Banbury, Mark

Chan, Hei Chun (Nicholas)

Collins, Clare E.

de van der Schueren, Marian

Fei, Xinzhu (Allison)

Giang, Joanna

Isenring, Elisabeth

Marshall, Skye

Milte, Rachel

Van der Meij, Barbara S

Warner, Molly

English

Bond University Research Portal

Bond UniversityResearch RepositoryThe FREER Pilot Study: Family in rehabilitation: empowering carers for improved malnutritionoutcomesMarshall, Skye; Fei, Xinzhu (Allison); Giang, Joanna; Warner, Molly; Chan, Hei Chun(Nicholas); Isenring, Elisabeth; Van der Meij, Barbara S; Collins, Clare E.; de van derSchueren, Marian; Banbury, Mark; Milte, RachelUnpublished: 14/10/2020Document Version:Peer reviewed versionLicence:CC BY-NC-NDLink to publication in Bond University research repository.Recommended citation(APA):Marshall, S., Fei, X. A., Giang, J., Warner, M., Chan, H. C. N., Isenring, E., Van der Meij, B. S., Collins, C. E., devan der Schueren, M., Banbury, M., & Milte, R. (2020). The FREER Pilot Study: Family in rehabilitation:empowering carers for improved malnutrition outcomes. 2020 Bond University HSM Medical & PostgraduateStudents Research Virtual Conference, Australia.General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright ownersand it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.For more information, or if you believe that this document breaches copyright, please contact the Bond University research repositorycoordinator.Download date: 22 Nov 2020The FREER Pilot StudyFamily in Rehabilitation: EmpowERing Carers forImproved Malnutrition OutcomesXinzhu (Allison) FeiMaster of Nutrition and Dietetic PacticeResearch TeamDr. Skye Marshall Molly Warner Joanna Giang Xinzhu FeiHei Chun Nicholas Chan Dr. Elizabeth Isenring Dr. Barbara van de Meij Dr. Clare CollinsDr. Marian de van der SchuerenMark Banbury Dr. Rachel MilteBackgroundhttps://www.thesun.co.uk/news/10872640/number-of-elderly-patients-admitted-to-hospital-with-malnutrition-rise-by-250-figures-reveal/Marshall, S., Young, A., Bauer, J., & Isenring, E. (2016). Malnutrition in Geriatric Rehabilitation: Prevalence, Patient Outcomes, and Criterion Validity of the Scored Patient-Generated Subjective Global Assessment and the Mini Nutritional Assessment..BarriersProtein-Energy Malnutrition 50% for RehabilitationMarshall, S., Young, A., Bauer, J., & Isenring, E. (2015). Malnourished older adults admitted to rehabilitation in rural New South Wales remain malnourished throughout rehabilitation and once discharged back to the community: A prospective cohort study. Journal of Aging Research & Clinical Practice, 4, 197-204. doi:10.14283/jarcp.2015.72Short-term nutrition care during rehabilitation admission is not sufficient for long-term nutrition outcomes for older inpatients.Issuehttps://www.theguardian.com/world/2020/mar/13/experts-question-bupa-care-home-ban-on-most-family-visitshttps://www.nursingtimes.net/clinical-archive/dementia/helping-family-carers-to-cope-with-dementia-11-07-2016/Patient- and Family Carer- Centred Care ModelObjectivesThe primary outcome aimed to determine if the FREER intervention in malnourished older adults during and post-rehabilitation improve nutritional status, compared with the usual care.Secondary outcomes evaluated physical function, quality of life, hospital and aged care admission post-discharge, family carer burden, and patient and family carer service satisfaction.MethodA pragmatic two-arm historically-controlled prospective pilot intervention study.Rehabilitation unit in rural New South Wales, Australia.Older adults (≥65 years) Historically Controlled group: Patient- centred care1. Standard High Protein High Energy diet during admission.2. Standard nutrition support.The FREER Intervention: Intervention group: Patient- and Family care- centred nutrition care using 3 strategies:1. Nutrition counselling during rehabilitation admission2. Telehealth follow-up during 3-month post-discharge3. Provision of individualized education resourcesVSMarshall, S., Young, A., Bauer, J., & Isenring, E. (2015). Malnourished older adults admitted to rehabilitation in rural New South Wales remain malnourished throughout rehabilitation and once discharged back to the community: A prospective cohort study. Journal of Aging Research & Clinical Practice, 4, 197-204. doi:10.14283/jarcp.2015.72Finding 1: Nutrition Status.6037.562.510050700102030405060708090100Admission to discharge Discharge to 3-month post-discharg Admission to 3-month post-dischargepercentage of participant %Improvement in Nutritional Assessment score Between two groups between timepointscontrol interventionP=0.74P=0.01*P=0.60Finding 2:• More participants in the intervention group were discharged to the community (home or to family and friends), and fewer were institutionalised compared to the control group (p<0.01). https://www.woundsource.com/blog/tips-and-tricks-discharging-patients-woundsFinding 3: Carer burden.• Little or no burden was reported to most of family carers pre and post the rehabilitation (>80%, n=10 at 3-month post-discharge).• Participants (67%) and family carers (60%) reported a good or very good overall satisfaction with the intervention.https://supercarers.com/blog/being-a-family-caregiver/Discussion & Recommendation Positive impactsTranslation into practiceInform a full RCTGrowing demandContinuum of nutrition care policyLimitationsStudy design: used historical control group.Data collection was not blinded.AcknowledgementHannah Mayr: APD, Subject ConvenorEvelyn Rathbone: Bond Statistician Conflicts of interest: None declared.Funding: This research was fund by Bond University Faculty  GrantReferenceMarshall, S., Young, A., Bauer, J., & Isenring, E. (2016). Malnutrition in Geriatric Rehabilitation: Prevalence, Patient Outcomes, and Criterion Validity of the Scored Patient-Generated Subjective Global Assessment and the Mini Nutritional Assessment. J Acad Nutr Diet, 116(5), 785-794. doi:10.1016/j.jand.2015.06.013Marshall, S., Young, A., Bauer, J., & Isenring, E. (2015). Malnourished older adults admitted to rehabilitation in rural New South Wales remain malnourished throughout rehabilitation and once discharged back to the community: A prospective cohort study. Journal of Aging Research & Clinical Practice, 4, 197-204. doi:10.14283/jarcp.2015.72Allen, D., Scarinci, N., & Hickson, L. (2018). The Nature of Patient- and Family-Centred Care for Young Adults Living with Chronic Disease and their Family Members: A Systematic Review. International journal of integrated care, 18(2), 14-14. doi:10.5334/ijic.3110Thank You !Questions?

The FREER Pilot Study: Family in rehabilitation: empowering carers for improved malnutrition outcomes

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The FREER Pilot Study: Family in rehabilitation: empowering carers for improved malnutrition outcomes

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