To establish the impairments and functional limitations in patients with chronic conditions at three academic hospitals, in Johannesburg Metropolitan, South Africa.
We conducted a retrospective cross-sectional study including adult palliative care patients diagnosed with life-threatening illnesses. Demographics and clinical information (diagnosis, ECOG-PS, and other comorbidities) were collected. The Eastern Cooperative Oncological Group Performance Scale (ECOG) was used to determine the performance status of patients. Pearson’s Chi-square was applied, and statistical significance was reported at P0.05.
4, 098 patients were enrolled. The most prevalent chronic conditions were cancer (75%), HIV (53.85), hypertension (26.2%), TB (13%) and diabetes (8.4%). Impairments identified included pain (81%); shortness of breath (38.8%); lack of energy (76%); drowsiness (43%) and poor mobility (67%). Level of performance was restricted in 47% of the patients and 21% were completely bedridden. Of the 4091 assessed for ECOG Performance score, 26.3% were ambulatory and capable of self-care but unable to carry out work activities. 21.2% were capable of limited self-care, confined to bed/chair for more than 50% of waking hours and 13 (0.3%) patients were 100% bedridden.
Patients with chronic conditions experience multiple impairments and limitations in functioning. The results complement other research on functional decline related to chronic diseases.
These results highlight the need for rehabilitation services in chronic service delivery. Patients with chronic conditions can be screened for impairments and referred to physiotherapy to manage the impairments and improve functional ability.
impairments
Functional limitation
