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Gazza C, Marcilly R, Kovacs B, Schiro J, Pelayo S. Integration of a new technology into a work system: a case study of a smart drinking glass in French nursing homes. Disabil Rehabil Assist Technol 2024; 19:1249-1261. [PMID: 36622869 DOI: 10.1080/17483107.2022.2162612] [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: 01/07/2021] [Revised: 09/04/2022] [Accepted: 12/20/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE To reduce the risk of dehydration in older adults, the French company Auxivia has developed a smart drinking glass (SDG) that can measure the amount of water drunk. The present study looked at the various work systems (WSs) designed for use of the SDG in a nursing home. The study's objectives were to (i) determine the WSs' impact on the staff's ability to comply with the device's prerequisites and ensure the device's effective use and (ii) draw up guidelines on designing work systems. MATERIALS AND METHODS At three nursing homes in France, two independent observers performed 9 h of observations at each site and a total of 29 interviews. RESULTS Decisions concerning implementation and the resulting WSs have an impact on the tasks to be performed, the tasks' inherent constraints and the use of the SDG. It is essential to take account of the sociotechnical system as a whole before integrating a technology. Ideally, the introduction of an SDG will go unnoticed by staff and residents; however, our results emphasize the value of highlighting work constraints via a human factors analysis. CONCLUSIONS It is essential to take account of sociotechnical WSs as a whole when integrating a technology.
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Affiliation(s)
- Clément Gazza
- Univ. Lille, Inserm, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
- Inserm, CIC 1403 - Centre d'investigation clinique, Lille, France
- CHU Lille, CIC 1403, Lille, France
| | - Romaric Marcilly
- Univ. Lille, Inserm, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
- Inserm, CIC 1403 - Centre d'investigation clinique, Lille, France
- CHU Lille, CIC 1403, Lille, France
| | | | - Jessica Schiro
- Univ. Lille, Inserm, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
- Inserm, CIC 1403 - Centre d'investigation clinique, Lille, France
- CHU Lille, CIC 1403, Lille, France
| | - Sylvia Pelayo
- Univ. Lille, Inserm, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
- Inserm, CIC 1403 - Centre d'investigation clinique, Lille, France
- CHU Lille, CIC 1403, Lille, France
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Paulis SJC, Everink IHJ, Huppertz VAL, Lohrmann C, Schols JMGA. Roles, mutual expectations and needs for improvement in the care of residents with (a risk of) dehydration: A qualitative study. J Adv Nurs 2024; 80:150-160. [PMID: 37424109 DOI: 10.1111/jan.15777] [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: 11/30/2022] [Revised: 05/24/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023]
Abstract
AIM Examining the perspectives of formal and informal caregivers and residents on roles, mutual expectations and needs for improvement in the care for residents with (a risk of) dehydration. DESIGN Qualitative study. METHODS Semi-structured interviews with 16 care professionals, three residents and three informal caregivers were conducted between October and November 2021. A thematic analysis was performed on the interviews. RESULTS Three topic summaries contributed to a comprehensive view on the care for residents with (a risk of) dehydration: role content, mutual expectations and needs for improvement. Many overlapping activities were found among care professionals, informal caregivers and allied care staff. While nursing staff and informal caregivers are essential in observing changes in the health status of residents, and medical staff in diagnosing and treating dehydration, the role of residents remains limited. Conflicting expectations emerged regarding, for example, the level of involvement of the resident and communication. Barriers to multidisciplinary collaboration were highlighted, including little structural involvement of allied care staff, limited insight into each other's expertise and poor communication between formal and informal caregivers. Seven areas for improvement emerged: awareness, resident profile, knowledge and expertise, treatment, monitoring and tools, working conditions and multidisciplinary working. CONCLUSION In general, many formal and informal caregivers are involved in the care of residents with (a risk of) dehydration. They depend on each other's observations, information and expertise which requires an interprofessional approach with specific attention to adequate prevention. For this, educational interventions focused on hydration care should be a core element in professional development programs of nursing homes and vocational training of future care professionals. IMPACT The care for residents with (a risk of) dehydration has multiple points for improvement. To be able to adequately address dehydration, it is essential for formal and informal caregivers and residents to address these barriers in clinical practice. REPORTING METHOD In writing this manuscript, the EQUATOR guidelines (reporting method SRQR) have been adhered to. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Simone J C Paulis
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Irma H J Everink
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Vivienne A L Huppertz
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Christa Lohrmann
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Jos M G A Schols
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Family Medicine and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Noor Azhar M, Bustam A, Naseem FS, Shuin SS, Md Yusuf MH, Hishamudin NU, Poh K. Improving the reliability of smartphone-based urine colorimetry using a colour card calibration method. Digit Health 2023; 9:20552076231154684. [PMID: 36798885 PMCID: PMC9926368 DOI: 10.1177/20552076231154684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Objective Urine colorimetry using a digital image-based colorimetry is potentially an accessible hydration assessment method. This study evaluated the agreement between urine colorimetry values measured with different smartphone brands under various lighting conditions in patients with dengue fever. Methods The urine samples were photographed in a customized photo box, under five simulated lighting conditions, using five smartphones. These images were analyzed using Adobe Photoshop to obtain urine Red, Green and Blue (RGB) values with and without colour correction. A commercially available colour calibration card was used for colour correction. Using intraclass correlation coefficient (ICC), inter-phone and intra-phone agreements of urine RGB values were analyzed. Results Without colour correction, the various smartphones produced the highest agreement for Blue and Green values under the 'daylight' lighting condition. With colour correction, ICC values showed 'exceptional' inter-phone and intra-phone agreement for the Blue and Green values (ICC > 0.9). Red values showed 'poor' (ICC < 0.5) agreement with and without colour correction in all lighting conditions. Out of the five phones compared in this study, Phone 4 produced the lowest intra-phone agreement. Conclusions Colour calibration using photo colour cards improved the reliability of smartphone-based urine colorimetry, making this a promising point-of-care hydration assessment tool using the ubiquitous smartphone.
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Affiliation(s)
| | - Aida Bustam
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Soo Siew Shuin
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Khadijah Poh
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,Khadijah Poh, Emergency Department, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Griswold CA, Vento KA, Blacker KJ. Voluntary Urinary Retention Effects on Cognitive Performance. Aerosp Med Hum Perform 2023; 94:79-85. [PMID: 36754996 DOI: 10.3357/amhp.6067.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
INTRODUCTION: Aircrew in-flight bladder relief remains an understudied stressor; specifically the effects of withholding urination on flight-relevant cognitive performance. This quasi-experimental study investigated whether voluntary urinary retention over a 3-h period negatively impacted cognitive performance.METHODS: We assessed vigilance using the psychomotor vigilance task (PVT) and measured the P3b event-related potential (ERP) in response to PVT stimuli. We also measured working memory (WM) performance using a change detection task and assessed the contralateral delay activity during the WM task using electroencephalography (EEG). Subjects (N = 29) completed a baseline test on both tasks, following bladder voiding and immediately after consuming 0.75 L of water. Subjects performed tasks at 1, 2, and 3 h post-void and urgency to void one's bladder was assessed regularly. A total of 17 subjects were able to complete the entire study protocol. Repeated-measures ANOVAs assessed changes in PVT and WM outcomes.RESULTS: Reaction time (RT) on the PVT was significantly impaired (5% slower) with longer urinary retention time and showed a 2.5-fold increase in the number of lapses (RT > 500 ms) with increased retention time. Together these results indicate that sustained attention was impaired with increased voluntary urine retention. We did not see significant changes in WM performance with our manipulations. Additionally, neural measures acquired with EEG for both tasks did not show any significant effect.DISCUSSION: As measured with the PVT, sustained attention was impaired during 3 h of voluntary urinary retention, highlighting the need for further development of adequate bladder relief systems in military aviation.Griswold CA, Vento KA, Blacker KJ. Voluntary urinary retention effects on cognitive performance. Aerosp Med Hum Perform. 2023; 94(2):79-85.
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Khoo SSH, Arroyo S, Lee YQ, Chew XJ, Li F, Sinnatamby S, Koa ABT, Lim SC. Development of a dysphagia cup to improve patients' fluid intake and reduce caregiver burden. BMJ Open Qual 2022; 11:bmjoq-2022-002055. [PMID: 36588323 PMCID: PMC9743403 DOI: 10.1136/bmjoq-2022-002055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
Ensuring that the elderly drink adequate fluids to meet their recommended daily allowance is often a challenge, especially among the elderly in hospitals and long-term care settings. The complex interplay of biological, medical and psychosocial factors that cause the elderly to become dehydrated is difficult to tackle especially in care settings where there is a staff shortage and heavy workload. The team realised that 90% of the elderly inpatients in the general ward of a teaching hospital in Singapore were not drinking enough to meet their needs, despite the hot and humid weather. Reasons which contributed to inadequate fluid intake included human resources, environmental, patient and system factors. Strategies were put in place to improve fluid intake but were not successful, due to staff shortage and time constraints. The team ended up innovating and producing a dysphagia cup to improve fluid intake, promote independence among patients while encouraging them to drink more, improve nursing efficiency, reduce caregiver burden and reduce aspiration risk. The cup was able to meet all the expectations with good feedback from the care team, patients and their families.
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Affiliation(s)
- Sophie Su Hui Khoo
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Sheila Arroyo
- Geriatric Medicine, Changi General Hospital, Singapore
| | - Yan Qing Lee
- Speech Therapy, Changi General Hospital, Singapore
| | - Xiao Jia Chew
- Occupational Therapy, Changi General Hospital, Singapore
| | - Fuyin Li
- Nursing, Changi General Hospital, Singapore
| | | | | | - Si Ching Lim
- Geriatric Medicine, Changi General Hospital, Singapore
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Exploring the Effects of Energy Constraints on Performance, Body Composition, Endocrinological/Hematological Biomarkers, and Immune System among Athletes: An Overview of the Fasting State. Nutrients 2022; 14:nu14153197. [PMID: 35956373 PMCID: PMC9370338 DOI: 10.3390/nu14153197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 02/05/2023] Open
Abstract
The Ramadan fasting period (RFP) means abstaining from consuming food and/or beverages during certain hours of the day—from sunrise to sunset. Engaging in exercise and sports during the RFP leads to the lipolysis of adipose tissue and an increase in the breakdown of peripheral fat, leading to an increase in fat consumption. The effects of the RFP on functional, hematological, and metabolic parameters needs further study as existing studies have reported contradictory results. The differences in the results of various studies are due to the geographical characteristics of Muslim athletes, their specific diets, and their genetics, which explain these variations. In recent years, the attention of medical and sports researchers on the effects of the RFP and energy restrictions on bodily functions and athletic performance has increased significantly. Therefore, this brief article examines the effects of the RFP on the immune system, body composition, hematology, and the functionality of athletes during and after the RFP. We found that most sporting activities were performed during any time of the day without being affected by Ramadan fasting. Athletes were able to participate in their physical activities during fasting periods and saw few effects on their performance. Sleep and nutritional factors should be adjusted so that athletic performance is not impaired.
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Boccardi V, Caponi C, Bianco AR, Tagliavento M, Croce MF, Scamosci M, Ruggiero C, Mecocci P. Dealing with dehydration in hospitalized oldest persons: accuracy of the calculated serum osmolarity. Aging Clin Exp Res 2022; 34:2547-2552. [PMID: 35794313 DOI: 10.1007/s40520-022-02185-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Assessment of hydration status is complex and difficult to detect in older persons. Different methods have been developed to determine hydration status in clinical settings, but their diagnostic accuracy remains questionable. AIMS The aim of this study was to determine and compare the diagnostic accuracy of all methods routinely used in acute settings to detect dehydration in a cohort of hospitalized oldest-old persons, using as primary reference standard blood urea nitrogen (BUN) to creatinine ratio. METHODS This retrospective study was conducted on 59 oldest-old subjects at hospital admission in an acute setting, with complete physical, biochemical, bioelectrical impedance analysis (BIA) and ultrasound assessment, including inferior vena cava diameters. RESULTS Fifty-nine (45 women/14 men) subjects, with a mean age of 87.4 ± 5.9 years, were studied. Based on the value of the BUN/creatinine ratio, the whole population was divided into hyperhydrated (n = 10), normohydrated (n = 42), and dehydrated (n = 7) groups. Among parameters indicating the hydration status, serum sodium levels (p < 0.0001), serum chloride levels (p = 0.010), calculated plasma osmolarity (p < 0.0001), and fat mass (FM) (p = 0.030) differed significantly among groups. A ROC analysis showed that the highest and most significant value for dehydration detection was the calculated plasma osmolarity (AUC: 0.820, p = 0.013), which significantly correlated with clinical parameters including heart rate (r = 0.300; p = 0.021), capillary refill (r = 0.379; p = 0.013) and systolic blood pressure (r = - 0.261; p = 0.046). DISCUSSION The measurement of calculated serum osmolarity is simple and inexpensive and may quickly provide high sensitivity and specificity indication of dehydration in hospitalized oldest-old persons.
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Affiliation(s)
- Virginia Boccardi
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Gambuli 1, 06132, Perugia, Italy.
| | - Carla Caponi
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Gambuli 1, 06132, Perugia, Italy
| | - Anna Rita Bianco
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Gambuli 1, 06132, Perugia, Italy
| | - Marco Tagliavento
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Gambuli 1, 06132, Perugia, Italy
| | - Michele Francesco Croce
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Gambuli 1, 06132, Perugia, Italy
| | - Michela Scamosci
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Gambuli 1, 06132, Perugia, Italy
| | - Carmelinda Ruggiero
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Gambuli 1, 06132, Perugia, Italy
| | - Patrizia Mecocci
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Gambuli 1, 06132, Perugia, Italy.,Division of Clinical Geriatrics, NVS Department, Karolinska Institutet, Stockholm, Sweden
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Alsahly RJ, Aldawsari AA, Alzaidy NF, Al Jabr FA, Alotaibi MM, Mohammed EY. Dry Eye Disease Symptoms and Its Association with Daily Beverage Intake Among Adults in Saudi Arabia. Clin Ophthalmol 2022; 16:453-460. [PMID: 35228792 PMCID: PMC8882024 DOI: 10.2147/opth.s355899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/16/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the association between dry eye disease (DED) symptoms and daily beverage intake among adults in Saudi Arabia. Patients and Methods In this cross-sectional, questionnaire-based study, we distributed an online questionnaire to men and women older than 18 years living in Saudi Arabia. The questionnaire consisted of items related to the sociodemographic characteristics of the participants and two validated indices: the Ocular Surface Disease Index (OSDI) and the brief 15-item Beverage Intake Questionnaire (BEVQ-15). Participants were excluded if they were aged less than 18 years; wore contact lenses; had existing eye disease (excluding refractive errors), history of eye surgery (including corrective eye surgeries), or autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, Sjogren’s syndrome); or were currently taking specific medications including antidepressants, antihistamines, and diuretics. Results After applying the study exclusion criteria, a total of 615 participants were included in the statistical analysis. The majority of participants were 18–34 years old (450, 73.2%), and men (381, 62%) exceeded women (234, 38%) by approximately 1.5-fold. OSDI scores showed that 344 participants (55.9%) had DED symptoms, 145 (23.6%) had mild dry eyes; and 106 (17.2%) and 93 (15.1%) had moderate and severe dry eyes, respectively. There was a significant association between sex and DED symptoms (p = 0.012); the frequency of DED symptoms in women exceeded that in men. However, no significant differences were observed with other demographic data such as age and location of residence. Although beverage intake was moderately correlated to OSDI score (R = 0.27), we found no significant association between beverage intake and DED symptoms. Conclusion This is the first study to highlight the association between DED symptoms and daily beverage intake. We found a significant association between DED symptoms and female sex. However, no significant association was found between DED symptoms and other demographic characteristics or beverage intake.
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Affiliation(s)
- Rakan Jaser Alsahly
- College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
- Correspondence: Rakan Jaser Alsahly, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia, Tel +966 566023995, Email
| | | | | | | | | | - Elsadig Yousef Mohammed
- Department of Community Medicine and Public Health, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
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Michelsen CF, Svendsen MBS, Bagger ML, Konradsen H. A study on accuracy and precision of fluid volume measurements by nurses, patients and healthy persons in a clinical setting. Nurs Open 2022; 9:1303-1310. [PMID: 34985207 PMCID: PMC8859054 DOI: 10.1002/nop2.1173] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 10/13/2021] [Accepted: 12/15/2021] [Indexed: 11/08/2022] Open
Abstract
AIM To evaluate the accuracy and precision for assessing fluid intake by examining the ability of nurses, patients and healthy people to visually estimate fluid volumes, thereby reflecting the fluid monitoring process in clinical practice. DESIGN A cross-sectional study. METHODS This study used the convenience sampling method and involved twenty-five participants from three groups; nurses, patients and healthy people. The participants carried out a set of different visual volume assessments of two types of fluids using two fluid containers. The exact volumes were measured, and the results were compared with the target volumes. RESULTS High variations were observed in the fluid volume assessments for patients, nurses and healthy persons and also were observed to be an effect of environmental factors (fluid container or fluid type) on volume perceptions. This highlights the importance of finding new and innovative ways of measuring fluids for oral intake in a hospital setting, to ensure accurate and reliable data on fluid balance and thereby increase patient safety.
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Affiliation(s)
| | | | | | - Hanne Konradsen
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Gastroenterology, Herlev and Gentofte University Hospital, Hellerup, Denmark
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10
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Paulis SJC, Everink IHJ, Halfens RJG, Lohrmann C, Schols JMGA. Perceived quality of collaboration in dehydration care among Dutch nursing home professionals: A cross-sectional study. J Adv Nurs 2022; 78:2357-2366. [PMID: 34981564 PMCID: PMC9545722 DOI: 10.1111/jan.15149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/19/2021] [Accepted: 12/18/2021] [Indexed: 11/29/2022]
Abstract
Aim To explore the perceived quality of collaboration in dehydration care among nursing and medical staff in Dutch nursing homes. Design A cross‐sectional study. Methods An online questionnaire was administered to nursing and medical staff in February 2020 to assess the quality of collaboration in dehydration care and its influencing factors. Descriptive statistics, chi‐square tests and multinomial logistic regression analysis were used to describe the results and examine differences between groups. Results In total, 695 questionnaires were completed by multiple levels of (specialized) nursing staff and nursing home physicians. The quality of collaboration was assessed as good (23.2%), sufficient (59.4%) and insufficient (17.4%). Predicting factors related to perceiving the quality of collaboration as good were working experience, dehydration training during education and the presence of a dehydration protocol/guideline in the nursing home. Enabling factors related to collaboration in dehydration care were ‘availability of sufficient aids to detect dehydration’, ‘continuity in the care relationship’ and ‘sufficient background data of the resident in the care record’. Factors that hinder collaboration were ‘insufficient knowledge about dehydration among nursing and medical staff’, ‘the absence of a team meeting in which the topic dehydration is discussed’ and ‘insufficient staffing level among nursing and medical staff’. Conclusion Collaboration in dehydration care was generally assessed as sufficient. Participants with >10 years of working experience, who received dehydration training during their education and had a dehydration protocol/guideline available in the nursing home, perceived the quality of collaboration more often as good. Experienced barriers and enablers for collaboration in dehydration care varied between professional groups. Therefore, it is important to gain more insight into (informal) caregivers’ perceptions on what is expected from each other about dehydration care. Impact Care professionals experience several limiting factors in collaborating in dehydration care. Addressing these factors could optimize dehydration care in Dutch nursing homes.
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Affiliation(s)
- Simone J C Paulis
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Irma H J Everink
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Ruud J G Halfens
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Christa Lohrmann
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Jos M G A Schols
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Family Medicine and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Narrative Review of Low-Intake Dehydration in Older Adults. Nutrients 2021; 13:nu13093142. [PMID: 34579019 PMCID: PMC8470893 DOI: 10.3390/nu13093142] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 12/17/2022] Open
Abstract
Low-intake dehydration is a common and often chronic condition in older adults. Adverse health outcomes associated with low-intake dehydration in older adults include poorer cognitive performance, reduced quality of life, worsened course of illness and recovery, and a high number of unplanned hospital admissions and increased mortality. The subjective methods to assess (risk of) dehydration are not reliable, and the evidence about preventive measures are also limited. So is the knowledge about the optimal intake of beverages per day. This narrative review presents the state of the science on the role of low intake hydration in older adults. Despite its simple cause—the inadequate intake of beverages—low-intake dehydration appears to be a very complex problem to address and much more research is needed in the area. Based on the existing evidence, it seems necessary to take setting specific differences and individual problems and needs into account to tackle dehydration in older adults. Further, it is necessary to increase awareness of the prevalence and severity of low-intake dehydration among older adults and in nursing staff in care homes and hospitals as well as among caregivers of older adults living at home.
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12
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Cohen R, Fernie G, Roshan Fekr A. Fluid Intake Monitoring Systems for the Elderly: A Review of the Literature. Nutrients 2021; 13:nu13062092. [PMID: 34205234 PMCID: PMC8233832 DOI: 10.3390/nu13062092] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/13/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022] Open
Abstract
Fluid intake monitoring is an essential component in preventing dehydration and overhydration, especially for the senior population. Numerous critical health problems are associated with poor or excessive drinking such as swelling of the brain and heart failure. Real-time systems for monitoring fluid intake will not only measure the exact amount consumed by the users, but could also motivate people to maintain a healthy lifestyle by providing feedback to encourage them to hydrate regularly throughout the day. This paper reviews the most recent solutions to automatic fluid intake monitoring both commercially and in the literature. The available technologies are divided into four categories: wearables, surfaces with embedded sensors, vision- and environmental-based solutions, and smart containers. A detailed performance evaluation was carried out considering detection accuracy, usability and availability. It was observed that the most promising results came from studies that used data fusion from multiple technologies, compared to using an individual technology. The areas that need further research and the challenges for each category are discussed in detail.
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Affiliation(s)
- Rachel Cohen
- The Kite Research Institute, Toronto Rehabilitation Institute—University Health Network, Toronto, ON M5G2A2, Canada; (G.F.); (A.R.F.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S3G9, Canada
- Correspondence:
| | - Geoff Fernie
- The Kite Research Institute, Toronto Rehabilitation Institute—University Health Network, Toronto, ON M5G2A2, Canada; (G.F.); (A.R.F.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S3G9, Canada
| | - Atena Roshan Fekr
- The Kite Research Institute, Toronto Rehabilitation Institute—University Health Network, Toronto, ON M5G2A2, Canada; (G.F.); (A.R.F.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S3G9, Canada
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Dehydration in older people: A systematic review of the effects of dehydration on health outcomes, healthcare costs and cognitive performance. Arch Gerontol Geriatr 2021; 95:104380. [PMID: 33636649 DOI: 10.1016/j.archger.2021.104380] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/27/2021] [Accepted: 02/13/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To systematically examine the effect of dehydration on health outcomes, identify associated financial costs and consider impacts on cognitive performance in older adults. DESIGN A systematic review of English-language articles via OVID using MEDLINE, PsychINFO, EMBASE, and others, to March 2018. Included studies examined the relationship between hydration status and health, care costs or cognitive outcome. SETTING Cross sectional and cohort data from studies reporting on dehydration in older adults. PARTICIPANTS Adults aged 60 years and older. MEASUREMENTS Independent quality ratings were assessed for all extracted articles. RESULTS Of 1684 articles screened, 18 papers (N = 33,707) met inclusion criteria. Participants were recruited from hospital settings, medical long-term care centres and the community dwelling population. Data were synthesised using a narrative summary. Mortality rates were higher in dehydrated patients. Furthermore, health outcomes, including frailty, bradyarrhythmia, transient ischemic attacks, oral health and surgery recovery are linked to and worsened by dehydration. Length of hospital stay, either as a principal or secondary diagnosis, is greater in those with dehydration, compared to those who are euhydrated. Finally, neurocognitive functioning may be impacted by dehydration. There are issues with study design, inconsistency in hydration status measurement and different measures used for outcome assessment. CONCLUSION Dehydration in older people is associated with increased mortality, poorer course of illness and increased costs for health services. In addition, there is some, but sparse evidence that dehydration in older people is linked to poorer cognitive performance. Intervention studies should test strategies for reducing dehydration in older adults.
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Schotman JM, van Borren MMGJ, Wetzels JFM, Kloke HJ, Reichert LJM, de Boer H. Sensitivity of total body electrical resistance measurements in detecting extracellular volume expansion induced by infusion of NaCl 0.9%. Eur J Clin Nutr 2020; 74:1638-1645. [DOI: 10.1038/s41430-020-0655-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/13/2022]
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Labruna G, Marra M, Nardelli C, Mancini A, Buono P, Sacchetti L, Pasanisi F. Very light physical activity amount in FTO genetically predisposed obese individuals. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-019-00587-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schotman JM, van Borren MMGJ, Kooistra MP, Doorenbos CJ, de Boer H. Towards personalized hydration assessment in patients, based on measurement of total body electrical resistance: Back to basics. Clin Nutr ESPEN 2019; 35:116-122. [PMID: 31987103 DOI: 10.1016/j.clnesp.2019.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 10/19/2019] [Accepted: 10/22/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Assessment of tissue hydration by conventional bioelectrical impedance analysis (BIA) has produced conflicting results because of flaws in the algorithms that are used to translate measurements of total body electrical resistance (TBER) into liters of body water. This type of error can be eliminated by a return to the TBER measurement itself, without attempting to convert Ohms into liters of body water. Aims of this study were to quantify tissue hydration based on TBER, to establish TBER normal values (TBERnorm), to improve the prediction of TBERnorm values in individual patients, and to evaluate this approach in patients on hemodialysis (HD). METHODS TBERnorm values were obtained in 213 healthy controls and corrected for body height (H-TBERnorm). Inter-individual H-TBERnorm variability was reduced by correction for arm muscle cross-sectional area (AMA). Performance of this approach was evaluated in 94 patients on HD. RESULTS H-TBERnorm was inversely related to AMA. Correction for AMA reduced the H-TBERnorm standard deviation by 31% in men and 23% in women. When applied to patients on HD, H-TBER changes within subjects were inversely related to ultrafiltration volumes, with a mean R2 of 0.95 ± 0.04 in men and 0.93 ± 0.07 in women. Clinically significant H-TBER increments occurred after volume reductions of 0.39 ± 0.25 L in men and 0.37 ± 0.18 L in women. CONCLUSIONS TBER measurements, corrected for height and AMA, have the potential to become an objective and sensitive method to assess hydration in patients. Its clinical value remains to be shown in intervention studies.
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Affiliation(s)
- J M Schotman
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands.
| | - M M G J van Borren
- Department of Clinical Chemistry, Rijnstate Hospital, Arnhem, the Netherlands
| | - M P Kooistra
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - C J Doorenbos
- Department of Internal Medicine, Deventer Hospital, Deventer, the Netherlands
| | - H de Boer
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
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Liska D, Mah E, Brisbois T, Barrios PL, Baker LB, Spriet LL. Narrative Review of Hydration and Selected Health Outcomes in the General Population. Nutrients 2019; 11:nu11010070. [PMID: 30609670 PMCID: PMC6356561 DOI: 10.3390/nu11010070] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/07/2018] [Accepted: 12/27/2018] [Indexed: 12/16/2022] Open
Abstract
Although adequate hydration is essential for health, little attention has been paid to the effects of hydration among the generally healthy population. This narrative review presents the state of the science on the role of hydration in health in the general population, specifically in skin health, neurological function (i.e., cognition, mood, and headache), gastrointestinal and renal functions, and body weight and composition. There is a growing body of evidence that supports the importance of adequate hydration in maintaining proper health, especially with regard to cognition, kidney stone risk, and weight management. However, the evidence is largely associative and lacks consistency, and the number of randomized trials is limited. Additionally, there are major gaps in knowledge related to health outcomes due to small variations in hydration status, the influence of sex and sex hormones, and age, especially in older adults and children.
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Affiliation(s)
- DeAnn Liska
- Biofortis, Mérieux NutriSciences, Addison, IL 60101, USA.
| | - Eunice Mah
- Biofortis, Mérieux NutriSciences, Addison, IL 60101, USA.
| | | | | | - Lindsay B Baker
- Gatorade Sports Science Institute, Barrington, IL 60010, USA.
| | - Lawrence L Spriet
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W, Canada.
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Czupryna P, Moniuszko-Malinowska A, Grygorczuk S, Pancewicz S, Dunaj J, Król M, Borawski K, Zajkowska J. Effect of a single dose of mannitol on hydration status and electrolyte concentrations in patients with tick-borne encephalitis. J Int Med Res 2018; 46:5083-5089. [PMID: 30124371 PMCID: PMC6300936 DOI: 10.1177/0300060518790175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/28/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study was performed to assess the effect of a single dose of 15% mannitol on the hydration status and electrolyte balance in patients with tick-borne encephalitis (TBE). METHODS Forty-one patients with TBE were treated with 0.25 g/kg of 15% mannitol. The electrolyte concentrations (Na, K, and Cl), creatinine concentration, and hydration status were measured before and after mannitol infusion. RESULTS After mannitol administration, 7 patients had hyponatremia, 3 had hypokalemia, 1 had hyperkalemia, and 17 had hypochloremia. The total body water volume (TBW) changed by 0.44% ± 0.55%, the external body water volume (EBW) changed by 0.12% ± 0.15%, and the internal body water volume (IBW) changed by 0.19% ± 0.40%. The mean ECW/ICW ratio was 0.7694 ± 0.07 before treatment and 0.7699 ± 0.07 after treatment. Age was correlated with the TBW change in men (R = 0.42, p < 0.05) and with the potassium change in women (R = 0.66, p < 0.05). CONCLUSIONS Patients with TBE should receive mannitol two to four times daily depending on the clinical manifestation. Administration of a single dose of mannitol (0.25 g/kg) requires at least 300 mL of fluid supplementation. Bioimpedance might be useful for individual evaluation of dehydration. Additionally, patients require monitoring for potential hyponatremia. Older men may be more prone to dehydration after receiving mannitol.
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Affiliation(s)
- Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Sambor Grygorczuk
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Sławomir Pancewicz
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Justyna Dunaj
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Monika Król
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Karol Borawski
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
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Eldamak AR, Fear EC. Conformal and Disposable Antenna-Based Sensor for Non-Invasive Sweat Monitoring. SENSORS 2018; 18:s18124088. [PMID: 30469510 PMCID: PMC6308724 DOI: 10.3390/s18124088] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/17/2018] [Accepted: 11/20/2018] [Indexed: 11/16/2022]
Abstract
This paper presents a feasibility study for a non-wearable, conformal, low cost, and disposable antenna-based sensor for non-invasive hydration monitoring using sweat. It is composed of a patch antenna implemented on a cellulose filter paper substrate and operating in the range 2–4 GHz. The paper substrate can absorb liquids, such as sweat on the skin, through two slots incorporated within the antenna structure. Thus, the substrate dielectric properties are altered according to the properties of the absorbed liquid. Changes in reflection-based measurements are used to analyze salt solutions and artificial sweat, specifically the amount of sampled solution and the sodium chloride (NaCl) concentration. Using the shift in resonant frequency and magnitude of the reflection coefficient, NaCl concentrations in the range of 8.5–200 mmol/L, representing different hydration states, are detected. The measurements demonstrate the feasibility of using microwave based measurements for hydration monitoring using sweat.
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Affiliation(s)
- Angie R Eldamak
- Department of Electronics and Electrical Communication Engineering, Faculty of Engineering, Ain Shams University, Cairo 11517, Egypt.
- Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada.
| | - Elise C Fear
- Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada.
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A Review on Opportunities To Assess Hydration in Wireless Body Area Networks. ELECTRONICS 2017. [DOI: 10.3390/electronics6040082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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