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Pazzaglia C, Camedda C, Ugenti NV, Trentin A, Scalorbi S, Longobucco Y. Community Health Assessment Tools Adoptable in Nursing Practice: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1667. [PMID: 36767035 PMCID: PMC9914332 DOI: 10.3390/ijerph20031667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
The WHO European Region defined the role of a new central professional for primary care, the Family and Community Nurse (FCN). The introduction of an FCN in the framework of health policies highlights a key role of nurses in addressing the needs of families and communities. A scoping review was conducted in order to identify and describe the available tools which have been adopted for the assessment of community health needs by FCNs. A comprehensive literature review on the Embase, Cochrane Library, PubMed, CINAHL, Scopus and PsycInfo databases was conducted including all studies up to May 2021. A total of 1563 studies were identified and 36 of them were included. The literature review made it possible to identify studies employing twelve different community assessment tools or modalities. Referring to the WHO framework proposed in 2001, some common themes have been identified with an uneven distribution, such as profiling the population, deciding on priorities for action and public healthcare programs, implementing the planned activities, an evaluation of the health outcomes, multidisciplinary activity, flexibility and involving the community. To the best of our knowledge, this work is the first attempt to provide an overview of community assessment tools, keeping the guidance provided by the WHO as a reference.
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Affiliation(s)
| | - Claudia Camedda
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | | | | | - Sandra Scalorbi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
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Keyvanloo Shahrestanaki S, Sharifi F, Shahsavari H, Ghonoodi F, Philp I, Bahramnezhad F, Navab E. Predicting The Risk of Fall in Community-Dwelling Older Adults in Iran. JOURNAL OF AGING AND ENVIRONMENT 2022. [DOI: 10.1080/26892618.2021.1918813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sahar Keyvanloo Shahrestanaki
- Geriatric Nursing Department, School of Nursing and Midwifery, Tehran University of medical sciences, Tehran, Iran
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooman Shahsavari
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of medical sciences, Tehran, Iran
| | - Fatemeh Ghonoodi
- Geriatric Nursing Department, School of Nursing and Midwifery, Tehran University of medical sciences, Tehran, Iran
| | - Ian Philp
- Honorary Professor in Healthcare for the Elderly, University of Suffolk, UK
| | - Fatemeh Bahramnezhad
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Spiritual Health Group, Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Navab
- Critical care and Geriatric Nursing Department, School of Nursing and Midwifery, Tehran University of medical sciences, Tehran, Iran
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Guerreiro C, Botelho M, Fernández-Martínez E, Marreiros A, Pais S. Determining the Profile of People with Fall Risk in Community-Living Older People in Algarve Region: A Cross-Sectional, Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042249. [PMID: 35206432 PMCID: PMC8871874 DOI: 10.3390/ijerph19042249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022]
Abstract
One in three people aged 65 years or older falls every year. Injuries associated with this event among the older population are a major cause of pain, disability, loss of functional autonomy and institutionalization. This study aimed to assess mobility and fall risk (FR) in community-living older people and to determine reliable and independent measures (health, social, environmental and risk factors) that can predict the mobility loss and FR. In total, 192 participants were included, with a mean age of 77.93 ± 8.38. FR was assessed by EASY-Care (EC) Standard 2010, the Tinetti Test and the Modified Falls Efficacy Scale (MFES). An exploratory analysis was conducted using the divisive non-hierarchical cluster method, aiming to identify a differentiator and homogeneous group of subjects (optimal group of variables) and to verify if that group shows differences in fall risk. Individually, the health, social, environmental and risk factor categories were not found to be an optimal group; they do not predict FR. The most significant predictor variables were a mix of the different categories, namely, the presence of pain, osteoarthritis (OA), and female gender. The finding of a profile that allows health professionals to be able to quickly identify people at FR will enable a reduction in injuries and fractures resulting from falls and, consequently, the associated costs.
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Affiliation(s)
- Carla Guerreiro
- Algarve Biomedical Center Research Institute (ABCRI), University of Algarve, 8005-139 Faro, Portugal; (C.G.); (M.B.); (A.M.); (S.P.)
| | - Marta Botelho
- Algarve Biomedical Center Research Institute (ABCRI), University of Algarve, 8005-139 Faro, Portugal; (C.G.); (M.B.); (A.M.); (S.P.)
| | - Elia Fernández-Martínez
- Department of Nursing, University of Huelva, 21004 Huelva, Spain
- Department of Nursing, University of Sevilla, 41009 Sevilla, Spain
- Correspondence:
| | - Ana Marreiros
- Algarve Biomedical Center Research Institute (ABCRI), University of Algarve, 8005-139 Faro, Portugal; (C.G.); (M.B.); (A.M.); (S.P.)
- Faculty of Medicine and Biomedical Sciences, University of Algarve, 8005-139 Faro, Portugal
| | - Sandra Pais
- Algarve Biomedical Center Research Institute (ABCRI), University of Algarve, 8005-139 Faro, Portugal; (C.G.); (M.B.); (A.M.); (S.P.)
- Faculty of Medicine and Biomedical Sciences, University of Algarve, 8005-139 Faro, Portugal
- Comprehensive Health Research Center (CHRC), 1150-082 Lisboa, Portugal
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Ogrin R, Meyer C, Karantzoulis A, Santana IJ, Hampson R. Assessing Older Community Members Using a Social Work Tool: Developing an Organizational Response. Gerontol Geriatr Med 2022; 8:23337214221119322. [PMID: 36046576 PMCID: PMC9421213 DOI: 10.1177/23337214221119322] [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: 05/13/2022] [Revised: 07/01/2022] [Accepted: 07/25/2022] [Indexed: 11/19/2022] Open
Abstract
Social Worker’s undertake psycho-social assessments and facilitate access to evidence-informed psychological and practical supports to optimize the physical, psychological, and social wellbeing of the community members in their care. Social workers employed at an aged and community care organization undertook a review of the gray and peer reviewed literature and did not identify any existing evidence-based tools. However, 10 key domains were identified from the search. Gaps in the domains were discovered, together with the need for guidance and prompts for less experienced staff and students. Five Social Workers, using co-design principles, reviewed the domains, and added further domains from their social work practice. An evidence-based assessment tool was developed which incorporated 11 domains. The tool can be used to assess the needs of people living in the community who are older and/or have compromised health and wellbeing. Further work is required to pilot test the tool.
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Affiliation(s)
- Rajna Ogrin
- Bolton Clarke Research Institute, Level 1, Forest Hill, VIC, Australia
- Griffith University, Brisbane, QLD, Australia
- Rajna Ogrin, Bolton Clarke Research Institute, Level 1, 347 Burwood Highway, Forest Hill, VIC, 3131, Australia.
| | - Claudia Meyer
- Bolton Clarke Research Institute, Level 1, Forest Hill, VIC, Australia
- La Trobe University, Bundoora, VIC, Australia
- Monash University, Frankston, VIC, Australia
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Lyndon H, Latour JM, Marsden J, Kent B. Designing a nurse-led assessment and care planning intervention to support frail older people in primary care: An e-Delphi study. J Adv Nurs 2021; 78:1031-1043. [PMID: 34626001 PMCID: PMC9291776 DOI: 10.1111/jan.15066] [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: 03/15/2021] [Revised: 07/14/2021] [Accepted: 09/23/2021] [Indexed: 11/26/2022]
Abstract
Aim To identify and establish expert consensus on important and feasible components of a nurse‐led, comprehensive geriatric assessment (CGA)‐based intervention for community‐dwelling older people who live with frailty. Design A three‐round modified e‐Delphi survey. Methods An expert panel of 33 UK specialist older people's, primary and community care nurses participated in the three‐round e‐Delphi survey over a 12‐month period in 2017–2018. Data from round 1 were analysed using content analysis. Descriptive statistics were used in the subsequent two rounds to demonstrate convergence of panel opinion and consensus. Results In round 1, experts proposed 30 CGA components that were combined with six additional components from a literature review and clustered into six domains. In round 2, components were rated for importance and feasibility. Rating scores for importance were high across all domains, with lower scores for feasibility. Round 3 revealed that 36 components achieved consensus on importance and 11 out of 36 components reached consensus on feasibility. Conclusion Based on expert panel opinion, the content of a nurse‐led CGA‐based intervention was established, with the aim of future feasibility testing in a randomized controlled trial. Impact This study provides feasible components of a CGA‐based intervention that can be implemented in clinical practice by nurses in partnership with older people who live with frailty. Following further testing and evaluation, the components have the potential to improve clinical outcomes, maximize independence and improve the quality of life for community‐dwelling frail older people.
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Affiliation(s)
| | - Jos M Latour
- University of Plymouth, Plymouth, UK.,Curtin University, Perth, Australia
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Li W, Wang Q, Chen Y, Pu Y, Xu G. Instrument development and validation of the comprehensive ability of older people assessment scale. Nurs Open 2021; 8:3073-3085. [PMID: 34357695 PMCID: PMC8510746 DOI: 10.1002/nop2.1020] [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] [Received: 10/12/2020] [Revised: 07/01/2021] [Accepted: 07/22/2021] [Indexed: 11/20/2022] Open
Abstract
Aim The study is aimed to develop and psychometrically test the Comprehensive Ability of Older People Assessment scale and classify the ability grades. Design A cross‐sectional design was used for instrument development. Method The Comprehensive Ability of Older People Assessment scale was developed by a sample of 971 older people from 4 long‐term care institutions in China. The data were collected between April 2018 and March 2020. One‐way analysis of variance and multiple regression analysis was used to screen scale items, while focus group interviews were used to integrate the subjective and objective items. Confirmative factor analysis and expert judgment were applied to explore construct validity. Reliability was explored through internal consistency estimation using Cronbach's alpha and homogeneity evaluation using corrected item‐total correlations. Cluster analysis and discriminant analysis were used to segment the comprehensive ability assessment scores and discriminant function was established to determine the boundary value of each segment, using correlation analysis to perform reverse verification. Results Factor analysis yielded 40 items with six dimensions, including “mentation and cognitive,” “perception and communication,” “emotional problems,” “mental and behavioural problems,” “daily life and social participation,” and “skin and oral status.” The Cronbach's α was 0.951, while the dimensions showed Cronbach's α values ranging from 0.760–0.946. The rationality and scientificity of this scale were proved by the correlation analysis of reverse validation. Conclusion The 4‐grade Comprehensive Ability of Older People Assessment scale is proved to be with good validity and reliability and should be considered for institutional assessors. Impact Assessors can accurately evaluate older people's health status and nursing needs through this scale in long‐term care institutions, communities and hospitals, so as to provide accurate and high‐quality nursing services. It will become a scientific basis for the government to offer accurate pension subsidies, purchase pension services scientifically for older people and establish third‐party objective evaluation and supervision.
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Affiliation(s)
- Weitong Li
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qiuqin Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yujing Chen
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yalou Pu
- Suzhou Vocational Health College, Suzhou, China
| | - Guihua Xu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Chadborn N, Craig C, Sands G, Schneider J, Gladman J. Improving community support for older people's needs through commissioning third sector services: a qualitative study. J Health Serv Res Policy 2019; 24:116-123. [PMID: 30971192 DOI: 10.1177/1355819619829774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM This exploratory study of commissioning third sector services for older people aimed to explore whether service data was fed back to commissioners and whether this could improve intelligence about the population and hence inform future commissioning decisions. BACKGROUND Third sector services are provided through charities and non-profit community organizations, and over recent years services have developed that assess and advise people for self-management or provide wellbeing support in the community. Third sector services have an opportunity to reach vulnerable populations and to provide intelligence about them. Some third sector services are state funded (commissioned) in the United Kingdom. While evidence is available about the commissioning of statutory health and social care, as well as private providers, there is limited evidence about how third sector health services are funded. METHODS Participants were recruited from commissioner organizations and third sector organizations, both with an interest in supporting the independence, self-management and wellbeing of older people. Organizations were recruited from five purposively selected sites within one region of England (East Midlands). Semi-structured interviews explored the relationships between commissioners and providers and the nature of funding arrangements, including co-production. Interviews also explored collection of data within the service and how data were fed back to commissioners. Focus groups were held with older people with the potential to benefit from wellbeing services. RESULTS Commissioning arrangements were varied, sometimes complex, and often involved co-production with the third sector. Commissioners valued third sector organizations for their engagement with the local community, value for money, outreach services and ability to provide information about the community. Assessing the needs and outcomes of individuals was integral to delivery of support and advice to older people. Diverse approaches were used to assess an individual's needs and outcomes, although there were concerns that some assessment questionnaires may be too complex for this vulnerable group. Assessment and outcomes data were also used to monitor the service contract and there was potential for the data to be summarized to inform commissioning strategies, but commissioners did not report using assessment data in this way, in practice. While the policy context encouraged partnerships with third sector organizations and their involvement in decision making, the relationship with third sector organizations was not valued within contract arrangements, and may have been made more difficult by the tendering process and the lack of analysis of service data. CONCLUSION This exploratory study has demonstrated a diversity of commissioning arrangements for third sector services across one region of England. Most commissioners invited co-production; that is, the commissioners sought input from the third sector while specifying details of the service. Service data, including assessments of needs and outcomes, were reported to commissioners, however commissioners did not appear to use this to full advantage to inform future commissioning decisions. This may indicate a need to improve measurement of needs and outcomes in order to improve the credibility of the commissioning process.
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Affiliation(s)
- Neil Chadborn
- 1 Research Fellow, NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, UK
| | - Chris Craig
- 2 Research Assistant, NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, UK
| | - Gina Sands
- 3 Senior Research Fellow, School of Health Sciences, University of Nottingham, UK
| | - Justine Schneider
- 4 Professor of Mental Health and Social Care, School of Sociology and Social Policy, University of Nottingham, UK
| | - John Gladman
- 5 Professor of Medicine of Older People, NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, UK
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Jerliu N, Burazeri G, Toçi E, Philp I, Czabanowska K, Ramadani N, Brand H. Application of EASY-Care Standard 2010 instrument in a population-based survey in transitional Kosovo. Eur J Public Health 2019; 29:367-371. [PMID: 30169678 DOI: 10.1093/eurpub/cky172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the health needs and priorities of older people in Kosovo, the newest state in Europe striving for a functional democracy after the breakdown of former Yugoslavia and the following war in the region. METHODS A cross-sectional study was conducted in Kosovo in 2011 including a nationwide representative sample of 1890 individuals aged ≥65 years (949 men, mean age: 73 ± 6 years; 941 women, mean age: 74 ± 7 years; overall response rate: 84%). All individuals were administered the full version of EASY-Care Standard 2010 instrument, inquiring about the need for support in activities of daily living ('independence'), the 'risk of breakdown in care' (leading to emergency admission to hospital) and the 'risk of falls'. RESULTS The degree of 'independence' was lower, whereas the 'risk of breakdown in care' and the 'risk of falls' were significantly higher in: older women; the oldest individuals (≥85 years); rural residents; participants living alone; those perceiving themselves as poor; participants who could not access medical care; those who perceived their general health status as poor; and older people who reported at least one chronic condition. CONCLUSIONS This is one of the very few reports from Southeast European region informing about the health needs and priorities of older people in a large and representative population-based sample of older men and women. The poor health status of older people, especially evident in the socio-demographic disadvantaged categories, should raise the awareness of policymakers and decision-makers for appropriate health and social care of elderly in Kosovo and in other European countries.
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Affiliation(s)
- Naim Jerliu
- National Institute of Public Health of Kosovo, Prishtina, Kosovo.,Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Genc Burazeri
- Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Department of Public Health, Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Ervin Toçi
- Department of Public Health, Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Ian Philp
- Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Katarzyna Czabanowska
- Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Naser Ramadani
- National Institute of Public Health of Kosovo, Prishtina, Kosovo.,Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Helmut Brand
- Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Brefka S, Dallmeier D, Mühlbauer V, von Arnim CAF, Bollig C, Onder G, Petrovic M, Schönfeldt-Lecuona C, Seibert M, Torbahn G, Voigt-Radloff S, Haefeli WE, Bauer JM, Denkinger MD. A Proposal for the Retrospective Identification and Categorization of Older People With Functional Impairments in Scientific Studies-Recommendations of the Medication and Quality of Life in Frail Older Persons (MedQoL) Research Group. J Am Med Dir Assoc 2019; 20:138-146. [PMID: 30638832 DOI: 10.1016/j.jamda.2018.11.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 10/22/2018] [Accepted: 11/06/2018] [Indexed: 12/23/2022]
Abstract
When treating older adults, a main factor to consider is physical frailty. Because specific assessments in clinical trials are frequently lacking, critical appraisal of treatment evidence with respect to functional status is challenging. Our aim was to identify and categorize assessments for functional status given in clinical trials in older adults to allow for a retrospective characterization and indirect comparison of treatment evidence from these cohorts. We conducted 4 separate systematic reviews of randomized and nonrandomized controlled clinical trials in older people with hypertension, diabetes, depression, and dementia. All assessments identified that reflected functional status were analyzed. Assessments were categorized across 4 different functional status levels. These levels span from functionally not impaired, slightly impaired, significantly impaired, to severely impaired/disabled. If available from the literature, cut-offs for these 4 functioning levels were extracted. If not, or if the existing cut-offs did not match the predefined functional levels, cut-off points were defined by an expert group composed of geriatricians, pharmacists, pharmacologists, neurologists, psychiatrists, and epidemiologists using a patient-centered approach. We identified 51 instruments that included measures of functional status. Although some of the assessments had clearly defined cut-offs across our predefined categories, many others did not. In most cases, no cut-offs existed for slightly impaired or severely impaired older adults. Missing cut-offs or values to adjust were determined by the expert group and are presented as described. The functional status assessments that were identified and operationalized across 4 functional levels could now be used for a retrospective characterization of functional status in randomized controlled trials and observational studies. Allocated categories only serve as approximations and should be validated head-to-head in future studies. Moreover, as general standard, upcoming studies involving older adults should include and explicitly report functional impairment as a baseline characteristic of all participants enrolled.
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Affiliation(s)
- Simone Brefka
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University, Ulm, Germany; Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Dhayana Dallmeier
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University, Ulm, Germany; Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Viktoria Mühlbauer
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University, Ulm, Germany; Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Christine A F von Arnim
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany; University Clinic Ulm, Department of Neurology, Ulm, Germany
| | - Claudia Bollig
- Center for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Freiburg, Germany; Medical Center, University of Freiburg, Cochrane Germany, Freiburg, Germany
| | - Graziano Onder
- Department of Geriatrics, Neurosciences and Orthopaedics, A. Gemelli University Hospital, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mirko Petrovic
- Department of Internal Medicine (Geriatrics), Ghent University, Ghent, Belgium
| | - Carlos Schönfeldt-Lecuona
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany; University Clinic Ulm, Department of Psychiatry and Psychotherapy III, Ulm, Germany
| | - Moritz Seibert
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany; University Clinic Ulm, Department of Neurology, Ulm, Germany
| | - Gabriel Torbahn
- Medical Center, University of Freiburg, Cochrane Germany, Freiburg, Germany; Institute for Biomedicine of Aging, Friedrich Alexander University Erlangen-Nürnberg, Germany
| | - Sebastian Voigt-Radloff
- Center for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Freiburg, Germany; Medical Center, University of Freiburg, Cochrane Germany, Freiburg, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
| | - Jürgen M Bauer
- Center for Geriatric Medicine, University of Heidelberg and Agaplesion Bethanien Hospital, Heidelberg, Germany
| | - Michael D Denkinger
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University, Ulm, Germany; Geriatric Center Ulm/Alb-Donau, Ulm, Germany.
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Strain WD, Hope SV, Green A, Kar P, Valabhji J, Sinclair AJ. Type 2 diabetes mellitus in older people: a brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative. Diabet Med 2018; 35:838-845. [PMID: 29633351 DOI: 10.1111/dme.13644] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2018] [Indexed: 12/25/2022]
Abstract
Rates of population ageing are unprecedented and this, combined with the progressive urbanization of lifestyles, has led to a dramatic shift in the epidemiology of diabetes towards old age, particularly to those aged 60-79 years. Both ageing and diabetes are recognized as important risk factors for the development of functional decline and disability. In addition, diabetes is associated with a high economic, social and health burden. Traditional macrovascular and microvascular complications of diabetes appear to account for less than half of the diabetes-related disability observed in older people. Despite this, older adults are under-represented in clinical trials. Guidelines from organizations such as the National Institute for Health and Care Excellence (NICE), the European Association for the Study of Diabetes, and the American Diabetes Association acknowledge the need for individualized care, but the glycaemic targets that are suggested to constitute good control [HbA1c 53-59 mmol/mol (7-7.5%)] are too tight for frail older individuals. We present a framework for the assessment of older adults and guidelines for the management of this population according to their frailty status, with the intention of reducing complications and improving quality of life for these people.
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Affiliation(s)
- W D Strain
- Diabetes and Vascular Research Centre, University of Exeter Medical School, Medical Academic Staff Committee, Lead Physician, Academic Department of Healthcare for the Older Person, Royal Devon and Exeter Hospital Trust, and British Medical Association Medical Academic Staff Committee
| | - S V Hope
- Secretary, British Geriatrics Society Special Interest Group in Diabetes, and University of Exeter Medical School
| | - A Green
- General Practitioner, Hedon Group Practice, East Yorkshire, and Clinical and Prescribing Policy Lead, British Medical Association GP Committee
| | - P Kar
- National Clinical Deputy Director for Diabetes, NHS England
| | - J Valabhji
- National Clinical Director for Obesity & Diabetes, NHS England and Imperial College London
| | - A J Sinclair
- Association of British Clinical Diabetologists and Director, Foundation for Diabetes Research in Older People, Diabetes Frail Ltd
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11
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Seematter-Bagnoud L, Büla C. Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach. Public Health Rev 2018; 39:8. [PMID: 29744236 PMCID: PMC5928588 DOI: 10.1186/s40985-018-0086-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 02/12/2018] [Indexed: 01/12/2023] Open
Abstract
This paper discusses the rationale behind performing a brief geriatric assessment as a first step in the management of older patients in primary care practice. While geriatric conditions are considered by older patients and health professionals as particularly relevant for health and well-being, they remain too often overlooked due to many patient- and physician-related factors. These include time constraints and lack of specific training to undertake comprehensive geriatric assessment. This article discusses the epidemiologic rationale for screening functional, cognitive, affective, hearing and visual impairments, and nutritional status as well as fall risk and social status. It proposes using brief screening tests in primary care practice to identify patients who may need further comprehensive geriatric assessment or specific interventions.
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Affiliation(s)
- Laurence Seematter-Bagnoud
- 1Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Center, Mont Paisible 16, CH-1011 Lausanne, Switzerland.,2Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
| | - Christophe Büla
- 1Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Center, Mont Paisible 16, CH-1011 Lausanne, Switzerland
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Dent E, Lien C, Lim WS, Wong WC, Wong CH, Ng TP, Woo J, Dong B, de la Vega S, Hua Poi PJ, Kamaruzzaman SBB, Won C, Chen LK, Rockwood K, Arai H, Rodriguez-Mañas L, Cao L, Cesari M, Chan P, Leung E, Landi F, Fried LP, Morley JE, Vellas B, Flicker L. The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty. J Am Med Dir Assoc 2018. [PMID: 28648901 DOI: 10.1016/j.jamda.2017.04.018] [Citation(s) in RCA: 352] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To develop Clinical Practice Guidelines for the screening, assessment and management of the geriatric condition of frailty. METHODS An adapted Grading of Recommendations, Assessment, Development, and Evaluation approach was used to develop the guidelines. This process involved detailed evaluation of the current scientific evidence paired with expert panel interpretation. Three categories of Clinical Practice Guidelines recommendations were developed: strong, conditional, and no recommendation. RECOMMENDATIONS Strong recommendations were (1) use a validated measurement tool to identify frailty; (2) prescribe physical activity with a resistance training component; and (3) address polypharmacy by reducing or deprescribing any inappropriate/superfluous medications. Conditional recommendations were (1) screen for, and address modifiable causes of fatigue; (2) for persons exhibiting unintentional weight loss, screen for reversible causes and consider food fortification and protein/caloric supplementation; and (3) prescribe vitamin D for individuals deficient in vitamin D. No recommendation was given regarding the provision of a patient support and education plan. CONCLUSIONS The recommendations provided herein are intended for use by healthcare providers in their management of older adults with frailty in the Asia Pacific region. It is proposed that regional guideline support committees be formed to help provide regular updates to these evidence-based guidelines.
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Affiliation(s)
- Elsa Dent
- Center for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Brisbane, Australia.
| | - Christopher Lien
- Department of Geriatric Medicine, Changi General Hospital, Singapore, Singapore
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore
| | - Wei Chin Wong
- Department of Geriatric Medicine, Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore
| | - Chek Hooi Wong
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Tze Pin Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jean Woo
- The S H Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Birong Dong
- Geriatrics Center Huaxi Hospital, Sichuan University, Chengdu, China
| | - Shelley de la Vega
- University of the Philippines College of Medicine, Manila, Philippines; Institute on Aging, National Institutes of Health, University of the Philippines, Manila, Philippines
| | - Philip Jun Hua Poi
- Division of Geriatrics, University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | | | - Chang Won
- Department of Family Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital; Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
| | | | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - Li Cao
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | - Piu Chan
- Department of Geriatrics, Neurology, and Neurobiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Edward Leung
- Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
| | | | - Linda P Fried
- Mailman School of Public Health, Columbia University Medical Center, New York, NY
| | - John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University, St. Louis, MO
| | | | - Leon Flicker
- Western Australia Center for Health and Aging, University of Western Australia, Perth, Australia
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Cowdell F, Dyson J, Long J, Macleod U. Self-reported skin concerns: An epidemiological study of community-dwelling older people. Int J Older People Nurs 2018; 13:e12195. [DOI: 10.1111/opn.12195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 02/15/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Fiona Cowdell
- Faculty of Health, Education and Life Sciences; Birmingham City University; Birmingham UK
| | - Judith Dyson
- School Health and Social Work; University of Hull; Hull UK
| | - Judith Long
- Hull and East Yorkshire Hospitals NHS Trust; Hull UK
| | - Una Macleod
- Hull York Medical School; University of Hull; Hull UK
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14
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Talarska D, Tobis S, Kotkowiak M, Strugała M, Stanisławska J, Wieczorowska-Tobis K. Determinants of Quality of Life and the Need for Support for the Elderly with Good Physical and Mental Functioning. Med Sci Monit 2018; 24:1604-1613. [PMID: 29551764 PMCID: PMC5870108 DOI: 10.12659/msm.907032] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background The ageing of population is the reason that there are various strategies developed to help seniors acquire greater independence and a better quality of life. The aim of this study was to explore the relationship between the elderly peope’s need for assistance and assessed quality of life. Material/Methods The study included 100 participants who were members of a Seniors Club in Poznań, Poland. The cross-sectional study utilized the following instruments: Abbreviated Mental Test Score (AMTS), Instrumental Activities of Daily Living (IADL), EASY-Care Standard 2010 questionnaire, (WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. Results Members of the Seniors’ Club showed good functional condition. In the AMTS test, they scored near maximum values (average 9.39±0.77 points), somewhat poorer results were found in the IADL scale (average 20.92±3.96 points). In the EASY-Care questionnaire, the study participants usually required partial support in the following areas: Mental health and well-being (59%), Staying healthy (29%), Getting around (22%), and Seeing, hearing and communicating (22%). The average score on Independence was 13.13±18.51, The risk of breakdown in care scale was 4.39±3.21. The risk of falls affected 21 participants (21%). Quality of life study using WHOQOL-BREF questionnaire found that the highest scores were achieved in Psychological and Environment domains, and the lowest score in the Physical health domain. Conclusions Quality of life as well as level of independence, risk of falls, and need for 24-hour care were significantly affected by the following factors: urinary incontinence, difficulties in mobility outside the home, despondency, and forgetfulness.
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Affiliation(s)
- Dorota Talarska
- Department of Preventive Medicine, University of Medical Sciences, Poznań, Poland
| | - Sławomir Tobis
- Laboratory of Occupational Therapy, Department of Geriatrics and Gerontology, University of Medical Sciences, Poznań, Poland
| | - Marta Kotkowiak
- Department of Preventive Medicine, University of Medical Sciences, Poznań, Poland
| | - Magdalena Strugała
- Department of Preventive Medicine, University of Medical Sciences, Poznań, Poland
| | - Joanna Stanisławska
- Department of Preventive Medicine, University of Medical Sciences, Poznań, Poland
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15
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Hildon ZJL, Tan CS, Shiraz F, Ng WC, Deng X, Koh GCH, Tan KB, Philp I, Wiggins D, Aw S, Wu T, Vrijhoef HJM. The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for detection of older people's health related needs, planning of community programs, and targeted care interventions. BMC Geriatr 2018; 18:49. [PMID: 29454316 PMCID: PMC5816546 DOI: 10.1186/s12877-018-0739-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 01/31/2018] [Indexed: 01/29/2023] Open
Abstract
Background This study introduces the conceptual basis and operational measure, of BioPyschoSocial (BPS) health and related risk to better understand how well older people are managing and to screen for risk status. The BPS Risk Screener is constructed to detect vulnerability at older ages, and seeks to measure dynamic processes that place equal emphasis on Psycho-emotional and Socio-interpersonal risks, as Bio-functional ones. We validate the proposed measure and describe its application to programming. Methods We undertook a quantitative cross-sectional, psychometric study with n = 1325 older Singaporeans, aged 60 and over. We adapted the EASYCare 2010 and Lubben Social Network Scale questionnaires to help determine the BPS domains using factor analysis from which we derive the BPS Risk Screener items. We then confirm its structure, and test the scoring system. The score is initially validated against self-reported general health then modelled against: number of falls; cognitive impairment; longstanding diseases; and further tested against service utilization (linked administrative data). Results Three B, P and S clusters are defined and identified and a BPS managing score (‘doing’ well, or ‘some’, ‘many’, and ‘overwhelming problems’) calculated such that the risk of problematic additive BPS effects, what we term health ‘loads’, are accounted for. Thirty-five items (factor loadings over 0.5) clustered into three distinct B, P, S domains and were found to be independently associated with self-reported health: B: 1.99 (1.64 to 2.41), P: 1.59 (1.28 to 1.98), S: 1.33 (1.10 to 1.60). The fit improved when combined into the managing score 2.33 (1.92 to 2.83, < 0.01). The score was associated with mounting risk for all outcomes. Conclusions BPS domain structures, and the novel scoring system capturing dynamic BPS additive effects, which can combine to engender vulnerability, are validated through this analysis. The resulting tool helps render clients’ risk status and related intervention needs transparent. Given its explicit and empirically supported attention to P and S risks, which have the potential to be more malleable than B ones, especially in the older old, this tool is designed to be change sensitive. Electronic supplementary material The online version of this article (10.1186/s12877-018-0739-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zoe J-L Hildon
- Johns Hopkins University, Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA. .,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. .,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Faculty of Public Health & Policy, London, England. .,, Singapore, Singapore.
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,, Singapore, Singapore
| | - Farah Shiraz
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,, Singapore, Singapore
| | - Wai Chong Ng
- Tsao Foundation, 298 Tiong Bahru Road, #15-01/06 Central Plaza, Singapore, 168730, Singapore
| | - Xiaodong Deng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,, Singapore, Singapore
| | - Gerald Choon Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,, Singapore, Singapore
| | - Kelvin Bryan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Ministry of Health, College of Medicine, Building 16 College Road, Singapore, 169854, Singapore.,, Singapore, Singapore
| | - Ian Philp
- University of Stirling, Stirling, UK
| | - Dick Wiggins
- UCL Institute of Education, IOE - Social Science, University College London, 20 Bedford Way, London, WC1H 0AL, England
| | - Su Aw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,, Singapore, Singapore
| | - Treena Wu
- Tsao Foundation, 298 Tiong Bahru Road, #15-01/06 Central Plaza, Singapore, 168730, Singapore
| | - Hubertus J M Vrijhoef
- Department of Patient & Care, Maastricht University Medical Center, Maastricht, the Netherlands.,Vrije Universiteit Brussels, Laarbeeklaan 103, 1090, Brussel, Belgium.,Panaxea, Matrix II, unit 1.08/9, Science Park 400, 1098, XH Amsterdam, The Netherlands
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16
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Lansbury LN, Roberts HC, Clift E, Herklots A, Robinson N, Sayer AA. Use of the electronic Frailty Index to identify vulnerable patients: a pilot study in primary care. Br J Gen Pract 2017; 67:e751-e756. [PMID: 28947622 PMCID: PMC5647918 DOI: 10.3399/bjgp17x693089] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/14/2017] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Identifying frailty is key to providing appropriate treatment for older people at high risk of adverse health outcomes. Screening tools proposed for primary care often involve additional workload. The electronic Frailty Index (eFI) has the potential to overcome this issue. AIM To assess the feasibility and acceptability of using the eFI in primary care. DESIGN AND SETTING Pilot study in one suburban primary care practice in southern England in 2016. METHOD Use of the eFI on the primary care TPP SystmOne database was explained to staff at the practice where a comprehensive geriatric assessment (CGA) clinic was being trialled. The practice data manager ran an eFI report for all patients (n = 6670). Date of birth was used to identify patients aged ≥75 years (n = 589). The eFI was determined for patients attending the CGA clinic (n = 18). RESULTS Practice staff ran the eFI reports in 5 minutes, which they reported was feasible and acceptable. The eFI range was 0.03 to 0.61 (mean 0.23) for all patients aged ≥75 years (mean 83 years, range 75 to 102 years). For CGA patients (mean 82 years, range 75 to 94 years) the eFI range was 0.19 to 0.53 (mean 0.33). Importantly, the eFI scores identified almost 12% of patients aged ≥75 years in this practice to have severe frailty. CONCLUSION It was feasible and acceptable to use the eFI in this pilot study. A higher mean eFI in the CGA patients demonstrated construct validity for frailty identification. Practice staff recognised the potential for the eFI to identify the top 2% of vulnerable patients for avoiding unplanned admissions.
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Affiliation(s)
- Lynn N Lansbury
- Academic Geriatric Medicine, National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, University of Southampton, Southampton
| | - Helen Clare Roberts
- Academic Geriatric Medicine, National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton
| | - Esther Clift
- Health Education England (Wessex), Faculty of Health Sciences, University of Southampton, Southampton
| | | | | | - Avan A Sayer
- National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre, and professor of geriatric medicine, Academic Geriatric Medicine, NIHR Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, University of Southampton, Southampton, Ageing, Geriatrics and Epidemiology, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, and National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle upon Tyne NHS Foundation Trust and Newcastle University, Newcastle upon Tyne
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17
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Integrated Care: Enhancing the Role of the Primary Health Care Professional in Preventing Functional Decline: A Systematic Review. J Am Med Dir Assoc 2017; 18:489-494. [DOI: 10.1016/j.jamda.2017.03.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 03/28/2017] [Indexed: 11/18/2022]
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18
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Brandão MP, Martins L, Philp I, Cardoso MF. Reliability and validity of the EASYCare-2010 Standard to assess elderly people in Portuguese Primary Health Care. Aten Primaria 2017; 49:576-585. [PMID: 28390731 PMCID: PMC6875982 DOI: 10.1016/j.aprim.2016.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/19/2016] [Accepted: 11/02/2016] [Indexed: 11/14/2022] Open
Abstract
Introduction The EASYCare is a multidimensional assessment tool for older people, which corresponds to the concerns and priorities of older people in relation to their needs, health, and quality of life. The EASYCare instrument has been used in many countries worldwide. Lack of reliability evidence has recently been raised by researchers. This study aimed to test the validity and reliability of the EASYCare-2010 instrument in community-dwelling Portuguese older people attended in Primary Health Care centres. Methods The sample for this transversal study (N = 244) was collected from Portuguese Primary Health Care Centers. Categorical Principal Component Analysis was used to assess the underlying dimensions of EASYCare-2010. Construct validity was evaluated through correlation with the World Health Organization Quality of Life Assessment Instrument-Short Form. Results A two-factor model (labelled “mobility and activities of daily life”, and “general well-being and safety”) was found. The EASYCare-2010 instrument showed acceptable levels for internal consistency (≥0.70). The EASYCare-2010 factors were correlated with measures of quality of life. Results showed that in most polytomous items, some of the more extreme categories were not considered at all or only by a residual number of participants. Conclusion EASY Care -2010 version is a valid and reliable instrument for holistic assessment of the older people attended in Primary Health Care centres in Portugal.
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Affiliation(s)
- Maria Piedade Brandão
- ESSUA - Health School, University of Aveiro, Aveiro, Portugal; CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal.
| | | | - Ian Philp
- Warwick Business School, Coventry, United Kingdom
| | - Margarida Fonseca Cardoso
- ICBAS - Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Porto, Portugal; CIIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal
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Validity of the EASYCare Standard 2010 assessment instrument for self-assessment of health, independence, and well-being of older people living at home in Poland. Eur J Ageing 2017. [PMID: 29531519 PMCID: PMC5840086 DOI: 10.1007/s10433-017-0422-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
EASYCare Standard 2010 is a brief instrument identifying concerns in health, functional independence, and well-being, from older persons’ perspective. It has not previously been validated for self-assessment. Our aim was to determine whether self-assessment (EC1) can give comparable results to an evaluation performed by professionals (EC2), for older people living at home. The study included community-dwelling individuals (aged at least 60 years, n = 100; 67 females) without dementia (abbreviated mental test score [AMTS] above 6). It comprised two assessments (self and professional), including summarising indexes: Independence score [IS], Risk of breakdown in care [RBC], Risk of falls [RF], performed within a period between 1 and 2 weeks. Additionally, during EC1, reference tests of physical and mental function (Barthel Index: 96.3 ± 6.5, Lawton scale: 6.7 ± 2.0, geriatric depression scale: 3.0 ± 2.7, AMTS: 10.2 ± 1.0) were applied to test for concurrent validity. Cohen’s kappa values (self-assessment vs. professional assessment) across all EASYCare domains were high (0.89–0.95). Results of all summarising indexes derived from self-assessment correlated strongly with reference tests. No differences were found in IS and RBC between EC1 and EC2 (8.6 ± 12.0 vs. 9.0 ± 12.7 and 1.0 ± 1.1 vs. 1.2 ± 1.4). Results of RF were higher in EC2 (1.0 ± 1.1 vs. 1.1 ± 1.4; p = 0.005), due to a different response to the item “Do you feel safe outside your home?” We conclude that self-assessment with EASYCare Standard in older people without severe functional impairment living at home can deliver valid results, similar to those obtained through professional assessment, thus providing an efficient system for assessment of relatively independent individuals.
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Kaehr E, Abele P, Little M. Utility of the Easy-Care Standard 2010 in the Comprehensive Geriatric Assessment of Adults Aging with Developmental Disabilities. J Am Med Dir Assoc 2016; 17:1159-1160. [PMID: 27751800 DOI: 10.1016/j.jamda.2016.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 08/31/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Ellen Kaehr
- Department of Geriatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Patricia Abele
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
| | - Milta Little
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
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21
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Geessink NH, Schoon Y, Olde Rikkert MGM, Melis RJ. Criterion Validity of a Frailty Index Derived from the Easycare Instrument. J Am Geriatr Soc 2016; 65:222-224. [PMID: 27879985 DOI: 10.1111/jgs.14546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Noralie H Geessink
- Department of Geriatrics, Radboud university medical center, Nijmegen, the Netherlands
| | - Yvonne Schoon
- Department of Geriatrics, Radboud university medical center, Nijmegen, the Netherlands
| | | | - René J Melis
- Department of Geriatrics, Radboud university medical center, Nijmegen, the Netherlands
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