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Skoumal M, Lindner-Rabl S, Honegger M, Pertinatsch C, Kadane C, Neubacher B, Herzog C, Roller-Wirnsberger R. Goal Setting for Participatory Person-Centered Geriatric Rehabilitation-From Function-Centered Rehabilitation towards Digitally Supported Personalized and Integrated Care for Older People. J Clin Med 2024; 13:4134. [PMID: 39064173 PMCID: PMC11277607 DOI: 10.3390/jcm13144134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/08/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
As chronic illness is common among older people, self-care practices for older people are needed to control health status, to prevent possible complications and to ensure optimal quality of life. The literature has demonstrated that integrated care approaches are one key success factor for delivering person-centered and sustainable care for older people, with rehabilitation being a cornerstone in tertiary care prevention for older citizens. The current paper addresses the state of the literature for person-centered geriatric rehabilitation (GR) and the importance of personalized and participatory goal setting. In accordance with the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF), social participation and the related goals are of particular importance for the entire rehabilitation process. The social participation of individuals enrolled into GR is therefore one of the milestones to be achieved during GR. Personalized goal setting during the entire rehabilitation process, Comprehensive Geriatric Assessment (CGA) and shared decision making allow a comprehensive care approach separate from solely function-based rehabilitation. The review also focusses on recent developments in digitalization in healthcare and delivers insights into how healthcare professionals' collaborative practice supports sustainable rehabilitation results in patients of advanced chronological age.
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Affiliation(s)
- Martin Skoumal
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Sonja Lindner-Rabl
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
| | - Martina Honegger
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Christoph Pertinatsch
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Christof Kadane
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Britta Neubacher
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Carolin Herzog
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
| | - Regina Roller-Wirnsberger
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
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Xin W, Xu D, Dou Z, Jacques A, Umbella J, Hill AM. Effectiveness of community-based rehabilitation (CBR) centres for improving physical fitness for community-dwelling older adults: a systematic review protocol. BMJ Open 2022; 12:e062992. [PMID: 36316066 PMCID: PMC9628507 DOI: 10.1136/bmjopen-2022-062992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The increasing ageing population has become a substantial challenge for both healthcare and social services in many Asian countries. There is a high incidence of chronic diseases and comorbidities in older populations, leading to impairments and functional disability. Functional disability may result in loss of independence, reduced quality of life and increased care needs. Community-based rehabilitation (CBR) provides rehabilitation to improve physical, mental and social outcomes. However, there is limited evidence regarding the effectiveness of CBR for improving older adults' physical fitness. The aim of this systematic review is to synthesise the evidence for the effectiveness of interventions delivered by CBR centres on physical fitness of community-dwelling older adults in Asian countries. METHODS AND ANALYSIS A search on four English databases (CINAHL, Medline, Scopus and Proquest) and two Chinese databases (China National Knowledge Internet and Wanfang Database) will be conducted from inception to 15 November 2021. Both English and Chinese publications will be included. Studies conducted in Asian countries using either experimental or quasi-experimental designs, with any type of control group, will be included. The primary outcomes are physical fitness (capacity to perform activities and tasks). Secondary outcomes are performance of activities of daily living and health-related quality of life. The quality of all included studies will be assessed using the Joanna Briggs Institute standardised critical appraisal tools. Two reviewers will independently complete study screening, selection, quality appraisal and data extraction. Quantitative data where possible will be pooled in statistical meta-analysis. All statistical analyses will be performed using Review Manager (Rev Man) V.5.3 software. ETHICS AND DISSEMINATION Ethical approval is not required for this review. Findings of the review will be disseminated electronically through a peer-reviewed publication and conference presentations. This review will provide high-quality evidence for CBR in Asian countries with growing ageing populations. Clinical and research recommendations will provide guidance for policy makers and clinical programmes in Asian healthcare systems. Findings will also inform healthcare systems in other countries that use CBR. PROSPERO REGISTRATION NUMBER CRD42021292088.
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Affiliation(s)
- Wei Xin
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- Rehabilitation Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Dan Xu
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zulin Dou
- Rehabilitation Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Angela Jacques
- The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Josephine Umbella
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Anne-Marie Hill
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
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Silverglow A, Johansson L, Lidén E, Wijk H. Perceptions of providing safe care for frail older people at home: A qualitative study based on focus group interviews with home care staff. Scand J Caring Sci 2021; 36:852-862. [PMID: 34423863 DOI: 10.1111/scs.13027] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Providing safe care is a core competence in healthcare. The concept usually refers to hospitals but, consistent with the increasing importance of integrated care, the provision of safe care needs to be extended to the context of home care, and more research is needed concerning home healthcare providers' perspectives in this context. AIM The aim of this study was to describe care providers' perceptions of providing safe care for frail older persons living at home. METHOD A qualitative methodology was chosen. In total, 30 care providers agreed to participate. Data were collected through five focus group interviews and analysed using a phenomenographic approach. RESULTS Three themes regarding care providers' perceptions of providing safe care emerged from the data: 'safe care is created in the encounter and interaction with the older person', 'safe care requires responsibility from the caregiver' and 'safe care is threatened by insufficient organisational resources'. The findings show that providing safe care is an endeavour that requires a holistic view among the care providers as well as effective collaboration within the team, but insufficient competence or a lack of time can make it difficult to safeguard the psychological and existential needs of older persons. CONCLUSION Providing safe care in home environments encompasses more than just risk reduction. The findings highlight the importance of establishing and integrating team-based and person-centred care into home care settings. Traditional communication structures for inpatient care also need to be adapted to the cross-disciplinary work in municipalities. Care providers should be given the opportunity to develop and maintain their competences and to prioritise relationship-oriented care.
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Affiliation(s)
- Anastasia Silverglow
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Johansson
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Eva Lidén
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden.,The Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Gothenburg, Sweden
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Tankumpuan T, Anuruang S, Jackson D, Hickman LD, DiGiacomo M, Davidson PM. Improved adherence in older patients with hypertension: An observational study of a community-based intervention. Int J Older People Nurs 2019; 14:e12248. [PMID: 31173482 DOI: 10.1111/opn.12248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/29/2019] [Accepted: 05/12/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This study sought to assess the effect of a community-based intervention influencing adherence status at baseline, 1, 3 and 6 months, and to evaluate the impact that a community-based intervention and socio-economic factors have on adherence. BACKGROUND Although high-quality treatment and modern hypertension clinical practice guidelines have been developed worldwide, the outcomes of patients with hypertension in Thailand are not optimal. Implementing a person-centred and integrated health services model to improve hypertension management, such as a community-based intervention, is challenging for healthcare providers in Thailand. DESIGN An observational study of a community-based intervention. METHODS The study comprised residents in 17 villages in one province of Thailand. A sample of 156 participants was allocated into the intervention and the control groups. Inclusion criteria were people aged 60 years or older diagnosed with hypertension. Exclusion criteria included the latest record of extreme hypertension and having a documented history of cognitive impairment. The intervention group received the 4-week community-based intervention programme. Multiple linear regression was applied to predict the adherence status at each phase. Multiple logistic regression was then implemented to predict influencing factors between the groups. RESULTS Patients who received the intervention had significantly lower adherence scores (reflecting a higher level of adherence) at 3 and 6 months after intervention by 1.66 and 1.45 times, respectively, when adjusting for other variables. After 6 months, the intervention was associated with a significant improvement in adherence when adjusting for other variables. CONCLUSION This study provides evidence to support the use of community-based interventions as an effective adjunct to hospital-based care of hypertension patients in Thailand. IMPLICATIONS FOR PRACTICE Understanding factors between health outcomes and social determinants of health is crucial for informing the development of culturally appropriate interventions.
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Affiliation(s)
| | | | - Debra Jackson
- Oxford Institute of Nursing, Midwifery & Allied Health Research (OxINMAHR), Oxford, UK
| | - Louise D Hickman
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Michelle DiGiacomo
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Improved Health Status and Life Satisfaction among Older People following Self-Help Group Intervention in Jakarta. Curr Gerontol Geriatr Res 2017; 2017:3879067. [PMID: 29225621 PMCID: PMC5684573 DOI: 10.1155/2017/3879067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 08/23/2017] [Accepted: 09/06/2017] [Indexed: 11/17/2022] Open
Abstract
Although self-help group for older people gains the effectiveness, the effect of a nursing intervention using a self-help group model as a guideline for self-monitoring and intervention on the health status and life satisfaction among older people still remains. To determine the effectiveness of this nursing intervention, an experimental design using multistage sampling method was used for this study. The self-help intervention included a single 50-70-minute session once a week for 12 weeks done, using the Life Satisfaction Inventory-A (LSI-A) questionnaire, and SF-36 shows a significant difference. Self-help intervention could be implemented by nurses for older people in the community to improve health and well-being.
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Jacelon CS, Gibbs MA, Ridgway JV. Computer technology for self-management: a scoping review. J Clin Nurs 2016; 25:1179-92. [PMID: 26990364 DOI: 10.1111/jocn.13221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2016] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this scoping review of literature is to explore the types of computer-based systems used for self-management of chronic disease, the goals and success of these systems, the value added by technology integration and the target audience for these systems. BACKGROUND Technology is changing the way health care is provided and the way that individuals manage their health. Individuals with chronic diseases are now able to use computer-based systems to self-manage their health. These systems have the ability to remind users of daily activities, and to help them recognise when symptoms are worsening and intervention is indicated. However, there are many questions about the types of systems available, the goals of these systems and the success with which individuals with chronic illness are using them. DESIGN This is a scoping review in which the Cumulative Index of Nursing and Allied Health Literature, PubMed and IEEE Xplore databases were searched. A total of 303 articles were reviewed, 89 articles were read in-depth and 30 were included in the scoping review. The Substitution, Augmentation, Modification, Redefinition model was used to evaluate the value added by the technology integration. FINDINGS Research on technology for self-management was conducted in 13 countries. Data analysis identified five kinds of platforms on which the systems were based, some systems were focused on a specific disease management processes, others were not. CONCLUSIONS For individuals to effectively use systems to maintain maximum wellness, the systems must have a strong component of self-management and provide the user with meaningful information regarding their health states. RELEVANCE TO CLINICAL PRACTICE Clinicians should choose systems for their clients based on the design, components and goals of the systems.
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Affiliation(s)
| | - Molly A Gibbs
- College of Nursing, University of Massachusetts, Amherst, MA, USA
| | - John Ve Ridgway
- College of Informatics and Computer Science, University of Massachusetts, Amherst, MA, USA
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