The population is aging and chronic conditions, which are major causes of pain and mobility
limitations, are on the rise, however, current access to physiotherapy is difficult.
Knowledge on managing disability is substantial, but methods to translate into action are
lacking. This project is designed to test a novel method of promoting function in vulnerable
seniors and simultaneously develop awareness in the new generation of physiotherapists that
they can have a proactive role in health promotion. The investigators are proposing a pilot
project targeting both students and patients.
The research question are (1) What are the needs of vulnerable patients at the MUHC? Two
groups will be targeted; newly discharged seniors (who will be eligible for an intervention)
and cancer outpatients who will be surveyed only);(2) For a senior population at risk for
physical deterioration, to what extent is a personalized mentoring approach to optimizing
function and preventing disability through developing self-management skills more effective
in improving outcomes than the provision of written material covering the same general
content? (3) Does a mentoring experience with vulnerable seniors through development and
teaching of a self-management program (comprised of education and support) produce meaningful
positive changes in future clinicians' knowledge, skills and attitude towards modes of
delivering physiotherapy services and promoting self-management in Canadian seniors?
There are two phases to this study: a survey and randomized controlled trial (RCT). The
survey phase will identify mobility needs of two groups, newly discharged seniors and cancer
outpatients. The needs assessment for newly discharged seniors will identify people eligible
for the (RCT) component; the needs assessment for cancer outpatients will inform the
development of interventions for this specific group. The RCT component will be piloted for
recently discharged community dwelling seniors 70 years and older only.
A sample of 400 seniors recently discharged from the adult, general, hospital sites of the
MUHC will be contacted for a needs assessment. From this pool, the investigators anticipate
100 will be eligible and 60 will be randomized, 30 to the mentor intervention and 30 to the
control group. Participants will be followed-up for 6 months and assessments will be
performed at 2 time points (baseline and 6 months). The main outcome is a standardized
response ratio (SRR) estimated across all persons and measures. SRRs will be calculated for
three groups of response variables: impairment/mobility measures, quality of life indicators,
and health services outcomes.
In parallel, to determine cancer survivor needs, the investigators will contact 600 cancer
survivors; as the investigators anticipate 400 will answer the survey. The analysis of this
survey will consist of frequency of specific needs by diagnosis and treatment.