenges for physiotherapists included frequent suspension of treatment and large functional fluctuations in patients.


CONCLUSIONS
There was a high referral rate to physiotherapy in this hospice. Functional changes in hospice patients were mapped, showing that physiotherapy involved both rehabilitative and quality of life/supportive measures. The most common treatments were physical activity interventions.
Physiotherapy Department, Milford Care Centre, Castletroy, Limerick, Ireland. sineadcobbe@gmail.com
Sinead
S
Cobbe
Norelee
N
Kennedy
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006738:Hospices; D006801:Humans; D007494:Ireland; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009043:Motor Activity; D026741:Physical Therapy Modalities; D012189:Retrospective Studies