1
|
Guo C, Lv J, Deng M, Song H, Yu M. Factors associated with self-neglect from a salutogenic perspective among community-dwelling older adults: A cross-sectional correlational study. Geriatr Nurs 2024; 59:86-93. [PMID: 38991299 DOI: 10.1016/j.gerinurse.2024.06.037] [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: 03/07/2024] [Revised: 06/20/2024] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES To identify the associated factors of self-neglect in older adults from a salutogenic perspective. METHODS A cross-sectional correlational study was conducted in two communities in Beijing with 486 older adults recruited from April to December 2022. Data were collected by a set of questionnaires. RESULTS Sense of coherence (β=-0.138), socio-demographic generalized resistance resources (GRRs) (smoking: β=0.156), social GRRs (living alone: β=0.093), psychological GRRs (self-esteem: β=-0.126), and motivational GRRs (powerful others locus of control: β=-0.199, chance locus of control: β=0.119) were all associated with self-neglect among older adults (p<0.05). CONCLUSIONS Sense of coherence and GRRs are vital to improve self-neglect in older adults. It is suggested to increase the level of self-esteem and the tendency of the health locus of control to largely facilitate self-neglect management in older adults.
Collapse
Affiliation(s)
- Chenming Guo
- School of Nursing, Peking University, Beijing, PR China
| | - Jinghong Lv
- School of Nursing, Peking University, Beijing, PR China
| | - Mengying Deng
- School of Nursing, Peking University, Beijing, PR China
| | - Hongdan Song
- School of Nursing, Peking University, Beijing, PR China
| | - Mingming Yu
- School of Nursing, Peking University, Beijing, PR China.
| |
Collapse
|
2
|
Feng W, Wang J, Zhang H, Wang Y, Sun Z, Chen Y. Association between malnutrition and cognitive frailty in older adults: A systematic review and meta-analysis. Geriatr Nurs 2024; 58:488-497. [PMID: 38970917 DOI: 10.1016/j.gerinurse.2024.06.020] [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: 01/29/2024] [Revised: 06/05/2024] [Accepted: 06/21/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND To systematically assess the association between cognitive frailty (CF) and malnutrition in older adults. METHODS 8 databases were retrieved up until April 2023 by two reviewers in dependently, and meta-analysis was performed by Stata 16.0 software. RESULTS A total of 19 studies were meta-analyzed to assess the relationship between CF and malnutrition in older adults. The pooled prevalence of CF from 17 studies was 23 %, and the pooled prevalence of malnutrition among patients with CF from 12 studies was 57 %. Data from 13 studies on the association between CF and malnutrition unveiled a high risk of CF in older adults with malnutrition (OR = 3.77, 95 % CI: 2.49-5.69). CONCLUSION The prevalence of malnutrition is high in older adults with CF, and there is a significant delve into targeted treatment and preventive measures to ameliorate the quality of life of older adults.
Collapse
Affiliation(s)
- Wanqiu Feng
- School of Nursing, Yanbian University of China, Yanji, Jilin, 133000, China
| | - Jinyang Wang
- School of Nursing, Yanbian University of China, Yanji, Jilin, 133000, China
| | - Hailian Zhang
- School of Nursing, Yanbian University of China, Yanji, Jilin, 133000, China.
| | - Yu Wang
- School of Nursing, Yanbian University of China, Yanji, Jilin, 133000, China
| | - Zihan Sun
- School of Nursing, Yanbian University of China, Yanji, Jilin, 133000, China
| | - Yuanyuan Chen
- School of Nursing, Yanbian University of China, Yanji, Jilin, 133000, China
| |
Collapse
|
3
|
Motamed-Jahromi M, Kaveh MH, Vitale E. Mindfulness and self-regulation intervention for improved self-neglect and self-regulation in diabetic older adults. Sci Rep 2024; 14:13857. [PMID: 38879620 PMCID: PMC11180124 DOI: 10.1038/s41598-024-64314-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/07/2024] [Indexed: 06/19/2024] Open
Abstract
The current study aimed to assess the impact of combined interventions including mindfulness and self-regulation on self-neglect and self-regulation among Iranian older adults with type 2 diabetes. This was a three-arm cluster randomized controlled trial study conducted among 135 older diabetic patients in Shiraz, Iran. Three urban healthcare centers (clusters) were randomly assigned to three study groups. The intervention groups received either a Self-Regulation-based Intervention Program (SRIP) or a Combined Mindfulness and Self-Regulation Intervention Program (CMSRIP), while the control group received routine care and COVID-19 prevention training. These training programs, which consisted of text and video-based content, were conducted over 24 weeks using WhatsApp as a mobile-based communication platform. Outcomes were measured using the Elder Self-Neglect Scale and Short-Form Self-Regulation Questionnaire at baseline, week 4, and week 16 post-intervention, with data analysis conducted using SPSS 20 software. The CMSRIP led to significantly greater improvement in the score of self-regulation (χ2 = 73.23, P-Value = < .001) and a reduction in the score of self-neglect (χ2 = 62.97, P-Value = < .001) at both 4 weeks and 16 weeks after education compared to SRIP. In the control group, there was also a slight improvement. Improvement of self-regulation and reduction of self-neglect in all three groups were less in week 16 than in week 4. Nevertheless, the changes in the intervention groups were significantly better than the control group. This study confirmed a combination of mindfulness-based intervention and self-regulation intervention can effectively improve self-neglect and self-regulation behavior in older patients with type 2 diabetes.Trial registration: This trial (ISRCTN77260130) was retrospectively registered on 28/09/2021.
Collapse
Affiliation(s)
| | - Mohammad Hossein Kaveh
- Research Center for Health Sciences, Department of Health Promotion, School of Health, Institute of Health, Shiraz University of Medical Sciences, Razi Boulevard, P.O. Box: 7153675541, Shiraz, Iran.
| | | |
Collapse
|
4
|
Luo M, Dong Y, Fan B, Zhang X, Liu H, Liang C, Rong H, Fei Y. Sleep Duration and Functional Disability Among Chinese Older Adults: Cross-Sectional Study. JMIR Aging 2024; 7:e53548. [PMID: 38771907 PMCID: PMC11196917 DOI: 10.2196/53548] [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: 10/10/2023] [Revised: 02/24/2024] [Accepted: 05/20/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND The duration of sleep plays a crucial role in the development of physiological functions that impact health. However, little is known about the associations between sleep duration and functional disability among older adults in China. OBJECTIVE This study aimed to explore the associations between sleep duration and functional disabilities in the older population (aged≥65 years) in China. METHODS The data for this cross-sectional study were gathered from respondents 65 years and older who participated in the 2018 survey of the China Health and Retirement Longitudinal Study, an ongoing nationwide longitudinal investigation of Chinese adults. The duration of sleep per night was obtained through face-to-face interviews. Functional disability was assessed according to activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. The association between sleep duration and functional disability was assessed by multivariable generalized linear models. A restricted cubic-spline model was used to explore the dose-response relationship between sleep duration and functional disability. RESULTS In total, 5519 participants (n=2471, 44.77% men) were included in this study with a mean age of 73.67 years, including 2800 (50.73%) respondents with a functional disability, 1978 (35.83%) with ADL disability, and 2299 (41.66%) with IADL disability. After adjusting for potential confounders, the older adults reporting shorter (≤4, 5, or 6 hours) or longer (8, 9, or ≥10 hours) sleep durations per night exhibited a notably increased risk of functional disability compared to that of respondents who reported having 7 hours of sleep per night (all P<.05), which revealed a U-shaped association between sleep duration and dysfunction. When the sleep duration fell below 7 hours, increased sleep duration was associated with a significantly lower risk of functional disability (odds ratio [OR] 0.85, 95% CI 0.79-0.91; P<.001). When the sleep duration exceeded 7 hours, the risk of functional disability associated with a prolonged sleep duration increased (OR 1.16, 95% CI 1.05-1.29; P<.001). CONCLUSIONS Sleep durations shorter and longer than 7 hours were associated with a higher risk of functional disability among Chinese adults 65 years and older. Future studies are needed to explore intervention strategies for improving sleep duration with a particular focus on functional disability.
Collapse
Affiliation(s)
- Minjing Luo
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Dong
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Bingbing Fan
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Xinyue Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hao Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Changhao Liang
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hongguo Rong
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yutong Fei
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
5
|
Lutz L, Klinger MF, Holz F, Verhoff MA, Amendt J. How to prove neglect in the context of the post-mortem examination. Forensic Sci Med Pathol 2024; 20:603-613. [PMID: 37578627 PMCID: PMC11296964 DOI: 10.1007/s12024-023-00695-2] [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] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
Understanding the causes, extent, and period of neglect is not only a medical but also a forensic task when it comes to legal investigations. In this study, we evaluated 46 autopsied cases where there was clear evidence of physical neglect during the last period of the deceased's life. The age of the deceased ranged from 21 to 96 years; most of them were female (71.7%). The majority of cases (89.9%) took place in a domestic environment, with partners or relatives providing care. The most frequent post-mortem findings were pressure sores, followed by inflammatory skin changes, and signs of malnutrition and dehydration. Neglect was the cause or co-cause of death in 23% of the cases. More than half of the deceased showed severe contamination of the skin surface by excrement, and in almost 40% of the cases, fly infestation was found. The majority of insects belonged to the group of house flies (Diptera: Muscidae), mainly the common house fly, Musca domestica. By analyzing the entomological evidence, it was possible to prove an insect infestation period of at least several days ante-mortem. Since the period of neglect may be relevant in terms of legal proceedings, the present work demonstrates the particular importance of insect traces in providing this evidence. While prosecution and conviction of caregivers remain challenging, it is all the more essential that entomology and legal medicine collaborate on the analysis of findings of neglect.
Collapse
Affiliation(s)
- L Lutz
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe-University, Kennedyallee 104, D-60596, Frankfurt Am Main, Germany.
| | - M F Klinger
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe-University, Kennedyallee 104, D-60596, Frankfurt Am Main, Germany
| | - F Holz
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe-University, Kennedyallee 104, D-60596, Frankfurt Am Main, Germany
| | - M A Verhoff
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe-University, Kennedyallee 104, D-60596, Frankfurt Am Main, Germany
| | - J Amendt
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe-University, Kennedyallee 104, D-60596, Frankfurt Am Main, Germany
| |
Collapse
|
6
|
Santing JAL, Hopman JH, Verheul RJ, van der Naalt J, van den Brand CL, Jellema K. Clinical value of S100B in detecting intracranial injury in elderly patients with mild traumatic brain injury. Injury 2024; 55:111313. [PMID: 38219558 DOI: 10.1016/j.injury.2024.111313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVE The biomarker S100B is a sensitive biomarker to detect traumatic intracranial injury in patients mild traumatic brain injury (mTBI). Higher blood values of S100B, resulting in lower specificity and decreased head computed tomography (CT) reduction has been regarded as one of shortcomings in patients over 65 years of age. The purpose of this study was to assess the accuracy of plasma S100B to detect intracranial injury in elderly patients with mTBI. METHODS A posthoc analysis was performed of a larger prospective cohort study. Previous recorded patient variables and plasma values of S100B from patients with mTBI who presented to the Emergency Department (ED) within 6 h of injury, underwent a head CT and had a blood sample drawn as part of their routine clinical care, were partitioned at 65 years of age. Sensitivity, specificity, negative predictive value, and positive predictive value of plasma S100B for predicting traumatic intracranial lesions on head CT, with a cut-off set at 0.105 μg/L, were calculated. Results were compared with data from an additional systematic review on the accuracy of S100B to detect intracranial injury in elderly patients with mTBI. RESULTS Data of 240 patients (48.4 %) of 65 years or older were analyzed. Sensitivity and NPV of S100B were 89 % and 86 % respectively, which is lower than among younger patients (both 97 %). The specificity decreased stepwise with older age: 22 %, 18 %, and 5 % for the age groups 65-74, 75-84, and ≥ 85 years old, respectively. The meta-analysis comprised 4 studies and the current study with data from 2166 patients. Pooled data estimated the sensitivity of s100B as 97.4 % (95 % CI 83.3-100 %) and specificity as 17.3 % (95 % CI 9.5-29.3 %) to detect intracranial injury in elderly patients with mTBI. CONCLUSION The biomarker S100B at the routine threshold has a limited clinical value in the management of elderly mTBI patients mainly due to a poor specificity leading to only a small decrease in head CTs. Alternate cut-off values and combining several plasma biomarkers with clinical variables may be useful strategies to increase the accuracy of S100B in (subgroups of) elderly mTBI patients.
Collapse
Affiliation(s)
| | - Joella H Hopman
- Department of Emergency Medicine, Haaglanden Medical Center, The Hague, The Netherlands
| | - Rolf J Verheul
- Department of Clinical Chemistry and Laboratory Medicine, Haaglanden Medical Center, The Hague, The Netherlands
| | - Joukje van der Naalt
- Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands
| | - Crispijn L van den Brand
- Department of Emergency Medicine, Haaglanden Medical Center, The Hague, The Netherlands; Department of Emergency Medicine, Erasmus Medical Center, The Netherlands
| | - Korné Jellema
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| |
Collapse
|
7
|
Norton M, Kellett S, Huddy V, Simmonds-Buckley M. Household factors and prevalence of squalor: meta-analysis and meta-regression. BMC Public Health 2024; 24:479. [PMID: 38360612 PMCID: PMC10870488 DOI: 10.1186/s12889-024-17983-3] [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: 12/08/2023] [Accepted: 02/04/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Severe domestic squalor occurs when a person lives in a dwelling that is significantly unclean, disorganised and unhygienic. The limited previous research has primarily focused on the characteristics of those who live in squalor and the associated risk factors. Robust and reliable studies of squalor prevalence have not been conducted. This study sought to produce a reliable estimate of the point prevalence of squalor. METHODS Using data from 13-years of the English Housing Survey, N = 85,681 households were included in a prevalence meta-analysis. Squalor prevalence over time, subgroup analysis and logistic regression investigated the role played by household and community characteristics. RESULTS The point prevalence of squalor was estimated to be 0.85% and squalor was seen to decrease significantly over time. More significant community deprivation, a rented dwelling, lower income and high numbers of people in the home was associated with a greater risk of squalor. CONCLUSIONS Squalor prevalence was higher than previous estimates and supports community care services in associated service planning. The results regarding household characteristics help to inform which households and individuals may be at a higher risk of living in squalid conditions.
Collapse
Affiliation(s)
| | - Stephen Kellett
- Rotherham Doncaster and South Humber NHS Trust, Rotherham, UK
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Vyv Huddy
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Melanie Simmonds-Buckley
- Rotherham Doncaster and South Humber NHS Trust, Rotherham, UK
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| |
Collapse
|
8
|
AlFehaidi AAAHZ, Khan SHU, Abdelrahman RA, Ahel NT, Shine P, De Ramos MD, Skairjeh NM, Khan SA, Al-Saadi RK. Predictors of malnutrition among older residents in Qatari long-term care facilities: a retrospective study. BMC Nutr 2024; 10:23. [PMID: 38303045 PMCID: PMC10835922 DOI: 10.1186/s40795-024-00827-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Malnutrition is a prevalent issue among older adults in long-term care facilities and is associated with adverse health outcomes and increased healthcare costs. Identifying the predictors of malnutrition in this population is crucial for developing effective intervention strategies. This study aimed to explore the factors contributing to malnourishment among older individuals living in long-term care facilities in Qatar. METHODS This cross-sectional study included 75 older adults from two long-term care facilities (Rumailah Hospital and Enaya Specialized Care Center) in Qatar. Baseline characteristics, including age, sex, length of stay, mortality, weight, body mass index, co-morbidities, and laboratory parameters, were assessed. Data were analyzed using the most recent version of the SPSS software, version 29. Predictors of malnutrition and mortality were identified using logistic regression analysis. RESULTS Of the 75 older individuals included in the study, 85% (64) were malnourished. The average age of the participants was 74.89 years, with a standard deviation of 10.21. Of all participants, approximately 61% (46) were males, and 39% (29) were females. Most malnourished older adults were classified as either at "moderate (29.69%)" or "severe risk (37.50%)," according to the Geriatric Nutritional Risk Index. Malnourished participants experienced a significant percentage of weight change within 3 months (14.01 ± 7.89); the only statistically significant predictor of malnutrition was the percentage of weight change within 3 months with an odds ratio (OR) of 4.8 (confidence interval [CI] 1.56-14.75) and p-value of 0.006. Statistically significant predictors of mortality were malnutrition (OR 24.84, CI 1.09-564) and age (OR 1.07, CI 1.00-1.14). CONCLUSIONS A significant predictor of malnutrition in older adults identified in this study was the sudden and recent change in weight, which can be employed to detect individuals at risk early and guide tailored interventions. Malnutrition is a significant predictor of mortality. Employing a multidimensional strategy to tackle malnutrition can improve outcomes for the older individuals.
Collapse
Affiliation(s)
- Al Anoud Ali H Z AlFehaidi
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar.
| | - Shafi Hashmath Ulla Khan
- Department of Geriatrics & Long-Term Care, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rana Albdeljubbar Abdelrahman
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Nesreen Talal Ahel
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Pavithra Shine
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Monica Doroja De Ramos
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Nisreen Mazin Skairjeh
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Shakeel Ahmad Khan
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | | |
Collapse
|
9
|
Xu Q, Xu L, Tao J, Chen X, Zhang Y, Jiang S, Dong C. Adaptation and validation of the Abrams geriatric self-neglect assessment scale among older Chinese people admitted to the hospital. Int J Older People Nurs 2023; 18:e12569. [PMID: 37574788 DOI: 10.1111/opn.12569] [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: 01/01/2023] [Revised: 06/07/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES Elder self-neglect is a global public health problem, and older people admitted to the hospital may have a higher risk of self-neglect due to their deteriorating health conditions. This study aimed to translate, adapt and validate the Abrams geriatric self-neglect assessment scale (AGSS) among older Chinese people admitted to the hospital. METHODS Data were derived from a cross-sectional survey of a convenience sample of 452 older people admitted to a general hospital. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the structural validity of the AGSS. Content validity, criterion validity, internal consistency reliability, and test-retest reliability were also conducted to assess the psychometric properties of the scale. RESULTS EFA yielded a 6-item one-factor model, which was supported by CFA and explained 44.74% of the total variance. The internal consistency was acceptable (Cronbach α = 0.740), and the test-retest reliability with a 14-day interval was good (intraclass correlation coefficient, ICC = 0.966). Significantly positive correlations with the caregiver-rated elder self-neglect assessment scale (r = 0.648) supported the concurrent validity of the scale. Significant differences in scores between respondents with different ages, marital statuses, educational levels and numbers of chronic diseases demonstrated the discriminative validity. CONCLUSION The Chinese version of the AGSS is an easy-to-use, reliable and valid measure with satisfactory psychometric properties. Future studies should recruit a more representative sample of older people in China to verify the applicability of the scale. IMPLICATIONS FOR PRACTICE The Chinese version of the AGSS enables clinical staff to accurately screen for and assess elder self-neglect upon hospital admission, which can inform the development of specific interventions and assignment of additional guardianship to those at risk of elder self-neglect.
Collapse
Affiliation(s)
- Qiongying Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Liuqing Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
- Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Jingrui Tao
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Xuewei Chen
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yao Zhang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Sisi Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
10
|
Motamed-Jahromi M, Kaveh MH, Khodabandeh Shahraki S, Yousefzadeh N, Dabbaghmanesh MH, Mohammadi M, Baloch GM. The Development and Validation of Elder Self-Neglect Scale (ESNS) in Iranian Community-dwelling Older Population. SOCIAL WORK IN PUBLIC HEALTH 2023; 38:311-322. [PMID: 36268975 DOI: 10.1080/19371918.2022.2135664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The aim of this study was to develop a valid and reliable elder self-neglect scale (ESNS) for field research on Iranian community-dwelling older adults. This mixed-method exploratory study was conducted in three stages: (1) item generation using literature review, (2) item reduction by expert panels, and (3) assessing the psychometric properties. In the third stage, the face, content, and construct validity (exploratory factor analysis) were performed on the first sample (n = 450), and the final 26-item scale was developed. After that, confirmatory factor analysis and reliability were assessed on the second sample (n = 250). Data were analyzed using IBM-SPSS v.23 and AMOS v.24. Exploratory factor analysis identified six factors with a total variance of 77.53%. The goodness of fit was indicated by Structural Equation Modeling. The Cronbach's alpha was estimated at 0.85. The optimal cutoff point was 73. This scale with 26 items seems to be an effective tool in screening elder self-neglect.
Collapse
Affiliation(s)
- Mohadeseh Motamed-Jahromi
- Department of Medical-Surgical Nursing, Nursing School, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohammad Hossein Kaveh
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Khodabandeh Shahraki
- Department of Community Health Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Negar Yousefzadeh
- Department of health services management, School of health manangment and information sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Mohammadi
- Department of Educational Administration and Planning, School of Education and Psychology, Shiraz University, Shiraz, Iran
| | - Gul Muhammad Baloch
- Department of Public Health, School of Psychology, Faculty of Health Sciences and Wellbeing, University of Sunderland, UK
| |
Collapse
|
11
|
Yu M, Qian M, Guo C, Wang Q. The role of frailty, social networks, and depression in self-neglect in an older Chinese population: A cross-sectional descriptive study. Geriatr Nurs 2023; 51:394-399. [PMID: 37127016 DOI: 10.1016/j.gerinurse.2023.04.007] [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: 03/10/2023] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVES To identify the role of frailty, social networks, and depression in self-neglect in an older Chinese population. METHODS The study was conducted in 521 older adults recruited from four community healthcare centers in a district in Beijing, China. Participants were investigated by a set of questionnaires. RESULTS Frailty (β=0.150, p=0.759) was not associated with self-neglect of older adults. Social isolation (β=1.980, p<0.001) and depression (β=3.606, p<0.001) were both factors associated with self-neglect in older adults. CONCLUSION Management of depression and improvement of social networks of older adults should be incorporated into interventional strategies to effectively control self-neglect. Understanding self-neglect and its associated factors will ultimately contribute to the intervention development and well-being of older adults.
Collapse
Affiliation(s)
- Mingming Yu
- School of Nursing, Peking University, Beijing, China.
| | - Min Qian
- Department of Nursing, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Chenming Guo
- School of Nursing, Peking University, Beijing, China
| | - Qun Wang
- School of Nursing, Shenzhen University, R405, A1 Building, Lihu Campus No.1066 Xueyuan Road, Nanshan District, Shenzhen, China.
| |
Collapse
|
12
|
Hovanesian J, Singh IP, Bauskar A, Vantipalli S, Ozden RG, Goldstein MH. Identifying and addressing common contributors to nonadherence with ophthalmic medical therapy. Curr Opin Ophthalmol 2023; 34:S1-S13. [PMID: 36951648 DOI: 10.1097/icu.0000000000000953] [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: 03/24/2023]
Abstract
PURPOSE OF REVIEW To discuss common reasons for nonadherence and review existing and emerging options to reduce nonadherence with ocular medical therapy and optimize therapeutic outcomes. RECENT FINDINGS Nonadherence can arise from patient-related issues (e.g. physical, cognitive) and healthcare-related issues (e.g. cost, access to care). Multiple strategies have been developed and evaluated to overcome these barriers to adherence. Identifying nonadherence and its cause(s) facilitates the development of strategies to overcome it. SUMMARY Many common causes of nonadherence can be mitigated through a variety of strategies presented.
Collapse
Affiliation(s)
| | - I Paul Singh
- The Eye Centers of Racine and Kenosha, Racine, Wisconsin
| | - Aditi Bauskar
- Ocular Therapeutix, Inc., Bedford, Massachusetts USA
| | | | | | | |
Collapse
|
13
|
Yu M, Wang W, Gu L, Ramachandran HJ. Perspectives and experiences of living with self‐neglect among older adults: A systematic review and meta‐synthesis. J Nurs Scholarsh 2022. [DOI: 10.1111/jnu.12854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/28/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Mingming Yu
- School of Nursing Peking University Beijing P.R. China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - Libin Gu
- School of Nursing Nanjing University of Chinese Medicine Nanjing P.R. China
| | - Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine National University of Singapore Singapore
| |
Collapse
|
14
|
Yu M, Qian M. The Chinese version of the Abrams geriatric Self-neglect scale:Translation, validity, and reliability. Geriatr Nurs 2022; 47:55-60. [PMID: 35850032 DOI: 10.1016/j.gerinurse.2022.06.011] [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: 05/16/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To translate, cross-culturally adapt, and validate the Abrams Geriatric Self-neglect Scale (AGSS) for the older population in China. METHODS The performance of the Chinese version of AGSS (C-AGSS) was evaluated among 334 older adults recruited from three community healthcare centers in Beijing, China. RESULTS The Cronbach's α was 0.601 and the content validity index was 0.96 for the C-AGSS. The unidimensional model of the scale was supported by the confirmatory factor analysis with an excellent model fit. The concurrent validity was demonstrated by the significant correlation (r=0.614, p<0.001) between the C-AGSS and the Scale of the Elderly Self-neglect (Rural). The hypothesized validity and the discriminative validity of the C-AGSS were also approved. CONCLUSIONS The C-AGSS has acceptable validity and reliability on self-neglect assessment in the Chinese older population. It can be used to classify and quantify the self-neglect of older adults in China.
Collapse
Affiliation(s)
- Mingming Yu
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China.
| | - Min Qian
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China
| |
Collapse
|
15
|
Xu L, Sun H, Xu H, Chen X, Xu Q, Jiang H, Ren L, Wang Y, Dong C. Self-neglect among older adults admitted to a Chinese comprehensive hospital in the COVID-19 pandemic era: a cross-sectional study. J Elder Abuse Negl 2022; 34:241-258. [PMID: 35765770 DOI: 10.1080/08946566.2022.2095319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study aims to explore the prevalence of self-neglect and associated factors among older adults admitted to the hospital in the COVID-19 pandemic context. The cross-sectional study conducted at a Chinese comprehensive hospital between January and April 2021, 452 older adults were recruited to complete the Abrams Geriatric Self-Neglect Scale, Social Support Rate Scale, FRAIL scale, Barthel index, Patient Health Questionnaire-9, and 10-item Connor-Davidson Resilience Scale. Multivariate logistic regression was used to explore the factors associated with elder self-neglect. The results showed that the prevalence of self-neglect among our sample was 30.3%. Factors that were associated with the risk of elder self-neglect included male, having multiple children (≥4), receiving infrequent visits from children, frailty, and depression. There is a need to screen for self-neglect among older adults admitted to the hospital in the COVID-19 pandemic context. Tailored interventions are warranted to improve the quality of life of older adults.
Collapse
Affiliation(s)
- Liuqing Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Geriatric Department, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing, Beijing, China
| | - Huan Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiufang Chen
- Geriatric Department, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiongying Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hao Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liya Ren
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuxin Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| |
Collapse
|
16
|
Zhao B, Wang H, Xie C, Huang X, Cao M. Mediating Role of Psychological Capital in the Relationship Between Social Support and Self-Neglect Among Chinese Community-Dwelling Older Adults. Front Psychol 2022; 13:903625. [PMID: 35814097 PMCID: PMC9257434 DOI: 10.3389/fpsyg.2022.903625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Self-neglect in older adults has become an important public health issue and is associated with negative health outcomes and increased morbidity and mortality. Social support has been recognized as a prominent predictor of self-neglect, but the underlying mechanism is unclear. This study aims to investigate and illustrate the associations among social support, psychological capital, and self-neglect. Methods This study used a cross-sectional convenience sampling design. A total of 511 older adults were recruited in Chinese communities. Spearman’s correlation coefficient and hierarchical multiple regression analysis were performed to assess the influencing factors of self-neglect. A structural equation model was applied to test the hypothesized mediation model. Results Social support and psychological capital were found to be negatively related to self-neglect. Social support and psychological capital explained 5.1 and 11.9% of the incremental variances of older adults’ self-neglect, respectively. Psychological capital acts as a mediator between social support and self-neglect. Conclusion Self-neglect among older adults is a rising problem in China. Social support and higher psychological capital could decrease the risk of self-neglect in older adults. It is crucial to improve social networks and facilitate psychological interventions to reduce such self-neglect.
Collapse
Affiliation(s)
- Binyu Zhao
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Hangsai Wang
- School of Nursing, Hangzhou Normal University, Hangzhou, China
- School of Medicine, Jinhua Polytechnic, Jinhua, China
| | - Chunqi Xie
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Xianhong Huang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Meijuan Cao
- School of Nursing, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Meijuan Cao,
| |
Collapse
|
17
|
Morris P, McCloskey R, Bulman D. Iatrogenesis in the Context of Residential Dementia Care: A Concept Analysis. Innov Aging 2022; 6:igac028. [PMID: 35832201 PMCID: PMC9273406 DOI: 10.1093/geroni/igac028] [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: 09/16/2021] [Indexed: 11/12/2022] Open
Abstract
Background and Objectives This concept analysis aims to explore iatrogenesis within the context of residential dementia care and to distinguish this phenomenon from similar phenomena, such as abuse and inadvertent harm. Research Design and Methods Walker and Avant's method for concept analysis was used to define critical attributes of iatrogenesis within residential dementia care, and to explore antecedents and consequences of its occurrence. A review of the literature about iatrogenesis in the context of residential dementia was conducted across 4 electronic databases. Texts about iatrogenesis in surgery, medicine, social work, psychology, and other relevant disciplines were also reviewed to provide additional context for the concept. Results Iatrogenesis takes a unique form in residential dementia care. The final definition of the concept proposed in this article is habituated, forceful, hands-on care provided to residents who exhibit responsive behaviors that result in emotional, physical, spiritual, social harm, and/or gradual functional decline, that is provided with the intention of supporting the resident's safety and dignity. Discussion and Implications The definition of iatrogenesis proposed in this article is an initial step toward developing evidence-based practice for the provision of nonconsensual assistance in residential dementia care. A theoretical definition like the one proposed in this article may serve as a starting point for the operationalization of the concept, which would promote future empirical research into staff and residents' experiences of health care-inflicted harms in this context. Theoretically, it contributes to critical conversations about the narratives, myths, and misperceptions that facilitate the provision of nonconsensual care.
Collapse
Affiliation(s)
- Patricia Morris
- School of Graduate Studies, University of New Brunswick, Saint John, New Brunswick, Canada
- Geriatric Medicine Clinic, Horizon Health Network, Saint John, New Brunswick, Canada
| | - Rose McCloskey
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Donna Bulman
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| |
Collapse
|
18
|
Yu M, Gu L, Shi Y, Wang W. A systematic review of self-neglect and its risk factors among community-dwelling older adults. Aging Ment Health 2021; 25:2179-2190. [PMID: 32954788 DOI: 10.1080/13607863.2020.1821168] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To systematically review published evidence on self-neglect (SN) and its risk factors among community-dwelling older adults. METHOD A comprehensive literature search was conducted in PubMed, Embase, CINAHL Plus, PsycINFO, and Scopus for studies that were published in English from inception to 8 April 2020. Grey database was also included to ensure a thorough search. The study quality was assessed by two reviewers independently using the Newcastle-Ottawa Scale or the checklist suggested by the Agency for Healthcare Research and Quality. RESULTS A total of 19 studies was included in this review. Various tools were used to assess SN among the available studies. The prevalence rates of SN among community-dwelling older adults ranged from 18.4% to 29.1%. The risk factors of SN identified by these studies involved sociodemographic characteristics (male gender, older age, low economic status, ethnicity, lower educational level, marital status, and lower number of children), health-related characteristics (cognitive impairment, lower level of physical function, nutritional status, higher number of medical comorbidities, and pain), psychological characteristics (depression), and social context characteristics (living alone, lower social networks and social engagement, lower neighborhood cohesion, and neighborhood disorder). CONCLUSION SN is a common and under-recognized phenomenon among community-dwelling older adults. Our review provides healthcare professionals with an insight into SN and its risk factors. More studies are required to test the potency of each independent risk factor to deepen our understanding of this particular phenomenon.
Collapse
Affiliation(s)
- Mingming Yu
- School of Nursing, Peking University, Beijing, P.R. China
| | - Libin Gu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, P.R. China
| | - Yuexian Shi
- School of Nursing, Peking University, Beijing, P.R. China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
19
|
Yu M, Ramachandran HJ, Qian M, Shi Y, Gu L, Wang W. Understanding professionals' perspectives and experiences of elder self-neglect: A systematic review and meta-synthesis of qualitative studies. J Nurs Scholarsh 2021; 54:24-30. [PMID: 34791792 DOI: 10.1111/jnu.12710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/18/2021] [Accepted: 07/23/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE To systematically review and synthesize the findings on various professionals' perspectives of elder self-neglect (ESN) and/or their experiences with ESN. DESIGN A systematic qualitative review was used. METHODS Primary qualitative studies published either in English or Chinese until August 2020 were systematically searched in the following databases: PubMed, Web of Science, Embase, CINAHL Plus, PsycINFO, Wanfang Data, and China National Knowledge Infrastructure (CNKI). FINDINGS Eleven studies were included. Five subthemes including retaining a sense of normalcy/identity, service refusal, isolation, contributing factors in ESN, and manifestations and consequences of ESN were included in the overarching theme of ESN features. Another two subthemes, emotional and ethical dilemmas in caring for self-neglecters and management strategies, were included under the second overarching theme of complicated experiences managing cases of ESN. CONCLUSIONS This qualitative synthesis provides a deep and comprehensive insight into professionals' perspectives and experiences of self-neglect in older adults. Understanding professionals' perspectives of ESN can help with the knowledge and theory development pertinent to this particular phenomenon. CLINICAL RELEVANCE Findings are valuable in informing the provision of funds and structural, informational, and emotional support systems development for professionals managing ESN cases. Establishing a strong link between ESN case management and improved outcomes in older self-neglecters is essential to establish a definite need for the provision of support, resource, and stardardized guidelines for these professionals.
Collapse
Affiliation(s)
- Mingming Yu
- School of Nursing, Peking University, Beijing, P.R. China
| | - Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Min Qian
- School of Nursing, Peking University, Beijing, P.R. China
| | - Yuexian Shi
- School of Nursing, Peking University, Beijing, P.R. China
| | - Libin Gu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, P.R. China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
20
|
Lussier M, Aboujaoudé A, Couture M, Moreau M, Laliberté C, Giroux S, Pigot H, Gaboury S, Bouchard K, Belchior P, Bottari C, Paré G, Consel C, Bier N. Using Ambient Assisted Living to Monitor Older Adults With Alzheimer Disease: Single-Case Study to Validate the Monitoring Report. JMIR Med Inform 2020; 8:e20215. [PMID: 33185555 PMCID: PMC7695528 DOI: 10.2196/20215] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/10/2020] [Accepted: 09/26/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Many older adults choose to live independently in their homes for as long as possible, despite psychosocial and medical conditions that compromise their independence in daily living and safety. Faced with unprecedented challenges in allocating resources, home care administrators are increasingly open to using monitoring technologies known as ambient assisted living (AAL) to better support care recipients. To be effective, these technologies should be able to report clinically relevant changes to support decision making at an individual level. OBJECTIVE The aim of this study is to examine the concurrent validity of AAL monitoring reports and information gathered by care professionals using triangulation. METHODS This longitudinal single-case study spans over 490 days of monitoring a 90-year-old woman with Alzheimer disease receiving support from local health care services. A clinical nurse in charge of her health and social care was interviewed 3 times during the project. Linear mixed models for repeated measures were used to analyze each daily activity (ie, sleep, outing activities, periods of low mobility, cooking-related activities, hygiene-related activities). Significant changes observed in data from monitoring reports were compared with information gathered by the care professional to explore concurrent validity. RESULTS Over time, the monitoring reports showed evolving trends in the care recipient's daily activities. Significant activity changes occurred over time regarding sleep, outings, cooking, mobility, and hygiene-related activities. Although the nurse observed some trends, the monitoring reports highlighted information that the nurse had not yet identified. Most trends detected in the monitoring reports were consistent with the clinical information gathered by the nurse. In addition, the AAL system detected changes in daily trends following an intervention specific to meal preparation. CONCLUSIONS Overall, trends identified by AAL monitoring are consistent with clinical reports. They help answer the nurse's questions and help the nurse develop interventions to maintain the care recipient at home. These findings suggest the vast potential of AAL technologies to support health care services and aging in place by providing valid and clinically relevant information over time regarding activities of daily living. Such data are essential when other sources yield incomplete information for decision making.
Collapse
Affiliation(s)
- Maxime Lussier
- Research Center of Institut universitaire de gériatrie de Montréal, Integrated Health and Social Services University Network for South-Central Montreal, Montreal, QC, Canada
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Aline Aboujaoudé
- Research Center of Institut universitaire de gériatrie de Montréal, Integrated Health and Social Services University Network for South-Central Montreal, Montreal, QC, Canada
| | - Mélanie Couture
- Integrated Health and Social Services University Network for West-Central Montreal, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Psychology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Maxim Moreau
- Research Chair in Digital Health, High Commercial Studies of Montreal, Montreal, QC, Canada
| | - Catherine Laliberté
- Faculty of Sciences and Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sylvain Giroux
- Faculty of Sciences and Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Hélène Pigot
- Faculty of Sciences and Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sébastien Gaboury
- Department of Mathematics and Computer Science, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Kévin Bouchard
- Department of Mathematics and Computer Science, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Patricia Belchior
- Research Center of Institut universitaire de gériatrie de Montréal, Integrated Health and Social Services University Network for South-Central Montreal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Carolina Bottari
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Guy Paré
- Research Chair in Digital Health, High Commercial Studies of Montreal, Montreal, QC, Canada
| | - Charles Consel
- Bordeaux Institute of Technology & Inria, Bordeaux, France
| | - Nathalie Bier
- Research Center of Institut universitaire de gériatrie de Montréal, Integrated Health and Social Services University Network for South-Central Montreal, Montreal, QC, Canada
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| |
Collapse
|
21
|
|
22
|
Wu M, Peng C, Chen Y, Yuan M, Zhao M, Wang C, Zeng T. Nurses' Perceptions of Factors Influencing Elder Self-neglect: A Qualitative Study. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 14:137-143. [PMID: 32603691 DOI: 10.1016/j.anr.2020.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 05/04/2020] [Accepted: 05/21/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses, usually working directly with elderly patients, have a better understanding of what factors may cause elder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect from the perception of nurses in the context of Chinese culture. METHODS Face-to-face, in-depth interviews were conducted from November 2018 to December 2018. Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a general hospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed to analyze the data. RESULTS Our conceptual model illustrated the findings based on the three themes of the conflict between personal recognition and social judgment, the choice between current needs and individual beliefs, as well as the compromise between insufficient abilities and limited resources. CONCLUSION Nurses together with family members and social workers can help older adults improve their awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs, as well as seek as much support as possible. Nurses should also respect the autonomy and self-determination of elder self-neglecters because self-neglect is related to older adults' values. Furthermore, larger studies are needed to quantitatively test and refine the model.
Collapse
Affiliation(s)
- Meiliyang Wu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chaohua Peng
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ye Chen
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengmei Yuan
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meizhen Zhao
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengshuang Wang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tieying Zeng
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
23
|
Freer K, Wallington SL. Social frailty: the importance of social and environmental factors in predicting frailty in older adults. Br J Community Nurs 2020; 24:486-492. [PMID: 31604045 DOI: 10.12968/bjcn.2019.24.10.486] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Frailty can have multifaceted contributors, including physical, psychological, social and environmental elements. There is a lack of clarity surrounding frailty as it lacks a universal common definition, multiple factors are attributed to frailty and no definitive assessment tool is available. The evidence suggests that there is a lack of research to indicate causal relationships between the various determinants of frailty in ageing individuals. This review discusses the important role that social and environmental factors play in predicting the risk of frailty in older adults, as well as discussing the various signs of frailty. Health professionals in primary and community care settings are well placed to prevent and identify social frailty in the persons they care for.
Collapse
Affiliation(s)
- Karen Freer
- Senior Occupational Therapist, Bolton Hospitals NHS Foundation Trust
| | - Sophie Louise Wallington
- Advanced Physiotherapist Practitioner, Manchester University NHS Foundation Trust Clinical Lecturer, Work-based Learning Facilitator, University of Bolton
| |
Collapse
|
24
|
Lehmann J, Michalowsky B, Kaczynski A, Thyrian JR, Schenk NS, Esser A, Zwingmann I, Hoffmann W. The Impact of Hospitalization on Readmission, Institutionalization, and Mortality of People with Dementia: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2019; 64:735-749. [PMID: 29966191 DOI: 10.3233/jad-171128] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND People with dementia (PwD) are at a high risk of hospitalization. Hospitals are often not adequately equipped for PwD and discharges often come unexpected. Therefore, PwD are at a risk of adverse outcomes. However, information about those outcomes is rare but crucial for the development of preventive strategies. OBJECTIVES To conduct a quantitative systematic review and meta-analyses on the impact of a hospitalization on readmission, institutionalization, and mortality in PwD. To identify factors associated with these outcomes. METHODS PubMed, CENTRAL, and ScienceDirect were searched for studies including terms for dementia, hospital, readmission, institutionalization, and mortality. Relevant were assessed by a quality criteria sheet. Results were summarized in a table. Meta-analysis was conducted with Review Manager 5.3. RESULTS The search yielded 1,108 studies; 20 fulfilled the inclusion criteria and 10 studies were eligible for meta-analyses. The incidence and relative risk (RR) of mortality (RR 1.74 CI95 % 1.50, 2.05) and institutionalization (RR: 2.16 CI95 % 1.31, 3.56) of PwD was significantly higher when compared to people without dementia. Results according to readmission rate were inconsistent. Factors significantly associated with the examined adverse outcomes were severity of dementia, number of medications, and deficits in daily living activities. CONCLUSION Hospitalization of PwD lead to adverse outcomes. An improvement in the identification of and care for PwD in the acute setting as well as in after care in the community setting, especially in the interface between both settings, is required to prevent adverse outcomes in hospitalized PwD.
Collapse
|
25
|
Hei A, Dong X. Neighborhood Disorder Is Associated With Greater Risk for Self-Neglect Among Chinese American Older Adults: Findings From PINE Study. Gerontol Geriatr Med 2018; 4:2333721418778185. [PMID: 30035195 PMCID: PMC6050619 DOI: 10.1177/2333721418778185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 12/21/2017] [Indexed: 11/17/2022] Open
Abstract
Objective: This study aims to examine the association between neighborhood disorder with self-neglect among a community-dwelling Chinese American older population. Method: Data were extracted from the Population Study of Chinese Elderly (PINE), a cross-sectional study of 3,157 participants living in the greater Chicago area. Self-neglect was assessed with systematic observations of participants’ personal and home environment. Neighborhood disorder was measured through eight questions. Logistic regression was used to examine the association between neighborhood disorder and self-neglect. Results: After adjusting for potential confounding factors, every one point higher in neighborhood disorder score was significantly associated with greater risk for overall self-neglect (odds ratio [OR] = 1.13, [1.11, 1.16]), mild self-neglect (OR = 1.14, [1.11, 1.17]), and moderate/severe self-neglect (OR = 1.12, [1.09, 1.16]). Regarding the phenotypes of self-neglect, every one point higher in neighborhood disorder score was significantly associated with greater risk for hoarding (OR = 1.17, [1.14, 1.20]), personal hygiene (OR = 1.15, [1.12, 1.19]), house in need of repair (OR = 1.12, [1.10, 1.15]), unsanitary conditions (OR = 1.12, [1.09, 1.15]), and inadequate utilities (OR = 1.10, [1.05, 1.15]). Discussion: This study underscores the significant association between disordered neighborhood and greater risk of self-neglect among Chinese American older adults. Improving neighborhood disorder problems could benefit for elder self-neglect prevention.
Collapse
|
26
|
Li J, Zhao D, Dong B, Yu D, Ren Q, Chen J, Qin Q, Bi P, Sun Y. Frailty index and its associations with self-neglect, social support and sociodemographic characteristics among older adults in rural China. Geriatr Gerontol Int 2018; 18:987-996. [DOI: 10.1111/ggi.13280] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/12/2017] [Accepted: 01/24/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Jie Li
- Department of Epidemiology and Health Statistics, School of Public Health; Anhui Medical University; Hefei China
| | - Dongdong Zhao
- Department of Epidemiology and Health Statistics, School of Public Health; Anhui Medical University; Hefei China
| | - Bao Dong
- Department of Epidemiology and Health Statistics, School of Public Health; Anhui Medical University; Hefei China
| | - Dandan Yu
- Department of Epidemiology and Health Statistics, School of Public Health; Anhui Medical University; Hefei China
| | - Qiongqiong Ren
- Department of Epidemiology and Health Statistics, School of Public Health; Anhui Medical University; Hefei China
| | - Jian Chen
- Ma’anshan Center for Disease Control and Prevention; Ma’anshan China
| | - Qirong Qin
- Ma’anshan Center for Disease Control and Prevention; Ma’anshan China
| | - Peng Bi
- Department of Epidemiology and Health Statistics, School of Public Health; Anhui Medical University; Hefei China
- The University of Adelaide, School of Public Health; Adelaide South Australia Australia
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health; Anhui Medical University; Hefei China
- Center for Evidence-Based Practice; Anhui Medical University; Hefei China
| |
Collapse
|
27
|
Associations of self-neglect with quality of life in older people in rural China: a cross-sectional study. Int Psychogeriatr 2017; 29:1015-1026. [PMID: 28245888 DOI: 10.1017/s1041610217000229] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Elder self-neglect (ESN) has become a public health issue globally. Limited studies have focused on ESN, as well as the relationship between ESN and quality of life (QoL) in developing countries. The study's objective is to explore the association between ESN and QoL among rural elderly in China. METHODS A cross-sectional study was conducted among 3,182 elder adults aged 60 years or older, using a cluster-sampling technique in one township in Dangtu, a county in Anhui province. All participants completed face-to-face interview in their household. QoL was assessed using a brief form of the World Health Organization's quality of life questionnaire (WHOQOL-BREF), and ESN was assessed using the Scale of the Elderly Self-neglect (SESN). Hierarchical linear regression models were used to analyze the associations between the ESN scores and QoL scores after adjusting for sociodemographic, social support, and physical and psychological variables. RESULTS The scores of overall ESN and five domains were significantly correlated with the scores of four QoL domains (p < 0.001). After adjusting for sociodemographic characteristics, social support, and physical and psychological health characteristics, elders who reported higher overall self-neglect scores had significantly lower scores in the four QoL domains (p < 0.001). Education, economic level, physical health, ADL, depression, and cognitive function are consistent predictors across all QoL domains. CONCLUSIONS ESN is an independent risk factor for poor QoL in elderly people in rural China. Understanding the role of ESN and its influence on QoL is important for the management of and intervention in ESN.
Collapse
|
28
|
Carpenter CR, Platts-Mills TF. Evolving prehospital, emergency department, and "inpatient" management models for geriatric emergencies. Clin Geriatr Med 2013; 29:31-47. [PMID: 23177599 PMCID: PMC3875836 DOI: 10.1016/j.cger.2012.09.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Alternative management methods are essential to ensure high-quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols to support early condition-specific treatment of older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to address the influence of other factors on the patient's health. This article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care.
Collapse
|