Towards a common definition of hospital-acquired deconditioning in adults: a scoping review
Background Hospital-acquired deconditioning is a term used in clinical practice, describing a loss of physical and/or cognitive function associated with hospitalisation. Previous reviews have addressed interventions, its prevalence in older adults and potential assessment tools. However, each review...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/1/e086976.full |
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| author | Katie Robinson Alison Cowley Meri Westlake Adam L. Gordon |
| author_facet | Katie Robinson Alison Cowley Meri Westlake Adam L. Gordon |
| author_sort | Katie Robinson |
| collection | DOAJ |
| description | Background Hospital-acquired deconditioning is a term used in clinical practice, describing a loss of physical and/or cognitive function associated with hospitalisation. Previous reviews have addressed interventions, its prevalence in older adults and potential assessment tools. However, each review has reported a core limitation, the need for an agreed-upon definition and diagnostic criteria for hospital-acquired deconditioning.Objective We aimed to identify key components used to define hospital-acquired deconditioning in adults. We sought to do this by identifying diagnostic criteria, describing how authors operationalised Hospital- Acquired Deconditioning (HAD), and describing differences between HAD and other immobility-linked syndromes. This article focuses on how hospital-acquired deconditioning is understood and operationalised.Design A scoping review using the Joanna Briggs Institute methodology for evidence synthesis.Eligibility criteria Published in English after 1 January 1990, investigating adults over 18, set in inpatient rehabilitation or acute care settings, and including either a definition or description of hospital-acquired deconditioning or an outline of strategies to assess, prevent or manage hospital-acquired deconditioning.Sources of evidence Published and grey literature, no restriction was placed on study design.Charting methods Relevant data, where available, was extracted from each source using a proprietary data extraction template.Results One hundred and three articles were included from 2403 retrieved results. Thirty-three were from rehabilitation or post-acute care settings, 53 from acute care, 15 from intensive care and two from other settings. The literature was diverse in methodology and research question addressed. Hospital-acquired deconditioning was poorly defined, no consistent patterns were identified in aetiology and sequelae; diagnostic criteria were not fully agreed on.Conclusions The literature on hospital-acquired deconditioning is large, diverse and incomplete. Further work is required to develop a shared definition of hospital-acquired deconditioning, enabling researchers to coalesce for better understanding of the phenomenon, and clinicians, in turn, to better treat and mitigate against it.Review registration OSF: https://osf.io/b5sgw/ |
| format | Article |
| id | doaj-art-a4524f2c83a1471f866363307a3f2d8e |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a4524f2c83a1471f866363307a3f2d8e2025-01-17T19:35:14ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-086976Towards a common definition of hospital-acquired deconditioning in adults: a scoping reviewKatie Robinson0Alison Cowley1Meri Westlake2Adam L. Gordon31 University of Nottingham, Nottingham, UK2 Research & Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK1 University of Nottingham, Nottingham, UK3 Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UKBackground Hospital-acquired deconditioning is a term used in clinical practice, describing a loss of physical and/or cognitive function associated with hospitalisation. Previous reviews have addressed interventions, its prevalence in older adults and potential assessment tools. However, each review has reported a core limitation, the need for an agreed-upon definition and diagnostic criteria for hospital-acquired deconditioning.Objective We aimed to identify key components used to define hospital-acquired deconditioning in adults. We sought to do this by identifying diagnostic criteria, describing how authors operationalised Hospital- Acquired Deconditioning (HAD), and describing differences between HAD and other immobility-linked syndromes. This article focuses on how hospital-acquired deconditioning is understood and operationalised.Design A scoping review using the Joanna Briggs Institute methodology for evidence synthesis.Eligibility criteria Published in English after 1 January 1990, investigating adults over 18, set in inpatient rehabilitation or acute care settings, and including either a definition or description of hospital-acquired deconditioning or an outline of strategies to assess, prevent or manage hospital-acquired deconditioning.Sources of evidence Published and grey literature, no restriction was placed on study design.Charting methods Relevant data, where available, was extracted from each source using a proprietary data extraction template.Results One hundred and three articles were included from 2403 retrieved results. Thirty-three were from rehabilitation or post-acute care settings, 53 from acute care, 15 from intensive care and two from other settings. The literature was diverse in methodology and research question addressed. Hospital-acquired deconditioning was poorly defined, no consistent patterns were identified in aetiology and sequelae; diagnostic criteria were not fully agreed on.Conclusions The literature on hospital-acquired deconditioning is large, diverse and incomplete. Further work is required to develop a shared definition of hospital-acquired deconditioning, enabling researchers to coalesce for better understanding of the phenomenon, and clinicians, in turn, to better treat and mitigate against it.Review registration OSF: https://osf.io/b5sgw/https://bmjopen.bmj.com/content/15/1/e086976.full |
| spellingShingle | Katie Robinson Alison Cowley Meri Westlake Adam L. Gordon Towards a common definition of hospital-acquired deconditioning in adults: a scoping review BMJ Open |
| title | Towards a common definition of hospital-acquired deconditioning in adults: a scoping review |
| title_full | Towards a common definition of hospital-acquired deconditioning in adults: a scoping review |
| title_fullStr | Towards a common definition of hospital-acquired deconditioning in adults: a scoping review |
| title_full_unstemmed | Towards a common definition of hospital-acquired deconditioning in adults: a scoping review |
| title_short | Towards a common definition of hospital-acquired deconditioning in adults: a scoping review |
| title_sort | towards a common definition of hospital acquired deconditioning in adults a scoping review |
| url | https://bmjopen.bmj.com/content/15/1/e086976.full |
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