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Chen S, Kent B, Cui Y. Interventions to prevent aspiration in older adults with dysphagia living in nursing homes: a scoping review. BMC Geriatr 2021; 21:429. [PMID: 34273953 PMCID: PMC8285814 DOI: 10.1186/s12877-021-02366-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 06/29/2021] [Indexed: 12/24/2022] Open
Abstract
Background Dysphagia is highly prevalent condition in older adults living in nursing homes. There is also evidence indicating that aspiration is one of the major health risks for these older adults, which is more likely to result in respiratory infections, aspiration pneumonia and sudden bolus death. Evidence syntheses have demonstrated the effectiveness of interventions for prevention of aspiration among hospitalized older people. The aim of this scoping review is to describe the current spread of interventions to prevent or reduce aspiration in older adults with dysphagia with a specific focus on those who reside in nursing homes. Methods The Joanna Briggs Institute methods and PRISMA-ScR guidelines were used to inform this review. MEDLINE, CINAHL, EMBASE, Cochrane Library, Joanna Briggs Institute EBP Database and Web of Science were searched for related articles from 2010 to 2020 as well as Chinese databases (CNKI, WANFANG DATA and VIP) and databases for unpublished material. A three-step search strategy was utilized, including the use of citation software to manage search results and de-duplication, abstract review and full-text review by two reviewers. Details of included studies were then extracted using a prepared data extraction tool. The resulting map was displayed in tabular form along with a narrative summary. Results Although 637 articles were located, 19 papers were included in the final analysis. Interventions to prevent aspiration in older adults with dysphagia living in nursing homes included: more bedside evaluation, modification of dietary, creating an appropriate environment for swallowing, providing appropriate feeding assistance, appropriate posture or maneuver for swallowing, appropriate rehabilitation program, medication treatment, and stimulation treatment. Conclusion Nursing homes, particularly those in developing countries, require more support for staff training and necessary equipment. Professional interventions provided by speech and language therapists are still limited in the setting of nursing homes. Modification of dietary was the most frequently used intervention to prevent or reduce aspiration. Multi-disciplinary interventions had the best results for aspiration management, but for many nursing homes, access to such teams is limited. Nursing home residents respond well to person-centered interventions that have a comprehensive consideration of their degree of aspiration risk, health condition, individual feelings and cognitive state.
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Affiliation(s)
- Shen Chen
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Bridie Kent
- The University of Plymouth Centre for Innovations in Health and Social Care: A Joanna Briggs Institute Centre of Excellence, Plymouth, UK.,School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, China.
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Chen S, Cui Y, Ding Y, Sun C, Xing Y, Zhou R, Liu G. Prevalence and risk factors of dysphagia among nursing home residents in eastern China: a cross-sectional study. BMC Geriatr 2020; 20:352. [PMID: 32943011 PMCID: PMC7495827 DOI: 10.1186/s12877-020-01752-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/02/2020] [Indexed: 12/19/2022] Open
Abstract
Background Dysphagia is a common health care problem and poses significant risks including mortality and hospitalization. China has many unsolved long-term care problems, as it is a developing country with the largest ageing population in the world. The present study aimed to identify the prevalence and risk factors of dysphagia among nursing home residents in China to direct caregivers towards preventative and corrective actions. Methods Data were collected from 18 public or private nursing homes in 9 districts of Nanjing, China. A total of 775 older adults (aged 60 ~ 105 years old; 60.6% female) were recruited. Each participant underwent a standardized face-to-face interview by at least 2 investigators. The presence of risk of dysphagia was assessed using the Chinese version of the EAT-10 scale. The Barthel Index (BI) was used to evaluate functional status. Additionally, demographic and health-related characteristics were collected from the participants and their medical files. Univariate analyses were first used to find out candidate risk factors, followed by binary logistic regression analyses to determine reliable impact factors after adjusting for confounders. Results Out of 775 older adults, the prevalence of dysphagia risk was calculated to be 31.1%. A total of 85.0% of the older adults reported at least one chronic disease, and diseases with the highest prevalence were hypertension (49.5%), stroke (40.4%), diabetes (25.5%) and dementia (18.2%). Approximately 11.9% of participants received tube feeding. The mean BI score was 56.2 (SD = 38.3). Risk factors for dysphagia were texture of diet (OR = 2.978, p ≤ 0.01), BI level (OR = 1.418, p ≤ 0.01), history of aspiration, pneumonia and heart attack (OR = 22.962, 4.909, 3.804, respectively, p ≤ 0.01), types of oral medication (OR = 1.723, p ≤ 0.05) and Parkinson disease (OR = 2.566, p ≤ 0.05). Conclusions A serious risk of dysphagia was observed among Chinese nursing home residents. Overall, nursing home residents were moderately dependent, according to the BI level. The risk for dysphagia increased with thinner diet texture, worse functional status, history of aspiration, pneumonia and heart attack, more oral medications and Parkinson disease. The findings of our study may serve to urge nursing home staff to pay more attention to the swallowing function of all residents and to take more actions in advance to prevent or reduce dysphagia.
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Affiliation(s)
- Shen Chen
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China
| | - Yan Cui
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China.
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China
| | - Changxian Sun
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China.,Jiangsu Vocational Institute of Commerce, 180 Longmian Avenue, Nanjing, 211168, China
| | - Ying Xing
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China
| | - Rong Zhou
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China
| | - Guohua Liu
- JORU QingHe Senior Care Center, 70 Youyi Street, Nanjing, 210041, China
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Backman A, Sjögren K, Lindkvist M, Lövheim H, Edvardsson D. Characteristics of highly rated leadership in nursing homes using item response theory. J Adv Nurs 2017; 73:2903-2913. [DOI: 10.1111/jan.13353] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2017] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Marie Lindkvist
- Department of Statistics; Umeå School of Business and Economics; Umeå University; Umeå Sweden
- Epidemiology and Global Health; Department of Public Health and Clinical Medicine; Umeå University; Umeå Sweden
| | - Hugo Lövheim
- Department of Community Medicine and Rehabilitation; Umeå University; Umeå Sweden
| | - David Edvardsson
- Department of Nursing; Umeå University; Umeå Sweden
- School of Nursing and Midwifery; La Trobe University; Melbourne Australia
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Edvardsson D, Backman A, Bergland Å, Björk S, Bölenius K, Kirkevold M, Lindkvist M, Lood Q, Lämås K, Lövheim H, Sandman PO, Sjögren K, Sköldunger A, Wimo A, Winblad B. The Umeå ageing and health research programme (U-Age): Exploring person-centred care and health-promoting living conditions for an ageing population. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/2057158516645705] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this article is to describe the Umeå ageing and health research programme that explores person-centred care and health-promoting living conditions for an ageing population in Sweden, and to place this research programme in a national and international context of available research evidence and trends in aged care policy and practice. Contemporary trends in aged care policy includes facilitating ageing in place and providing person-centred care across home and aged care settings, despite limited evidence on how person-centred care can be operationalised in home care services and sheltered housing accommodation for older people. The Umeå ageing and health research programme consists of four research projects employing controlled, cross-sectional and longitudinal designs across ageing in place, sheltered housing, and nursing homes. The research programme is expected to provide translational knowledge on the structure, content and outcomes of person-centred care and health-promoting living conditions in home care, sheltered housing models, and nursing homes for older people and people with dementia.
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Affiliation(s)
- David Edvardsson
- Department of Nursing, Umeå University, Sweden
- School of Nursing and Midwifery, La Trobe University, Australia
| | | | | | | | | | | | - Marie Lindkvist
- Statistics, USBE, Umeå University, Sweden
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Qarin Lood
- Department of Nursing, Umeå University, Sweden
- School of Nursing and Midwifery, La Trobe University, Australia
| | | | - Hugo Lövheim
- Department of Community Medicine and Rehabilitation, Umeå University, Sweden
| | - Per-Olof Sandman
- Department of Nursing, Umeå University, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden
- Department of Health Sciences, Luleå University of Technology, Sweden
| | | | | | - Anders Wimo
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Sweden
| | - Bengt Winblad
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Sweden
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Park YH, Bang HL, Han HR, Chang HK. Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review. J Korean Acad Nurs 2015; 45:1-13. [DOI: 10.4040/jkan.2015.45.1.1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yeon-Hwan Park
- College of Nursing, Seoul National University, Seoul, Korea
| | - Hwal Lan Bang
- The Research Institute of Nursing Science, Seoul National University, Seoul, Korea
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Clinical instructors' knowledge and perceptions about nursing care of older people: A pilot study. Nurse Educ Pract 2014; 14:434-40. [DOI: 10.1016/j.nepr.2014.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 10/28/2013] [Accepted: 03/03/2014] [Indexed: 11/22/2022]
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Abstract
AIM Ageism in health care delivery and nursing poses a fundamental threat to health and society. In this commentary, implications of age discrimination are presented to generate an agenda for action in nursing management. BACKGROUND In nations like the United States and the United Kingdom, nursing is an ageing profession caring for an ageing society where age discrimination takes many forms and has broad impact. EVALUATION This commentary critically synthesizes the literature on ageism and relevant data on ageing societies for nurse managers and other leaders. KEY ISSUES Investigations of ageism suggest that discrimination negatively affects health and results in poor health care experiences. Age discrimination is present in nursing, exacerbating workforce shortages and limiting the use of expertise within the profession. CONCLUSION Nursing faces a future for which understanding ageing societies and ageism is essential. An agenda for the future is proposed. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers possess the power to enact an agenda for combating ageism in health care and nursing.
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Affiliation(s)
- Sarah H Kagan
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Park YH, Han HR, Oh BM, Lee J, Park JA, Yu SJ, Chang H. Prevalence and associated factors of dysphagia in nursing home residents. Geriatr Nurs 2013; 34:212-7. [PMID: 23528180 DOI: 10.1016/j.gerinurse.2013.02.014] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 02/21/2013] [Accepted: 02/21/2013] [Indexed: 11/20/2022]
Abstract
Dysphagia is a major health care problem in nursing homes. It can lead to fatal complications including aspiration pneumonia and even death. The aims of this study were to evaluate the prevalence of dysphagia in nursing home residents in South Korea and to identify factors associated with dysphagia. The study was conducted in two urban nursing homes and a total of 395 older adults (aged 65-103 years old, 76.5% female) were enrolled. The presence of dysphagia was evaluated using the Gugging Swallowing Screen (GUSS) test. Out of 395 older adults, the prevalence of dysphagia was 52.7%. The following were all risk factors associated with dysphagia: Aged 75 years or older, male gender, history of dementia, feeding time longer than 20 min, severe dependent functional status, solid meal type, high nutritional risk, and underweight. To prevent complications from dysphagia in nursing home residents, systematic screening and evaluation programs for dysphagia are needed.
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Affiliation(s)
- Yeon-Hwan Park
- College of Nursing, Seoul National University, 28 Yeongeon-dong, Jongro-gu, Seoul 110-799, South Korea
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Job satisfaction amongst aged care staff: exploring the influence of person-centered care provision. Int Psychogeriatr 2011; 23:1205-12. [PMID: 21320379 DOI: 10.1017/s1041610211000159] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There are challenges in attracting and sustaining a competent and stable workforce in aged care, and key issues of concern such as low staff job satisfaction and feelings of not being able to provide high quality care have been described. This study aimed to explore the association between person-centered care provision and job satisfaction in aged care staff. METHODS Residential aged care staff (n = 297) in Australia completed the measure of job satisfaction and the person-centered care assessment tool. Univariate analyses examined relationships between variables, and multiple linear regression analysis explored the extent to whichperceived person-centredness could predict job satisfaction of staff. RESULTS Perceived person-centred care provision was significantly associated with job satisfaction, and person-centred care provision could explain nearly half of the variation in job satisfaction. The regression model with the three person-centered care subscales as predictor variables accounted for 40% of the variance in job satisfaction. Personalizing care had the largest independent influence on job satisfaction, followed by amount of organizational support and degree of environmental accessibility. Personalizing care and amount of organizational support had a statistically significant unique influence. CONCLUSIONS As person-centered care positively correlated with staff job satisfaction, supporting staff in providing person-centered care can enhance job satisfaction and might facilitate attracting and retaining staff in residential aged care. The findings reiterate a need to shift focus from merely completing care tasks and following organizational routines to providing high quality person-centered care that promotes the good life of residents in aged care.
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