[Rehabilitation in residential long-term care : Longitudinal study of functional independence, quality of life and return home].

BACKGROUND

The rehabilitation-oriented approach is gaining relevance in residential long-term care; however, the empirical evidence remains fragmented.

OBJECTIVE

This study examined patient-related outcomes of a structured rehabilitation-oriented nursing approach in long-term care, focusing on functional independence, perceived health, health-related quality of life and return to private home.

METHOD: A prospective single-arm study was conducted in three long-term care facilities with assessments at three time points (T0, T1 and T2). From the 90 recruited patients, 67 were included. The outcomes included the SINGER score (Scores of Independence for Neurologic and Geriatric Rehabilitation), the Barthel index, the SF-36 score (Short Form Health Survey) and HPEASKD (German short version of Hertz perceived enactment of autonomy scale [HPKD]). Longitudinal changes were analyzed using repeated measures general linear models.

RESULTS

The functional independence increased descriptively from T0 to T2, without a significant T0-T2 time effect (p = 0.306). The perception of general health showed a significant time effect (p = 0.023). Significant time effects were also observed in the SF-36 domains of physical functioning, physical role functioning, social functioning, mental health and the mental component summary scale. Within 6 months 32.8% of the patients (n = 22) returned to their private homes.

CONCLUSION

Under real-world conditions, no uniform pattern of change was observed across all outcomes. The findings are consistent with the international discourse on functional ability, reablement and geriatric rehabilitation; however, interpretation of the observed trajectories and return home events is limited by the nonrandomized design, selective allocation to the lighthouse group and selective attrition over time; causal conclusions regarding effectiveness cannot be drawn.