Development of nursing guidelines for early exercise combined with pulmonary rehabilitation for the patient whom are older and bedridden: A Delphi study
Year: 2025
Type: article
Abstract: • A stratified, function-based rehabilitation framework tailored for older bedridden adults using the modified Barthel Index, enabling personalized and scalable interventions. • Integration of evidence, guidelines, and expert consensus into a cohesive early exercise and pulmonary rehabilitation program within a medical consortium model. • Rigorous development and validation process using a two-round Delphi method with multidisciplinary experts, ensuring high content validity and clinical applicability. • A standardized, interdisciplinary intervention protocol designed to enhance care coordination and promote consistent, high-quality nursing and rehabilitation services. Develop a graded scheme for early exercise and lung rehabilitation for patients whom are older and bedridden, using the Barthel Index as a foundation, to guide clinical nurses and support the creation of standardized nursing guidelines. An interdisciplinary geriatric team (GIT) developed an early exercise and pulmonary rehabilitation program for older bedridden adults within a medical consortium model. The initial plan was informed by a systematic literature review and clinical guidelines, and stratified by functional status using the modified Barthel Index (MBI). Two rounds of Delphi consultations with multidisciplinary experts were conducted to refine the content and reach consensus. Iterative revisions ensured high agreement, resulting in an evidence- and expert-informed intervention framework. After two rounds of Delphi consultation with 10 multidisciplinary experts, a structured early exercise and pulmonary rehabilitation program for older bedridden adults was developed. The final framework consists of 24 items across four domains, informed by high expert authority (Cr = 0.91–0.99) and strong consensus. Experts demonstrated statistically significant agreement (Kendall’s W = 0.418–0.539, both P < 0.05), with high mean importance scores (4.15–5.00) and acceptable full-score rates. Key revisions included expanded exercise components, integration of limb-specific instructions, and incorporation of music therapy in advanced stages. The program is delivered over 8 weeks, with 5 sessions per week, each lasting approximately 50 minutes. The integrated early exercise and lung rehabilitation program is scientifically sound and reliable, contributing to uniform nursing quality and serving as a valuable reference for related research and practice.
Source: Geriatric Nursing
Author: Xuting Lu
Institutions: Nanjing First Hospital, Nanjing Medical University
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,280
Funder: Nanjing Medical University
OpenAlex ID: W4414482244