1
|
Li Y, Hung V, Ho K, Kavalieratos D, Warda N, Zimmermann C, Quinn KL. The Validity of Patient-Reported Outcome Measures of Quality of Life in Palliative Care: A Systematic Review. J Palliat Med 2024; 27:545-562. [PMID: 37971747 DOI: 10.1089/jpm.2023.0294] [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] [Indexed: 11/19/2023] Open
Abstract
Importance: A recent systematic review and meta-analysis found that palliative care was not associated with improvement in quality of life (QOL) in terminal noncancer illness. Among potential reasons for a null effect, it is unclear if patient-reported outcome measures (PROMs) measuring QOL were derived or validated among populations with advanced life-limiting illness (ALLI). Objective: To systematically review the derivation and validation of QOL PROMs from a recent meta-analysis of randomized controlled trials (RCT) of palliative care interventions in people with terminal noncancer illness. Evidence Review: EMBASE, MEDLINE, and PsycINFO were searched from inception to January 8, 2023 for primary validation studies of QOL PROMs in populations with ALLI, defined as adults with a progressive terminal condition and an estimated median survival of less than or equal to one year. The primary outcome was the proportion of PROMs that were derived or validated in ≥1 ALLI population. Findings: Twenty-one unique studies of derivation (n = 13) and validation (n = 11, 3 studies evaluated both) provided data on 9657 participants (mean age 63 years, 50% female) across 15 unique QOL PROMs and subscales. Among studies of validation, 9 were in people with cancer (n = 2289, n = 5 PROMs), 1 in neurodegenerative disease (n = 23, n = 1 PROM), and 1 with mixed diseases (n = 248, n = 1 PROM). Across 15 QOL PROMs and subscales, 47% (n = 7) were derived or validated in an ALLI population. The majority of these seven PROMs were exclusively derived or validated among people with cancer (57%, n = 4). QOL PROMs such as Quality of Life at End of Life, EuroQoL-5 Dimension 5-level, and 36-item Short Form Survey demonstrated validity in more than one terminal noncancer illness. Conclusions: Most QOL PROMs that measured the effect of palliative care on QOL in RCTs were neither derived nor validated in an ALLI population. These findings raise questions about the inferences that palliative care does not improve QOL among people with terminal noncancer illness.
Collapse
Affiliation(s)
- Yifan Li
- Division of Palliative Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vivian Hung
- Department of Medicine, Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, Ontario, Canada
| | - Kevin Ho
- Department of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Dio Kavalieratos
- Division of Palliative Medicine, Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
| | - Nahrain Warda
- Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Division of Palliative Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
| | - Kieran L Quinn
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, Ontario, Canada
- Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
- ICES, Toronto and Ottawa, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Ma Y, Gong J, Zeng L, Wang Q, Yao X, Li H, Chen Y, Liu F, Zhang M, Ren H, Xiao LD, Lian Y. The Effectiveness of a Community Nurse-Led Support Program for Dementia Caregivers in Chinese Communities: The Chongqing Ageing and Dementia Study. J Alzheimers Dis Rep 2023; 7:1153-1164. [PMID: 38025803 PMCID: PMC10657713 DOI: 10.3233/adr-230067] [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: 07/13/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023] Open
Abstract
Background As the primary caregivers for people with dementia in China, family caregivers face a significant care burden that can negatively impact their mental and physical health. It is vital to investigate ways to support these caregivers. Objective To assess the effectiveness of a program led by community nurses to support caregivers of individuals with dementia. Methods A total of 30 caregivers received nurse-led support in addition to usual care, while 28 caregivers received only usual care. The primary outcome was caregivers' sense of competency in providing dementia care, which was measured using the Short Sense of Competence Questionnaire (SSCQ). Secondary outcomes included caregivers' ability to perform daily activities, behavioral and psychological symptoms of dementia (BPSD) using a neuropsychiatric inventory questionnaire, and quality of life using the short form health survey (SF-36). The trial was registered at the Chinese Clinical Trial Registry (ChiCTR 2300071484). Results Compared to the control group, the intervention group had significantly higher SSCQ scores and a lower caregiver distress index over time. Physical and mental health-related quality of life also improved significantly among caregivers in the intervention group. However, there was no significant difference between the two groups in terms of activities of daily living and BPSD. Conclusions The community nurse-led support program significantly improved caregivers' competency in providing dementia care and quality of life and reduced distress. These findings have important implications for dementia care policies, resources, and workforce development in China, including strengthening community dementia care services through collaboration with specialists in hospitals.
Collapse
Affiliation(s)
- Yuanyuan Ma
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Juan Gong
- Daping Community Healthcare Center, Yuzhong District, Chongqing, China
| | - Lingli Zeng
- Daping Community Healthcare Center, Yuzhong District, Chongqing, China
| | - Qinghua Wang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Xiuqing Yao
- Department of Rehabilitation, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huiming Li
- Department of Prevention and Healthcare, Medicine and Research Sector, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yaozhi Chen
- Department of Prevention and Healthcare, Medicine and Research Sector, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Feng Liu
- Department of Sleep and Psychology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Mengyuan Zhang
- Department of Clinical Nutrition, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Hui Ren
- School of Nursing, Third Military Medical University, Chongqing, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Yan Lian
- Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
- Department of Prevention and Healthcare, Medicine and Research Sector, Daping Hospital, Third Military Medical University, Chongqing, China
| |
Collapse
|
3
|
Platen M, Flessa S, Teipel S, Rädke A, Scharf A, Mohr W, Buchholz M, Hoffmann W, Michalowsky B. Impact of low-value medications on quality of life, hospitalization and costs - A longitudinal analysis of patients living with dementia. Alzheimers Dement 2023; 19:4520-4531. [PMID: 36905286 DOI: 10.1002/alz.13012] [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: 10/18/2022] [Revised: 01/19/2023] [Accepted: 01/22/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION This study aimed to analyze the impact of low-value medications (Lvm), that is, medications unlikely to benefit patients but to cause harm, on patient-centered outcomes over 24 months. METHODS This longitudinal analysis was based on baseline, 12 and 24 months follow-up data of 352 patients with dementia. The impact of Lvm on health-related quality of life (HRQoL), hospitalizations, and health care costs were assessed using multiple panel-specific regression models. RESULTS Over 24 months, 182 patients (52%) received Lvm at least once and 56 (16%) continuously. Lvm significantly increased the risk of hospitalization by 49% (odds ratio, confidence interval [CI] 95% 1.06-2.09; p = 0.022), increased health care costs by €6810 (CI 95% -707€-14,27€; p = 0.076), and reduced patients' HRQoL (b = -1.55; CI 95% -2.76 to -0.35; p = 0.011). DISCUSSION More than every second patient received Lvm, negatively impacting patient-reported HRQoL, hospitalizations, and costs. Innovative approaches are needed to encourage prescribers to avoid and replace Lvm in dementia care. HIGHLIGHTS Over 24 months, more than every second patient received low-value medications (Lvm). Lvm negatively impact physical, psychological, and financial outcomes. Appropriate measures are needed to change prescription behaviors.
Collapse
Affiliation(s)
- Moritz Platen
- German Center for Neurodegenerative Diseases (DZNE), site Greifswald, Ellernholzstrasse 1-2, Greifswald, Germany
| | - Steffen Flessa
- Department of General Business Administration and Health Care Management, University of Greifswald, Friedrich-Loeffler-Straße 70, Greifswald, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), site Rostock, Gehlsheimer Str. 20, Rostock, Germany
- Department of Psychosomatic Medicine, University Hospital Rostock, Gehlsheimer Str. 20, Rostock, Germany
| | - Anika Rädke
- German Center for Neurodegenerative Diseases (DZNE), site Greifswald, Ellernholzstrasse 1-2, Greifswald, Germany
| | - Annelie Scharf
- German Center for Neurodegenerative Diseases (DZNE), site Greifswald, Ellernholzstrasse 1-2, Greifswald, Germany
| | - Wiebke Mohr
- German Center for Neurodegenerative Diseases (DZNE), site Greifswald, Ellernholzstrasse 1-2, Greifswald, Germany
| | - Maresa Buchholz
- German Center for Neurodegenerative Diseases (DZNE), site Greifswald, Ellernholzstrasse 1-2, Greifswald, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), site Greifswald, Ellernholzstrasse 1-2, Greifswald, Germany
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald (UMG), Ellernholzstrasse 1-2, Greifswald, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE), site Greifswald, Ellernholzstrasse 1-2, Greifswald, Germany
| |
Collapse
|
4
|
Identifying Primary Care Models of Dementia Care that Improve Quality of Life for People Living with Dementia and their Care Partners: An Environmental Scan. Can J Aging 2022; 41:550-564. [PMID: 36482723 DOI: 10.1017/s0714980821000635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Dementia is a growing concern in Canada, affecting peoples' health and raising the cost of care. Between June and October 2019, we conducted an environmental scan to identify primary care models, strategies, and resources for dementia care from 11 pre-selected countries and assess their impact on quality-of-life measures. Search strategies included a rapid scoping review, grey literature search, and discussions with stakeholders. Eighteen primary care-based models of dementia care were identified. Common factors include team-based care, centralized care/case coordination, individual treatment plans, a stepped-care approach, and support for care partners. Five provinces had released a dementia strategy. Evidence of positive outcomes supported primary care-based models for dementia care, although only one model demonstrated evidence of impact on quality of life. Although these findings are encouraging, further research is needed to identify primary care-based models of dementia care that demonstrably improve quality of life for people living with dementia and their care partners.
Collapse
|
5
|
Tari AR, Berg HH, Videm V, Bråthen G, White LR, Røsbjørgen RN, Scheffler K, Dalen H, Holte E, Haberg AK, Selbaek G, Lydersen S, Duezel E, Bergh S, Logan-Halvorsrud KR, Sando SB, Wisløff U. Safety and efficacy of plasma transfusion from exercise-trained donors in patients with early Alzheimer's disease: protocol for the ExPlas study. BMJ Open 2022; 12:e056964. [PMID: 36538409 PMCID: PMC9453994 DOI: 10.1136/bmjopen-2021-056964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Given that exercise training reduces the risk of developing Alzheimer's disease (AD), induces changes in the blood composition and has widespread systemic benefits, it is reasonable to hypothesise that exercised plasma (ExPlas) may have rejuvenative properties. The main objective is to test safety and tolerability of transfusing ExPlas from young, healthy, fit adults to patients with mild cognitive impairment (MCI) or early AD. The study is a pilot for a future efficacy study. The key secondary objectives are examining the effect of plasma transfusions on cognitive function, fitness level, vascular risk profile, assessment of cerebral blood flow and hippocampal volume, quality of life, functional connectivity assessed by resting state functional MRI and biomarkers in blood and cerebrospinal fluid. METHODS AND ANALYSIS ExPlas is a double-blinded, randomised controlled clinical single-centre trial. Patients up to 75 years of age with diagnosis early symptomatic phase AD will be recruited from two Norwegian hospitals. ExPlas is plasma drawn by plasmapheresis once a month for 4 months, from a total of 30 fit male donors (aged 18-40, BMI≤27 kg/m2 and maximal oxygen uptake>55 mL/kg/min). All units will be virus inactivated by the Intercept method in accordance with procedures at St. Olavs University Hospital. Comparison with isotonic saline allows differentiation from a non-blood product. The main study consists of 6 rounds of examinations in addition to 12 plasma transfusions divided over three 4-week periods during study year-1. It is also planned to conduct follow-up examinations 2 and 5 years after baseline ETHICS AND DISSEMINATION: Written informed consent will be obtained from all participants and participation is voluntary. All participants have a next of kin who will follow them throughout the study to represent the patient's interest. The study is approved by the Regional Committee for Medical and Health Research Ethics (REK 2018/702) and the Norwegian Medicines Agency (EudraCT No. 2018-000148-24). The study will be published in an open access journal and results will be presented at numerous national and international meetings as well as on social media platforms. TRIAL REGISTRATION NUMBER EudraCT No. 2018-000148-24. CLINICALTRIALS gov, NCT05068830.
Collapse
Affiliation(s)
- Atefe R Tari
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
| | - Helene Haugen Berg
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
| | - Vibeke Videm
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Immunology and Transfusion Medicine, St Olavs University Hosptial, Trondheim, Norway
| | - Geir Bråthen
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Linda R White
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ragnhild Nyhus Røsbjørgen
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Katja Scheffler
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Havard Dalen
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Espen Holte
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Asta K Haberg
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Stian Lydersen
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Emrah Duezel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
| | - Sverre Bergh
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | | | - Sigrid Botne Sando
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
| |
Collapse
|
6
|
Lin SF, Fan YC, Kuo TT, Pan WH, Bai CH. Quality of life and cognitive assessment in healthy older Asian people with early and moderate chronic kidney disease: The NAHSIT 2013–2016 and validation study. PLoS One 2022; 17:e0264915. [PMID: 35271629 PMCID: PMC8912208 DOI: 10.1371/journal.pone.0264915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background Taiwan has the highest prevalence of chronic kidney disease (CKD). Impaired cognition and quality of life are significant phenomena in the late stages of CKD. We sought to obtain an overview and the attributable effect of impaired glomerular filtration on multiple domains in cognition and dimensions of quality of life for community-based healthy older adults in Taiwan. Methods The study was derived from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013–2016, a nationwide cross-sectional study conducted to sample healthy, community-based older adults aged ≥65 years in Taiwan. Participants were categorized into four CKD groups: CKD stage 1, stage 2, stages 3a and 3b, and stages 4–5. The Mini-Mental State Examination (MMSE) and the QoL questionnaire derived from the 12-item Short Form Health Survey (SF-12) were measured. Generalized linear mixed models (GLMMs) and principal component regressions were employed for the analysis and validation, respectively. Results Participants with moderate CKD (stages 3a and 3b) showed deficits in global MMSE, domain orientation to time, calculation, complex commands, and role-physical and vitality in QoL questionnaires. In GLMMs, impaired eGFR per 30 mL/min/1.73 m² was associated with lower global MMSE scores (β = -0.807, standard error [SE] = 0.235, P = 0.0007), domain orientation to time (β = -0.155, SE = 0.047, P = 0.0011), calculation (β = -0.338, SE = 0.109, P = 0.0020), complex commands (β = -0.156, SE = 0.079, P = 0.0494), and role-physical (β = -2.219, SE = 0.779, P = 0.0046) dimensions of QoL. Conclusions Elderly Han Chinese adults with moderately impaired renal filtration could manifest cognitive deficits in orientation to time, calculation, and impaired quality of life in physical role functioning.
Collapse
Affiliation(s)
- Sheng-Feng Lin
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yen-Chun Fan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Tung Kuo
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Harn Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Chyi-Huey Bai
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
7
|
Platen M, Fleßa S, Rädke A, Wucherer D, Thyrian JR, Mohr W, Scharf A, Mühlichen F, Hoffmann W, Michalowsky B. Prevalence of Low-Value Care and Its Associations with Patient-Centered Outcomes in Dementia. J Alzheimers Dis 2021; 83:1775-1787. [PMID: 34459396 PMCID: PMC8609693 DOI: 10.3233/jad-210439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Low-value care (LvC) is defined as care unlikely to provide a benefit to the patient regarding the patient’s preferences, potential harms, costs, or available alternatives. Avoiding LvC and promoting recommended evidence-based treatments, referred to as high-value care (HvC), could improve patient-reported outcomes for people living with dementia (PwD). Objective: This study aims to determine the prevalence of LvC and HvC in dementia and the associations of LvC and HvC with patients’ quality of life and hospitalization. Methods: The analysis was based on data of the DelpHi trial and included 516 PwD. Dementia-specific guidelines, the “Choosing Wisely” campaign and the PRISCUS list were used to indicate LvC and HvC treatments, resulting in 347 LvC and HvC related recommendations. Of these, 77 recommendations (51 for LvC, 26 for HvC) were measured within the DelpHi-trial and finally used for this analysis. The association of LvC and HvC treatments with PwD health-related quality of life (HRQoL) and hospitalization was assessed using multiple regression models. Results: LvC was highly prevalent in PwD (31%). PwD receiving LvC had a significantly lower quality of life (b = –0.07; 95% CI –0.14 – –0.01) and were significantly more likely to be hospitalized (OR = 2.06; 95% CI 1.26–3.39). Different HvC treatments were associated with both positive and negative changes in HRQoL. Conclusion: LvC could cause adverse outcomes and should be identified as early as possible and tried to be replaced. Future research should examine innovative models of care or treatment pathways supporting the identification and replacement of LvC in dementia.
Collapse
Affiliation(s)
- Moritz Platen
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Steffen Fleßa
- Department of General Business Administration and Health Care Management, University of Greifswald, Greifswald, Germany
| | - Anika Rädke
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Diana Wucherer
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald (UMG), Greifswald, Germany
| | - Wiebke Mohr
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Annelie Scharf
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Franka Mühlichen
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald (UMG), Greifswald, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| |
Collapse
|
8
|
Müller K, Peters M. [Tracking systems in people with dementia in long-term care - Update of an integrative review]. Pflege 2021; 34:181-190. [PMID: 34105985 DOI: 10.1024/1012-5302/a000816] [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: 11/19/2022]
Abstract
Tracking systems in people with dementia in long-term care - Update of an integrative review Abstract. Background: This article is an update of the article by Hülsken-Giesler et al. (2019) and describes the latest findings on tracking systems in inpatient long-term care. RESEARCH QUESTION The research question also follows on from the underlying article and again deals with the application of tracking systems and their consequences for residents and nursing staff. METHODS A systematic literature search in the databases MEDLINE via PubMed and CINAHL as well as a hand search for the period starting in August 2017 was performed. The included literature was evaluated by two independent persons regarding content and methodology. RESULTS In addition to deductive categories from the underlying work, further inductive categories could be formed and thus ethical and implementation aspects could be included. CONCLUSION Since the first analysis, the focus in nursing science studies on the use of tracking systems in inpatient long-term care has shifted to ethical aspects. Also, the successful and long-term integration into care practice is now relevant.
Collapse
|
9
|
Farina N, King D, Burgon C, Berwald S, Bustard E, Feeney Y, Habibi R, Comas-Herrera A, Knapp M, Banerjee S. Disease severity accounts for minimal variance of quality of life in people with dementia and their carers: analyses of cross-sectional data from the MODEM study. BMC Geriatr 2020. [PMID: 32631252 DOI: 10.1186/s12877‐020‐01629‐1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the progressive nature of dementia, it is important to understand links between disease severity and health-related outcomes. The aim of this study is to explore the relationship between disease severity and the quality of life (QoL) of people with dementia and their family carers using a number of disease-specific and generic measures. METHODS In the MODEM cohort study, three-hundred and seven people with clinically diagnosed dementia and their carers were recruited on a quota basis to provide equal numbers of people with mild (standardised Mini-Mental State Examination (sMMSE), n = 110), moderate (sMMSE 10-19, n = 100), and severe (sMMSE 0-9, n = 97) cognitive impairment. A series of multiple regression models were created to understand the associations between dementia severity and the QoL of people with dementia and the QoL of their carers. QoL was measured using self- (DEMQOL, EQ-5D, CASP-19) and proxy-reports (DEMQOL-Proxy, EQ-5D) of disease-specific and generic QoL of the person with dementia. Carer generic QoL was measured by self-report (EQ-5D, SF-12). RESULTS Disease severity, as measured by the sMMSE, was not significantly associated with the QoL of the person with dementia or the carer (p > 0.05), even after controlling for potential confounding variables for self-reported instruments. Proxy measures (rated by the carer) differed systematically in that there were small, but statistically significant proportions of the variance of QoL was explained by severity of cognitive impairment in multiple adjusted models. We also found little in the way of statistically significant relationships between the QoL of people with dementia and that of their carers except between DEMQOL-Proxy scores and the carer EQ-5D scores and carer SF-12 mental sub-scores. CONCLUSIONS The data generated supports the somewhat counterintuitive argument that severity of cognitive impairment (and therefore severity of dementia) is not associated with lower QoL for the person with dementia when self-report measures are used. However, in absolute terms, as judged by the variance in the multivariate models, it is clear that the contribution of dementia severity to the QoL of people with dementia is minimal whatever the measurement used, be it self- or proxy-rated, or disease-specific or generic.
Collapse
Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK.
| | - Derek King
- London School of Economics and Political Science, London, UK
| | - Clare Burgon
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK.,Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Sharne Berwald
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Elizabeth Bustard
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Yvonne Feeney
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Ruth Habibi
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | | | - Martin Knapp
- London School of Economics and Political Science, London, UK
| | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK.,Faculty of Health, University of Plymouth, Plymouth, UK
| | | |
Collapse
|
10
|
Farina N, King D, Burgon C, Berwald S, Bustard E, Feeney Y, Habibi R, Comas-Herrera A, Knapp M, Banerjee S. Disease severity accounts for minimal variance of quality of life in people with dementia and their carers: analyses of cross-sectional data from the MODEM study. BMC Geriatr 2020; 20:232. [PMID: 32631252 PMCID: PMC7339395 DOI: 10.1186/s12877-020-01629-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 06/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the progressive nature of dementia, it is important to understand links between disease severity and health-related outcomes. The aim of this study is to explore the relationship between disease severity and the quality of life (QoL) of people with dementia and their family carers using a number of disease-specific and generic measures. METHODS In the MODEM cohort study, three-hundred and seven people with clinically diagnosed dementia and their carers were recruited on a quota basis to provide equal numbers of people with mild (standardised Mini-Mental State Examination (sMMSE), n = 110), moderate (sMMSE 10-19, n = 100), and severe (sMMSE 0-9, n = 97) cognitive impairment. A series of multiple regression models were created to understand the associations between dementia severity and the QoL of people with dementia and the QoL of their carers. QoL was measured using self- (DEMQOL, EQ-5D, CASP-19) and proxy-reports (DEMQOL-Proxy, EQ-5D) of disease-specific and generic QoL of the person with dementia. Carer generic QoL was measured by self-report (EQ-5D, SF-12). RESULTS Disease severity, as measured by the sMMSE, was not significantly associated with the QoL of the person with dementia or the carer (p > 0.05), even after controlling for potential confounding variables for self-reported instruments. Proxy measures (rated by the carer) differed systematically in that there were small, but statistically significant proportions of the variance of QoL was explained by severity of cognitive impairment in multiple adjusted models. We also found little in the way of statistically significant relationships between the QoL of people with dementia and that of their carers except between DEMQOL-Proxy scores and the carer EQ-5D scores and carer SF-12 mental sub-scores. CONCLUSIONS The data generated supports the somewhat counterintuitive argument that severity of cognitive impairment (and therefore severity of dementia) is not associated with lower QoL for the person with dementia when self-report measures are used. However, in absolute terms, as judged by the variance in the multivariate models, it is clear that the contribution of dementia severity to the QoL of people with dementia is minimal whatever the measurement used, be it self- or proxy-rated, or disease-specific or generic.
Collapse
Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK.
| | - Derek King
- London School of Economics and Political Science, London, UK
| | - Clare Burgon
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Sharne Berwald
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Elizabeth Bustard
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Yvonne Feeney
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Ruth Habibi
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | | | - Martin Knapp
- London School of Economics and Political Science, London, UK
| | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
- Faculty of Health, University of Plymouth, Plymouth, UK
| |
Collapse
|
11
|
Michalowsky B, Xie F, Eichler T, Hertel J, Kaczynski A, Kilimann I, Teipel S, Wucherer D, Zwingmann I, Thyrian JR, Hoffmann W. Cost-effectiveness of a collaborative dementia care management-Results of a cluster-randomized controlled trial. Alzheimers Dement 2019; 15:1296-1308. [PMID: 31409541 DOI: 10.1016/j.jalz.2019.05.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/16/2019] [Accepted: 05/26/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the cost-effectiveness of collaborative dementia care management (DCM). METHODS The cost-effectiveness analysis was based on the data of 444 patients of a cluster-randomized, controlled trial, conceptualized to evaluate a collaborative DCM that aimed to optimize treatment and care in dementia. Health-care resource use, costs, quality-adjusted life years (QALYs), and incremental cost per QALY gained were measured over a 24-month time horizon. RESULTS DCM increased QALYs (+0.05) and decreased costs (-569€) due to a lower hospitalization and a delayed institutionalization (7 months) compared with usual care. The probability of DCM being cost-effective was 88% at willingness-to-pay thresholds of 40,000€ per QALY gained and higher in patients living alone compared to those not living alone (96% vs. 26%). DISCUSSION DCM is likely to be a cost-effective strategy in treating dementia and thus beneficial for public health-care payers and patients, especially for those living alone.
Collapse
Affiliation(s)
- Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany; Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Canada.
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Canada; Program for Health Economics and Outcome Measures (PHENOM), Hamilton, Canada
| | - Tilly Eichler
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
| | - Johannes Hertel
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Anika Kaczynski
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
| | - Ingo Kilimann
- Department of Psychosomatic Medicine, University Hospital Rostock, Rostock, Germany; German Centre for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Stefan Teipel
- Department of Psychosomatic Medicine, University Hospital Rostock, Rostock, Germany; German Centre for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Diana Wucherer
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
| | - Ina Zwingmann
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
| | | | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany; Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald (UMG), Greifswald, Germany
| |
Collapse
|
12
|
Dewitte L, Vandenbulcke M, Dezutter J. Cognitive functioning and quality of life: Diverging views of older adults with Alzheimer and professional care staff. Int J Geriatr Psychiatry 2018; 33:1074-1081. [PMID: 29869400 DOI: 10.1002/gps.4895] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 04/03/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Staff ratings of quality of life (QOL) in dementia are often lower and more strongly related to the cognitive functioning of the person with dementia than self-ratings. However, cognition-related items in QOL measures and limited cognitive screening measures hamper a clear understanding of the relationship, 2 issues we addressed in the current study. METHODS We collected data of 88 pairs of older adults with Alzheimer disease and their professional caregivers in 9 residential care settings. Both self-report and staff report of the QOL of residents were assessed with the Quality of Life in Alzheimer's Disease. Cognitive functioning was assessed with the Mini-Mental State Examination and a battery of specific cognitive measures. RESULTS Intraclass correlations and a paired sample t test confirmed a discrepancy between self-rating and staff rating, with staff significantly underestimating QOL as experienced by the resident. After removing the possibly confounding memory item of the Quality of Life in Alzheimer's Disease, Mini-Mental State Examination score remained a significant predictor of staff ratings but not self-ratings in regression analyses. Exploratory analyses of specific cognitive measures showed a significant contribution of a memory test of intentional visual association learning in the prediction of staff-rated QOL. CONCLUSIONS Staff reports cannot simply substitute reports of the subjective experience of residents with Alzheimer, so both judgments should be taken into account to form an adequate picture of QOL. Staff might be guided more strongly by a cognitive point of view when evaluating QOL of residents with Alzheimer disease, while the latter might have shifted their evaluation standards to cope adequately with the challenges posed by their disease.
Collapse
Affiliation(s)
- Laura Dewitte
- KU Leuven-University of Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussels, Belgium
| | - Mathieu Vandenbulcke
- KU Leuven-University of Leuven, Leuven, Belgium.,University Psychiatric Centre KU Leuven, Leuven, Belgium
| | | |
Collapse
|
13
|
Boureau AS, Trochu JN, Rouaud A, Hureau R, Jaafar P, Manigold T, Letocart V, Guerin P, Berrut G, de Decker L. Predictors of Health-Related Quality of Life Decline after Transcatheter Aortic Valve Replacement in Older Patients with Severe Aortic Stenosis. J Nutr Health Aging 2017; 21:105-111. [PMID: 27999856 DOI: 10.1007/s12603-016-0739-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Transcatheter aortic-valve implantation (TAVI) has been shown to improve survival and quality of life in patients with severe aortic stenosis. However, one-third of patients have poor outcome as death, functional decline or quality of life (QoL) decline. The aim of this study was to determine cardiac and geriatric predictors of physical and mental QoL decline 6 months after a TAVI procedure in patients aged 75 and older. METHODS Between January 2013 and June 2014, we did a prospective and multicenter study including patients ≥ 75 years old referred for TAVI. The primary outcome was the measure of QoL, assessed by the Short Form 36 survey (SF-36), before and 6 months after the intervention. Association between QoL decline and baseline characteristics including cardiac and geriatric factors was analysed by logistic regression models. RESULTS Mean age of the 150 patients studied was 83.7 years old and 56% were men. The primary end point, mean SF-36 physical summary score, significantly improved between baseline and 6-month (33.6 vs. 36.4, p=0.003) whereas mental component score significantly decreased (48.2 vs. 36.4, p-value<0.001). However, patients with presence of depressive symptoms before the intervention had mental QoL improvement at six months (OR 0.04 [0.01-0.19], p-value<0.001) and no significant geriatric predictors were associated with physical QoL decline. CONCLUSION The mental QoL significantly decreased and patients with preoperative depressive symptoms had mental QoL improvement at six months. Researches are needed to confirm that mental QoL of patients with depressive symptoms can be improved by TAVI.
Collapse
Affiliation(s)
- A S Boureau
- Anne Sophie Boureau, MD, Department of Geriatrics, Nantes University Hospital, boulevard Jacques Monod, 44093 Nantes Cedex 1, France; telephone number : + 33 2 40 16 50 46, fax number : +33 2 40 16 53 58, e-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
The impact of depressive symptoms on health-related quality of life in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease. Int Psychogeriatr 2016; 28:2045-2054. [PMID: 27576786 DOI: 10.1017/s1041610216001289] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is an important issue in the context of dementia care. The purpose of this study was to investigate the association between HRQOL and depressive symptoms in patients with subjective cognitive decline (SCD) and subtypes of mild cognitive impairment (MCI) and Alzheimer´s disease (AD). METHODS In this cross-sectional, observational study, a control group and four experimental groups (SCD, non-amnestic MCI, amnesticMCI, AD) were compared. Neuropsychological measurers (NTBV) and psychological questionnaires were used for data collection. RESULTS The control group scored higher than patients with SCD, naMCI, aMCI, or AD for the Mental Health Component Score (MHCS) of the Short Form of the Health Survey (SF-36). The Physical Health Component Score (PHCS) of the SF-36 differed only between some groups. Furthermore, cognitive variables were more strongly associated with the physical aspects of HRQOL, whereas depressive symptoms were more strongly related with the mental aspects of HRQOL. CONCLUSIONS HRQOL and depressive symptoms are closely related in patients with cognitive impairments. Therefore, it is of great importance to assess patients with subjective impairment carefully in terms of depressive symptoms.
Collapse
|
15
|
Moreno JA, Nicholls E, Ojeda N, De los Reyes-Aragón CJ, Rivera D, Arango-Lasprilla JC. Caregiving in Dementia and its Impact on Psychological Functioning and Health-Related Quality of Life: Findings from a Colombian Sample. J Cross Cult Gerontol 2016; 30:393-408. [PMID: 26290365 DOI: 10.1007/s10823-015-9270-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Existing published studies about health-related quality of life (HRQOL) in caregivers of dementia patients living in Latin American countries are very limited. However, cultural aspects, personal values, and social structure may affect the way caregivers experience their role in different societies. The current study investigated the relationship between HRQOL and psychological factors using a cross-sectional design. The sample consisted of 102 informal caregivers of patients with dementia from Bogotá, Colombia, South America. Measures included the Patient Health Questionnaire (PHQ-9) for depression, the Satisfaction with Life Scale (SWLS), the Zarit Burden Interview, and the Short Health Questionnaire (SF36) for HRQOL. Canonical correlations revealed that there was a significant relationship between caregivers' mental health and HRQOL, such that caregivers with better satisfaction with life and less symptoms of depression had more vitality and better general health. There is a strong relationship between mental health and health-related quality of life in Colombian caregivers of dementia patients living in their country of origin. Specific aspects of mental health, including satisfaction with life and depression, need to be addressed in order to improve caregivers' quality of life. Given that mental health care resources may be scarce in Latin American countries, culturally appropriate interventions should focus on preventing/treating depression and promote life satisfaction, as a way to improve their quality of life.
Collapse
Affiliation(s)
- Jhon Alexander Moreno
- Center for Interdisciplinary Research in Rehabilitation-Centre de Réadaptation Lucie-Bruneau, Montréal, Québec, Canada. .,Département de Psychologie, Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Université de Montréal, Montréal, Québec, Canada.
| | | | - Natalia Ojeda
- Department of Psychology, University of Deusto, Bilbao, Spain
| | | | - Diego Rivera
- Department of Psychology, University of Deusto, Bilbao, Spain
| | - Juan Carlos Arango-Lasprilla
- Department of Psychology, University of Deusto, Bilbao, Spain.,IKERBASQUE, Basque Foundation for Science Bilbao, Bilbao, Spain
| |
Collapse
|
16
|
Hsiao HT, Li SY, Yang YP, Lin LL, Lin SI, Wang JJ. Cognitive Function and Quality of Life in Community-Dwelling Seniors with Mild Cognitive Impairment in Taiwan. Community Ment Health J 2016; 52:493-8. [PMID: 26993652 DOI: 10.1007/s10597-016-9993-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 01/27/2016] [Indexed: 11/29/2022]
Abstract
The aims of this study were to examine the relationships between overall cognitive function and the quality of life (QOL) domains, and to compare the differences in these by age, gender, and educational level in community-dwelling seniors in Taiwan. A cross-sectional study was conducted, with the participants screened and recruited from Southern Tainan. The Saint Louis University Mental Status Examination was used to screen the cognitive status of the participants. A total of 144 seniors participated in this study were assessed using the Taiwanese version of WHOQOL-BREF. The results showed that the participants performed better in the cognitive domains of "figure identification" and "orientation" while they performed poor in "delayed recall" and "immediate paragraph recall". No significant relationship between cognitive function and overall QOL, but a positive relationship between cognitive function and the physical health domain of QOL was found. The findings of this study provide valuable information for community healthcare providers.
Collapse
Affiliation(s)
- Hua-Tsen Hsiao
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, No. 1, Ta-Hsueh Rd., Tainan City, 70101, Taiwan, ROC.,Department of Nursing, School of Nursing, Fooyin University, 151 Jinxue Rd., Daliao Dist., Kaohsiung City, 83102, Taiwan, ROC
| | - Shu-Ying Li
- Taiwan Taipei School for Visually Impaired, No. 1, Ln. 207, Sec. 2, Zhongcheng Rd., Shilin Dist., Taipei City, 111, Taiwan, ROC
| | - Ya-Ping Yang
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, No. 1, Ta-Hsueh Rd., Tainan City, 70101, Taiwan, ROC
| | - Linda L Lin
- Institute of Pysical Education, Health and Leisure Studies, National Cheng Kung University, No. 1, Ta-Hsueh Rd., Tainan City, 70101, Taiwan, ROC
| | - Sang-I Lin
- Department of Pysical Therapy, College of Medicine, National Cheng Kung University, No. 1, Ta-Hsueh Rd., Tainan City, 70101, Taiwan, ROC
| | - Jing-Jy Wang
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, No. 1, Ta-Hsueh Rd., Tainan City, 70101, Taiwan, ROC.
| |
Collapse
|
17
|
Abstract
SummaryFear of falling (FoF) is a common condition in older age. However, there is a paucity of research on its prevalence, impact and treatment in older people with dementia. People with dementia have an increased risk of falls which present a significant threat to their independence, as well as having a significant economic impact on health and social services. This review outlines the key issues in relation to FoF, current guidelines and assessment tools and their use for people with dementia. Further research needs to be completed in both addressing the specific assessment barriers that people with dementia may face regarding the use of current FoF tools, with further exploration surrounding the individual's experience of FoF and how this may be impacting upon their quality of life and functionality. Until a well-validated method has been developed, clinicians need to utilize available tools as guidelines, seek the assistance of proxies at all stages of the care journey, and use clinical judgement to assess FoF in patients with dementia.
Collapse
|
18
|
Kraemer HC. Toward sound objective evaluation of clinical measures. Am J Geriatr Psychiatry 2013; 21:589-95. [PMID: 23764524 DOI: 10.1016/j.jagp.2013.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 03/13/2013] [Accepted: 03/18/2013] [Indexed: 11/18/2022]
Abstract
The quality of all clinical decision-making, as well as power and precision in clinical research results, depends fundamentally on the quality of the measures used. Yet evaluations of the quality of clinical measures likely to be used either in clinic or research applications are difficult to execute or to critique because the criteria for judging such studies are so ill-defined. Here a set of guidelines is proposed, modeled on CONSORT guidelines for randomized clinical trials, first defining the terms often inconsistently used in the research literature and then identifying certain errors that seem to recur in evaluation studies.
Collapse
|