Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol

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Older people, particularly those with physical and social complexities are at risk of hospital-associated deconditioning, which is associated with increased length of stay in hospital, institutionalization, mortality, and increased healthcare costs. Thus, identification of effective approaches for the assessment, management, and prevention of HAD are pertinent. Occupational therapy has a potential role to play in prevention and treatment of HAD among older people. This scoping review will identify and map existing occupational therapy interventions which address deconditioning among older people. Methods This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. A comprehensive search strategy using relevant key words and index terms will be developed and applied across Embase (OVID), Medline (OVID), CINHAL (EBSCO), PsychInfo (ProQuest), SCOPUS databases. This will be followed by search of the reference lists of selected sources and hand-search relevant data-hubs. The search will cover studies published in English from January 2014 to the present date. Titles and abstracts will be screened against inclusion criteria. Data will be extracted using a form developed for this review. The Template for Intervention Description and Replication (TIDieR) checklist (Hoffmann et al., 2014) will be applied to papers where specific interventions are reported. Key information on assessment and intervention practices will be categorised and classified in a narrative summary. Conclusion This scoping review will examine current practice internationally regarding the role of occupational therapy in prevention and treatment of HAD among older people. 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HRB Open Res 2024, 7 :35 ( https://doi.org/10.12688/hrbopenres.13885.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol [version 1; peer review: 1 approved, 1 approved with reservations] Margaret Mc Grath https://orcid.org/0000-0002-4742-6805 1 , Fiona Condon https://orcid.org/0009-0000-1903-4196 2 , Megan Kiely 2 , Jenna Keane 2 , Ruth Usher https://orcid.org/0000-0001-9405-7080 1 Margaret Mc Grath https://orcid.org/0000-0002-4742-6805 1 , Fiona Condon https://orcid.org/0009-0000-1903-4196 2 , [...] Megan Kiely 2 , Jenna Keane 2 , Ruth Usher https://orcid.org/0000-0001-9405-7080 1 PUBLISHED 12 Jun 2024 Author details Author details 1 Occupational Therapy, University College Cork, Cork, County Cork, Ireland 2 Occupational Therapy, Cork University Hospital, Cork, Ireland Margaret Mc Grath Roles: Conceptualization, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Fiona Condon Roles: Conceptualization, Methodology, Writing – Review & Editing Megan Kiely Roles: Writing – Review & Editing Jenna Keane Roles: Writing – Review & Editing Ruth Usher Roles: Methodology, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Hospital-acquired deconditioning (HAD) is recognised as a state of reduced physiological, psychological, and functional after an acute hospitalization. Older people, particularly those with physical and social complexities are at risk of hospital-associated deconditioning, which is associated with increased length of stay in hospital, institutionalization, mortality, and increased healthcare costs. Thus, identification of effective approaches for the assessment, management, and prevention of HAD are pertinent. Occupational therapy has a potential role to play in prevention and treatment of HAD among older people. This scoping review will identify and map existing occupational therapy interventions which address deconditioning among older people. Methods This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. A comprehensive search strategy using relevant key words and index terms will be developed and applied across Embase (OVID), Medline (OVID), CINHAL (EBSCO), PsychInfo (ProQuest), SCOPUS databases. This will be followed by search of the reference lists of selected sources and hand-search relevant data-hubs. The search will cover studies published in English from January 2014 to the present date. Titles and abstracts will be screened against inclusion criteria. Data will be extracted using a form developed for this review. The Template for Intervention Description and Replication (TIDieR) checklist (Hoffmann et al. , 2014) will be applied to papers where specific interventions are reported. Key information on assessment and intervention practices will be categorised and classified in a narrative summary. Conclusion This scoping review will examine current practice internationally regarding the role of occupational therapy in prevention and treatment of HAD among older people. READ ALL READ LESS Keywords Older people; Hospital-acquired deconditioning syndrome; Occupational therapy; acute hospital; rehabilitation; Scoping Review Corresponding Author(s) Ruth Usher ( [email protected] ) Close Corresponding author: Ruth Usher Competing interests: No competing interests were disclosed. Grant information: This work was supported by the Evidence Synthesis Programme [ESI-2021-001]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2024 Mc Grath M et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Mc Grath M, Condon F, Kiely M et al. Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2024, 7 :35 ( https://doi.org/10.12688/hrbopenres.13885.1 ) First published: 12 Jun 2024, 7 :35 ( https://doi.org/10.12688/hrbopenres.13885.1 ) Latest published: 12 Jun 2024, 7 :35 ( https://doi.org/10.12688/hrbopenres.13885.1 ) Background Deconditioning syndrome is defined as a ‘condition of physiological, psychological and functional decline that occurs as a result of complex physical changes following prolonged bed rest and the associated loss of muscle strength’ ( Arora, 2022 ). Among older people hospital-associated deconditioning, also known as post-hospital syndrome, is well recognized, with up to 30% of older people experiencing functional decline following admission ( Loyd et al. , 2020 ). For older people, hospital-acquired deconditioning is associated with increased risk of mortality, increased likelihood of re-hospitalization and institutionalization within 12 months ( Hoyer et al. , 2014 ; van Rijn et al. , 2016 ). Moreover, for communities, hospital-acquired deconditioning is associated with higher healthcare spending and increased burden of care ( Falvey et al. , 2015 ). For this reason, there is an urgent need to identify effective approaches to prevent hospital-acquired deconditioning and to manage the impact on individuals and societies. Existing research has focused on exercised-based interventions, typically delivered by physiotherapists or exercise physiologists. A recent systematic review indicated limited evidence to support the use of such interventions ( Smith et al. , 2020 ) and other authors have suggested that deconditioning interventions should adopt a more holistic approach and address both physical and cognitive functioning ( Chen et al. , 2022 ). Occupational therapy has a potential role to play in prevention and treatment of hospital-associated deconditioning among older people. However, little is known about occupational therapy practice in this area and to date, no rigorous review of occupational therapy practice in this area has been published. A preliminary search of JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews and PROSPERO was completed in March 2024 and found no relevant completed or ongoing systematic or scoping reviews. Aim This scoping review will identify the following (i) what occupational therapy interventions exist to address deconditioning among older people and (ii) the intervention characteristics including outcomes used and impact observed. Inclusion criteria Participants The review will consider studies that involve older adults, defined as aged 65 years and over, with a diagnosis of hospital-acquired deconditioning syndrome. Concept We will consider all studies and publications of occupational therapy that provide information about interventions, approaches and procedures that are used to address hospital-acquired deconditioning among older people. Context This review will consider studies that describe interventions for older people admitted to a hospital setting, including acute or rehabilitation settings. Types of sources This scoping review will consider all types of quantitative, qualitative, or mixed-methods studies or reports describing occupational therapy approaches to address hospital-acquired deconditioning syndrome among older adults. Gray literature that includes information on occupational therapy and hospital-acquired deconditioning for older adults, including expert opinions and editorials, and papers and reports regarding policies and strategies in use by professional bodies or organizations will also be included. Methods The Joanna Briggs Institute (JBI) scoping review methodological framework ( Peters et al. , 2022 ) will be used. Study selection and analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta Analyses extension for scoping reviews guidelines ( Tricco et al. , 2018 ) for conducting a scoping review. Search strategy A systematic search strategy will be developed in collaboration with an academic librarian to identify relevant texts. Embase (OVID), Medline (OVID), CINHAL (EBSCO), PsychInfo (ProQuest), SCOPUS will be searched from inception. A sample search strategy for CINAHL (EBSCO) database is provided in Table 1 . The search will cover studies published in English from January 2014 to the present to ensure that included reports are relevant to current clinical practice. The reference list of identified reports and articles will be appraised and screened for additional studies. The titles and abstracts of all identified studies potentially eligible for inclusion in the review will be screened and full-text versions of included articles will be obtained. Authors of primary studies or reviews may be contacted for further information. Table 1. Search Search Terms 1 (MH "Acute Care") OR (MH "Inpatients") OR (MH "Hospital Units+") OR (MH "Rehabilitation, Geriatric") OR ( hospital OR "acute setting" OR "subacute" OR "sub-acute" OR "sub acute" OR "rehabilitation unit" OR "acute facilit*" OR "rehabilitation facilit*" OR "acute ward" OR inpatient* ) OR ( hospital OR "acute setting" OR "subacute" OR "sub-acute" OR "sub acute" OR "rehabilitation unit" OR "acute facilit*" OR "rehabilitation facilit*" OR "acute ward" OR inpatient* ) 2 "occupational therap*" OR "occupational therap*" 3 (MH "Frail Elderly") OR (MH "Aged+") OR (MH "Hospitalization of Older Persons") OR (MH "Gerontologic Care") OR ( "older adult*" OR elderly OR geriatric* or aging OR senior* OR "older people" OR "older person" OR "over 65" OR frail* OR "vulnerab*"OR "65+" ) OR ( "older adult*" OR elderly OR geriatric* or aging OR senior* OR "older people" OR "older person" OR "over 65" OR frail* OR "vulnerab*"OR "65+" ) 4 ( (hospital-associated OR hospital-acquired OR “hospital associated” OR “hospital acquired”) N10 (declin* OR function* OR decondition* OR deteriorat*) ) OR ( (hospital-associated OR hospital-acquired OR “hospital associated” OR “hospital acquired”) N10 (declin* OR function* OR decondition* OR deteriorat*) ) OR ( (hospitalisation OR "length of stay") N10 (function* OR "function* ability" OR "function* status” OR impair* OR declin* OR "functional dependenc*" OR decondition" OR deteriorat*) ) OR ( (hospitali?ation OR "length of stay") N10 (function* OR "function* ability" OR "function* status” OR impair* OR declin* OR "functional dependenc*" OR decondition" OR deteriorat*) ) OR (MH "Deconditioning") 5 S1 AND S2 AND S3 AND S4 Study selection Titles and abstracts will be screened against the inclusion criteria using COVIDENCE to manage the screening process. Duplicates will be removed. All papers will be independently reviewed by two researchers and conflicts resolved by a third reviewer. Data extraction Data extraction will be completed for all included texts using a standardized data extraction form developed for this review (see Table 2 ). We will extract data relating to the aims of the research/publication, demographics characteristics of older adults with hospital-acquired deconditioning, contexts in which occupational therapists were working, methods used to describe interventions and evaluate treatments and core research/publication findings. Where specific interventions are reported we will use the Template for Intervention Description and Replication (TIDieR) checklist ( Hoffmann et al. , 2014 ) to capture information about the intervention provided. The extraction form will be trialled on a small number of studies to ensure all relevant information is extracted. As the review is an iterative process, it will be further refined and continually updated. Table 2. Data Extraction Form. Data to be extracted Item Reviewer notes Publication characteristics Title Year of publication Author Study aims/purpose Type of study (e.g. feasibility study/pilot study/ CT/opinion piece) Country of origin Participant characteristics Sample size Inclusion criteria Age Sex Diagnoses/ Risk factors Socio-economic factors Dwelling place Discharge destination Intervention characteristics Assessment approaches Standardised/non-standardised approach Instruments used Element of deconditioning addressed (e.g. physical, psychological, cognitive, functional) Intervention time point Intervention duration Intervention location Healthcare professionals involved Intervention outcomes Gaps in research Gaps identified Recommendations for research Overall conclusion Data analysis The results of the search will be reported in full in the final scoping review report and presented in a PRISMA flow diagram. A narrative summary will be prepared to map where and how occupational therapy contributes to prevention and/or management of hospital acquired deconditioning among older people. Where appropriate data will be synthesised to provide a comprehensive account of assessment and intervention practices. The overall review questions will be used to present results and if appropriate gaps in current knowledge will be identified. Study status Database searches have been completed and title and abstract screening is currently underway. Data availability No data are associated with this article. Faculty Opinions recommended References Arora A: Time to move again: from deconditioning to reconditioning. Age Ageing. 2022; 51 (2): afab227. PubMed Abstract | Publisher Full Text Chen Y, Almirall-Sánchez A, Mockler D, et al. : Hospital-Associated Deconditioning: not only physical, but also cognitive. Int J Geriatr Psychiatry. 2022; 37 (3). PubMed Abstract | Publisher Full Text | Free Full Text Falvey JR, Mangione KK, Stevens-Lapsley JE: Rethinking Hospital-Associated Deconditioning: proposed paradigm shift. Phys Ther. 2015; 95 (9): 1307–1315. PubMed Abstract | Publisher Full Text | Free Full Text Hoffmann TC, Glasziou PP, Boutron I, et al. : Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014; 348 : g1687. PubMed Abstract | Publisher Full Text Hoyer EH, Needham DM, Atanelov L, et al. : Association of impaired functional status at hospital discharge and subsequent rehospitalization. J Hosp Med. 2014; 9 (5): 277–282. PubMed Abstract | Publisher Full Text | Free Full Text Loyd C, Markland AD, Zhang Y, et al. : Prevalence of Hospital-Associated Disability in older adults: a meta-analysis. J Am Med Dir Assoc. 2020; 21 (4): 455–461.e455. PubMed Abstract | Publisher Full Text | Free Full Text Peters MDJ, Godfrey C, McInerney P, et al. : Best practice guidance and reporting items for the development of scoping review protocols. JBI Evid Synth. 2022; 20 (4): 953–968. PubMed Abstract | Publisher Full Text Smith TO, Sreekanta A, Walkeden S, et al. : Interventions for reducing Hospital-Associated Deconditioning: a systematic review and meta-analysis. Arch Gerontol Geriatr. 2020; 90 : 104176. PubMed Abstract | Publisher Full Text Tricco AC, Lillie E, Zarin W, et al. : PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169 (7): 467–473. PubMed Abstract | Publisher Full Text van Rijn M, Buurman BM, MacNeil-Vroomen JL, et al. : Changes in the in-hospital mortality and 30-day post-discharge mortality in acutely admitted older patients: retrospective observational study. Age Ageing. 2016; 45 (1): 41–47. PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 12 Jun 2024 ADD YOUR COMMENT Comment Author details Author details 1 Occupational Therapy, University College Cork, Cork, County Cork, Ireland 2 Occupational Therapy, Cork University Hospital, Cork, Ireland Margaret Mc Grath Roles: Conceptualization, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Fiona Condon Roles: Conceptualization, Methodology, Writing – Review & Editing Megan Kiely Roles: Writing – Review & Editing Jenna Keane Roles: Writing – Review & Editing Ruth Usher Roles: Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information This work was supported by the Evidence Synthesis Programme [ESI-2021-001]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (1) version 1 Published: 12 Jun 2024, 7:35 https://doi.org/10.12688/hrbopenres.13885.1 Copyright © 2024 Mc Grath M et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Mc Grath M, Condon F, Kiely M et al. Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2024, 7 :35 ( https://doi.org/10.12688/hrbopenres.13885.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 12 Jun 2024 Views 0 Cite How to cite this report: Tse T. Reviewer Report For: Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2024, 7 :35 ( https://doi.org/10.21956/hrbopenres.15225.r41005 ) The direct URL for this report is: https://hrbopenresearch.org/articles/7-35/v1#referee-response-41005 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 18 Jul 2024 Tamara Tse , La Trobe University, Melbourne, Victoria, Australia Approved with Reservations VIEWS 0 https://doi.org/10.21956/hrbopenres.15225.r41005 Thank you for the opportunity to review this scoping review protocol looking at identifying and mapping exiting occupational therapy interventions which address deconditioning among older people. The review is timely and well written. The rational is well described and the ... Continue reading READ ALL Thank you for the opportunity to review this scoping review protocol looking at identifying and mapping exiting occupational therapy interventions which address deconditioning among older people. The review is timely and well written. The rational is well described and the methods align with the aim of the study. The inclusion and exclusion criteria, search strategy, study selection, data extraction are well described. I would like to know more about how the data will be synthesized and whether a particular approach or strategy will be used for the quantitative data, qualitative data and mixed methods data. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Teaching and research academic in occupational therapy with an interest in health services research, measuring and evaluating change and service improvement, including measures of participation I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Tse T. Reviewer Report For: Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2024, 7 :35 ( https://doi.org/10.21956/hrbopenres.15225.r41005 ) The direct URL for this report is: https://hrbopenresearch.org/articles/7-35/v1#referee-response-41005 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Thawisuk C. Reviewer Report For: Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2024, 7 :35 ( https://doi.org/10.21956/hrbopenres.15225.r40716 ) The direct URL for this report is: https://hrbopenresearch.org/articles/7-35/v1#referee-response-40716 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 03 Jul 2024 Chirathip Thawisuk , Chiang Mai University, Chiang Mai, Chiang Mai, Thailand Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15225.r40716 This protocol outlines a comprehensive scoping review of occupational therapy interventions for hospital-associated deconditioning (HAD) in older adults. The authors present a well-structured approach to map the literature on this important clinical topic. The review aims to identify existing ... Continue reading READ ALL This protocol outlines a comprehensive scoping review of occupational therapy interventions for hospital-associated deconditioning (HAD) in older adults. The authors present a well-structured approach to map the literature on this important clinical topic. The review aims to identify existing occupational therapy interventions for HAD in older adults and characterize their features and outcomes. Key strengths of the protocol include clear objectives, the use of established scoping review frameworks, and a comprehensive search strategy across multiple databases, including gray literature. The rigorous screening and data extraction processes enhance the review's potential value. By mapping current occupational therapy practices for HAD in older adults, this review has the potential to inform clinical practice and guide future research directions. The well-conceived protocol lays the groundwork for a valuable scoping review that could enhance our understanding of occupational therapy's role in addressing HAD among older adults. Overall, this review has the potential to significantly impact the field by providing a comprehensive overview of occupational therapy interventions for HAD in older adults. The insights gained from this review could prove invaluable in shaping both clinical practice and future research efforts in this important area of healthcare. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Occupational Therapy I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Thawisuk C. Reviewer Report For: Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2024, 7 :35 ( https://doi.org/10.21956/hrbopenres.15225.r40716 ) The direct URL for this report is: https://hrbopenresearch.org/articles/7-35/v1#referee-response-40716 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 12 Jun 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 1 12 Jun 24 read read Chirathip Thawisuk , Chiang Mai University, Chiang Mai, Thailand Tamara Tse , La Trobe University, Melbourne, Australia Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Tse T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 18 Jul 2024 | for Version 1 Tamara Tse , La Trobe University, Melbourne, Victoria, Australia 0 Views copyright © 2024 Tse T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for the opportunity to review this scoping review protocol looking at identifying and mapping exiting occupational therapy interventions which address deconditioning among older people. The review is timely and well written. The rational is well described and the methods align with the aim of the study. The inclusion and exclusion criteria, search strategy, study selection, data extraction are well described. I would like to know more about how the data will be synthesized and whether a particular approach or strategy will be used for the quantitative data, qualitative data and mixed methods data. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Teaching and research academic in occupational therapy with an interest in health services research, measuring and evaluating change and service improvement, including measures of participation I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Tse T. Peer Review Report For: Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2024, 7 :35 ( https://doi.org/10.21956/hrbopenres.15225.r41005) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/7-35/v1#referee-response-41005 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Thawisuk C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 03 Jul 2024 | for Version 1 Chirathip Thawisuk , Chiang Mai University, Chiang Mai, Chiang Mai, Thailand 0 Views copyright © 2024 Thawisuk C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This protocol outlines a comprehensive scoping review of occupational therapy interventions for hospital-associated deconditioning (HAD) in older adults. The authors present a well-structured approach to map the literature on this important clinical topic. The review aims to identify existing occupational therapy interventions for HAD in older adults and characterize their features and outcomes. Key strengths of the protocol include clear objectives, the use of established scoping review frameworks, and a comprehensive search strategy across multiple databases, including gray literature. The rigorous screening and data extraction processes enhance the review's potential value. By mapping current occupational therapy practices for HAD in older adults, this review has the potential to inform clinical practice and guide future research directions. The well-conceived protocol lays the groundwork for a valuable scoping review that could enhance our understanding of occupational therapy's role in addressing HAD among older adults. Overall, this review has the potential to significantly impact the field by providing a comprehensive overview of occupational therapy interventions for HAD in older adults. The insights gained from this review could prove invaluable in shaping both clinical practice and future research efforts in this important area of healthcare. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Occupational Therapy I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Thawisuk C. Peer Review Report For: Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2024, 7 :35 ( https://doi.org/10.21956/hrbopenres.15225.r40716) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/7-35/v1#referee-response-40716 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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