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Scrimaglia S, Ricci M, Masini A, Montalti M, Conti A, Camedda C, Panella M, Dallolio L, Longobucco Y. The Role of Family or Community Nurse in Dealing with Frail and Chronic Patients in Italy: A Scoping Review. Geriatrics (Basel) 2024; 9:81. [PMID: 38920437 PMCID: PMC11203250 DOI: 10.3390/geriatrics9030081] [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: 04/14/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024] Open
Abstract
Even though Family and Community Nurses (FCNs) were introduced into the Italian healthcare system in 2000, to date, there is a substantial knowledge gap regarding the implementation of these professional figures within the Primary Care (PC) system. This scoping review aims to provide a comprehensive picture of the role of FCNs in managing older adults and the elderly with chronic conditions within the Italian PC system. A search on Medline, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase, and Scopus was conducted including studies published until 7 April 2023. Among 141 potential articles, only 4 met our inclusion criteria. Each of these studies attributed their findings to the presence of FCNs. They reported a significant decrease in the prevalence of several behaviours among patients diagnosed with hypertension, a reduction in metabolic complications among frail patients receiving home enteral nutrition, a decline in hospital readmissions or emergency services utilization among patients >65 years of ages with at least one chronic disease, and, notably, a high level of effectiveness in detecting major cardiovascular events in patients with cardiac implantable electronic devices. Despite the effectiveness of interventions managed by FCNs, comprehensive information and research on the integration of this role within the PC setting are still lacking in the Italian healthcare system.
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Affiliation(s)
- Susan Scrimaglia
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (S.S.); (M.R.); (M.M.); (L.D.)
| | - Matteo Ricci
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (S.S.); (M.R.); (M.M.); (L.D.)
| | - Alice Masini
- Department of Translational Medicine, University of Eastern Piedmont Amedeo Avogadro, 28100 Novara, Italy; (A.C.); (M.P.)
| | - Marco Montalti
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (S.S.); (M.R.); (M.M.); (L.D.)
| | - Andrea Conti
- Department of Translational Medicine, University of Eastern Piedmont Amedeo Avogadro, 28100 Novara, Italy; (A.C.); (M.P.)
- Doctoral Program in Food, Health, and Logevity, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
| | - Claudia Camedda
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Massimiliano Panella
- Department of Translational Medicine, University of Eastern Piedmont Amedeo Avogadro, 28100 Novara, Italy; (A.C.); (M.P.)
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (S.S.); (M.R.); (M.M.); (L.D.)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50134 Firenze, Italy;
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Zhu H, Ma S, Ding Y, Xia H. Associations between employment and mental health of older workers with disparate conditions: Evidence from China. Geriatr Nurs 2024; 56:244-251. [PMID: 38387148 DOI: 10.1016/j.gerinurse.2024.02.023] [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: 11/19/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE This study aimed to examine associations between the employment of older people and mental health across demographic characteristics, socioeconomic conditions, and health status, with a focus on pensions. METHODS This study included 4,512 participants aged 60-69 from the CLASS in 2014. A multiple linear regression was conducted to investigate the association between employment and mental health. A causal forest model was applied to estimate the heterogeneous treatment effects. RESULTS Employed individuals (n = 1,295) reported better mental health than their non-employed counterparts. This association displayed significant heterogeneity, primarily attributed to pensions. Those with lower pensions may be compelled to work due to financial reasons, thus offsetting the health-promotion effect of employment. CONCLUSION Employment may benefit the mental health of older adults, which has a more significant marginal effect on those who are men, older, urban residents, without a spouse, below primary education, receiving more pensions, and less family and friend support.
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Affiliation(s)
- Huoyun Zhu
- School of Public Administration and Emergency Management, Institute of Common Prosperity and National Governance, Jinan University, Guangzhou, China.
| | - Shilong Ma
- School of Public Administration and Emergency Management, Jinan University, Guangzhou, China
| | - Yu Ding
- School of Public Affaris, Xiamen University, Xiamen, China
| | - Huiqin Xia
- College of Political Science and Law, Jiangxi Normal University, Nanchang, China
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Lee J, Park S, Cho MH, Kang JW, Kim M, Choi S, Kim SG, Choi JH, Han K, Kim CO, Moon IC, Choi M, Jang SN. Development of a web-based care networking system to support visiting healthcare professionals in the community. BMC Health Serv Res 2023; 23:1427. [PMID: 38104086 PMCID: PMC10725602 DOI: 10.1186/s12913-023-10434-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The role of visiting health services has been proven to be effective in promoting the health of older populations. Hence, developing a web system for nurses may help improve the quality of visiting health services for community-dwelling frail older adults. This study was conducted to develop a web application that reflects the needs of visiting nurses. METHODS Visiting nurses of public health centers and community centers in South Korea participated in the design and evaluation process. Six nurses took part in the focus group interviews, and 21 visiting nurses and community center managers participated in the satisfaction evaluation. Focus group interviews were conducted to identify the needs of visiting nurses with respect to system function. Based on the findings, a web application that can support the effective delivery of home visiting services in the community was developed. An artificial intelligence (AI) algorithm was also developed to recommend health and welfare services according to each patient's health status. After development, a structured survey was conducted to evaluate user satisfaction with system features using Kano's model. RESULTS The new system can be used with mobile devices to increase the mobility of visiting nurses. The system includes 13 features that support the management of patient data and enhance the efficiency of visiting services (e.g., map, navigation, scheduler, protocol archives, professional advice, and online case conferencing). The user satisfaction survey revealed that nurses showed high satisfaction with the system. Among all features, the nurses were most satisfied with the care plan, which included AI-based recommendations for community referral. CONCLUSIONS The system developed from the study has attractive features for visiting nurses and supports their essential tasks. The system can help with effective case management for older adults requiring in-home care and reduce nurses' workload. It can also improve communication and networking between healthcare and long-term care institutions.
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Affiliation(s)
- Jakyung Lee
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Susan Park
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Mi-Hee Cho
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974, Republic of Korea
| | - Ji-Won Kang
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Minkyoung Kim
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Suhyeon Choi
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Seok-Gyu Kim
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Ji-Hee Choi
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Keumhee Han
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Chang-O Kim
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Il-Chul Moon
- Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Moon Choi
- Graduate School of Science and Technology Policy, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Soong-Nang Jang
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea.
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974, Republic of Korea.
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Ergin E, Akin B, Kocoglu-Tanyer D. Effect of Home Visits by Nurses on the Physical and Psychosocial Health of Older Adults: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:733-745. [PMID: 35936539 PMCID: PMC9288399 DOI: 10.18502/ijph.v51i4.9234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022]
Abstract
Background One of the best ways to maintain and develop physical and psychosocial health is to make regular home visits. This meta-analysis aimed to determine (by subgroups) the effects of interventions based on nurses' home visits on physical and psychological health outcomes of older people. Methods This search was carried out using the The CINAHL, Cochrane, MEDLINE, PubMed, Science Direct, Web of Science, and Turkish databases. Experimental and observational studies were included. Results The meta-analysis included 26 (with subgroups 50) out of 13110 studies. The minimum and maximum values of the effect size (Hedges g) were g = -0.708 and g = 0.525, respectively. The average effect size was g = 0.084 (SD = 0.21). Conclusion Home visit interventions are effective in reducing the frequency of hospitalization in the older adults, and improving physical and psychosocial health. They are negatively effective on falls and have no significant effect on the quality of life.
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Affiliation(s)
- Emine Ergin
- Department of Public Health Nursing, Faculty of Health Sciences, İstanbul Aydın University, İstanbul, Turkey
| | - Belgin Akin
- Department of Public Health Nursing, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey
| | - Deniz Kocoglu-Tanyer
- Department of Public Health Nursing, Faculty of Nursing, Selcuk University, Konya, Turkey
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Queirós C, Silva MATCP, Cruz I, Cardoso A, Morais EJ. Nursing diagnoses focused on universal self-care requisites. Int Nurs Rev 2021; 68:328-340. [PMID: 33539567 DOI: 10.1111/inr.12654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023]
Abstract
AIMS (1) To identify and analyse diagnoses documented by nurses in Portugal within the scope of universal self-care requisites; (2) to determine the main problems with nursing diagnoses syntaxes for semantic interoperability purposes; and (3) to suggest unified nursing diagnoses syntaxes within the scope of universal self-care requisites. BACKGROUND/INTRODUCTION Ageing societies and the increase in chronic diseases have led to significant concern regarding individuals' dependence to ensure self-care. ICNP is widely used by Portuguese nurses in electronic health records for documentation of nursing diagnoses and interventions. METHODS A qualitative study using inductive content analysis and focus group: 1. nursing e-documentation content analysis and 2. focus group to explore implicit criteria or insights from content analysis results. RESULTS From a corpus of analysis with 1793 nursing diagnoses, 432 nursing diagnoses centred on universal self-care requisites emerged from the content analysis. One hundred ten nursing diagnoses resulted from the application of new encoding criteria that emerged after a focus group meeting. CONCLUSION Results reveal that nursing diagnoses related to universal self-care requisites can emphasize the impairment or potentialities of the individuals performing self-care. It also shows a lack of consensus on nominating the nursing diagnoses of people with a deficit in universal self-care requisites, resulting in different diagnoses to express the same needs. IMPLICATIONS FOR NURSING PRACTICE Representation of most relevant nursing diagnoses within the scope of universal self-care requisites. IMPLICATIONS FOR HEALTH POLICY Incorporating standardized language into electronic health records is not enough for improving quality and continuity of care and semantic interoperability achievement. Electronic health records need to work with a nursing ontology in the backend to meet these requirements.
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Affiliation(s)
- Carmen Queirós
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,CIDESI: ICN-Accredited Centre for Information Systems and ICNP® Research and Development, Nursing School of Porto, Porto, Portugal.,Health Sciences Research Unit: Nursing (UICISA: E), Coimbra Nursing School (ESEnfC), Coimbra, Portugal.,Department of Ortho-physiatry, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Maria Antónia Taveira Cruz Paiva Silva
- CIDESI: ICN-Accredited Centre for Information Systems and ICNP® Research and Development, Nursing School of Porto, Porto, Portugal.,Nursing School of Porto, Porto, Portugal
| | - Inês Cruz
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,CIDESI: ICN-Accredited Centre for Information Systems and ICNP® Research and Development, Nursing School of Porto, Porto, Portugal.,Nursing School of Porto, Porto, Portugal
| | - Alexandrina Cardoso
- CIDESI: ICN-Accredited Centre for Information Systems and ICNP® Research and Development, Nursing School of Porto, Porto, Portugal.,Nursing School of Porto, Porto, Portugal
| | - Ernesto J Morais
- CIDESI: ICN-Accredited Centre for Information Systems and ICNP® Research and Development, Nursing School of Porto, Porto, Portugal.,Nursing School of Porto, Porto, Portugal
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Shamliyan TA, Khalil DH, Middleton M. Interventions for Community-dwelling Patients with Multiple Chronic Illnesses. Am J Med 2017; 130:148-152. [PMID: 27838377 DOI: 10.1016/j.amjmed.2016.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 10/19/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Tatyana A Shamliyan
- Senior Director, Evidence-Based Medicine Quality Assurance, Elsevier, 1600 JFK Blvd 20(th) floor, Philadelphia, PA 19103.
| | - Dr Hanan Khalil
- Senior Lecturer/Pharmacist Academic, Faculty of Medicine, Nursing and Health Sciences, Monash Rural Heath, Monash University; Editor-in-Chief- International Journal of Evidence-Based Healthcare
| | - Maria Middleton
- Project Coordinator, Evidence-Based Medicine Center, Elsevier, 1600 JFK Blvd 20(th) floor, Philadelphia, PA 19103
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Cochrane A, Furlong M, McGilloway S, Molloy DW, Stevenson M, Donnelly M. Time-limited home-care reablement services for maintaining and improving the functional independence of older adults. Cochrane Database Syst Rev 2016; 10:CD010825. [PMID: 27726122 PMCID: PMC6457975 DOI: 10.1002/14651858.cd010825.pub2] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Reablement, also known as restorative care, is one possible approach to home-care services for older adults at risk of functional decline. Unlike traditional home-care services, reablement is frequently time-limited (usually six to 12 weeks) and aims to maximise independence by offering an intensive multidisciplinary, person-centred and goal-directed intervention. OBJECTIVES To assess the effects of time-limited home-care reablement services (up to 12 weeks) for maintaining and improving the functional independence of older adults (aged 65 years or more) when compared to usual home-care or wait-list control group. SEARCH METHODS We searched the following databases with no language restrictions during April to June 2015: the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (OvidSP); Embase (OvidSP); PsycINFO (OvidSP); ERIC; Sociological Abstracts; ProQuest Dissertations and Theses; CINAHL (EBSCOhost); SIGLE (OpenGrey); AgeLine and Social Care Online. We also searched the reference lists of relevant studies and reviews as well as contacting authors in the field. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster randomised or quasi-randomised trials of time-limited reablement services for older adults (aged 65 years or more) delivered in their home; and incorporated a usual home-care or wait-list control group. DATA COLLECTION AND ANALYSIS Two authors independently assessed studies for inclusion, extracted data, assessed the risk of bias of individual studies and considered quality of the evidence using GRADE. We contacted study authors for additional information where needed. MAIN RESULTS Two studies, comparing reablement with usual home-care services with 811 participants, met our eligibility criteria for inclusion; we also identified three potentially eligible studies, but findings were not yet available. One included study was conducted in Western Australia with 750 participants (mean age 82.29 years). The second study was conducted in Norway (61 participants; mean age 79 years).We are very uncertain as to the effects of reablement compared with usual care as the evidence was of very low quality for all of the outcomes reported. The main findings were as follows.Functional status: very low quality evidence suggested that reablement may be slightly more effective than usual care in improving function at nine to 12 months (lower scores reflect greater independence; standardised mean difference (SMD) -0.30; 95% confidence interval (CI) -0.53 to -0.06; 2 studies with 249 participants).Adverse events: reablement may make little or no difference to mortality at 12 months' follow-up (RR 0.97; 95% CI 0.74 to 1.29; 2 studies with 811 participants) or rates of unplanned hospital admission at 24 months (RR 0.94; 95% CI 0.85 to 1.03; 1 study with 750 participants).The very low quality evidence also means we are uncertain whether reablement may influence quality of life (SMD -0.23; 95% CI -0.48 to 0.02; 2 trials with 249 participants) or living arrangements (RR 0.92, 95% CI 0.62 to 1.34; 1 study with 750 participants) at time points up to 12 months. People receiving reablement may be slightly less likely to have been approved for a higher level of personal care than people receiving usual care over the 24 months' follow-up (RR 0.87; 95% CI 0.77 to 0.98; 1 trial, 750 participants). Similarly, although there may be a small reduction in total aggregated home and healthcare costs over the 24-month follow-up (reablement: AUD 19,888; usual care: AUD 22,757; 1 trial with 750 participants), we are uncertain about the size and importance of these effects as the results were based on very low quality evidence.Neither study reported user satisfaction with the service. AUTHORS' CONCLUSIONS There is considerable uncertainty regarding the effects of reablement as the evidence was of very low quality according to our GRADE ratings. Therefore, the effectiveness of reablement services cannot be supported or refuted until more robust evidence becomes available. There is an urgent need for high quality trials across different health and social care systems due to the increasingly high profile of reablement services in policy and practice in several countries.
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Affiliation(s)
- Andy Cochrane
- National University of Ireland MaynoothMaynooth University Department of PsychologyMaynoothCo KildareIreland
| | - Mairead Furlong
- National University of Ireland MaynoothMaynooth University Department of PsychologyMaynoothCo KildareIreland
| | - Sinead McGilloway
- National University of Ireland MaynoothMaynooth University Department of PsychologyMaynoothCo KildareIreland
| | - David W Molloy
- University College CorkCentre of Gerontology and Rehabilitation, School of Medicinec/o St Finbarr's HospitalDouglas RoadCorkCo CorkIreland
| | - Michael Stevenson
- Royal Group of Hospitals TrustClinical Research Support Centre274 Grosvenor RoadBelfastNorthern IrelandUKBT12 6BA
| | - Michael Donnelly
- Queen's University BelfastCentre for Public HealthMulhouse Building, Royal Group of HospitalsGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
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van Het Bolscher-Niehuis MJT, den Ouden MEM, de Vocht HM, Francke AL. Effects of self-management support programmes on activities of daily living of older adults: A systematic review. Int J Nurs Stud 2016; 61:230-47. [PMID: 27400029 DOI: 10.1016/j.ijnurstu.2016.06.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 06/09/2016] [Accepted: 06/24/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The ability of older adults to carry out activities of daily living and to adapt and to manage their own life decreases due to deterioration of their physical and cognitive condition. Nurses and other health care professionals should support the self-management ability of older adults to prevent activities of daily living dependence and increase the ability to adapt and to self-manage the consequences of living with a chronic condition. OBJECTIVE To gain insight into the evidence of the effects of self-management support programmes on the activities of daily living of older adults living at home. DESIGN A systematic literature review of original research publications. DATA SOURCES Searches were performed in PubMed, CINAHL, PsychInfo, EMBASE and the Cochrane Central Register of Controlled Trials (in February 2016). No limitations were applied regarding date of publication, language or country. REVIEW METHODS Publications were eligible for this review on condition that they described a self-management support programme directed at adults of on average 65 years or older, and living in the community; used a randomized control group design; and presented information about the effects on activities of daily living. The methodological quality of the included studies was independently assessed by the authors using the quality criteria for reviews of the Cochrane Effective Practice and Organisation of Care Review Group. A best evidence synthesis was performed using guidelines provided by the Cochrane Collaboration Back Review Group. RESULTS A total of 6246 potentially relevant references were found. After screening the references, 12 studies with a randomized controlled trial design were included. The methodological assessment of the 12 studies indicated variations in the risk of bias from low (n=1) to unclear (n=3) and high (n=8). Although there was considerable variation in study population, intervention characteristics and measurement instruments used, most studies (n=11) showed effects of self-management support programmes on the activities of daily living of older adults. CONCLUSIONS There is a moderate level of evidence that self-management support programmes with a multi-component structure, containing disease-specific information, education of knowledge and skills and, in particular, individually tailored coaching, improve the activities of daily living of older adults. Further research is required to gain insight into the most appropriate context and approach of self-management support interventions targeting activities of daily living of older adults living in the community.
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Affiliation(s)
| | - Marjolein E M den Ouden
- Centre for Nursing Research, Saxion University of Applied Sciences, Deventer/Enschede, P.O. Box 70.000, 7500 KB Enschede, The Netherlands
| | - Hilde M de Vocht
- Centre for Nursing Research, Saxion University of Applied Sciences, Deventer/Enschede, P.O. Box 70.000, 7500 KB Enschede, The Netherlands
| | - Anneke L Francke
- The Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands; Department of Public and Occupational Health, EMGO Institute for Health and Care Research (EMGO+) of the VU University Medical Centre Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
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