Telehealth-Supported Discharge Programme for Frail Older Adults

Physical fitness will be assessed using the Senior Fitness Test (SFT), which is comprised of seven tests that evaluate body strength, flexibility, agility, aerobic capacity, and body composition. The tests include the following: 30-second chair stand, 30-second arm curl, 2-minute step test, chair sit-and-reach, back scratch, 8-foot-up-and-go, and 2-minute step-in-place test. Each component is scored separately using standardized units (e.g., number of repetitions, distance, or time), with higher scores generally indicating better physical fitness, except for timed tests (e.g., 8-foot up-and-go), where lower times indicate better performance.

Functional independence will be evaluated using the Katz Index of Independence in Activities of Daily Living (ADL). The Katz Index of Independence in ADL is a 6-item tool that assesses basic self-care abilities, such as feeding, bathing, dressing, transferring, toileting, and mobility. Total scores range from 0 to 6, with higher scores indicating greater independence in self-care activities.

Functional independence will also be evaluated using the Lawton Instrumental Activities of Daily Living (IADL) Scale. The Lawton IADL Scale consists of 8 items that evaluate complex activities for independent living, such as preparing meals, handling finances, using transportation, housekeeping, doing laundry, shopping, using the telephone, and taking medications. Total scores range from 0 to 8, with higher scores indicating greater independence in instrumental activities.

Depressive symptoms will be measured by the 4-item Geriatric Depression Scale (GDS-4). The GDS-4 consists of four dichotomous (yes/no) items, with total scores ranging from 0 to 4. Higher scores indicate greater depressive symptoms.

Social support will be assessed using the 10-item Duke Social Support Index (DSSI), which evaluates constructs such as social satisfaction and social interaction. Total scores range from 0 to 30, with higher scores reflecting greater perceived levels of social support.

Health-related quality of life (QoL) will be assessed using the EuroQol 5 Dimension 5-Level (EQ-5D-5L) questionnaire. The instrument aims to evaluate the following five QoL dimensions: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Each dimension is rated on five levels, which include no problems (1), slight problems (2), moderate problems (3), severe problems (4), and extreme problems/unable to perform (5). Responses can be calculated into a single index score, typically ranging from less than 0 (worse than death) to 1 (full health), with higher scores indicating better health-related QoL.

Subjective well-being will be measured using the 5-item WHO Well-being Index, which assesses mental well-being over the past two weeks. The scale is comprised of five positively worded items rated on a 6-point Likert scale, yielding a total score ranging from 0 to 25. Higher scores indicate greater subjective well-being, with a cutoff below 13 suggesting poor well-being.

Participants will provide self-reported data on the use of inpatient hospital services from the Client Service Receipt Inventory (CRSI).

Participants will provide self-reported data on the use of inpatient hospital services from the CRSI.

Participants will provide self-reported data on the use of inpatient hospital services from the CRSI.