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Dahlke S, Rayner JA, Fetherstonhaugh D, Butler JI, Kennedy M. Gerontological educational interventions for student nurses: a systematic review of qualitative findings. Int J Nurs Educ Scholarsh 2025; 22:ijnes-2023-0042. [PMID: 38459787 DOI: 10.1515/ijnes-2023-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/28/2023] [Indexed: 03/10/2024]
Abstract
OBJECTIVES This systematic review of qualitative studies explored interventions to improve student nurses' knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing. METHODS Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses' knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies. CONCLUSIONS Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students' negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses' knowledge, attitudes, and willingness to work with older people, so that they can be replicated.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Jo-Anne Rayner
- ACEBAC, 2080 La Trobe University , Bundoora, VIC, Australia
| | | | | | - Megan Kennedy
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Ku GMV, van de Put W, Katsuva D, Ahmed MAA, Rosenberg M, Meessen B. Quality of care for chronic conditions: identifying specificities of quality aims based on scoping review and Delphi survey. Glob Health Action 2024; 17:2381878. [PMID: 39149932 PMCID: PMC11332280 DOI: 10.1080/16549716.2024.2381878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/12/2024] [Indexed: 08/17/2024] Open
Abstract
There is a growing need to implement high quality chronic care to address the global burden of chronic conditions. However, to our knowledge, there have been no systematic attempts to define and specify aims for chronic care quality. To address this gap, we conducted a scoping review and Delphi survey to establish and validate comprehensive specifications. The Institute of Medicine's (IOM) quality of care definition and aims were used as the foundation. We purposively selected articles from the scientific (n=48) and grey literature (n=26). We sought papers that acknowledged and unpacked the plurality of quality in chronic care and proposed or utilised frameworks, studied their implementation, or investigated at least two IOM quality care aims and implementation. Articles were analysed both deductively and inductively. The findings were validated through a Delphi survey involving 49 international chronic care experts with varied knowledge of, and experience in, low-and-middle-income countries. Considering the natural history of chronic conditions and the journey of a person with a chronic condition, we defined and identified the aims of chronic care quality. The six IOM aims apply with specific meanings. We identified a seventh aim, continuity, which relates to the issue of chronicity. The group endorsed our specifications and several participants gave contextualised interpretations and concrete examples. Chronic conditions pose specific challenges underscoring the relevance of tailoring quality of care aims. The next steps require a tailored definition and specific aims to improve, measure and assure the quality of chronic care.
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Affiliation(s)
- Grace Marie V. Ku
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Gerontology, Faculty of Medicine & Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Preventive Medicine, Faculty of Medicine & Surgery, University of Santo Tomas, Manila, Philippines
| | - Willem van de Put
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Deogratias Katsuva
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Mohamad Ali Ag Ahmed
- Sherpa University Institute, Montreal, Canada
- Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, Canada
| | - Megumi Rosenberg
- Centre for Health Development, World Health Organization, Kobe, Japan
| | - Bruno Meessen
- Health Financing and Economics Department, World Health Organization, Geneva, Switzerland
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Gerbaudo-González N, Rodríguez-González R, Facal-Mayo D, Gandoy-Crego M. Personalized interactive multimedia systems to support meaningful activities in dementia care: A systematic review To be published in: Archives of Gerontology and Geriatrics. Arch Gerontol Geriatr 2024; 127:105575. [PMID: 39038393 DOI: 10.1016/j.archger.2024.105575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 07/09/2024] [Accepted: 07/13/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND AND OBJECTIVES Interactive multimedia systems are widely used to enhance participation in meaningful activities for older people living with dementia. This review aims to analyze and synthesize current evidence regarding personalization of these systems, by considering the type of content included, the selection process and the experience of people living with dementia when interacting with the content. MATERIALS AND METHODS In accordance with PRISMA guidelines (PROSPERO registration number blinded for review), a systematic search was undertaken across 4 databases. Meta-aggregation pooled data for synthesis. RESULTS A total of 520 articles were identified from searches in four databases, and 15 were included in this review. Two classes of content were identified: personal, often autobiographical; and curated, carefully chosen generic content appropriate for a wider group of people in the demographic. Variety of content can act as a trigger for autobiographical memories. Personalized music enhanced a desire to engage and prompted meaningful interactions among participants. DISCUSSION AND IMPLICATIONS Despite some differences in the selected studies, the findings enabled us outline key points to consider when personalizing interactive multimedia systems for people living with dementia. Further research should focus on studying the social condition of the target users during the personalization process and on the benefits for caregivers.
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Affiliation(s)
- Noelia Gerbaudo-González
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Raquel Rodríguez-González
- Department of Psyquiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Spain
| | - David Facal-Mayo
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Manuel Gandoy-Crego
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
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Liu M, Wang Y, Zeng Q, Li J, Yang L, Zeng Y. Prevalence of involuntary treatment among community-living older persons with dementia: A systematic review. Arch Gerontol Geriatr 2024; 127:105574. [PMID: 39059035 DOI: 10.1016/j.archger.2024.105574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 06/25/2024] [Accepted: 07/07/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to ascertain the prevalence of involuntary treatment among community-living older persons with dementia and explore associated factors. METHODS We comprehensively searched seven electronic databases (PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, and Scopus) from their inception to October 17, 2023, with an update conducted on April 1, 2024. Meta-analysis synthesized prevalence estimates of involuntary treatment and its three subcategories, with 95% confidence intervals. RESULTS This study included 11 research papers involving 12,136 community-dwelling individuals with cognitive impairment and dementia from 19 countries. The pooled prevalence of involuntary treatment among community-dwelling older persons with dementia was 45.2% (95% CI: 33.7-60.5%). Subcategories included physical restraints (9.8%, 95% CI: 5.1-18.8%), psychotropic medication (19.1%, 95% CI: 13.6-26.9%), and non-consensual care (34.3%, 27.6-42.7%). Factors influencing involuntary treatment were categorized as caregiver-related and care recipient-related. CONCLUSION This study underscores the prevalent use of involuntary treatment among community-dwelling older persons with dementia, emphasizing its association with specific caregiver and care recipient factors. Addressing these findings underscores the importance of proactive measures and targeted interventions to improve the quality of care for this vulnerable population.
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Affiliation(s)
- Minyan Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuqiang Wang
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Qinglin Zeng
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Jia Li
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Liping Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yanli Zeng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
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Huang CJ, Hsu NW, Chen HC. Prevalence, dimensions, and correlates of excessive daytime sleepiness in community-dwelling older adults: the Yilan study, Taiwan. Ann Med 2024; 56:2352028. [PMID: 38803075 PMCID: PMC11136468 DOI: 10.1080/07853890.2024.2352028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Daytime sleepiness is an important health problem. However, the dimensionality of the Epworth Sleepiness Scale (ESS) in older adults remains unclear. This study aimed to determine the prevalence of ESS-defined excessive daytime sleepiness in older adults. Furthermore, the dimensionality of ESS and its respective correlates were also compared. MATERIALS AND METHODS This is a community-based survey in which community-dwelling older adults aged ≥ 65 years participated. Excessive daytime sleepiness was assessed using the ESS and was defined as an ESS score of > 10. Exploratory factor analysis was performed to identify the ESS factors. Multiple logistic regression analysis was used to examine the independent correlates of the ESS-defined and factor-specific correlates of excessive daytime sleepiness. RESULTS In total, 3978 older adults participated in this study. The mean age was 76.6 ± 6.7 years, with 53.8% ≥ 75 years, and 57.1% were female. The prevalence of ESS-defined excessive daytime sleepiness was 16.0%. An exploratory factor analysis revealed two factors in the ESS, which were designated as 'passive' and 'active' according to the soporific levels of ESS items loaded in each factor. Multiple logistic regression showed that male, illiteracy, depression, disability, short sleep duration and no exposure to hypnotics were risk indicators for ESS-defined excessive daytime sleepiness. However, the correlates for passive and active factor-defined excessive daytime sleepiness differ in pattern, especially in variables related to education, exercise, mental health, and sleep. CONCLUSIONS The prevalence of ESS-defined excessive daytime sleepiness is high, and its correlates vary among older adults. This study also suggests a dual ESS structure in community-dwelling older adults.
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Affiliation(s)
- Chiu-Jui Huang
- Department of Medical Education, National Taiwan University Hospital, Taiwan
| | - Nai-Wei Hsu
- Division of Cardiology, Department of Internal Medicine & Community Medicine Center, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Public Health Bureau, Yilan County, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
- School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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Liu Y, Hughes MC, Wang H. Financial train, health behaviors, and psychological well-being of family caregivers of older adults during the COVID-19 pandemic. PEC INNOVATION 2024; 4:100290. [PMID: 38799257 PMCID: PMC11127198 DOI: 10.1016/j.pecinn.2024.100290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/22/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
Objectives This study aims to examine the change in financial strain, health behaviors, and psychological well-being of family caregivers of older adults during the COVID-19 pandemic and explore the differences in mental health outcomes by gender, race, and relationship status. Methods Using the 2020 National Health and Aging Trends Study COVID-19 supplement, our sample included 2026 family caregivers of older adults. Structural equation modeling was conducted. Results Caregivers with financial strain showed worse mental health than those with no financial strain. Female or adult children caregivers reported significantly less time walking, more financial strain, and a higher level of negative mental health outcomes compared to male or spouse caregivers; non-White caregivers reported greater positive mental health outcomes compared to White caregivers during the pandemic. Discussion Health professionals should consider the financial and mental health impact of COVID-19 among family caregivers when designing and delivering caregiver support programs. Innovation This study provides nationally representative estimates of several important health behaviors and health outcomes for caregivers of older adults during and after the COVID-19 pandemic, helping to fill the knowledge gap about the characteristics of caregivers whose health and well-being were most affected by the pandemic.
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Affiliation(s)
- Yujun Liu
- School of Family and Consumer Sciences, Northern Illinois University, 1425 W. Lincoln Hwy, DeKalb, IL 815-753-1301, United States of America
| | - M. Courtney Hughes
- School of Health Studies, Northern Illinois University, DeKalb, IL, United States of America
| | - Heng Wang
- Department of Family & Preventive Medicine, Rush University Medical Center, Chicago, IL, United States of America
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Mun G, Shim J. Stroke knowledge and health-promoting behaviors: Mediating effect of patient self-esteem. PATIENT EDUCATION AND COUNSELING 2024; 129:108398. [PMID: 39216147 DOI: 10.1016/j.pec.2024.108398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 07/14/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To investigate the levels of and associations between stroke knowledge, self-esteem, and health-promoting behavior (HPB) among stroke patients, and examine the mediating effect of self-esteem in the stroke knowledge-HPB relationship. METHODS This descriptive correlational study involved a total of 150 stroke patients. We collected data through questionnaires during outpatient visits at two Korean secondary hospitals, inquiring about general and disease-related characteristics, stroke knowledge, self-esteem, and HPB. Correlation and mediation analyses were performed. RESULTS Stroke knowledge significantly increased patients' self-esteem (β = .53, p = .001) and HPB (β = 1.64, p < .001). Self-esteem mediated the relationship between stroke knowledge and HPB, with the mediating effect coefficient determined to be 1.68 [95 % CI (0.56,-2.46)]. CONCLUSION Education and intervention programs that increase both self-esteem and stroke knowledge need to be developed and evaluated such that stroke patients are motivated to engage in HPB. PRACTICE IMPLICATIONS Stroke patients are often physically and mentally impaired, and low self-esteem can be a barrier to engaging in HPB after diagnosis, negatively affecting their health outcomes. Nursing interventions focused on enhancing self-esteem can empower these patients to effectively engage in HPB. Healthcare professionals should adequately communicate and impart disease-related knowledge to patients with poor disease-related knowledge or education.
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Affiliation(s)
- GyeongChae Mun
- College of Nursing, Dongguk University, 123 Dongdae-ro, Gyeongju 21936, South Korea.
| | - JaeLan Shim
- College of Nursing, Dongguk University, 123 Dongdae-ro, Gyeongju 21936, South Korea.
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Dorri N, Riegel B. Development and psychometric evaluation of the self-care of informal caregivers inventory. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100237. [PMID: 39328836 PMCID: PMC11426053 DOI: 10.1016/j.ijnsa.2024.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 08/12/2024] [Accepted: 09/04/2024] [Indexed: 09/28/2024] Open
Abstract
Background In recent years, a growing body of literature on informal caregivers' health and well-being has emerged, highlighting the need for a tool to measure their self-care practices. Objective The aim of the study was to develop a theory-based instrument measuring the self-care behaviors of informal caregivers and test its psychometric properties. Design The initial phase of instrument development entailed a detailed, six-step process (conceptualization, theoretical adaptation, back-translation and cultural adaptation, cognitive interviewing, item enhancement, and content validity), followed by formal psychometric testing (participant engagement, validity, internal consistency reliability, test-retest reliability). Setting Study conducted at a hospital located in Tehran, Iran. Participants A sample of 234 informal caregivers of cancer outpatients receiving treatment in oncology wards was enrolled. Caregivers had to be 18 years or older, recognized as the primary caregiver by the patient, and willing to provide informed consent. Methods The Self-Care of Informal Caregivers Inventory items comprise three dimensions: self-care maintenance (11 items), self-care monitoring (7 items), and self-care management (9 items), which achieved a content validity index rating of 100 % in a panel of experts. Data were collected from caregivers during routine clinic visits. Construct validity was verified through exploratory structural equation modelling and reliability was verified using Cronbach's α and multidimensional model-based reliability. Test-retest reliability was evaluated using the Intraclass Correlation Coefficient. Results All three dimensions showed good model fit indices (self-care maintenance: Comparative Fit Index = 1.00, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.044; self-care monitoring: Comparative Fit Index = 1.00, Tucker-Lewis Index = 1.00, Root Mean Square Error of Approximation = 0.027; self-care management: Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.048) and Cronbach's α of 0.88, 0.88, and 0.91, respectively. The overall multidimensional model-based reliability was 0.93. The Intraclass Correlation Coefficient values for the three dimensions were 0.94, 0.60, and 0.51, respectively. Conclusion Preliminary testing provides support for use of the Self-Care of Informal Caregivers Inventory in research. Using this theory-based instrument to assess the self-care practices of informal caregivers can assist in identifying topics to discuss and opportunities for guidance. Tweetable Abstract The Self-Care of Informal Caregivers Inventory: A validated tool for informal caregivers is useful for research. #Informalcaregivers #SelfCare.
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Affiliation(s)
- Negin Dorri
- Department of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Center for Home Care Policy & Research at VNS Health, New York, NY, USA
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Didikoglu A, Guler ES, Turk HK, Can K, Erim AN, Payton A, Murgatroyd C, Pakpahan E, Minshull J, Robinson AC, Maharani A. Depression in older adults and its associations with sleep and synaptic density. J Affect Disord 2024; 366:379-385. [PMID: 39216641 DOI: 10.1016/j.jad.2024.08.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/24/2024] [Accepted: 08/28/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Depression among older adults is a global concern, contributing to disability and overall illness burden. Understanding its trajectory, associated risk factors, and implications for mortality is essential for effective intervention. Moreover, the relationship between depression, sleep disturbances, and synaptic density in the ageing brain remains complex and poorly understood. METHODS Using data from the University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age cohort, comprising 6375 participants, we conducted comprehensive assessments of depression trajectories using generalized linear mixed models and mortality risks using Cox mixed-effects models. Generalized structural equation modelling was performed to explore longitudinal associations between sleep duration and depression. Lastly, associations between post-mortem synaptic density and depression were investigated. RESULTS Our findings revealed that depression rates declined until age 80 before increasing again. Depression was associated with a 10 % increased risk of mortality in older adults. Reduced sleep was correlated with depression, and depression measured early in the study predicted future reduced sleep. Post-mortem analysis showed a global reduction in synaptic density associated with depression, particularly pronounced in the frontal lobe. LIMITATIONS Limitations include recall bias, limiting generalizability due to dominantly including White British participants and difficulty in establishing causation between synaptic density and depression. CONCLUSION Our study underscores the significance of addressing depression in older adults, not only for mental health but also for mortality risk and neurobiological health. Early detection and intervention strategies are crucial for improving outcomes in elderly populations, potentially mitigating adverse effects on sleep, synaptic density, cognitive health, and longevity.
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Affiliation(s)
- Altug Didikoglu
- Division of Neuroscience, Faculty of Science, Izmir institute of Technology, Izmir, Turkey; Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience, The University of Manchester, Manchester, UK.
| | - Esin Simge Guler
- Division of Molecular Biology and Genetics, Faculty of Science, Izmir Institute of Technology, Izmir, Turkey
| | - Halil Kaan Turk
- Division of Molecular Biology and Genetics, Faculty of Science, Izmir Institute of Technology, Izmir, Turkey
| | - Kubilay Can
- Division of Molecular Biology and Genetics, Faculty of Science, Izmir Institute of Technology, Izmir, Turkey
| | - Aleyna Nur Erim
- Division of Molecular Biology and Genetics, Faculty of Science, Izmir Institute of Technology, Izmir, Turkey
| | - Antony Payton
- Division of Informatics, Imaging & Data Science, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Chris Murgatroyd
- School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Eduwin Pakpahan
- Applied Statistics Research Group, Department of Mathematics, Physics & Electrical Engineering, Northumbria University, Newcastle upon Tyne, UK
| | - James Minshull
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience, The University of Manchester, Manchester, UK
| | - Andrew C Robinson
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience, The University of Manchester, Manchester, UK
| | - Asri Maharani
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
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Al Hamad H, Valappil SA, Sathian B. Needs assessment survey among healthcare professionals to implement the 4Ms framework: a cross-sectional study from Qatar. Aging Male 2024; 27:2401161. [PMID: 39340357 DOI: 10.1080/13685538.2024.2401161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Accepted: 09/01/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Worldwide, the evidence-based 4Ms framework of the Age-Friendly Health System (AFHS) improves the experience of caring for older adults. This study aimed to examine healthcare professionals' perceptions, attitudes, and behaviors regarding the AFHS and 4Ms before they were implemented. METHODS This study was a questionnaire-based survey of 252 healthcare professionals in geriatrics and long-term care departments, Rumailah Hospital, Acute Care Services in Hamad General Hospital, and home healthcare services to assess their perceptions, attitudes, and behaviors regarding 4Ms from November 1, 2022, to July 31, 2023. RESULTS Most respondents acknowledged the benefits of providing care through AFHS. However, only 62% of respondents reported using the 4Ms framework. The most commonly used types of age-friendly care provided by health care professionals were reviews of high-risk medication use (64.2%) and screening for mobility limitations (55.8%). CONCLUSION The findings suggest that there is a need for more training and education regarding the 4Ms framework for health care providers. This training should focus on specific aspects of the framework, such as how to assess what matters most to older adults; how to manage their mobility, mentation, and medication; and how to coordinate care across settings.
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Affiliation(s)
- Hanadi Al Hamad
- Geriatrics and Long-Term Care Department, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sameer Acharath Valappil
- Geriatrics and Long-Term Care Department, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Brijesh Sathian
- Geriatrics and Long-Term Care Department, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
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Almevall A, Juuso P, Melander C, Zingmark K. Exploring the meaning of a good life for older widows with extensive need of care: a qualitative in-home interview study. Int J Qual Stud Health Well-being 2024; 19:2322757. [PMID: 38431864 PMCID: PMC10911179 DOI: 10.1080/17482631.2024.2322757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Studies of older women's life transitions is rare but gains relevance as the aging population, with older women as the majority, expands. PURPOSE To explore the meaning of a good life for older widows with extensive home care needs. MATERIALS AND METHODS Semi-structured interviews were carried out with eleven women, aged 80 and over (82-95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5-6 hours, mean 3). Data were analysed by reflexive thematic analysis. RESULTS The theme "This Day in My Home, the frame of my life" reflects the women's experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely. CONCLUSION A day at home may seem static, yet it mirrors life's dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home.
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Affiliation(s)
- Ariel Almevall
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Päivi Juuso
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Catharina Melander
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Karin Zingmark
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
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Samwiri Nkambule E, Msiska G. Chronic illness experience in the context of resource-limited settings: a concept analysis. Int J Qual Stud Health Well-being 2024; 19:2378912. [PMID: 39007854 PMCID: PMC11251436 DOI: 10.1080/17482631.2024.2378912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 07/08/2024] [Indexed: 07/16/2024] Open
Abstract
AIM This review describes the ways in which individuals experience chronic illnesses in resource-limited settings; to define the concept and understand its attributes, antecedents and consequences. METHODS A comprehensive analysis of the databases CINAHL, PubMed and Google Scholar was conducted. During literature search the following limits were applied: articles published in English with available full-text; articles that focused on living with chronic illness in adults from the patient's perspective. RESULTS The following three attributes of chronic illness experience were identified: transformational experience, acceptance and self-management. Prominent predisposing factors (antecedents) were: genetic inheritance, malnutrition and poverty, high levels of stress and unhealthy lifestyle. The most dominant consequences were as follows: impact on quality of life; self-management burden; burden to others and economic stressors. CONCLUSIONS The findings underscore the need for health-care professionals to understand the chronic illness experience in the context of resource-limited settings and its consequences. The greater insights into the concept of chronic illness experience in resource-limited settings will guide nurses to support people in the realities of chronic illness experience in resource-limited settings in developing countries. This knowledge can guide nurses in providing competent care to chronically ill individuals, including meeting their individual needs with such illnesses.
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Affiliation(s)
| | - Gladys Msiska
- School of Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
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Adebayo K, Omobowale M, Akinyemi A, Usman R, Olujimi A, Omodara F. "I am the one taking care of her and donating blood": lived experiences of role-routines of hospital-based informal caregiving in Nigeria. Int J Qual Stud Health Well-being 2024; 19:2356928. [PMID: 38773959 PMCID: PMC11123441 DOI: 10.1080/17482631.2024.2356928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/14/2024] [Indexed: 05/24/2024] Open
Abstract
PURPOSE Informal caregivers (ICs) in Africa perform a long list of tasks to support hospitalization care. However, available studies are weak in accounting for the experiences of everyday role-routines of hospital-based informal caregiving (HIC) in under-resourced settings. This article explored the experiences of role-routines among informal caregivers in a Nigerian tertiary health facility. METHODS The ethnographic exploratory study relied on primary data collected from 75 participants, including 21 ICs, 15 inpatients, 36 hospital staff, and 3 ad-hoc/paid carers in a tertiary health facility in Southwestern Nigeria. RESULTS ICs perform several essential roles for hospitalized relatives, with each role characterized by a range of tasks. An integrative narrative of everyday routines of HIC as experienced by ICs showed critical complexities and complications involved in seemingly simple tasks of assisting hospitalized relatives with hygiene maintenance, medical investigations, blood donation, resource mobilization, errand-running, patient- and self-care and others. The role-routines are burdensome and ICs' experiences of them revealed the undercurrents of how health systems dysfunctions condition family members to support hospitalization care in Nigeria. CONCLUSION The intensity and repetitive nature of role-routines is suggestive of "routinization of suffering". We recommend the closing of gaps driving hospital-based informal caregiving in Africa's under-resourced settings.
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Affiliation(s)
- Kudus Adebayo
- Institute of African Studies, University of Ibadan, Ibadan, Nigeria
- School of Public Health, University of The Witwatersrand, Johannesburg, South Africa
| | - Mofeyisara Omobowale
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Rukayat Usman
- Institute of African Studies, University of Ibadan, Ibadan, Nigeria
| | - Atinuke Olujimi
- Department of Sociology, University of Ibadan, Ibadan, Nigeria
| | - Funmilayo Omodara
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Karaca NB, Arin-Bal G, Sezer S, Kelesoglu Dincer AB, Kinikli G, Boström C, Kinikli GI. Physical Activity, Kinesiophobia, Pain Catastrophizing, Body Awareness, Depression and Disease Activity in Patients With Ankylosing Spondylitis and Rheumatoid Arthritis: A Cross-Sectional Explorative Study. Musculoskeletal Care 2024; 22:e1953. [PMID: 39349418 DOI: 10.1002/msc.1953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 09/16/2024] [Accepted: 09/17/2024] [Indexed: 10/02/2024]
Abstract
OBJECTIVE/AIM The aim was to compare the levels of physical activity, kinesiophobia, pain catastrophizing, body awareness, and depression in patients with Ankylosing Spondylitis (AS) and Rheumatoid Arthritis (RA) and to explore the associations between these outcomes and disease activity. METHODS Seventy-eight patients with AS (n = 30) and RA (n = 48) were included. Outcomes were assessed using the International Physical Activity Questionnaire-Short Form, the Tampa Scale of Kinesiophobia, the Pain Catastrophizing Scale, the Body Awareness Questionnaire, and the Beck Depression Inventory. Disease activity levels were determined using the Bath Ankylosing Spondylitis Disease Activity Index for AS and the Disease Activity Score 28 score for RA. RESULTS AS patients were younger, had a higher proportion of men, and were more physically active than RA patients (p < 0.05). Both groups exhibited high levels of kinesiophobia but low levels of pain catastrophizing, similar body awareness and mild depression scores. Moderate correlations (r ≥ 0.5) were observed between kinesiophobia and depression, body awareness and pain catastrophizing and depression, and pain catastrophizing and disease activity in AS patients. In RA patients, moderate correlations (r ≥ 0.5) were found between kinesiophobia and pain catastrophizing. CONCLUSION Addressing physical activity, kinesiophobia, pain catastrophizing, body awareness, and depression is important in managing AS and RA patients. Notably, correlations among outcomes differed between groups, with more significant correlations in AS. Further studies are needed to explore these in greater detail.
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Affiliation(s)
- Nur Banu Karaca
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gamze Arin-Bal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Serdar Sezer
- Department of Rheumatology, Ankara Training and Research Hospital, Ankara, Turkey
| | | | - Gulay Kinikli
- Faculty of Medicine, Department of Rheumatology, Ankara University, Ankara, Turkey
| | - Carina Boström
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Gizem Irem Kinikli
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Harnett T, Möllergren G, Jönson H. The use of home care as relational work: outlines for a research programme. Int J Qual Stud Health Well-being 2024; 19:2371538. [PMID: 38913083 PMCID: PMC11198145 DOI: 10.1080/17482631.2024.2371538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/19/2024] [Indexed: 06/25/2024] Open
Abstract
PURPOSE Care has been theorized as a relational practice, but the research has focused on providers rather than users. Older care users have been cast in a passive role, and their relational activities to help with the provision of their care or to support those who provide it are underexplored. The purpose of this study is to develop knowledge about home care use as a form of relational 'work'. METHODS The data for the study consists of 34 qualitative interviews with home care users in Sweden and 15 observations of care provision. The data has been coded using thematic analysis. RESULTS The analysis identifies two overlapping forms of relational work done by care users in the home care context: care-centred work, where care users work to facilitate care situations that were positive for staff and for the provision of care; and person-centred work, where care users work to foster personal relations by focusing on care staff as unique individuals. CONCLUSIONS The article proposes a research programme on relational work by care users, prompted by the finding that such efforts seem central for the understanding of eldercare in a variety of contexts.
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Affiliation(s)
- Tove Harnett
- School of Social Work, Lund University, Lund, Sweden
| | | | - Håkan Jönson
- School of Social Work, Lund University, Lund, Sweden
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16
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Rees J, Liu W, Canson J, Crosby L, Tinker A, Probst F, Ourselin S, Antonelli M, Molteni E, Mexia N, Shi Y, Matcham F. Qualitative exploration of the lived experiences of loneliness in later life to inform technology development. Int J Qual Stud Health Well-being 2024; 19:2398259. [PMID: 39305060 PMCID: PMC11418060 DOI: 10.1080/17482631.2024.2398259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 08/26/2024] [Indexed: 09/25/2024] Open
Abstract
PURPOSE Loneliness is a negative emotional state which is common in later life. The accumulative effects of loneliness have a significant impact on the physical and mental health of older adults. We aim to qualitatively explore the experiences of loneliness in later life and identify relevant behaviours and indicators which will inform novel methods of loneliness detection and intervention. METHODS We conducted 60 semi-structured interviews with people aged 65 and over between September 2022 and August 2023. Data were analysed using a reflective thematic approach with early theme development on NVIVO software. RESULTS Three themes were identified from the experiences of loneliness in older adults. 1) Unique responses to loneliness, including crying, increased eating or drinking and sleep difficulties, 2) Age-related losses, such as networks, roles, and abilities to engage in activities reducing over time and 3) Individual differences in overcoming loneliness, where strategies such as keeping busy and adopting a positive mindset were impacted by motivation and mood of older adults. CONCLUSION Distinct signs and relevant factors to loneliness in later life have been identified which can be detected by future sensing technologies. Findings of this in-depth qualitative study highlight that loneliness is a subjective experience requiring a holistic and person-centred approach to detection and intervention.
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Affiliation(s)
- Jessica Rees
- Department of Global Health and Social Medicine, King’s College London, London, UK
| | - Wei Liu
- Department of Engineering, King’s College London, London, UK
| | - Jiana Canson
- School of Psychology, University of Sussex, Falmer, UK
| | - Lynda Crosby
- School of Psychology, University of Sussex, Falmer, UK
| | - Anthea Tinker
- Department of Global Health and Social Medicine, King’s College London, London, UK
| | - Freya Probst
- Department of Engineering, King’s College London, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK
| | - Michela Antonelli
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK
| | - Erika Molteni
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK
| | | | - Yu Shi
- School of Design, University of Leeds, Leeds, UK
| | - Faith Matcham
- School of Psychology, University of Sussex, Falmer, UK
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17
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Chow EHY, Tiwari A. Perceptions of abused Chinese women on community-based participatory approach programme in addressing their needs. Int J Qual Stud Health Well-being 2024; 19:2331107. [PMID: 38564773 PMCID: PMC10989199 DOI: 10.1080/17482631.2024.2331107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The community-based participatory approach (CBPA) has gained increasing recognition worldwide for enhancing the effectiveness of intervention. It is relatively new in Chinese societies and participants' perceptions are underexplored. This study aims to explore abused Chinese women's perceptions on the CBPA programme in addressing their needs. METHODS A total of 11 abused Chinese women were recruited for a focus group and individual interviews. A semi-structured interview guide was used. All interviews were audio-recorded and data were transcribed verbatim. Conventional content analysis was used for analysis. RESULTS Four themes were identified regarding the women's perceptions and experiences of the community-based participatory approach programme: (1) Women's perceived acceptability of the CBPA programme; (2) Women's perceived usefulness of the CBPA programme; (3) Women's perceived feasibility of the CBPA programme; and (4) Empowering the women through participating in CBPA. CONCLUSIONS Abused Chinese women had high perceived acceptance and positive experiences towards the community-based participatory approach. Women benefited from their robust participation throughout the process. The findings confirm the potential of using the community-based participatory approach in designing interventions for future programme planning and intervention to address the needs of abused Chinese women.
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Affiliation(s)
| | - Agnes Tiwari
- School of Nursing, Hong Kong Sanatorium & Hospital Limited, Hong Kong, China
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18
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Ruggiero F, Zirone E, Mellace D, Capetti B, Molisso MT, Ferrucci R, Barbieri S, Di Guida L, Pizzo S, Mameli F. How the COVID-19 pandemic reshaped telepsychology: Insights from an Italian survey. Internet Interv 2024; 38:100764. [PMID: 39286608 PMCID: PMC11403050 DOI: 10.1016/j.invent.2024.100764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 08/02/2024] [Accepted: 08/09/2024] [Indexed: 09/19/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic rapidly boosted the introduction of certain changes in mental healthcare services, consequently driving up the adoption of remote care delivery options. We conducted an online Italian survey to evaluate telepsychology use, attitudes, acceptance, and training needs, as well as to understand patient-professional interactions in video-consultations, aiming to inform future mental healthcare practices and policies. The current study's survey responses were collected using an anonymous, self-reported questionnaire on the 'REDCap' platform from 25 October 2022 to 26 July 2023. In total, 128 mental health professionals and 113 patients completed the survey. In our sample, 69 % of patients and 79.7 % of mental health professionals reported having used telepsychology during COVID-19 pandemic; in particular, 84.6 % of patients and 95.1 % of professionals selected video-consultation modality. Data showed that participants expressed high satisfaction with this communication tool. The increase in satisfaction was directly proportional to increase in the quality of interactions and in relation to the quality of the experiences. The critical factors influencing the video-consultation experience include communication style, information completeness, patient-centredness, and the comfort underscoring the central role of the professional-patient relationship, which, substantially, remains a key element in the psychological treatment process. These findings reinforce the need for continued refinement and expansion of telepsychology services, thus highlighting the potential for integrating innovative technologies into mental health practise.
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Affiliation(s)
- Fabiana Ruggiero
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza n. 35, 20122 Milan, Italy
| | - Eleonora Zirone
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza n. 35, 20122 Milan, Italy
| | - Denise Mellace
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza n. 35, 20122 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Studies of Milan, Via Festa del Perdono n. 7, 20122 Milan, Italy
| | - Benedetta Capetti
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy
| | - Maria Takeko Molisso
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza n. 35, 20122 Milan, Italy
| | - Roberta Ferrucci
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza n. 35, 20122 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Studies of Milan, Via Festa del Perdono n. 7, 20122 Milan, Italy
| | - Sergio Barbieri
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza n. 35, 20122 Milan, Italy
| | - Lucia Di Guida
- School of Psychotherapy, Miller Institute for Behavioral and Cognitive Therapy, Piazza della Vittoria, n. 15/23, 16121 Genoa, Italy
| | - Susanna Pizzo
- School of Psychotherapy, Miller Institute for Behavioral and Cognitive Therapy, Piazza della Vittoria, n. 15/23, 16121 Genoa, Italy
| | - Francesca Mameli
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza n. 35, 20122 Milan, Italy
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19
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Wen Z, Wang H, Liang Q, Liu L, Zhang W, Zhang X. Mediating effect of social support and resilience between loneliness and depression in older adults: A systematic review and meta-analytic structural equation modeling. J Affect Disord 2024; 365:246-257. [PMID: 39147150 DOI: 10.1016/j.jad.2024.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Loneliness is a powerful stressor for depression in older adults, and resilience and social support may mediate this relationship, while the evidence is limited. Hence, our study aims to explore the mediating role of social support and resilience between loneliness and depression and to test possible moderators. METHODS We searched 12 databases without language and publish time restrictions and obtained the correlation coefficients. This review constructed two-stage meta-analytical structural equality modeling (MASEA) to test the mediating effect of social support and resilience. Additionally, use one-stage MASEA to test the moderator effect of women proportion, published year, and country of study. RESULTS This study included 53 studies and 40, 929 older adults. Loneliness directly affected depression (β = 0.28, 95 % CI: 0.20, 0.36). Social support (β = 0.06, 95 % CI: 0.02, 0.09) and resilience (β = 0.15, 95 % CI: 0.12, 0.18) mediated the relationship. The proportion of women in the sample was moderator (χ2(5) = 11.10, p = 0.05). When the proportion exceeded 60 %, the path coefficient of loneliness and social support (β = -0.45, SE = 0.055) was larger than that of the subgroup below 60 % (β = -0.32, SE = 0.041). LIMITATIONS It was indefinite whether the evidence would be supported in longitudinal designs. Influenced by the original research data, it is impossible to calculate the model parameters of gender discrepancy. CONCLUSIONS Health aging policy-makers adopting social support and resilience intervention will help strengthen the coping skills of older adults confronting loneliness and reduce the risk of depression.
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Affiliation(s)
- Zhifei Wen
- Department of Dermatological, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongyan Wang
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China
| | - Qingfang Liang
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Chengdu, China
| | - Linfeng Liu
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China
| | - Wen Zhang
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China
| | - Xiangeng Zhang
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China.
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20
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An J, Su Z, Meng S. Effect of aerobic training versus resistance training for improving cardiorespiratory fitness and body composition in middle-aged to older adults: A systematic review and meta-analysis of randomized controlled trials. Arch Gerontol Geriatr 2024; 126:105530. [PMID: 38878596 DOI: 10.1016/j.archger.2024.105530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/29/2024] [Accepted: 06/10/2024] [Indexed: 09/05/2024]
Abstract
This systematic review and meta-analysis aimed to examine the influence of aerobic training (AT) versus resistance training (RT) on cardiorespiratory fitness and body composition in middle-aged to older adults. Four electronic databases including PubMed, Scopus, Cochrane CENTRAL, and web of science, as well as reference lists of included randomized controlled trials (RCTs) were searched from inception to April 2024. Data were pooled by the inverse-variance method and reported as mean differences (MDs) with 95 % confidence intervals (CIs). Thirty-eight RCTs, with a pooled sample of 1682 participants, met our inclusion criteria. Meta-analysis revealed that AT significantly improved VO2max/peak (MD = 1.80, 95 % CI: 0.96 to 2.64, p < 0.0001) and 6-MWT (MD = 18.58, 95 % CI: 10.38 to 26.78, p < 0.00001), and significantly decreased body mass (MD = -1.23, 95 % CI: -1.98 to -0.47, p = 0.001) versus RT. However, changes in lean body mass favored RT over AT. Moreover, changes in VO2max/peak and 6-MWT following AT were significant among both healthy and unhealthy participants, or men and women, after medium-term (< 24 weeks) and long-term (≥ 24 weeks) interventions, and among participants aged ≤65 and >65. Our results propose that AT should be considered an efficient approach to improving cardiorespiratory fitness and overall body composition with aging, particularly in terms of VO2max and 6-MWT performance. However, for improvements in lean body mass, RT may be more beneficial. Therefore, a combination of AT and RT might be optimal for comprehensive fitness and body composition improvements with aging.
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Affiliation(s)
- Jianqun An
- College of Sports Science, Lingnan Normal University, Zhanjiang 524048, Guangdong, China
| | - Zhanguo Su
- Faculty of Physical Education, Huainan Normal University, Huainan 232038, Anhui, China.
| | - Shangjie Meng
- International College, Krirk University, Bangkok 10220, Thailand
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21
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Beydoun MA, Beydoun HA, Georgescu MF, Maino Vieytes CA, Fanelli-Kuczmarski MT, Noren Hooten N, Evans MK, Zonderman AB. Plasma homocysteine and longitudinal change in cognitive function among urban adults. J Affect Disord 2024; 364:65-79. [PMID: 39134149 PMCID: PMC11423561 DOI: 10.1016/j.jad.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 07/05/2024] [Accepted: 08/09/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Cross-sectional and longitudinal studies have inconsistently linked cognitive performance and change over time to an elevated level of homocysteine (Hcy), with few conducted among urban adults. METHODS Longitudinal data [Visit 1 (2004-2009) and Visit 2 (2009-2013)] were analyzed from up to 1430 selected Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) participants. Baseline and follow-up blood Hcy was measured, while 11 cognitive function test scores were assessed at either of these two visits. Overall, sex- and race-stratified associations were evaluated using mixed-effects linear regression models, adjusting for key potential confounders. Interaction effects between Hcy and serum levels of folate and vitamin B-12 were also tested. RESULTS We found that greater LnHcyv1 was significantly associated with poorer baseline attention based on higher Loge (TRAILS A, in seconds) [β (SE): 0.101 (0.031), P = 0.001]. Heterogeneity was also found by sex and by race. Most notably, among men only, LnHcyv1 was associated with faster decline on the BVRT (# of errors), a measure of visuo-spatial memory (β (SE): 0.297(0.115), P = 0.010, reduced model); while among African American adults only, an elevated and increasing LnHcy over time was associated with faster rate of decline on Loge (TRAILS B, in seconds) [β (SE): +0.012 (0.005), p = 0.008], a measure of executive function. Interactions between Hcy, folate and vitamin B-12 blood exposures were also detected. CONCLUSIONS In summary, sex- and race-specific adverse association between elevated Hcy and cognitive performance over time were detected among middle-aged urban adults, in domains of attention, visuo-spatial memory and executive functioning.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224, USA
| | - Hind A Beydoun
- VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Washington, DC 20420, USA; Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Michael F Georgescu
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224, USA
| | - Christian A Maino Vieytes
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224, USA
| | - Marie T Fanelli-Kuczmarski
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224, USA
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21224, USA
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22
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Burnett J, Campetti R, Froberg R, Beauchamp JE, Lees-Haggerty K. Perspectives on elder mistreatment screening and responding in emergency departments: A qualitative study with survivors. Int J Psychiatry Med 2024; 59:633-643. [PMID: 38196310 DOI: 10.1177/00912174231225765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
OBJECTIVE Elder Mistreatment (EM) occurs in approximately 10% of older adults and is associated with trauma-related outcomes including depression, anxiety, posttraumatic stress disorder, and early mortality. Low screening and older adult self-reporting, especially within emergency departments, represent missed opportunities for identify and mitigate future EM occurrences and consequences. To date, no studies have obtained EM survivors' perspectives on EM screening and response practices in emergency departments. METHODS Semi-structured interviews with 19 EM survivors of those with Adult Protective Services validated EM were completed in older adults' homes. The Elder Mistreatment Emergency Department Screening and Response Tool (EM-SART) was used to guide the interview questions. All interviews were recorded, transcribed, and analyzed using qualitative thematic analyses. RESULTS The participants were mostly female (63%) and white (58%) with an average age of 74 years. Physical abuse accounted for 67% of the EM incidents. Three themes emerged indicating the survivor preference for (1) building rapport and approaching the older adult with compassion and care, (2) setting the context before asking the EM questions, and (3) allowing mutuality, collaborative work, and shared decision-making during the response. CONCLUSIONS Older adults are agreeable and willing to self-report and actively engage in the EM screening and response practices in the emergency department if trauma-informed care principles are utilized.
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Affiliation(s)
- Jason Burnett
- The University of Texas Health Science Center, Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, Houston, TX, USA
| | | | | | - Jennifer Es Beauchamp
- The University of Texas Health Science Center, Cizik School of Nursing, Houston, TX, USA
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Xiao L, Ullah S, Hu R, Wang J, Wang H, Chang CC, Kwok T, Zhu M, Ratcliffe J, Brodaty H, Brijnath B, Chang HCR, Wong B, Zhou Y, He J, Xia M, Hong JY, Che S, Milte R. The effects of a facilitator-enabled online multicomponent iSupport for dementia programme: A multicentre randomised controlled trial. Int J Nurs Stud 2024; 159:104868. [PMID: 39163682 DOI: 10.1016/j.ijnurstu.2024.104868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/30/2024] [Accepted: 07/30/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND Multicomponent interventions with carers of people with dementia demonstrate positive effects on the health and quality of life for carers and care recipients. The World Health Organization's iSupport for Dementia is an evidence-based online psychoeducation programme for carers. However, the programme was mainly implemented as a self-learning tool which might have limited its positive effects on carers and care recipients. Evidence for online multicomponent interventions with carers that incorporates the iSupport programme remains unknown. OBJECTIVES This study aimed to partner with health and social care organisations to evaluate the effects of a facilitator-enabled online multicomponent Chinese iSupport programme, which included psychoeducation using the iSupport programme, facilitator-enabled carer support groups and access to care services. DESIGN A multicentre randomised controlled trial. SETTINGS AND PARTICIPANTS Participants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022. METHODS The intervention group received the Chinese iSupport programme delivered online. The intervention lasted for 6 months. Our primary outcome was carers' quality of life. Our secondary outcomes were carers' self-efficacy, social support, distress reactions to changed behaviours, care recipients' frequency of changed behaviours, quality of life, unplanned hospital admissions, emergency department presentations and permanent admissions to nursing homes. The outcomes were measured at baseline (T0), 6 months (T1) and 9 months (T2). We applied a multivariate mixed effect linear regression model to capture the group effect, time effect and their interaction. RESULTS In total, 266 eligible family carers agreed to participate and were randomly assigned to an intervention group (n = 131) or a usual care group (n = 135). Most carers were women with a mean age of 53 years. The intervention group showed a statistically significant higher score of mental-health-related quality of life (mean difference = 4.1, 95 % CI: 1.5, 6.8, p = 0.002), self-efficacy in controlling upsetting thoughts (mean difference = 7.1, 95 % CI: 2.2, 12.0, p = 0.005) and lower score of distress reactions to changed behaviours (mean difference = -0.1, 95 % CI: -0.3, -0.03, p = 0.012) than the usual care group at T1. CONCLUSION The facilitator-enabled online multicomponent Chinese iSupport programme demonstrated positive effects for carers on mental health-related quality of life, controlling upsetting thoughts and distress reactions to changed behaviours of people with dementia. TRIAL REGISTRATION This study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (ACTRN12621000276853). TWEETABLE ABSTRACT The facilitator-enabled online multicomponent Chinese iSupport programme improved family carers' mental health-related quality of life, control of upsetting thoughts and distress reactions to changed behaviours of people with dementia.
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Affiliation(s)
- Lily Xiao
- College of Nursing and Health Sciences, Flinders University, Australia.
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Australia
| | - Rujun Hu
- Department of Nursing, Affiliated Hospital of Zunyi and School of Nursing, Zunyi Medical University, China
| | - Jing Wang
- College of Nursing and Health Sciences, Flinders University, Australia; Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, China
| | - Huali Wang
- Dementia Care and Research Center, Institute of Mental Health, Peking University, Sixth Hospital (Institute of Mental Health), Beijing Key Lab for Translational Research for Dementia Diagnosis and Treatment, Beijing, China
| | - Chia-Chi Chang
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taiwan, China; College of Interdisciplinary Studies, Taipei Medical University, Taiwan, China
| | - Timothy Kwok
- Jockey Club Centre for Positive Ageing, Hong Kong, China; Department of Medicine & Therapeutics and School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Mingxia Zhu
- Kiang Wu Nursing College of Macau, Macau, China
| | - Julie Ratcliffe
- College of Nursing and Health Sciences, Flinders University, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Australia; Melbourne School of Population and Global Health, University of Melbourne, Australia; School of Social Sciences, University of Western Australia, Australia
| | | | - Bel Wong
- Jockey Club Centre for Positive Ageing, Hong Kong, China
| | - Yunrui Zhou
- College of Nursing and Health Sciences, Flinders University, Australia
| | - Jinjie He
- School of Economics and Management, Xi'an University, China
| | - Mengmeng Xia
- Dementia Care and Research Center, Peking University, Institute of Mental Health, Beijing, China
| | - Jhih-Yang Hong
- School of Gerontology and Long-Term Care, Taipei Medical University, Taiwan, China
| | - Shirley Che
- Nursing and Health Education Research Centre, Kiang Wu Nursing College of Macau, Macau, China
| | - Rachel Milte
- College of Nursing and Health Sciences, Flinders University, Australia
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Cho E, Lee JY, Yang M, Jang J, Cho J, Kim MJ. Symptom-specific non-pharmacological interventions for behavioral and psychological symptoms of dementia: An umbrella review. Int J Nurs Stud 2024; 159:104866. [PMID: 39163681 DOI: 10.1016/j.ijnurstu.2024.104866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 07/23/2024] [Accepted: 07/25/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND Non-pharmacological interventions are considered the first-line treatment for managing the behavioral and psychological symptoms of dementia. Given the heterogeneous characteristics of these symptoms, which vary for each individual and tend to fluctuate, a symptom-specific approach is necessary for providing individualized non-pharmacological interventions for people with dementia. However, clear guidelines regarding the appropriate types of interventions for individual symptoms or clusters of behavioral and psychological symptoms of dementia are lacking. OBJECTIVES The aim of this umbrella review was to summarize the current evidence on non-pharmacological interventions for behavioral and psychological symptoms of dementia and provide guidance for determining the appropriate types of interventions for each behavioral and psychological symptom of dementia. DESIGN An umbrella review of systematic reviews and/or meta-analyses. METHODS The Cochrane methodology for umbrella reviews was employed for this review, and the review protocol was registered. PubMed, CINAHL, Embase, PsycINFO, and Cochrane databases were searched for relevant reviews using the 'population, intervention, control, and outcomes' formulation. Two reviewers independently screened the extracted articles for eligibility. The quality of each selected review was independently assessed by the two reviewers using A Measurement Tool to Assess Systematic Reviews 2. The results were narratively synthesized and categorized according to each symptom. RESULTS Thirty-five systematic reviews, 71 % of which were also meta-analyses, were included in this review. The methodologies employed in the included reviews were significantly heterogeneous. The qualities of the reviews ranged from low to moderate. Diverse types of non-pharmacological interventions were identified in the reviews, with music therapy being the most frequently discussed. Among the various symptoms, depression was most frequently addressed, followed by overall symptoms, agitation, anxiety, sleep problems, and apathy. Music therapy was found to be effective for improving both overall and specific symptoms, including depression and anxiety. Notably, relatively weak evidence supports the effectiveness of exercise in addressing each symptom. Aromatherapy could be considered for agitation, whereas reminiscence may be effective in managing overall and specific symptoms, such as depression. CONCLUSIONS The results showed that the evidence of symptom-specific effectiveness of non-pharmacological interventions varied across the different behavioral and psychological symptoms of dementia, highlighting the need for a symptom-specific approach in future research. Furthermore, future research is needed to facilitate the development of symptom-specific guidelines that can enhance the quality of individualized dementia care. REGISTRATION Registered with PROSPERO (number: CRD42022340930) on November 9, 2022.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Ji Yeon Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea; School of Nursing, Inha University, Incheon, Republic of Korea
| | - Minhee Yang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Jiyoon Jang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea; Nell Hodgson Woodruff School of Nursing, Emory University
| | - Jungwon Cho
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Min Jung Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea; Research Institute of AI and Nursing Science, College of Nursing, Gachon University, Incheon, Republic of Korea.
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Andrews M, Cheema BS, Siette J. Barriers and facilitators to implementation of physical activity programs for individuals with dementia living in aged care homes: A systematic review. Arch Gerontol Geriatr 2024; 126:105535. [PMID: 38936317 DOI: 10.1016/j.archger.2024.105535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/27/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES This systematic review aimed to identify barriers and facilitators to the implementation of physical activity programs for residents with dementia in aged care homes. METHODS A search was conducted using the databases Medline, PubMed, PsycINFO, CINAHL, Embase, and ProQuest, and captured articles were assessed for inclusion in the review. Included studies were appraised using the Mixed Methods Appraisal Tool (MMAT). Data extraction was performed for study characteristics, identified barriers and facilitators to physical activity implementation, and synthesised narratively. RESULTS Following full-text screening, 13 articles were included in the review. Reporting quality was high in the majority of studies (69 %). Overall, barriers to implementation of physical activity programs were linked to factors related to the resident or the aged care facility, rather than inherently with the physical activity itself. The most identified barriers were understaffing (62 %), resident fatigue or lack of motivation (46 %), distrust of staff (31 %), and fear of injury (31 %). The most identified facilitators were having a structured physical activity protocol (46 %), opportunities for social interaction (38 %), instructor-led sessions (38 %) and offering an individually tailored program (31 %). CONCLUSIONS Addressing barriers of understaffing and resident fatigue whilst simultaneously offering structured, personalised group physical activity programs led by instructors may help optimise implementation. Future research should focus on developing tailored implementation plans, evaluating their effectiveness and cost-effectiveness, and identifying best practices to support the delivery of physical activity interventions in residential aged care settings. PROSPERO REGISTRATION NUMBER CRD42022372308.
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Affiliation(s)
- Mitchell Andrews
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW, 2109, Australia
| | - Birinder S Cheema
- School of Health Sciences, Translational Health Research Institute and the National Institute of Complementary Medicine, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia.
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Wang X, Yang T, Li Y, Ma C, Yang M, Qian Q, Ma G, Pei H, Feng J, Yan F, Fan X, Cao J, Ma Y. Intrinsic capacity decline as a predictor of functional disability in the elderly: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 126:105550. [PMID: 38991290 DOI: 10.1016/j.archger.2024.105550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES To examine the predictive value of intrinsic capacity decline on functional disability among the elderly. DESIGN Meta-analysis. METHODS PubMed, EMBASE, Web of Science, The Cochrane Library, Wanfang Database, China Knowledge Resource Integrated Database (CNKI), Weipu Database (VIP), and Chinese Biomedical Database (CBM) were searched for relevant studies published from the inception until June 1, 2024. Stata 17.0 software was used to perform the meta-analysis. The methodological quality was evaluated using the Newcastle Ottawa Scale. The overall quality of evidence used GRADE guidelines to assess. A study protocol was registered in PROSPERO (CRD42023475461). RESULTS The meta-analysis included 8 cohort studies including 9744 elderly people. Functional disability including ADL disability (n = 6) and IADL disability (n = 7). The results showed that intrinsic capacity decline could predict ADL disability (HR = 1.08, 95 %CI 1.04-1.12; I2 = 98.2 %, P < 0.001) and IADL disability (HR = 1.11, 95 %CI 1.05-1.17; I2 = 96.4 %, P < 0.001). The overall risk of bias was low. And the grade of evidence that assessed by GRADE guidelines was rated as moderate. CONCLUSIONS Intrinsic capacity decline is a predictor of functional disability in the elderly. Therefore, screening intrinsic capacity decline has important clinical implications for early identifying the risk of functional disability, which contributes to providing individualized interventions ahead of potential functional disability for the elderly, thereby preventing functional disability, improving the quality of life and promoting healthy aging.
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Affiliation(s)
- Xuedan Wang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Tingting Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Yidan Li
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Chi Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Mengyu Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Qiuxia Qian
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Guifen Ma
- Gannan Tibetan Autonomous Prefecture Health School, Gannan Tibetan Autonomous Prefecture, China
| | - Hongbo Pei
- School of Public Health, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Juanjuan Feng
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Fanghong Yan
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Xiangping Fan
- Department of Nursing, The Third People's Hospital of Lanzhou, Lanzhou, Gansu, China.
| | - Jianxun Cao
- Radiology Department, Gansu Provincial Hospital, Lanzhou City, Gansu Province, China.
| | - Yuxia Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China.
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Wang H, Liang Y, Wu H, Shi H, Hou R. Effect of multicomponent exercise intervention in community dwelling frail elderly: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 126:105543. [PMID: 38908349 DOI: 10.1016/j.archger.2024.105543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/03/2024] [Accepted: 06/17/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE To assess the impact of multicomponent exercises on physical functions of frail elderly in communities, evaluating their effect on muscle strength, balance, and endurance, and their influence on quality of life. METHOD PubMed, Embase, Cochrane, and Web of Science were searched to collect relevant randomized controlled trials. The search cutoff date was January 24, 2024. Included studies met pre-specified inclusion and exclusion criteria. Data analysis was performed using Revman 5.4 and Stata 15.0 software. RESULT This analysis included 19 studies. After 12 weeks, the multicomponent exercises significantly enhanced participants' performance in various physical function assessments. Specifically, in the Timed Up and Go Test, the exercise group showed a significant reduction in time [SMD = -0.86 (95 % CI: -1.40 to -0.33)]. In the Short Physical Performance Battery, interventions shorter than 6 weeks significantly increased scores [SMD = 1.01 (95 % CI: 0.64 to 1.37)], and those longer than 6 weeks showed improvements [SMD = 0.53 (95 % CI: 0.26 to 0.80)]. Muscle strength also improved, with handgrip strength and knee extensor strength enhancements [SMD = 0.93 (95 % CI: 0.27 to 1.59); SMD = 0.72 (95 % CI: 0.24 to 1.20)]. However, there was no statistically significant difference in walking speed between the groups [SMD = 0.04 (95 % CI: -0.33 to 0.40)]. CONCLUSION Although multicomponent exercises significantly improve muscle strength, balance, and endurance in frail elderly individuals, there is no conclusive evidence of their effect on enhancing quality of life or long-term health outcomes. Further research is needed to explore the specific impacts of different types and intensities of exercises on this population.
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Affiliation(s)
- Haifang Wang
- Faculty of Nursing, Linfen Vocational and Technical College, Linfen 041000, China
| | - Yan Liang
- Department of Ophthalmology, Affiliated Zhongshan Hospital of Dalian University, Dalian, 116000, China
| | - Huijuan Wu
- Department of Nursing, The First Affiliated Hospital of Linfen Vocational and Technical College, Linfen 041000, China
| | - Hongyu Shi
- Department of Neurology, The First Affiliated Hospital of Linfen Vocational and Technical College, Linfen 041000, China
| | - Ran Hou
- Department of Otolaryngology, The Second Hospital of Shanxi Medical University, Taiyuan, 030000, China.
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Li Y, Yang T, Wang X, He X, Dong J, Qian Q, Zhang X, Zheng J, Fan X, Ma Y. The ability of decline in intrinsic capacity to indicate the risk of mortality in older adults: A meta-analysis. Maturitas 2024; 189:108109. [PMID: 39293255 DOI: 10.1016/j.maturitas.2024.108109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 06/28/2024] [Accepted: 08/27/2024] [Indexed: 09/20/2024]
Abstract
OBJECTIVE To evaluate the ability of decline in intrinsic capacity to indicate the risk of mortality in older adults. DESIGN Meta-analysis. METHODS PubMed, EMBASE, Web of Science, the Cochrane Library, Wanfang Database, CNKI, VIP, and CBM were searched for relevant studies published from inception to October 31, 2023. Stata17.0 software was used to perform the meta-analysis. A random effects model was used to pool the results of the risk of mortality (as hazard ratios, HRs) in older adults and decline in intrinsic capacity. The Newcastle Ottawa Scale was used to evaluate the quality of studies. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was used to determine the confidence in the estimated effect of pooled outcomes. RESULTS Twelve studies, with a total of 38,531 participants, were included in this meta-analysis. The findings show that older adults with intrinsic capacity decline have a higher risk of mortality (HR = 1.11, 95 % CI 1.08-1.14, I2 = 95.9 %, P<0.001) than older adults with normal intrinsic capacity. The pooled HR estimates for the locomotion, vitality, and cognitive dimensions of intrinsic capacity in the prediction of mortality were 0.89 (HR = 0.89, 95%CI 0.83-0.96, I2 = 41.3 %, P = 0.146), 0.76 (HR = 0.98, 95 % CI 0.59-0.97, I2 = 60.8 %, P = 0.078), and 0.99 (HR = 0.99, 95 % CI 0.98-1.00, I2 = 0.0 %, P = 0.664), respectively. The pooled HR estimates of the psychological dimension to predict mortality were not statistically significant (P > 0.05). GRADE evaluations of outcome indicators were of moderate confidence. CONCLUSIONS Decline in intrinsic capacity is a significant predictor of mortality. Locomotion, vitality, and cognition dimensions can all predict mortality. Clinical personnel should early assess the intrinsic capacity of older adults, focusing on changes in the dimensions of locomotion and vitality, to identify the risk of mortality, avoid adverse health outcomes, and improve the quality of life of older adults. Review protocol registered in PROSPERO: CRD42023481246.
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Affiliation(s)
- Yidan Li
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Tingting Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Xuedan Wang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Xiang He
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Jianhui Dong
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Qiuxia Qian
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Xingxia Zhang
- Department of Nursing, The Third People's Hospital of Gansu Province, Lanzhou City, Gansu Province, China
| | - Jie Zheng
- Department of Nursing, The Third People's Hospital of Gansu Province, Lanzhou City, Gansu Province, China
| | - Xiangping Fan
- Department of Nursing, The Third People's Hospital of Lanzhou, Lanzhou, Gansu, China.
| | - Yuxia Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China.
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Moody E, Adisaputri G, McDougall H, Weeks LE, Belliveau A, Bilski P, Koller K. The Experience of Hospitalisation for People Living With Dementia: A Qualitative Exploration of How Context Shapes Experiences. Int J Older People Nurs 2024; 19:e12651. [PMID: 39344220 DOI: 10.1111/opn.12651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 08/30/2024] [Accepted: 09/03/2024] [Indexed: 10/01/2024]
Abstract
INTRODUCTION Dementia has become an increasingly pressing issue in healthcare systems, and acute care settings such as hospitals have been shown to be particularly problematic for people living with dementia. People living with dementia are hospitalised at higher rates than those without and often have poor experiences and outcomes of hospitalisation. To support the evolution of hospital systems to better meet the needs of people living with dementia, it is important to consider the relationship between the context of the hospital and the experiences of people living with dementia and their caregivers. The term context refers to the environment and conditions that shape experiences and includes elements such as policies, procedures, design and social norms. A greater understanding of the relationship between the hospital context and the experiences of people living with dementia will support the future development of interventions to modify contextual elements to improve the experiences of people living with dementia. Our aim was to explore the relationship between the experiences of people living with dementia and their caregivers in hospital, and the contextual elements of the hospital. METHODS In this interpretive descriptive study, we conducted interviews with people living with dementia and caregivers of people living with dementia about their experiences in hospital. Interviews were conducted with people living with dementia (n = 3), caregivers of people living with dementia (n = 8) and one dyad of a person living with dementia and their caregiver (n = 1) about the hospitalisation of the person living with dementia. Using inductive and deductive methods of analysis, we describe contextual factors that shape their experiences. RESULTS Our findings demonstrate how the hospital context shaped the experiences of people living with dementia and their caregivers while the person living with dementia was hospitalised. The themes reflect elements of the hospital context: communication systems, the value of caregivers, the focus on acute physical needs, staff capacity, the physical environment and normalised practices. The findings suggest that there are aspects of the hospital context that can be modified to influence the experiences of people living with dementia and their caregivers. CONCLUSION This study demonstrates how the context of hospital shapes the experiences of people living with dementia and their caregivers and points to aspects of the context that health system leaders could explore to begin to improve the capacity of hospitals to support people living with dementia. IMPLICATIONS FOR PRACTICE The study provides evidence of the need for health system leaders and practitioner to explore how the hospital context shapes the experiences of people wtih dementia and their caregivers, and begins to explore ways that contextual changes can improve their experiences.
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Affiliation(s)
- Elaine Moody
- School of Nursing, Dalhousie University, Halifax, Canada
| | | | | | - Lori E Weeks
- School of Health Administration, Dalhousie University, Halifax, Canada
| | - Anne Belliveau
- School of Nursing, Dalhousie University, Halifax, Canada
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Pohan RA, Astuti RD, Pohan PBA, Ramadhani E, Saputra R. Navigating bio-psychosocial pathways in the relationship between food insecurity and mobility in the elderly. J Psychosom Res 2024; 186:111891. [PMID: 39190948 DOI: 10.1016/j.jpsychores.2024.111891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Accepted: 08/20/2024] [Indexed: 08/29/2024]
Affiliation(s)
- Rizky Andana Pohan
- Department of Islamic Guidance and Counseling, Institut Agama Islam Negeri Langsa, Langsa, Indonesia.
| | - Ririn Dwi Astuti
- Department of Biology Education, Yayasan Potret Indonesia Sejahtera, Langsa, Indonesia
| | - Putri Bunga Aisyah Pohan
- Department of Science Education, Universitas Negeri Yogyakarta, Kabupaten Sleman, Daerah Istimewa Yogyakarta, Indonesia
| | - Erfan Ramadhani
- Department of Guidance and Counseling, Universitas PGRI Palembang, Palembang, Indonesia
| | - Rikas Saputra
- Department of Islamic Guidance and Counseling, Universitas Islam Negeri Raden Fatah Palembang, Palembang, Indonesia.
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Cruz E Souza ILDP, de Oliveira DC, Souza TB, Ramírez PC, Soares NC, Luiz MM, Delinocente MLB, Steptoe A, de Oliveira C, Alexandre TDS. Dynapenia and sarcopenia identify walking speed decline in women but not in men. Arch Gerontol Geriatr 2024; 126:105545. [PMID: 38950511 DOI: 10.1016/j.archger.2024.105545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/17/2024] [Accepted: 06/22/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE To determine the best indicator of mobility decline between dynapenia, low skeletal muscle mass index (SMMI), and sarcopenia defined by the EWGSOP2 using different cutoff points for grip strength. METHODS A longitudinal study was conducted with a follow-up of eight years, involving 2,680 individuals aged 60 and older who participated in the ELSA study with a walking speed greater than 0.8 m/s at baseline. Dynapenia was defined using different cutoff points for grip strength. SMMI was defined by the 20th percentile of the entire ELSA sample distribution and sarcopenia was defined based on the EWGSOP2, using different cutoff points for grip strength. Mobility was analysed using the walking speed test. RESULTS Over time, the greatest decline in walking speed occurred in dynapenic women with grip strength < 17 kg (-0.005 m/s per year; 95 % CI: -0.01 to -0.001) and < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001). With regards to sarcopenia, the greatest walking speed decline occurred in women with probable sarcopenia when defined by grip strength < 17 kg [(-0.006 m/s per year; 95 % CI: -0.01 to -0.001) or grip strength < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001)]. Dynapenia in men as well as low SMMI and sarcopenia in men and women did not enable identifying the risk of mobility decline. CONCLUSION Dynapenia and probable sarcopenia defined by grip strength < 17 kg and < 20 kg enabled identifying walking speed decline over time only in women.
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Affiliation(s)
| | | | | | - Paula Camila Ramírez
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, Brazil; Escuela de Fisioterapia, Universidad Industrial de Santander, Colombia
| | | | - Mariane Marques Luiz
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, Brazil
| | | | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, Brazil; Postgraduate Program in Gerontology, Universidade Federal de São Carlos, Brazil; Department of Epidemiology and Public Health, University College London, London, UK; Gerontology Department, Universidade Federal de São Carlos, Brazil.
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Menzies RE, McMullen K, Riotto GD, Iliescu S, Petrovic B, Remfrey M. From dread to disorder: A meta-analysis of the impact of death anxiety on mental illness symptoms. Clin Psychol Rev 2024; 113:102490. [PMID: 39208495 DOI: 10.1016/j.cpr.2024.102490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 07/03/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
Growing research suggests that death anxiety may be transdiagnostic, playing a key role in the development and symptomology of psychopathology. This meta-analysis examined the relationship between death anxiety and mental illness symptoms. In total, 104 papers were included, representing cross-sectional data from 99 studies (ntotal = 24,434), and experimental data from 11 studies (ntotal = 1372). Meta-analyses of cross-sectional studies indicated a moderate correlation (r = 0.397) between death anxiety and overall mental illness symptoms. The clinical nature of the group emerged as a significant moderator of this effect. In addition, the relationship between death anxiety and mental illness symptoms was larger for clinical samples (r = 0.580), and for anxiety-related symptoms (r = 0.506) than for depression. Additional meta-analyses of 11 mortality salience studies revealed that death reminders had an overall moderate impact on clinical symptoms (Hedge's g = 0.481). The relevance of the sample to the symptom being measured significantly predicted this relationship; that is, the effect was moderate-to-large (Hedge's g = 0.671) when excluding comparison subgroups for which the effect was not predicted by the authors. The clinical nature of the sample did not significantly moderate the effect. The experimental studies were generally of higher quality and lower risk of publication bias compared to cross-sectional studies. These findings support the strong transdiagnostic role of death anxiety across numerous disorders. Clinical implications include the potential need to treat death anxiety directly, to maximise long-term therapy benefits.
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Oda K, Bakri NN, Majeed S, Bartlett S, Thomson MW, Parsons J, Boyd M, Ferguson AC, Smith M. Improving Nursing Oral Care Practice for Community-Dwelling Care-Dependent Older People. Int J Older People Nurs 2024; 19:e12656. [PMID: 39344447 DOI: 10.1111/opn.12656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 08/26/2024] [Accepted: 09/16/2024] [Indexed: 10/01/2024]
Abstract
AIM Oral care is one of the most neglected nursing practices owing to a lack of training, standard nursing oral care guidelines and low confidence and skills. There is little evidence to inform the development of oral care training and guidelines, which ideally should be done in collaboration with oral health professionals. Further, there is a lack of research, particularly in New Zealand, with nursing staff caring for care-dependent older people, including those ageing in their own homes. This pilot study aimed to determine the impact of oral care training on nursing staff knowledge, attitudes and confidence in supporting community-dwelling older peoples' oral care. METHOD Mixed methods design comprising delivery of an oral healthcare and assessment training intervention by a team comprising nursing and oral health professionals, pre- and post-intervention questionnaires (N = 14) and a post-intervention focus group with community-based nursing staff (N = 5). RESULTS Staff knowledge significantly improved (p = 0.046) following interprofessional collaborative training, but attitude and confidence scores did not (p = 0.127), although focus group responses suggested that participants' confidence was heightened. Participants expressed the need to implement oral care practices to benefit clients' health, clarify roles and identify oral care as a core competency. They sought to make individual- and organisational-level practice changes accordingly. CONCLUSION Oral care training based on interprofessional collaboration and education enhances nursing staff knowledge but not their confidence in oral care provision. Ongoing, hands-on practical training for nursing staff in collaboration with oral health professionals has the potential to advance nursing oral-care practice and improve care-dependent older peoples' oral care. IMPLICATION FOR PRACTICE Oral care training and education with oral health professionals is effective to enhance nursing staff knowledge and awareness in oral health care. However, transforming knowledge into nursing oral care practice requires hands on practical training and ongoing collaboration with oral health professionals to improve care-dependent older people's oral health care.
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Affiliation(s)
- Keiko Oda
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Nazahiah N Bakri
- Centre of Population Oral Health and Clinical Prevention Studies, Universiti Teknologi MARA, Selangor, Malaysia
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Sarah Majeed
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Shennae Bartlett
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Murray W Thomson
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - John Parsons
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Michal Boyd
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Anna C Ferguson
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Moira Smith
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
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Shintani T, Yanai S, Kanasaki A, Iida T, Endo S. Long-term d-allose administration ameliorates age-related cognitive impairment and loss of bone strength in male mice. Exp Gerontol 2024; 196:112555. [PMID: 39179160 DOI: 10.1016/j.exger.2024.112555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/12/2024] [Accepted: 08/20/2024] [Indexed: 08/26/2024]
Abstract
Age-related physical and cognitive decline may be ameliorated by consuming functional foods. d-Allose, reported to have multiple health benefits, may temper aging phenotypes, particularly brain function. We investigated whether d-allose supplementation improves cognitive function. A standard battery of behavioral tests was administered to 18-month-old male mice after consuming diet containing 3 % d-allose for 6 months. Following a wire-hanging test, an open-field test, Morris water maze, fear-conditioning, and an analgesia test were sequentially performed. Bone density and strength were assessed afterwards. Possible mechanism(s) under-lying memory changes in hippocampus were also examined with a DNA microarray. d-Allose failed to influence muscle strength, locomotor activity and anxiety, fear memory, or pain sensitivity. However, d-allose improved hippocampus-dependent spatial learning and memory, and it may contribute to increase bone strength. d-Allose also changed the expression of some genes in hippocampus involved in cognitive functions. Long-term d-allose supplementation appears to modestly change aging phenotypes and improve spatial memory.
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Affiliation(s)
- Tomoya Shintani
- Research and Development, Matsutani Chemical Industry Co., Ltd., 5-3 Kita-Itami, Itami City, Hyogo 664-8508, Japan
| | - Shuichi Yanai
- Aging Neuroscience Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan; Animal Facility, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Akane Kanasaki
- Research and Development, Matsutani Chemical Industry Co., Ltd., 5-3 Kita-Itami, Itami City, Hyogo 664-8508, Japan.
| | - Tetsuo Iida
- Research and Development, Matsutani Chemical Industry Co., Ltd., 5-3 Kita-Itami, Itami City, Hyogo 664-8508, Japan
| | - Shogo Endo
- Aging Neuroscience Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
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Maheshwari S, Dai C, Giri S, Harmon C, Tucker A, Fowler ME, Outlaw D, Williams GR. Intrinsic capacity and survival among older adults with gastrointestinal malignancies: The Cancer and Aging Resilience Evaluation registry. Cancer 2024; 130:3530-3539. [PMID: 38865419 DOI: 10.1002/cncr.35427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Intrinsic capacity (IC) was introduced by the World Health Organization (WHO) as a marker of healthy aging, and is defined as the combination of an individual's physical, mental, and psychological capacities. This study aimed to assess IC via a patient-reported geriatric assessment (GA) and evaluate its association with survival among older adults with gastrointestinal (GI) malignancies. METHODS Data were used from a single-institution prospective registry of older adults undergoing GA before cancer therapy. Key domains of IC (vitality, locomotion, and sensory [hearing and visual], psychological, and cognitive capacities) were captured via GA, and each was given a score of 0 or 1 (0, impaired) to compute the total IC score (range, 0-6, where 6 indicates no impairment and ≤5 indicates impairment in ≥1 domains). A frailty index (FI) was measured via the deficit accumulation method. Cox regression models and Kaplan-Meier curves were used to examine the impact of IC impairment on survival. RESULTS The study included 665 patients; the median age was 68 years, 57.4% were men, and 72.9% were White. The median IC score was 4, and 79.3% of participants showed impairment in ≥1 domains of IC. Most commonly impaired domains were locomotion (48.7%) and vitality (43.9%). IC was inversely associated with FI (Spearman coefficient, -0.75; p < .001). IC impairment was associated with inferior overall survival (score, 4-5: adjusted hazard ratio [aHR], 1.7; 95% CI, 1.11-2.48; score, 2-3: aHR, 1.9; 95% CI, 1.30-2.85; score, 0-1: aHR, 1.9; 95% CI, 1.11-2.48). CONCLUSIONS IC impairment is associated with frailty and reduced overall survival in older patients with GI malignancies. GA can be used to screen for IC impairment as recommended by the WHO. PLAIN LANGUAGE SUMMARY The World Health Organization introduced intrinsic capacity as a marker of healthy aging. Intrinsic capacity is the combination of an individual's physical, mental, and psychological capacities. It contains six key domains: vitality, locomotion, and sensory (hearing and visual), psychological, and cognitive capacities. Older adults with cancer are susceptible to a decrease in intrinsic capacity as a result of cancer and the aging process. In this study, we aimed to assess the intrinsic capacity for patients with gastrointestinal cancer and also identify whether there exists any association of intrinsic capacity with overall survival. We identified that approximately 80% of this population had one or more impaired domains, and more intrinsic capacity impairment was associated with reduced overall survival.
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Affiliation(s)
- Supriya Maheshwari
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chen Dai
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Smith Giri
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christian Harmon
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Abigail Tucker
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mackenzie E Fowler
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Darryl Outlaw
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Grant R Williams
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Chen J, Peng G, Sun B. Alzheimer's disease and sleep disorders: A bidirectional relationship. Neuroscience 2024; 557:12-23. [PMID: 39137870 DOI: 10.1016/j.neuroscience.2024.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 07/30/2024] [Accepted: 08/07/2024] [Indexed: 08/15/2024]
Abstract
Alzheimer's disease (AD) is the most prevalent dementia, pathologically featuring abnormal accumulation of amyloid-β (Aβ) and hyperphosphorylated tau, while sleep, divided into rapid eye movement sleep (REM) and nonrapid eye movement sleep (NREM), plays a key role in consolidating social and spatial memory. Emerging evidence has revealed that sleep disorders such as circadian disturbances and disruption of neuronal rhythm activity are considered as both candidate risks and consequence of AD, suggesting a bidirectional relationship between sleep and AD. This review will firstly grasp basic knowledge of AD pathogenesis, then highlight macrostructural and microstructural alteration of sleep along with AD progression, explain the interaction between accumulation of Aβ and hyperphosphorylated tau, which are two critical neuropathological processes of AD, as well as neuroinflammation and sleep, and finally introduce several methods of sleep enhancement as strategies to reduce AD-associated neuropathology. Although theories about the bidirectional relationship and relevant therapeutic methods in mice have been well developed in recent years, the knowledge in human is still limited. More studies on how to effectively ameliorate AD pathology in patients by sleep enhancement and what specific roles of sleep play in AD are needed.
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Affiliation(s)
- Junhua Chen
- Chu Kochen Honors College of Zhejiang University, Hangzhou, Zhejiang 310058, China.
| | - Guoping Peng
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
| | - Binggui Sun
- Department of Anesthesiology of the Children's Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine and National Clinical Research Center for Child Health, Zhejiang University, Hangzhou, Zhejiang Province 310058, China; NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brain Medicine, Zhejiang University Hangzhou, Zhejiang Province 310058, China.
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Nyamathi A, Dutt N, Lee JA, Rahmani AM, Rasouli M, Krogh D, Krogh E, Sultzer D, Rashid H, Liaqat H, Jawad R, Azhar F, Ahmad A, Qamar B, Bhatti TY, Khay C, Ludlow J, Gibbs L, Rousseau J, Abbasian M, Song Y, Jeong C, Brunswicker S. Establishing the Foundations of Emotional Intelligence in Care Companion Robots to Mitigate Agitation Among High-Risk Patients With Dementia: Protocol for an Empathetic Patient-Robot Interaction Study. JMIR Res Protoc 2024; 13:e55761. [PMID: 39365656 DOI: 10.2196/55761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/21/2024] [Accepted: 07/12/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND An estimated 6.7 million persons are living with dementia in the United States, a number expected to double by 2060. Persons experiencing moderate to severe dementia are 4 to 5 times more likely to fall than those without dementia, due to agitation and unsteady gait. Socially assistive robots fail to address the changing emotional states associated with agitation, and it is unclear how emotional states change, how they impact agitation and gait over time, and how social robots can best respond by showing empathy. OBJECTIVE This study aims to design and validate a foundational model of emotional intelligence for empathetic patient-robot interaction that mitigates agitation among those at the highest risk: persons experiencing moderate to severe dementia. METHODS A design science approach will be adopted to (1) collect and store granular, personal, and chronological data using Personicle (an open-source software platform developed to automatically collect data from phones and other devices), incorporating real-time visual, audio, and physiological sensing technologies in a simulation laboratory and at board and care facilities; (2) develop statistical models to understand and forecast the emotional state, agitation level, and gait pattern of persons experiencing moderate to severe dementia in real time using machine learning and artificial intelligence and Personicle; (3) design and test an empathy-focused conversation model, focused on storytelling; and (4) test and evaluate this model for a care companion robot (CCR) in the community. RESULTS The study was funded in October 2023. For aim 1, architecture development for Personicle data collection began with a search for existing open-source data in January 2024. A community advisory board was formed and met in December 2023 to provide feedback on the use of CCRs and provide personal stories. Full institutional review board approval was received in March 2024 to place cameras and CCRs at the sites. In March 2024, atomic marker development was begun. For aim 2, after a review of open-source data on patients with dementia, the development of an emotional classifier was begun. Data labeling was started in April 2024 and completed in June 2024 with ongoing validation. Moreover, the team established a baseline multimodal model trained and validated on healthy-person data sets, using transformer architecture in a semisupervised manner, and later retrained on the labeled data set of patients experiencing moderate to severe dementia. In April 2024, empathy alignment of large language models was initiated using prompt engineering and reinforcement learning. CONCLUSIONS This innovative caregiving approach is designed to recognize the signs of agitation and, upon recognition, intervene with empathetic verbal communication. This proposal has the potential to have a significant impact on an emerging field of computational dementia science by reducing unnecessary agitation and falls of persons experiencing moderate to severe dementia, while reducing caregiver burden. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55761.
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Affiliation(s)
- Adeline Nyamathi
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States
| | - Nikil Dutt
- Donald Bren School of Information and Computer Sciences, University of California Irvine, Irvine, CA, United States
| | - Jung-Ah Lee
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States
| | - Amir M Rahmani
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States
| | - Mahkameh Rasouli
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States
| | - Donna Krogh
- Smart Forward, Rancho Palos Verdes, CA, United States
| | - Erik Krogh
- Smart Forward, Rancho Palos Verdes, CA, United States
| | - David Sultzer
- Department of Psychiatry and Human Behavior, and Institute for Memory Impairments and Neurological Disorders, University of California Irvine, Irvine, CA, United States
| | | | | | | | | | | | | | | | - Chet Khay
- Amore Senior Living, Laguna Niguel, CA, United States
| | - Jocelyn Ludlow
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States
| | - Lisa Gibbs
- School of Medicine, University of California Irvine, Irvine, CA, United States
| | - Julie Rousseau
- School of Medicine, University of California Irvine, Irvine, CA, United States
| | - Mahyar Abbasian
- Donald Bren School of Information and Computer Sciences, University of California Irvine, Irvine, CA, United States
| | - Yutong Song
- Donald Bren School of Information and Computer Sciences, University of California Irvine, Irvine, CA, United States
| | - Cheonkam Jeong
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States
- Research Center for Digital Innovation, Purdue University, West Lafayette, IN, United States
| | - Sabine Brunswicker
- Research Center for Digital Innovation, Purdue University, West Lafayette, IN, United States
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Alameda-Cuesta A, Oter-Quintana C, Lizcano-Álvarez Á, Brito-Brito PR, Talavera-Sáez A, Cid-Expósito MG. NANDA-I and NOC Linkages for Six Psychosocial Nursing Diagnoses: A Validation Study. Issues Ment Health Nurs 2024:1-10. [PMID: 39365984 DOI: 10.1080/01612840.2024.2400512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/06/2024]
Abstract
The aim of this study was to validate the diagnostic content and the NANDA-I and NOC linkages for six psychosocial nursing diagnoses. This multicentre, descriptive, cross-sectional validation study followed Fehring's model. Expert nurses in nursing methodology and standardised nursing languages in Spain participated, with expertise criteria based on academic level and clinical, teaching, and research experience in the fields of nursing methodology and standardised nursing languages. This study adhered to the STROBE guidelines for cross-sectional studies. Eighty-seven professionals participated in the diagnostic content validation phase, and 57 in the NANDA-I and NOC linkages validation phase. The content validity indices of the six diagnoses ranged from 0.74 to 0.84, all considered valid. All 84 proposed defining characteristics were valid, with 42 scoring ≥0.8. Thirty-two linkages between diagnoses and NOC outcomes were proposed, all valid, with mean scores between 0.73 and 0.98. Each diagnosis was linked to 5-6 NOC outcomes, comprising 26 main outcomes and 6 supplementary outcomes. Overall coverage rates for each diagnosis ranged from 68.42% to 100%. All linkages between defining characteristics and NOC outcome indicators were validated. The six selected psychosocial diagnoses, their defining characteristics, and the proposed linkages between diagnoses and outcomes have been validated. The validation of linkages between NOC indicators and nearly all major defining characteristics of these six psychosocial diagnoses will make it possible to enhance diagnostic accuracy and enable continuous assessment of the effects of nursing interventions on the clinical progression of these diagnoses.
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Affiliation(s)
| | | | | | | | - Ana Talavera-Sáez
- Dr. Luengo Rodríguez Healthcare Facility, Primary Healthcare Management Board, Madrid Health Service, Móstoles, Spain
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Abdelkhalek H, Elliott K, Whitfield T, Pazvantova K, Zabihi S, Wenborn J, Walker Z. Effectiveness of a 14-week protocol for cognitive stimulation therapy for mild dementia: results from a pragmatic study using routinely collected clinical data. Aging Ment Health 2024:1-9. [PMID: 39364856 DOI: 10.1080/13607863.2024.2410256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 09/22/2024] [Indexed: 10/05/2024]
Abstract
OBJECTIVES To explore the effectiveness of an adapted 14-week cognitive stimulation therapy (CST) protocol on psychoaffective symptoms and quality of life (QOL) for people living with mild dementia. METHOD The sample for this pragmatic study were people with dementia who underwent CST between May 2016 and September 2022 during routine healthcare. Measures of participants' psychoaffective symptoms and QOL were administered before CST ('baseline') and following CST ('post-intervention'). The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety symptoms, depression symptoms, and their sum score (referred to as HADS-total). The Quality of Life-Alzheimer's Disease (QOL-AD) scale was used to measure participants' quality of life (both patient and carer ratings were available). Change in these outcomes was assessed using linear mixed models. RESULTS Two hundred and twenty-five participants attended ≥1 session of adapted CST (84% attended at least 9/14 sessions, considered 'high' adherence). The mean change [95% confidence interval] in HADS-total scores indicated improvement (-0.9; [-1.9, -0.0]). Mean scores on the other outcomes showed neither improvement nor worsening. CONCLUSION Overall, this pragmatic study shows that an adapted 14-week face-to-face CST protocol is effective in improving mental health in people with mild dementia and has the potential to be widely implemented within routine healthcare.
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Affiliation(s)
| | - Karen Elliott
- Essex Partnership University NHS Foundation Trust, Essex, UK
| | - Tim Whitfield
- Division of Psychiatry, University College London, London, UK
| | | | - Sedigheh Zabihi
- Division of Psychiatry, University College London, London, UK
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jennifer Wenborn
- Essex Partnership University NHS Foundation Trust, Essex, UK
- Division of Psychiatry, University College London, London, UK
| | - Zuzana Walker
- Essex Partnership University NHS Foundation Trust, Essex, UK
- Division of Psychiatry, University College London, London, UK
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Xie Y, Shen S, Liu C, Hong H, Guan H, Zhang J, Yu W. Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Randomized Controlled Trial. JMIR Aging 2024; 7:e50847. [PMID: 39365914 DOI: 10.2196/50847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 06/04/2024] [Accepted: 07/08/2024] [Indexed: 10/06/2024] Open
Abstract
Background As dementia progresses, patients exhibit various psychological and behavioral symptoms, imposing a significant burden on families and society, including behavioral and psychological symptoms of dementia. However, caregivers lack professional care knowledge and skills, making it difficult for them to effectively cope with the diverse challenges of caregiving. Therefore, it is necessary to provide caregivers with professional knowledge and skills guidance. Objective This study aimed to analyze the impact of internet-based training on behavioral and psychological symptoms of dementia in patients, and explore how this training model affects the caregiving abilities and caregiving burden of the family caregivers of patients with dementia. Methods Using a consecutive enrollment method, the Department of Geriatrics at Zhejiang Hospital (Zhejiang, China) recruited 72 informal caregivers of patients with dementia. These caregivers were randomly divided into an intervention group and a control group, with 36 participants in each group. The intervention group underwent caregiver skill training via a web-based platform, whereas the control group initially received face-to-face follow-up guidance and was subsequently offered web-based training after 6 months. To assess the effectiveness of the intervention program, we used the Neuropsychiatric Inventory Questionnaire (NPI-Q), the Chinese version of the Zarit Burden Interview (CZBI), and the Sense of Competence in Dementia Care Staff Scale (SCIDS) for evaluations conducted before the intervention, 3 months after the intervention, and 6 months after the intervention. Results Between July 2019 and December 2020, a total of 66 patients successfully completed the intervention and follow-up. After 6 months of intervention, the NPI-Q score of the intervention group was 3.18 (SD 3.81), the CZBI score was 10.97 (SD 5.43), and the SCIDS score was 71.88 (SD 4.78). The NPI-Q score of the control group was 8.09 (SD 8.52), the CZBI score was 30.30 (SD 13.05), and the SCIDS score was 50.12 (SD 9.10). There were statistically significant differences in NPI-Q (P=.004), CZBI (P<.001), and SCIDS scores (P<.001) between the intervention group and the control group. Repeated measures analysis of variance showed that compared with before the intervention, there were statistically significant differences in CZBI (P<.001) and SCIDS (P<.001) scores 3 months after the intervention, while the difference in NPI-Q (P=.11) scores was not significant. The total scores of NPI-Q (P<.001), CZBI (P<.001), and SCIDS (P<.001) were significantly improved 6 months after the intervention. In addition, the results of the covariance analysis showed that after excluding the time effect, the web-based training intervention significantly reduced the NPI-Q score (-2.79, 95% CI -4.38 to -1.19; P<.001) of patients with dementia and the CZBI score (-13.52, 95% CI -15.87 to -11.16; P<.001) of caregivers, while increasing the SCIDS score (12.24, 95% CI 9.02-15.47; P<.001). Conclusions Internet-based training could significantly reduce the level of behavioral symptoms in older patients with dementia and alleviate the burden on caregivers, enhancing their caregiving abilities. Our results confirmed the effectiveness and feasibility of web-based training, which was of great significance in providing caregiving knowledge training for informal caregivers of persons with dementia.
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Affiliation(s)
- Yanhong Xie
- Geriatrics Department, Zhejiang Hospital, Hangzhou, China
| | - Shanshan Shen
- Geriatrics Department, Zhejiang Hospital, Hangzhou, China
| | - Caixia Liu
- Nursing Department, Zhejiang Hospital, Hangzhou, Zhejiang Province, China., China
| | - Hong Hong
- General Surgery, Zhejiang Hospital, 1229 Gudun Road, Xihu District, Hangzhou, Zhejiang Province, 310013, China, 86 15700106790
| | - Huilan Guan
- Geriatrics Department, Zhejiang Hospital, Hangzhou, China
| | - Jingmei Zhang
- Geriatrics Department, Zhejiang Hospital, Hangzhou, China
| | - Wanqi Yu
- The Medical Record Statistics Department, Zhejiang Hospital, Hangzhou, China
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Rogers SE, Mulvey J, Turingan R, Coco LM, Hubbard CC, Binford S, Harrison JD. Mobility Loss in Hospitalized Adults Predicts Poor Clinical Outcomes. J Nurs Care Qual 2024:00001786-990000000-00171. [PMID: 39361883 DOI: 10.1097/ncq.0000000000000816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
BACKGROUND The Johns Hopkins Activity and Mobility Program is a systematic approach to measure and improve patient mobility. PURPOSE The purpose of this study was to evaluate the relationship between mobility loss and quality outcomes. METHODS A retrospective cohort study design was used. Patients were categorized into 3 groups (gain, loss, no change in mobility) using the Johns Hopkins Highest Level of Mobility (JH-HLM) scores. The association between mobility loss and falls risk, in-hospital mortality, delirium, discharge to a facility, length of stay, and 30 day readmissions were assessed. RESULTS Those who lost mobility were more at risk of being a high fall risk, in-hospital mortality, delirium, discharging to a facility, and had 48% longer lengths of stay. There was no association between mobility loss and 30-day readmissions. CONCLUSIONS Loss of mobility assessed using JH-HLM scores is associated with worse patient outcomes.
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Affiliation(s)
- Stephanie E Rogers
- Author Affiliations: Department of Medicine, Division of Geriatrics, University of California, San Francisco, California (Dr. Rogers); University of Utah School of Medicine, Salt Lake City, Utah (Mulvey); Department of Medicine, Division of Geriatrics, University of California, San Francisco, California (Turingan); Department of Rehabilitation Services, UCSF Health, San Francisco, California (Coco); Department of Medicine, Division of Hospital Medicine, UCSF, San Francisco, California (Hubbard); Department of Nursing, UCSF, San Francisco, California (Binford); and Department of Medicine, Division of Hospital Medicine, UCSF, San Francisco, California (Harrison)
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42
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Jung D, Park J, Choi E, Yoo L, Kim K, Cho S, Shin S. Educational needs of direct care workers in long-term care facilities providing mealtime assistance to older adults with dementia. BMC Geriatr 2024; 24:808. [PMID: 39363169 DOI: 10.1186/s12877-024-05368-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/09/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Older adults with dementia in long-term care facilities often encounter challenges in self-feeding owing to cognitive and physical impairments. Although direct care workers play a crucial role in facilitating mealtime activities, they lack adequate and specific training. To develop an effective educational training program for this purpose, it is essential to understand the educational needs of direct care workers providing meal assistance. Therefore, this study aimed to identify the educational needs prioritized by direct care workers in long-term care facilities, regarding providing eating assistance to older adults with dementia. METHODS Adopting a mixed-methods approach, this study combined quantitative analysis using Borich's needs assessment and locus for focus models with qualitative insights from focus group interviews. Participants comprised 174 direct care workers and five nursing managers from various long-term care facilities in South Korea. RESULTS This study identified four main educational priorities: enhancing knowledge regarding swallowing function, understanding institutional support mechanisms, applying multisensory stimulation techniques, and addressing food forgetfulness in older adults with dementia. These findings were aligned with the qualitative data that emphasized the necessity of training in these specific areas to improve the quality of meal assistance provided to this vulnerable population. CONCLUSION The findings underscore the critical need for focused educational programs that equip direct care workers with the skills and knowledge necessary to effectively assist older adults with dementia during mealtime. This study advocates the implementation of continuous education and training initiatives led by nursing management to improve the meal assistance environment for older adults with dementia, thereby enhancing their overall care and quality of life.
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Affiliation(s)
- Dukyoo Jung
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea
| | - Jisung Park
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea.
| | - Eunju Choi
- Department of Nursing, College of Medical Sciences, Jeonju University, 303 Cheonjam-Ro, Wansan-Gu Jeonju-Si, Jeonbuk, 55069, Republic of Korea
| | - Leeho Yoo
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea
| | - Kahyun Kim
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea
| | - Seyoung Cho
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea
| | - Soogyung Shin
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea
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43
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Zhao H, Shi H, He M, Cui L, Wang S, Zhao J, Li W, Wei Y, Zhang W, Chen Z, Liu H, Zhang X. Associations of caring for grandchildren and great-grandparents with depressive symptoms and life satisfaction in Chinese grandparents: The moderating roles of urban-rural residence and social participation. FAMILY PROCESS 2024. [PMID: 39363509 DOI: 10.1111/famp.13066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 07/25/2024] [Accepted: 09/05/2024] [Indexed: 10/05/2024]
Abstract
This study aims to investigate the associations of caring for grandchildren and/or great-grandparents with depressive symptoms, as well as life satisfaction in Chinese grandparents, and analyze the moderating roles of urban-rural residence and social participation. A nationally representative sample of 2973 grandparents in families with great-grandparents and grandchildren were selected from the 2018 China Health and Retirement Longitudinal Study (CHARLS). The Center for Epidemiologic Studies Depression (CESD-10) and the single-item were used to measure depressive symptoms and life satisfaction. Social participation included participation in social and intellectual activities. The binary logistic regression model was employed to explore the relationship between caring and depressive symptoms, as well as life satisfaction in the whole participants, different urban-rural residence, and social participation groups, respectively. Caring was associated with depressive symptoms and life satisfaction (p < 0.05). A significant interaction existed between caring and urban-rural residence for depressive symptoms (interaction p = 0.029) and life satisfaction (interaction p = 0.027). Significant interactions were also found among caring, urban-rural residence, and social activities with depressive symptoms (interaction p = 0.025). In urban, caring for both was negatively related to depressive symptoms for the non-social activists, while in rural, caring for great-grandparents was positively associated with depressive symptoms for social activists (p < 0.05). Any new policy design related to preventing and reducing the possibility of mental disorders in Chinese grandparents should be tailored to heterogeneous subgroups who live in different rural-urban and social activities participation.
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Affiliation(s)
- Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
- School of Medicine, Sias University, Zhengzhou, Henan, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Li Cui
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shixun Wang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Jieyu Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yachen Wei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjing Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Ziqiang Chen
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
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44
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Guo J, Wister A, Mitchell B, Li S. Number of Chronic Conditions and Death Anxiety Among Older Adults in Rural China: A Longitudinal Study in Anhui Province. J Aging Health 2024:8982643241289516. [PMID: 39361775 DOI: 10.1177/08982643241289516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
Objectives: Death anxiety is feelings of worry and fear regarding death. This study explored the effect of number of chronic conditions on death anxiety in older adults and the moderating effect of age. Methods: This study used the fifth, sixth, seventh, and eighth waves of longitudinal data (2012-2021) collected in Anhui, China (5014 person-year observations). A mixed linear model was used to examine the effect of number of chronic conditions on death anxiety and the moderating effect of age. Results: The number of chronic conditions showed an inverted U-shaped relationship with death anxiety, with death anxiety being lower in older adults with older age. As age increased, the U-shaped curve became flatter, and the extremes shifted to the right. Discussion: Particular attention should be given to younger older adults with chronic conditions to help them recover earlier from the negative impact by providing information and counseling about their chronic conditions.
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Affiliation(s)
- Jin Guo
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
| | - Andrew Wister
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Barbara Mitchell
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
- Department of Sociology and Anthropology, Simon Fraser University, Burnaby, BC, Canada
| | - Shuzhuo Li
- Center for Aging and Health Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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45
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Nydahl P, Chahdi M, Debue AS, Deffner T, Galazzi A, Gallie L, La-Calle GH, Krotsetis S, Lewko A, Lindroth H, Liu K, Paulino MC, Prigge A, van den Boogaard M, von Haken R. You are safe here: A flyer with re-orientating messages for families of patients with delirium in the intensive care unit. Nurs Crit Care 2024. [PMID: 39362828 DOI: 10.1111/nicc.13169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/05/2024] [Accepted: 09/12/2024] [Indexed: 10/05/2024]
Abstract
Patients in delirium require trustful communication and re-orientation. We developed a flyer with positive, re-orientating suggestions for families of delirious patients in intensive care units. Suggestions include creating a safe environment, interpreting unusual behaviours positively and fostering mental resilience. Additionally, families are encouraged to prioritize their own well-being, recognizing their crucial role in supporting their loved ones. This flyer offers practical strategies across four key areas: ensuring security and orientation, reframing noises and body experiences, managing agitation and reshaping perceptions. By equipping families with knowledge and tools, this resource aims to promote understanding, resilience and strength to humanize delirium care.
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Affiliation(s)
- Peter Nydahl
- Nursing Research and Development, University Hospital Schleswig-Holstein, Kiel, Germany
- Institute of Nursing Science and Development, Paracelsus Medical University, Salzburg, Austria
| | - Mohamed Chahdi
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | | | - Teresa Deffner
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | | | - Louise Gallie
- Quality and Research, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | | | - Susanne Krotsetis
- Nursing Research and Development, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Agnieszka Lewko
- Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
| | - Heidi Lindroth
- Division of Nursing Research, Department of Nursing, Mayo Clinic, Rochester, Minnesota, USA
- Center for Aging Research, Regenstrief Institute, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Keibun Liu
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia
- Institute for Molecular Bioscience (IMB), The University of Queensland, Brisbane, Australia
- Quality and Research, Non-Profit Organization ICU Collaboration Network (ICON), Tokyo, Japan
| | - Maria Carolina Paulino
- Department of Intensive Care, Hospital da Luz Lisboa, Lisbon, Portugal
- Intensive Care Unit 4, Hospital de Sao Francisco Xavier, CHLO, Lisbon, Portugal
- NOVA Medical School, New University of Lisbon, Lisbon, Portugal
| | - Arvid Prigge
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Schleswig-Holstein Kiel, Kiel, Germany
| | - Mark van den Boogaard
- Department Intensive Care, Radboud University Medica Center, Nijmegen, The Netherlands
| | - Rebecca von Haken
- Department of Anesthesiology, University Hospital Mannheim, Mannheim, Germany
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46
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Kokorelias KM, Saragosa M, Abdelhalim R, Philippopoulos E, Vo A. Experiences of internationally educated nurses working with older adults: A scoping review protocol. PLoS One 2024; 19:e0307795. [PMID: 39361566 PMCID: PMC11449320 DOI: 10.1371/journal.pone.0307795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/11/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Canada, like many other jurisdictions worldwide, is facing a nursing shortage. At the same time, high-income countries are facing a rapidly ageing and more complex older adult population. Demands for more responsive health care services are driving systems of care to meet the evolving needs of the ageing population. Internationally-educated nurses (IENs) can help fill gaps in the care of older adults, but may need considerable support to work in new social and health care environments. However, the experiences of IENs within the geriatric care literature have not been comprehensively reviewed. This protocol will outline a scoping review to determine: (1) what is known about the experiences and support needs of IENs in geriatric healthcare settings within high income countries? (2) what are current supportive-pathways for IENs in geriatric practice settings? And (3) what are the research gaps in the existing literature on the experiences and support needs of IENs within the context of geriatrics? METHODS A scoping review will be conducted guided by the methodological framework set out by Arksey and O'Malley (2005) and later advanced by Levac, Colquhoun and O'Brien (2010). The search strategy will be applied to seven databases (MEDLINE, PubMed (non-MEDLINE records), PsycINFO, PsychArticles, CINAHL, Scopus, Web of Science). Grey literature will be searched using Google search engines, targeted websites and consultation with content experts. Articles of any publication date will be included. A two-stage screening process will be conducted in duplicate (i.e., two reviewers per stage) to determine eligible articles. Data from eligible articles will be extracted using a piloted charting form. Extracted data will be analyzed using thematic and descriptive analyses. DISCUSSION The findings of the upcoming will highlight opportunities and recommendations to inform future research and support training to support IENs working with older adults within high income countries. Publication, presentations and stakeholder meetings will disseminate our findings.
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Affiliation(s)
- Kristina M. Kokorelias
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- National Institute on Ageing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Marianne Saragosa
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
| | | | | | - Ann Vo
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
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Zhou Z, Wang D, Sun J, Zhu M, Teng L. A Machine Learning-Based Prediction Model for the Probability of Fall Risk Among Chinese Community-Dwelling Older Adults. Comput Inform Nurs 2024:00024665-990000000-00235. [PMID: 39356834 DOI: 10.1097/cin.0000000000001202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Fall is a common adverse event among older adults. This study aimed to identify essential fall factors and develop a machine learning-based prediction model to predict the fall risk category among community-dwelling older adults, leading to earlier intervention and better outcomes. Three prediction models (logistic regression, random forest, and naive Bayes) were constructed and evaluated. A total of 459 people were involved, including 156 participants (34.0%) with high fall risk. Seven independent predictors (frail status, age, smoking, heart attack, cerebrovascular disease, arthritis, and osteoporosis) were selected to develop the models. Among the three machine learning models, the logistic regression model had the best model fit, with the highest area under the curve (0.856) and accuracy (0.797) and sensitivity (0.735) in the test set. The logistic regression model had excellent discrimination, calibration, and clinical decision-making ability, which could aid in accurately identifying the high-risk groups and taking early intervention with the model.
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Affiliation(s)
- Zhou Zhou
- Author Affiliations: Wuxi School of Medicine, Jiangnan University, Jiangsu (Mr Zhou; Mss Wang, Sun, and Zhu; and Dr Teng); Traditional Chinese Medicine Hospital of Qinghai Province, Xining, Qinghai (Ms Wang), China
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48
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Smith JM, Burgdorf JG, Riser TJ, Ryvicker M. Skilled home healthcare utilization and outcomes for older adults with dementia: A scoping review. J Am Geriatr Soc 2024. [PMID: 39355968 DOI: 10.1111/jgs.19203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/21/2024] [Accepted: 09/10/2024] [Indexed: 10/03/2024]
Abstract
OBJECTIVES This study aims to summarize the existing research literature examining Medicare-skilled home health (HH) utilization and clinical outcomes for persons with dementia (PwD). We sought to answer the following questions: (1) How is dementia defined and classified in the HH literature? (2) What associations have been observed between dementia status and patterns of HH utilization? (3) What associations have been observed between dementia status and HH outcomes? METHODS Using Arksey and O'Malley's framework for scoping reviews, we searched PubMed, Google Scholar, and select relevant journals for quantitative studies conducted in the United States between 2000 and 2023 examining Medicare HH use and outcomes for PwD. We describe and compare approaches to classify dementia, identify findings related to HH utilization and outcomes supported by the preponderance of evidence, and comment on existing gaps and areas of ambiguity in the literature. RESULTS Thirty-two articles met the inclusion criteria. Most used claims-based data to classify dementia, leveraged national data, and were limited to traditional Medicare beneficiaries. Studies found meaningful differences in HH utilization by dementia status; most notably, PwD were more likely to access HH without a preceding hospitalization, had longer lengths of stay, and incurred higher HH costs. Literature relating to clinical outcomes was more difficult to interpret, due to significant variation in study objectives, samples, and outcome measures which prompted more nuanced and even contradictory conclusions. There is a dearth of research identifying how specific HH care pathways (e.g., service types, visit frequency) impact outcomes for this patient population. CONCLUSIONS This review supports the understanding that PwD are a unique subpopulation of HH patients who require special attention in policy development and evaluation. Critical research is needed to examine clinical outcomes in PwD further to inform practice and improve care quality.
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Affiliation(s)
- Jamie M Smith
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Julia G Burgdorf
- Center for Home Care Policy & Research at VNS Health, New York, New York, USA
| | | | - Miriam Ryvicker
- Center for Home Care Policy & Research at VNS Health, New York, New York, USA
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Loerzel V, Alamian A, Clochesy J, Geddie PI. Serious Gaming for Chemotherapy-Induced Nausea and Vomiting in Older Adults With Cancer: Protocol for a Randomized Clinical Trial. JMIR Res Protoc 2024; 13:e64673. [PMID: 39357051 DOI: 10.2196/64673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/06/2024] [Accepted: 08/08/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Older adults are at high risk for toxicity due to cancer treatment and increased risk for adverse events related to chemotherapy-induced nausea and vomiting (CINV). Unfortunately, older adults report multiple treatment-related symptoms but use few strategies to self-manage these symptoms due to erroneous beliefs related to the effectiveness of commonly taught self-management strategies. We developed a novel serious game, Managing at Home (MAH), to help older adults learn how to effectively self-manage CINV at home. OBJECTIVE This study has 2 aims. Aim 1 is to examine changes in CINV severity, self-management behaviors, functioning, quality of life, cognitive representation, and health care use within the intervention group from baseline (T1) to completion of the study (T6). Aim 2 is to determine the efficacy of the MAH intervention by comparing differences in primary outcomes (CINV severity and health care use) and secondary outcomes (self-management behaviors, functioning, and quality of life) between the intervention and control groups at each follow-up visit (T2-T6) and completion of the study (T6). METHODS This is a longitudinal randomized clinical trial. We will collect data from 500 older adults receiving cancer-related chemotherapy at baseline (T1) and at each treatment cycle until cycle 6 (T6). Participants will be enrolled if they are 60 years or older of age, are newly diagnosed with cancer, being treated with any chemotherapy agent with moderate or high emetic potential, are on a 2-, 3-, or 4-week treatment cycle, are proficient in English, and have a telephone. Previous diagnosis or treatment for cancer, end-stage disease with less than 6 months to live, and uncorrected visual or hearing impairment are exclusion criteria. RESULTS This study was funded in September 2022 and received institutional review board approval in October 2022. As of July 2023, the enrollment of participants is ongoing and currently has 130 enrolled participants. Data collection and analysis will be complete in 2027. CONCLUSIONS This study addresses self-management of CINV in older adults using an innovative serious game. The MAH intervention uses simulation and gaming technology to engage older adults in active learning in order to reframe erroneous perceptions about symptom self-management. If shown to be effective, it can easily be adapted to include other cancer-related symptoms or other chronic illnesses. TRIAL REGISTRATION ClinicalTrials.gov NCT05838638; https://clinicaltrials.gov/study/NCT05838638. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/64673.
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Affiliation(s)
- Victoria Loerzel
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Arsham Alamian
- School of Nursing, University of Miami, Miami, FL, United States
| | - John Clochesy
- School of Nursing, University of Miami, Miami, FL, United States
| | - Patricia I Geddie
- Department of Nursing Research, Moffitt Cancer Center, Tampa, FL, United States
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50
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Wells T, Russell E. "I've Got a Lot of Other Things I Do": The Nuances of Digital Engagement among Older People. Can J Aging 2024:1-11. [PMID: 39356040 DOI: 10.1017/s0714980824000266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2024] Open
Abstract
As Western society becomes increasingly digitally dependent and many older adults actively engage in the online world, understanding the experiences of those who largely do not use digital technology in their daily lives is crucial. Individual interviews were conducted (pre-pandemic) with 23 older adults who, based on self-identification, did not regularly use digital technology, exploring how their experiences as limited digital technology users may have impacted their daily lives. An iterative collaborative qualitative analysis demonstrated three main themes: internet concerns, frustrations with digital technology, and conflicting motivators to use digital technology. Findings suggest that addressing digital concerns and providing effective digital skill learning opportunities may encourage some older adults to become more digitally engaged. However, as people, including older adults, can be uninterested in using these technologies, organizations and institutions should work to offer ways to support people of all ages who are not engaged online.
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Affiliation(s)
- Tabytha Wells
- Department of Psychology, Trent University, 1600 West Bank Drive, Peterborough, OntarioK9L 0G2, Canada
| | - Elizabeth Russell
- Department of Psychology, Trent University, 1600 West Bank Drive, Peterborough, OntarioK9L 0G2, Canada
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