Attitudes of Healthcare Staff Related to Using Point of Care Ultrasound for Frailty Assessment, A Qualitative Study-Advances in Geriatric Medicine and Research-CSCIED科技核心评价数据库-手机版

Attitudes of Healthcare Staff Related to Using Point of Care Ultrasound for Frailty Assessment, A Qualitative Study

Attitudes of Healthcare Staff Related to Using Point of Care Ultrasound for Frailty Assessment, A Qualitative Study

ES评分 0 浏览量：86 下载量：0

DOI	10.20900/agmr20250021
刊名	Advances in Geriatric Medicine and Research AGMR
年，卷(期)	2025, 7(4)
作者	Matthew Wang*,Anne L. Worth,Hillary B. Spangler,David H. Lynch,Ria Dancel,John A. Batsis,
作者单位	Division of Geriatric Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA ; Division of Hospital Medicine, University of North Carolina Hospitals, Chapel Hill, NC 27514, USA ; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA ;
摘要	Frailty is a common syndrome in older adults that informs many aspects of patient care. Recent studies suggest that point-of-care ultrasound (POCUS) may be useful in bedside frailty assessment by identifying muscle characteristics associated with frailty such as decreased muscle thickness and increased intramuscular fat. To explore current perspectives on using POCUS in frailty assessment as well as frailty assessment practices, we conducted semi-structured interviews with 22 interdisciplinary staff in a specialized geriatrics unit. Responses were coded and analyzed to inductively determine common themes. Frailty definitions and assessment methods varied widely across and within disciplines. Patient cooperation and time were perceived as main barriers to frailty assessment. Objective measures were not employed by most participants. Most participants were familiar with POCUS and thought it could be helpful to assess frailty. Reported potential barriers to implementation included time, cost, training, and patient cooperation. POCUS offers objective evidence of frailty in hospitalized older adults who are often unable to fully participate in standardized frailty assessments. This qualitative study highlights a need for standardization and objectivity in current practice while identifying practical considerations for implementing POCUS.
Abstract	Frailty is a common syndrome in older adults that informs many aspects of patient care. Recent studies suggest that point-of-care ultrasound (POCUS) may be useful in bedside frailty assessment by identifying muscle characteristics associated with frailty such as decreased muscle thickness and increased intramuscular fat. To explore current perspectives on using POCUS in frailty assessment as well as frailty assessment practices, we conducted semi-structured interviews with 22 interdisciplinary staff in a specialized geriatrics unit. Responses were coded and analyzed to inductively determine common themes. Frailty definitions and assessment methods varied widely across and within disciplines. Patient cooperation and time were perceived as main barriers to frailty assessment. Objective measures were not employed by most participants. Most participants were familiar with POCUS and thought it could be helpful to assess frailty. Reported potential barriers to implementation included time, cost, training, and patient cooperation. POCUS offers objective evidence of frailty in hospitalized older adults who are often unable to fully participate in standardized frailty assessments. This qualitative study highlights a need for standardization and objectivity in current practice while identifying practical considerations for implementing POCUS.
关键词	frailty; assessment; qualitative; hospitalizations; ultrasound; interdisciplinary
KeyWord	frailty; assessment; qualitative; hospitalizations; ultrasound; interdisciplinary
基金项目
页码	-

参考文献
相关文献

1.Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: Implications for clinical practice and public health. Lancet. 2019;394:1365-75.
2.Chen X, Mao G, Leng SX. Frailty syndrome: An overview. Clin Interv Aging. 2014;9:433-41.
3.O’Caoimh R, Sezgin D, O’Donovan MR, Molloy DW, Clegg A, Rockwood K, et al. Prevalence of frailty in 62 countries across the world: A systematic review and meta-analysis of population-level studies. Age Ageing. 2021;50:96-104.
4.Bandeen-Roche K, Seplaki CL, Huang J, Buta B, Kalyani RR, Varadhan R, et al. Frailty in older adults: A nationally representative profile in the United States. J Gerontol A Biol Sci Med Sci. 2015;70:1427-34.
5.Ghosh TS, Rampelli S, Jeffery IB, Santoro A, Neto M, Capri M, et al. Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across five European countries. Gut. 2020;69:1218-28.
6.Serra-Prat M, Sist X, Domenich R, Jurado L, Saiz A, Roces A, et al. Effectiveness of an intervention to prevent frailty in pre-frail community-dwelling older people consulting in primary care: A randomised controlled trial. Age Ageing. 2017;46(3):401-7. doi: 10.1093/ageing/afw242.
7.Ng TP, Feng L, Nyunt MSZ, Feng L, Niti M, Tan BY, et al. Nutritional, physical, cognitive, and combination interventions and frailty reversal among older adults: A randomized controlled trial. Am J Med. 2015;128:1225-36.e1.
8.Sadjapong U, Yodkeeree S, Sungkarat S, Siviroj P. Multicomponent exercise program reduces frailty and inflammatory biomarkers and improves physical performance in community-dwelling older adults: A randomized controlled trial. Int J Environ Res Public Health. 2020;17(11):3760. doi: 10.3390/ijerph17113760.
9.Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16:601-8.
10.Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146-57.
11.Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. ScientificWorldJournal. 2001;1:323-36.
12.Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173:489-95.
13.Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: A review. Eur J Intern Med. 2016;31:3-10.
14.Remskar MH, Theophanous R, Bowman A, Simonson LE, Koehler J, Basrai Z, et al. Current use, training, and barriers of point-of-care ultrasound in anesthesiology: A national survey of Veterans Affairs Hospitals. J Cardiothorac Vasc Anesth. 2023;37:1390-6.
15.Finn EM, Zwemer EK, Stephens JR, Dancel R. The state of internal medicine point-of-care ultrasound (POCUS) fellowships in the United States and Canada. Am J Med. 2023;136:830-6.
16.Arnold M, Jonas C, Carter R. Point-of-care ultrasonography. Am Fam Physician. 2020;101:275-85.
17.Mazzarone T, Morelli V, Giusti A, Bianco MG, Maccioni L, Cargiolli C, et al. Predicting in-hospital acute heart failure worsening in the oldest old: Insights from point-of-care ultrasound. J Clin Med. 2023;12(23):7423. doi: 10.3390/jcm12237423.
18.Shimoni Z, Fruger E, Froom P. Measurement of post-void residual bladder volumes in hospitalized older adults. Am J Med. 2015;128:77-81.
19.Gottlieb M, Avila J, Chottiner M, Peksa G. Point-of-care ultrasonography for the diagnosis of skin and soft tissue abscesses: A systematic review and meta-analysis. Ann Emerg Med. 2020;76:67-77.
20.Benton E, Liteplo AS, Shokoohi H, Loesche MA, Yacoub S, Thatphet P, et al. A pilot study examining the use of ultrasound to measure sarcopenia, frailty and fall in older patients. Am J Emerg Med. 2021;46:310-6.
21.Ticinesi A, Meschi T, Narici MV, Lauretani F, Maggio M. Muscle ultrasound and sarcopenia in older individuals: A clinical perspective. J Am Med Dir Assoc. 2017;18:290-300.
22.Burton AM, Stock MS. Consistency of novel ultrasound equations for estimating percent intramuscular fat. Clin Physiol Funct Imaging. 2018;38(6):1062-6. doi: 10.1111/cpf.12532.
23.Fu H, Wang L, Zhang W, Lu J, Yang M. Diagnostic test accuracy of ultrasound for sarcopenia diagnosis: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2023;14:57-70.
24.Bencivenga L, Picaro F, Ferrante L, Komici K, Ruggiero F, Sepe I, et al. Muscle ultrasound as imaging domain of frailty. Front Med (Lausanne). 2022;9:922345.
25.Hafızoğlu M, Yıldırım HK, Okyar Baş A, Karaduman D, Şahiner Z, Doğu BB, et al. Role of muscle ultrasound in frailty assessment in older adults with type 2 diabetes mellitus. BMC Geriatr. 2024;24:397.
26.Lv S, Ling L, Shi H, Chen X, Chen S, Zhu S, et al. Application of muscle thickness and quality measured by ultrasound in frailty assessment in China. Front Med (Lausanne). 2022;9:859555. doi: 10.3389/fmed.2022.859555.
27.Nijholt W, Scafoglieri A, Jager-Wittenaar H, Hobbelen JSM, van de Schans CP. The reliability and validity of ultrasound to quantify muscles in older adults: A systematic review. J Cachexia Sarcopenia Muscle. 2017;8:702-12.
28.Harris-Love MO, Avila NA, Adams B, Zhou J, Seamon B, Ismail C, et al. The comparative associations of ultrasound and computed tomography estimates of muscle quality with physical performance and metabolic parameters in older men. J Clin Med. 2018;7:340.
29.Casey P, Alasmar M, McLaughlin J, Ang Y, McPhee J, Heire P, et al. The current use of ultrasound to measure skeletal muscle and its ability to predict clinical outcomes: A systematic review. J Cachexia Sarcopenia Muscle. 2022;13:2298-309.
30.Guerreiro AC, Tonelli AC, Orzechowski R, Dalla Corte RR, Moriguchi EH, de Melle RB. Bedside ultrasound of quadriceps to predict rehospitalization and functional decline in hospitalized elders. Front Med (Lausanne). 2017;4:00122. doi: 10.3389/fmed.2017.00122.
31.Akazawa N, Kishi M, Hino T, Tsuji R, Tamura K, Hioka A, et al. Intramuscular adipose tissue in the quadriceps is more strongly related to recovery of activities of daily living than muscle mass in older inpatients. J Cachexia Sarcopenia Muscle. 2021;12:891-9.
32.Gogtay M, Choudhury RS, Williams JP, Mader MJ, Murray KJ, Haro EK, et al. Point-of-care ultrasound in geriatrics: A national survey of VA medical centers. BMC Geriatr. 2023;23:605.
33.Norman RE, Sinha SK. Patient outcomes related to receiving care on a dedicated Acute Care for Elders (ACE) unit versus with an ACE order set. J Am Geriatr Soc. 2022;70:2101-6.
34.Wong J, Montague S, Wallace P, Negishi K, Liteplo A, Ringrose J, et al. Barriers to learning and using point-of-care ultrasound: A survey of practicing internists in six North American institutions. Ultrasound J. 2020;12:19.

引用本文

Matthew Wang*,Anne L. Worth,Hillary B. Spangler,David H. Lynch,Ria Dancel,John A. Batsis. Attitudes of Healthcare Staff Related to Using Point of Care Ultrasound for Frailty Assessment, A Qualitative Study [J]. Advances in Geriatric Medicine and Research. 2025; 7; (4). - .

文献评论

相关学者

相关机构