Factors Affecting Quality of Life Among the Elderly in Long-Term Care Hospitals

The influence of socio-cognitive mindfulness, moral sensitivity and dementia communication behaviors on dementia nursing performance of nurses in long-term care hospitals: a cross-sectional study

BACKGROUND

By incorporating socio-cognitive mindfulness which has been under-examined in the nursing field, this study investigated the relationships between socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance of nurses in long-term care hospitals. This study also examined the factors influencing nurses' dementia nursing performance.

METHODS

A cross-sectional study was conducted with 209 nurses from long-term care hospitals in Korea. Data were collected between August 1 and August 31, 2022. Participants completed the questionnaire assessing their socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance. Pearson's correlation and hierarchical multiple regression analysis were performed for data analysis.

RESULTS

Dementia nursing performance of the nurses in long-term care hospitals was positively related to their socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors. Furthermore, nurses' dementia communication behaviors, moral sensitivity, and total clinical career, in that order, were found to be the factors influencing their dementia nursing performance.

CONCLUSION

The findings indicate that the higher socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors, the higher dementia nursing performance, and that higher dementia nursing performance is associated with better dementia communication behaviors, greater moral sensitivity, and more extensive clinical experiences. This study provides a foundation for developing effective interventions to enhance dementia nursing performance in the future. To improve dementia nursing performance of nurses in long-term care hospitals, it is necessary to improve dementia communication behaviors and moral sensitivity, and prepare multilateral countermeasures to maintain nurses' clinical careers.

Quality of Life of Residents in Seniors' Homes in Poland and Germany

BACKGROUND

Homes for the elderly and care facilities are not only a place of treatment, but also a place of permanent residence for older people. It is assumed that older adults' quality of life in the centres may not be sufficient for their long well-being. The purpose of this study was to determine the level of quality of life among nursing home residents in Poland and Germany and the impact of disability on functioning in their major life domains.

MATERIAL AND METHODS

This study was carried out using the WHOQOL-BREF questionnaire (abridged version) on 1000 people-500 residents of the centre in Poland and 500 residents in Germany.

RESULTS

The quality of life of Polish and German residents is at an average level and is closely related to their degree of independence. People with greater independence assessed their quality of life higher.

CONCLUSION

The degree of disability affects one's own health and the quality of life of the residents. Therefore, to improve older adults' quality of life, certain steps should be taken, including supporting them in maintaining their health and independence on a daily basis.

Impact of healthcare service quality on older people's satisfaction at geriatric medical centers: a rapid review

Introduction

Older adults are concerned about the quality of care as many of them are vulnerable to the co-occurrence of geriatric syndromes and age-related diseases due to accumulated impairments in multiple systems. Literature indicates that though people are living longer, they are not necessarily living healthier, which creates the need for providing quality healthcare services specifically to address the needs of this population. B This rapid review investigates the impact of healthcare service quality on older people's satisfaction at geriatric medical centers.

Methods

The rapid review includes 11 articles from searches on PubMed, PsycINFO and Google Scholar.

Results

The reviewed studies indicate that the quality of healthcare services to older adults enhances their satisfaction at senior facilities and produces positive patient outcomes. A thematic analysis of these studies revealed four major themes related to the review topic: perceived quality of healthcare services, patients' quality of life, patient satisfaction, and provider-patient communication.

Implications for practice

Nurses should provide high-quality care to older adults in geriatric settings to improve patients' and their families' satisfaction. Nurses should target quality leadership, implement quality improvement, and communicate effectively. Nurses should also offer patient-centered care by involving family members in care planning.

Characteristics associated with poor atrial fibrillation-related quality of life in adults with atrial fibrillation

PURPOSE

Few studies have examined the relationship between poor atrial fibrillation-related quality of life (AFQoL) and a battery of geriatric factors. The objective of this study is to describe factors associated with poor AFQoL in older adults with atrial fibrillation (AF) with a focus on sociodemographic and clinical factors and a battery of geriatric factors.

METHODS

Cross-sectional analysis of a prospective cohort study of participants aged 65+ with high stroke risk and AF. AFQoL was measured using the validated Atrial Fibrillation Effect on Quality of Life (score 0-100) and categorized as poor (<80) or good (80-100). Chi-square and t -tests evaluated differences in factors across poor AFQoL and significant characteristics ( P  < 0.05) were entered into a logistic regression model to identify variables related to poor AFQoL.

RESULTS

Of 1244 participants (mean age 75.5), 42% reported poor AFQoL. Falls in the past 6 months, pre/frail and frailty, depression, anxiety, social isolation, vision impairment, oral anticoagulant therapy, rhythm control, chronic obstructive pulmonary disease and polypharmacy were associated with higher odds of poor AFQoL. Marriage and college education were associated with a lower odds of poor AFQoL.

CONCLUSIONS

More than 4 out of 10 older adults with AF reported poor AFQoL. Geriatric factors associated with higher odds of reporting poor AFQoL include recent falls, frailty, depression, anxiety, social isolation and vision impairment. Findings from this study may help clinicians screen for patients with poor AFQoL who could benefit from tailored management to ensure the delivery of patient-centered care and improved well being among older adults with AF.

Effects of COVID-19 pandemic on mental health among adults: A comparative analysis from different communities in Chengmai County, China

Background

Due to the strict measures employed to control the spread of SARS-CoV-2, the extent of COVID-19 goes beyond morbidity and mortality and affects individuals’ mental health in the long term.

Objective

This cross-sectional study aimed to investigate the effects of the COVID-19 pandemic on mental health and its contributing factors among older people in Chengmai County, China.

Methods

A web-based survey was administered through WeChat between March and April 2020. Older people (ie, >50 years) from local and foreign community groups completed the survey, which included items on sociodemographic and clinical characteristics, the 7-item Generalized Anxiety Disorder scale (GAD-7), and the 9-item Patient Health Questionnaire (PHQ-9). Independent t tests and a multiple linear regression analysis were used to investigate differences between anxiety and depression and the factors associated with these symptoms across the 2 groups.

Results

Overall, 469 responses were received; 119 responses (25.4%) were from male participants and 202 (43.1%) were from those older than 65 years. Of the 469 responses, 245 (52.2%) were from the local community group and 224 (47.8%) from the foreign group. The mean GAD-7 (P=.003) scores were significantly higher in the local group. Anxiety was significantly more present in the local group (61/245, 24.9% compared to 35/224, 15.6% in the foreign group; P=.01). A total of 6 respondents presented severe anxiety and 2 presented severe depression.

Conclusions

This study demonstrated that both community groups of older adults from the Chinese “Hometown of Longevity” presented anxiety or depressive disorders during the first months of the pandemic. Local community groups presented significantly more mental health disorders, which were associated with a history of previous psychological disorders.

Influence of Attachment Anxiety on the Relationship between Loneliness and Depression among Long-Term Care Residents

BACKGROUND

Attachment styles influence an individual's ability to maintain relationships throughout their lifespan. Insecure attachment has been associated with many aspects of mental health. The study aimed to explore the influence of attachment on loneliness and depression among old-age residents in long-term care facilities.

METHODS

A survey was conducted among residents from long term care facilities (LTC) in Thailand during the COVID-19 pandemic; 221 older people participated in the study. The mean aged was 73.60 ± 7.45 years old, and 57.5% female. All participants completed the Geriatric Depression Scale, the six-item revised version of the University of California Los Angeles Loneliness Scale, and the Revised Experience of Close Relationships questionnaire to measure depressive symptoms, loneliness, and attachment style. Hierarchical multiple regression analysis was performed to find the predictors for depressive symptoms.

RESULTS

In all, 40.7% of residents in LTC facilities experienced depression. Male sex, education, loneliness, and attachment anxiety predicted the increased level of depressive symptoms.

CONCLUSION

Loneliness was confirmed to be significantly associated with depressive symptoms, and attachment anxiety was found to be a strong predicting factor of depressive symptoms. Intervention and research regarding reducing loneliness and attachment anxiety should be promoted in LTC settings.

Handgrip Strength and Depression Among Older Chinese Inpatients: A Cross-Sectional Study

OBJECTIVE

There have been studies exploring the association between handgrip and depression among community-dwelling adults; however, evidence for this association among hospitalized older adults is scarce. We aimed to use a larger-scale population from multiple centers to explore the association between low handgrip strength and depression.

METHODS

This was a cross-sectional study that included hospitalized patients aged 65 years or older from different hospitals in China. Depression was assessed by a short-form Chinese Geriatric Depression Scale (GDS-15) with a cutoff value of 5 points or more. Dominant hand handgrip strength was assessed by a dynamometer. A generalized additive model and multivariable regression analysis were conducted.

RESULTS

There were 9,368 participants, with an average age of 72.4 (SD=5.7) in the final analysis. The prevalence of low handgrip strength and depressive symptoms among older Chinese hospitalized patients was 50.3% and 16.3%, respectively. There seemed to be a nonlinear relationship between handgrip strength and depression, and curve fitting and threshold analyses indicated that when handgrip strength was less than 35.6 kg, the depression risk decreased significantly with increasing handgrip strength. However, this association between handgrip strength and depression was not significant when the handgrip strength was greater than 35.6 kg. In addition, after adjusting for potential confounders, older patients with low handgrip strength had an increased risk of depression compared to those with normal handgrip strength (OR=1.46; 95% CI=1.27-1.68). The subgroup analysis found the results were unchanged.

CONCLUSION

Our study indicates that low handgrip strength was associated with a higher risk of depression among older Chinese hospitalized patients, implying that early patient screening for handgrip strength and initiating effective intervention programs, such as resistance training and nutritional supplements, could be helpful for older patients.