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Nicoli EM, Silva FVCE, Assad LG, Cardinelli CC, Alves RA, de Oliveira SG. Nursing care for hospitalized older adults - fall accidents versus safe mobility: a scoping review. Rev Bras Enferm 2024; 77:e20230180. [PMID: 39045975 PMCID: PMC11259443 DOI: 10.1590/0034-7167-2023-0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/24/2024] [Indexed: 07/25/2024] Open
Abstract
OBJECTIVES to map the constituent elements of the safe mobility concept present in hospital care for older adults. METHODS a scoping review of 35 articles searched in databases and gray literature - BDENF/VHL, Scopus, CINAHL/EBSCO, Embase, Web of Science, PEDro, MEDLINE/PubMed and CAPES Theses and Dissertations Catalog. No time or language cut-off was established. RESULTS none of the studies presented a clear safe mobility concept, however its constituent elements involve factors related to patient (behavioral factors, conditions, diseases, signs and symptoms, nutritional status, age, balance, strength, gait quality, sleep), the institution (environment, treatment devices, guidelines, medications and polypharmacy, material and human resources and clothing/shoes) and the nature of the interventions (related to the patient, institution and family). FINAL CONSIDERATIONS the constituent elements of safe mobility express hospital units' capacity to guarantee care and protection from fall accidents for hospitalized older adults.
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Affiliation(s)
- Esther Mourão Nicoli
- Universidade do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Raquel Azevedo Alves
- Universidade do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
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Wermelinger Ávila MP, Corrêa JC, Zaidem MCDCF, Passos MV, Sena Lomba Vasconcelos AP, Lucchetti ALG, Lucchetti G. Resilience and Mental Health Among Regularly and Intermittently Active Older Adults: Results From a Four-Year Longitudinal Study. J Appl Gerontol 2022; 41:1924-1933. [PMID: 35543168 DOI: 10.1177/07334648221095075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aims to investigate whether regularly active individuals have different levels of mental health and resilience compared to intermittently active individuals. METHODS In this 4-year longitudinal study, 180 older people were included. General linear models were used to assess the level of physical activity, psychological resilience, and mental health among regularly and intermittently active older adults. RESULTS Those who maintained regular physical activity were more resilient than those who did not. However, no differences were observed for mental health outcomes. Although those with higher levels of resilience had fewer mental health problems, there were no significant differences between the groups based on their level of physical activity. CONCLUSION Differences in resilience levels favoring regularly active individuals were found. In both groups, resilience was inversely associated with mental health problems. These findings may help elucidate the underlying mechanisms in the relationship between physical activity and health outcomes.
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Affiliation(s)
| | - Jimilly Caputo Corrêa
- Division of Geriatric Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
| | | | - Matheus Venancio Passos
- Division of Geriatric Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
| | | | | | - Giancarlo Lucchetti
- Division of Geriatric Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
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Influence of Perceived Stress and Stress Coping Adequacy on Multiple Health-Related Lifestyle Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010284. [PMID: 35010544 PMCID: PMC8751155 DOI: 10.3390/ijerph19010284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/19/2021] [Accepted: 12/24/2021] [Indexed: 01/20/2023]
Abstract
Stress is a primary target of national health promotion efforts such as Healthy Japan in the 21st century (HJ21). However, little is known about how the combination of perceived stress and coping adequacy influence health-related lifestyle behaviors in line with national health promotion. This study assessed the association between combined perceived stress and coping adequacy and multiple health-related lifestyle behaviors in HJ21 practices. This cross-sectional survey that included specialists in health management comprehensively assessed multiple health-related lifestyle behaviors in accordance with HJ21. Total health-related lifestyle behavior scores were calculated and perceived stress and coping adequacy were recorded and categorized into four groups with group 1 to 4 being high to none, and highly adequate to not at all, respectively. The average total lifestyle behavior scores (standard deviation [SD]) were 35.1 (3.5), 33.7 (3.6), 31.8 (3.8), and 30.5 (4.9) for groups 1 to 4 of coping adequacy (p < 0.001). Further, individuals who had higher stress coping adequacy had better multiple health-related lifestyle behaviors after adjusting for demographic factors and perceived stress in the linear trend among the groups. Stress coping skills might be an essential target for stress reduction, ultimately leading to health promotion for disease prevention and longevity.
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Feng F, Shi G, Chen H, Jia P, Bao L, Xu F, Sun QC, Tang H. Comprehensive Interventions Including Vitamin D Effectively Reduce the Risk of Falls in Elderly Osteoporotic Patients. Orthop Surg 2021; 13:1262-1268. [PMID: 33951328 PMCID: PMC8274142 DOI: 10.1111/os.13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/14/2021] [Accepted: 03/11/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate the effects of different intervention measures to prevent falls in elderly osteoporotic patients. Methods A randomized controlled trial was conducted in our outpatient ward from August 2014 to September 2015. A total of 420 patients over 60 years of age were assigned to four groups. NA VitD group took 800 mg calcium and 800 IU non‐active vitamin D. P‐NA VitD group took 800 mg calcium, 800 IU non‐active vitamin D, and received physical exercise. A VitD group took 800 mg calcium and 0.5 μg active vitamin D. P‐A VitD took 800 mg calcium, 0.5 μg active vitamin D, and received physical exercise. Physical exercise includes guidance in improving muscle strength and balance ability. Short physical performance battery (SPPB), grip strength, modified falls efficacy scale (MFES), blood calcium, and 25‐hydroxyl vitamin D were measured before interventions and at 3, 6, and 12 months after interventions. Bone mineral density (BMD) was detected before interventions and at 12 months after interventions. The incidence of falls and fractures, adverse events, and drug reactions were recorded for 12 months. Results A total of 420 patients were allocated in the four groups: 98 cases into the NA VitD group (11 males, 87 females), 97 cases into the P‐NA VitD group (13 males, 84 females), 99 cases in the A VitD group (15 males, 84 females), and 98 cases into the P‐A VitD group (11 males, 87 females). At 6 months after interventions, the SPPB of A VitD group significantly increased from 6.9 ± 1.9 to 8.0 ± 2.4 (P < 0.05), and the SPPB of A VitD group significantly increased from 7.2 ± 2.1 to 8.6 ± 1.7 (P < 0.05). At 6 months after interventions, MFES of P‐NA VitD group 7.0 ± 1.6 to 7.6 ± 1.6 (P < 0.05), and MFES of P‐A VitD group significantly increased from 6.7 ± 1.6 to 7.5 ± 1.6 (P < 0.05). At 12 months after interventions, SPPB of all groups, grip strength, and MFES of P‐NA VitD group, A VitD group, P‐A VitD group were significantly improved (P < 0.05). The BMD of lumbar vertebrae of A VitD group significantly increased from 0.742 ± 0.042 to 0.776 ± 0.039, and P‐A VitD group significantly increased from 0.743 ± 0.048 to 0.783 ± 0.042 (P < 0.05). No serious adverse events occurred during the 12 months of follow‐up. Conclusion Active vitamin D is better than non‐active vitamin D to improve physical ability and the BMD of lumbar vertebrae and reduce the risk of falls.
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Affiliation(s)
- Fei Feng
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guan Shi
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hao Chen
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pu Jia
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Li Bao
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Feng Xu
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qin-Chao Sun
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hai Tang
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Mangione KK, Posner MA, Craik RL, Wolff EF, Fortinsky RH, Beamer BA, Binder EF, Orwig DL, Magaziner J, Resnick B. Using Treatment Fidelity Measures to Understand Walking Recovery: A Secondary Analysis From the Community Ambulation Project. Phys Ther 2021; 101:6210027. [PMID: 33823028 PMCID: PMC8520021 DOI: 10.1093/ptj/pzab109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/30/2020] [Accepted: 02/24/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Physical therapist intervention studies can be deemed ineffective when, in fact, they may not have been delivered as intended. Measurement of treatment fidelity (TF) can address this issue. The purpose of this study was to describe TF of a home-based intervention, identify factors associated with TF, and examine whether components of TF were associated with the outcome of change in 6-minute walk distance (∆6MWD). METHODS This is a secondary analysis of community-dwelling hip fracture participants who completed standard therapy and were randomly assigned to the active intervention (Push). Push was 16 weeks of lower extremity strengthening, function, and endurance training. TF was defined as delivery (attendance rate, exercise duration) and receipt (progression in training load, heart rate reserve [HRR] during endurance training, and exercise position [exercise on floor]). The outcome was ∆6MWD. Independent variables included baseline (demographic and clinical) measures. Descriptive statistics were calculated; linear and logistic regressions were performed. RESULTS Eighty-nine participants were included in this analysis; 59 (66%) had attendance of 75% or greater. Participants walked for 20 minutes or more for 78% of sessions. The average training load increased by 22%; the mean HRR was 35%; and 61 (69%) participants exercised on the floor for at least 75% of sessions. Regression analyses showed that a higher body mass index and greater baseline 6MWD were related to components of TF; 4 out of 5 components of TF were significantly related to ∆6MWD. The strongest TF relationship showed that those who exercised on the floor improved by 62 m (95% CI = 31-93 m) more than those who did not get on the floor. CONCLUSIONS Measures of TF should extend beyond attendance rate. This analysis demonstrates how measures of TF, including program attendance, progression in training load, endurance duration, and exercising on the floor were significantly related to improvement in 6MWD in participants post hip fracture. IMPACT This careful analysis of treatment fidelity assured that the intervention was delivered and received as intended. Analysis of data from a large trial with participants after hip fracture showed that regular attendance, frequent endurance training for 20 minutes, increases in lower extremity training loads, and exercising on the floor were associated with improvements in the outcome of 6-minute-walk distance. The strongest association with improvement was exercising on the floor.
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Affiliation(s)
- Kathleen K Mangione
- Department of Physical Therapy, Arcadia University, 450 S Easton Rd, Glenside, Pennsylvania, USA,Address all correspondence to Dr Mangione at:
| | - Michael A Posner
- Department of Mathematics and Statistics, Villanova University, Villanova, Pennsylvania, USA
| | - Rebecca L Craik
- College of Health Science, Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA
| | - Edward F Wolff
- Department of Computer Science and Mathematics, Arcadia University, Glenside, Pennsylvania, USA
| | - Richard H Fortinsky
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Brock A Beamer
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA,Geriatric Research, Education, and Clinical Center at the Veterans Affairs Maryland Health Care System, Baltimore, Maryland, USA
| | - Ellen F Binder
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Denise L Orwig
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jay Magaziner
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Barbara Resnick
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
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Feasibility, Reliability, and Validity of the MotionWatch 8 to Evaluate Physical Activity Among Older Adults With and Without Cognitive Impairment in Assisted Living Settings. J Aging Phys Act 2020; 29:391-399. [PMID: 33361499 DOI: 10.1123/japa.2020-0198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/28/2020] [Accepted: 08/01/2020] [Indexed: 12/23/2022]
Abstract
This study tested the feasibility, reliability, and validity of the MotionWatch 8 among assisted living residents with and without cognitive impairment. Data from the Dissemination and Implementation of Function Focused Care in Assisted Living Using the Evidence Integration Triangle study were used. The sample included 781 individuals from 85 facilities with a mean age of 89.48 (SD = 7.43) years. The majority were female (71%), White (97%), and overall (44%) had cognitive impairment. A total of 70% were willing to wear the MotionWatch 8. Reliability was supported as there was no difference in time spent in activity across three consecutive wear days. Validity was based on hypothesis testing, and function was associated with counts of activity at baseline (p = .001) and 4 months (p = .001). Those with cognitive impairment engaged in less physical activity (p = .04). The MotionWatch 8 is a useful option for measuring physical activity in older adults with and without cognitive impairment.
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Waterman H, Ballinger C, Brundle C, Chastin S, Gage H, Harper R, Henson D, Laventure B, McEvoy L, Pilling M, Olleveant N, Skelton DA, Stanford P, Todd C. A feasibility study to prevent falls in older people who are sight impaired: the VIP2UK randomised controlled trial. Trials 2016; 17:464. [PMID: 27671540 PMCID: PMC5037880 DOI: 10.1186/s13063-016-1565-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 08/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Published evaluations of successful interventions to prevent falls in people with sight impairment (SI) are limited. The aim of this feasibility study is to optimise the design and investigation of home safety (HS) and home exercise (HE) programmes to prevent falls in older people with SI. METHODS A community-based feasibility study in north-west England comprising a three-arm randomised controlled trial (RCT) allocated participants to (1) a control group receiving usual care and social visits, (2) an experimental group receiving the HS programme and (3) an experimental group receiving the HS + HE programme. Participants were community-dwelling, aged 65 years and older and sight impaired. Primary outcome data on falls were collected continuously over 6 months. Secondary outcomes on physical activity (self-report and instrumented) and adherence were collected at baseline and 3 and 6 months for HE and at 6 months for the HS programme. Costs for the HS and HS + HE groups were calculated from logs of time spent on home visits, telephone calls and travel. The research assistant and statistician were blinded to group allocation. RESULTS Altogether, 49 people were recruited over a 9-month period (randomised: 16 to control, 16 to HS, 17 to HS + HE). The interventions were implemented over 6 months by an occupational therapist at a cost per person (pounds sterling, 2011) of £249 (HS) and £674 (HS + HE). Eighty-eight percent (43/49) completed the trial and 6-month follow-up. At 6-month follow-up, 100 % reported partially or completely adhering to HS recommendations but evidence for adherence to HE was equivocal. Although self-reported physical activity increased, instrumented monitoring showed a decrease in walking activity. There were no statistically significant differences in falls between the groups; however, the study was not powered to detect a difference. CONCLUSION It is feasible and acceptable for an occupational therapist to deliver HS and HE falls prevention programmes to people with SI living independently in the community. Future studies could access Local Authority Registers of people with SI to improve recruitment rates. Further research is required to identify how to improve adherence to HE and to measure changes in physical activity before conducting a definitive RCT. TRIAL REGISTRATION ISRCTN53433311 , registered on 8 May 2014.
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Affiliation(s)
- Heather Waterman
- University of Cardiff, Eastgate House, 35-43 Newport Road, Cardiff, CF24 0AB, UK.
| | | | | | | | | | - Robert Harper
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.,Manchester Academic Health Sciences Centre, Manchester, UK
| | - David Henson
- Manchester Academic Health Sciences Centre, Manchester, UK.,University of Manchester, Manchester, UK
| | | | - Lisa McEvoy
- Manchester Academic Health Sciences Centre, Manchester, UK.,Trafford General Hospital, Trafford, UK
| | - Mark Pilling
- Manchester Academic Health Sciences Centre, Manchester, UK.,University of Manchester, Manchester, UK
| | - Nicky Olleveant
- Manchester Academic Health Sciences Centre, Manchester, UK.,University of Manchester, Manchester, UK
| | | | - Penelope Stanford
- Manchester Academic Health Sciences Centre, Manchester, UK.,University of Manchester, Manchester, UK
| | - Chris Todd
- Manchester Academic Health Sciences Centre, Manchester, UK.,University of Manchester, Manchester, UK
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Resnick B, Galik E, Wells PT CL, Boltz M, Holtzman L. Optimizing physical activity among older adults post trauma: Overcoming system and patient challenges. Int J Orthop Trauma Nurs 2015; 19:194-206. [PMID: 26547682 PMCID: PMC4637820 DOI: 10.1016/j.ijotn.2015.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/24/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND By 2050 it is anticipated that close to half (40%) of all trauma patients will be over the age of 65. Recovery for these individuals is more complicated than among younger individuals. Early mobilization has been shown to improve outcomes. Unfortunately, there are many challenges to early mobilization. The Function Focused Care Intervention was developed to overcome these challenges. PURPOSE The purpose of this paper was to describe the initial recruitment of the first 25 participants and delineate the challenges and successes associated with implementation of this intervention. RESULTS Overall recruitment rates were consistent with other studies and the intervention was implemented as intended. Most patients were female, white and on average 79 years of age. Optimizing physical activity of patients was a low priority for the nurses with patient safety taking precedence. Patients spent most of the time in bed. Age, depression and tethering were the only factors that were associated with physical activity and functional outcomes of patients. CONCLUSION Ongoing work is needed to keep patients physically active in the immediate post trauma recovery period.
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Affiliation(s)
- Barbara Resnick
- Professor, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, Tel: 410 706 5178
| | - Elizabeth Galik
- Associate Professor, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, Tel: 410 706 5178
| | - Chris L. Wells PT
- Clinical Associate Professor, Physical Therapy and Rehabilitation Science 655 W. Baltimore Street, Baltimore MD 21201, Tel: 410 706 6663
| | - Marie Boltz
- Boston College, William F. Connell School of Nursing, 140 Commonwealth Ave, Chestnut Hill, MA 02467, Tel: 617-552-6379
| | - Lauren Holtzman
- Project Manager, University of Maryland, School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, Tel: 410 706 5178
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Doron J, Trouillet R, Maneveau A, Neveu D, Ninot G. Coping profiles, perceived stress and health-related behaviors: a cluster analysis approach. Health Promot Int 2014; 30:88-100. [DOI: 10.1093/heapro/dau090] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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