1
|
Dahlke S, Rayner JA, Fetherstonhaugh D, Butler JI, Kennedy M. Gerontological educational interventions for student nurses: a systematic review of qualitative findings. Int J Nurs Educ Scholarsh 2025; 22:ijnes-2023-0042. [PMID: 38459787 DOI: 10.1515/ijnes-2023-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/28/2023] [Indexed: 03/10/2024]
Abstract
OBJECTIVES This systematic review of qualitative studies explored interventions to improve student nurses' knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing. METHODS Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses' knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies. CONCLUSIONS Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students' negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses' knowledge, attitudes, and willingness to work with older people, so that they can be replicated.
Collapse
Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Jo-Anne Rayner
- ACEBAC, 2080 La Trobe University , Bundoora, VIC, Australia
| | | | | | - Megan Kennedy
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
2
|
Gerdin AL, Hellzén O, Alm AK, Rising MH. Older persons' experiences of care encounters in their home: A multiple-case study. J Clin Nurs 2024; 33:2287-2297. [PMID: 38291544 DOI: 10.1111/jocn.17043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/22/2023] [Accepted: 01/15/2024] [Indexed: 02/01/2024]
Abstract
AIM To explore and describe older persons' unique experiences of care encounters with home care nurses in a real-life context. BACKGROUND The increasing number of older persons in society contributes to increases in age-related impairments compromising their quality of life. Future care consists of "hospitals at home" where care encounters occur in a person's private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted. DESIGN Multiple-case study. METHODS The cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated. FINDINGS The cross-analysis emerged in three categories: "Nursing routine rules the care encounters", "Lack of knowledge and information" and "Dependency on support from others". CONCLUSIONS Our research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person-centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time-sensitive care encounters. REPORTING METHOD Findings were reported using COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION Patients were interviewed and contributed with data for this study. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE This study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality.
Collapse
Affiliation(s)
| | - Ove Hellzén
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | | | | |
Collapse
|
3
|
Hjalmarsson A, Östlund G, Asp M, Kerstis B, Holmberg M. Entrusting life to professionals: A phenomenological hermeneutical study of older persons' participation in prehospital emergency care involving municipal home care and ambulance services. Scand J Caring Sci 2024; 38:273-283. [PMID: 37915130 DOI: 10.1111/scs.13223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/02/2023] [Accepted: 10/15/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Participation in care is considered to promote safe and qualitative care. Care-dependent older persons ageing in place have increased emergency care needs, which initiate inter-organisational collaboration involving municipal home care and ambulance services. Previous research concludes that uncertainties exist regarding what participation in care means in clinical practice, which necessitates the need to illuminate the phenomenon for older persons in critical life situations. AIM This study aimed to illuminate meanings of participation in prehospital emergency care from the perspective of care-dependent older persons experiencing acute illness at home. DESIGN This study has a qualitative design with a lifeworld approach. METHOD A phenomenological hermeneutical method was used to analyse transcribed telephone interviews with eleven care-dependent persons aged 70-93 years. RESULTS Care-dependent older persons' participation in prehospital emergency care means 'Entrusting life to professional caregivers' when being in helpless solitude and existentially unsafe, which emphasises a deepened interpersonal dependence. Meanings of participation in care from the perspective of older persons involve Being reassured in togetherness, Being pliant in trust of emergency expertise, Being enabled through the agency of professional caregivers, and Encountering readiness in the emergency care chain. CONCLUSION Care-dependent older persons' participation in prehospital emergency care is existential and involves interpersonal dependence. Togetherness brings reassurance, safety and opportunity for emotional rest while accessing the professional caregivers' power, competence and abilities which provide opportunities for existence and movement towards well-being and continued living. IMPLICATIONS FOR PRACTICE Prehospital emergency care from the perspective of care-dependent older persons transcends organisational boundaries and includes the municipal mobile safety alarm service. The involved municipal and regional organisations need to provide support by implementing lifeworld-led care models and care alternatives that enable professionals to recognise the existential dimension of participation in care.
Collapse
Affiliation(s)
- Anna Hjalmarsson
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden
| | - Gunnel Östlund
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden
| | - Margareta Asp
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden
| | - Birgitta Kerstis
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden
| | - Mats Holmberg
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden
- Faculty of Health and Life Sciences Linnaeus University, Växjö, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- Department of Ambulance Services, Region Sörmland, Katrineholm, Sweden
| |
Collapse
|
4
|
Sapula SA, Hart BJ, Siderius NL, Amsalu A, Blaikie JM, Venter H. Multidrug-resistant Stenotrophomonas maltophilia in residential aged care facilities: An emerging threat. Microbiologyopen 2024; 13:e1409. [PMID: 38682784 PMCID: PMC11057060 DOI: 10.1002/mbo3.1409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/20/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024] Open
Abstract
Stenotrophomonas maltophilia is a multidrug-resistant (MDR), Gram-negative bacterium intrinsically resistant to beta-lactams, including last-resort carbapenems. As an opportunistic pathogen, it can cause serious healthcare-related infections. This study assesses the prevalence, resistance profiles, and genetic diversity of S. maltophilia isolated from residential aged care facilities (RACFs). RACFs are known for their overuse and often inappropriate use of antibiotics, creating a strong selective environment that favors the development of bacterial resistance. The study was conducted on 73 S. maltophilia isolates recovered from wastewater and facility swab samples obtained from three RACFs and a retirement village. Phenotypic and genotypic assessments of the isolates revealed high carbapenem resistance, exemplifying their intrinsic beta-lactam resistance. Alarmingly, 49.3% (36/73) of the isolates were non-wild type for colistin, with minimum inhibitory concentration values of > 4 mg/L, and 11.0% (8/73) were resistant to trimethoprim-sulfamethoxazole. No resistance mechanisms were detected for either antimicrobial. Genotypic assessment of known lineages revealed isolates clustering with Sm17 and Sm18, lineages not previously reported in Australia, suggesting the potential ongoing spread of MDR S. maltophilia. Lastly, although only a few isolates were biocide tolerant (2.7%, 2/73), their ability to grow in high concentrations (64 mg/L) of triclosan is concerning, as it may be selecting for their survival and continued dissemination.
Collapse
Affiliation(s)
- Sylvia A. Sapula
- Health and Biomedical Innovation, UniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Bradley J. Hart
- Health and Biomedical Innovation, UniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Naomi L. Siderius
- Health and Biomedical Innovation, UniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Anteneh Amsalu
- Health and Biomedical Innovation, UniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
- Department of Medical MicrobiologyUniversity of GondarGondarEthiopia
| | - Jack M. Blaikie
- Health and Biomedical Innovation, UniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Henrietta Venter
- Health and Biomedical Innovation, UniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| |
Collapse
|
5
|
Ayalon L, Ulitsa N, AboJabel H, Engdau-Vanda S. "We Used to Have Four Seasons, but Now There Is Only One": Perceptions Concerning the Changing Climate and Environment in a Diverse Sample of Israeli Older Persons. J Appl Gerontol 2024; 43:527-535. [PMID: 38085273 PMCID: PMC10981184 DOI: 10.1177/07334648231212279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/21/2023] [Accepted: 10/18/2023] [Indexed: 04/01/2024] Open
Abstract
Solastalgia is the pain caused by the loss of solace and isolation from one's environment. Solastalgia is contrasted with nostalgia, which is defined as melancholy characterized by homesickness or the distance from one's home. The present study examines the two concepts of solastalgia and nostalgia in the context of climate change among diverse populations of older Israelis. In total, 50 older persons from four different population groups (e.g., veteran Israeli Jews, Israeli Arabs, immigrants from the former Soviet Union, and Ethiopian immigrants) were interviewed. All interviews were transcribed and analyzed thematically. Members of all four groups expressed emotional distress and grief associated with the changing climate, increased environmental pollution, and the disappearance of nature. Perceptions around the undesirability of these changes were quite unanimous, thus leading us to conclude that the outcomes associated with solastalgia and nostalgia are quite similar despite different etiological explanations.
Collapse
|
6
|
Farrelly A, Daly L. Older persons' experiences of frailty: A systematic review. Int J Older People Nurs 2024; 19:e12611. [PMID: 38747586 DOI: 10.1111/opn.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 03/01/2024] [Accepted: 04/14/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES The objective of this study was to synthesise the evidence of older persons' experiences of frailty. BACKGROUND The world's population is ageing with those aged over 60 years expected to total 2 billion by 2050. Although not exclusive to ageing, there is a higher prevalence of frailty in older adults, with corresponding demand for related healthcare. While definitions of frailty are debated, there is emerging consensus that sole reliance on biomedical conceptualisations is inadequate to capture the complex needs of older persons living with frailty. In addition, the voices of older persons have largely been excluded from frailty discourses. There is a consequent need for an expanded approach. METHODS A meta-synthesis was conducted of the literature on older persons' experiences of frailty. CINAHL, Medline, Embase and ASSIA databases were systematically searched up to January 2024. Reference lists of retrieved sources and grey literature were also searched. Studies were independently evaluated for inclusion by two reviewers using predetermined inclusion criteria. Included studies were quality appraised using a standardised tool, and extracted data were thematically analysed and synthesised. RESULTS Eight hundred and thirteen studies were identified as potentially relevant. Following title and abstract review, 52 studies were selected for full-text review. Thirty-four studies were subsequently excluded as they did not address the systematic review question, leaving 17 included in the final review. An additional two studies were identified via grey literature sources. Older persons' experiences of frailty were synthesised with reference to three themes: (i) living with frailty: a multidimensional experience; (ii) living with frailty: acceptability and associations; and (iii) living with frailty: resisting and adapting and losing control. CONCLUSIONS Older persons' experiences of frailty revealed a resistance to the biomedical use of the term generally used in clinical practice. Instead, a more nuanced and multidimensional understanding of frailty was identified in the experiences of older persons. IMPLICATIONS FOR PRACTICE Health and social care personnel should therefore consider an expanded approach in practice that incorporates the perspective of older people who strive to maintain independence and control when living with frailty. Doing so may enhance shared understanding and person-centred care planning between older persons and professionals.
Collapse
Affiliation(s)
- Alice Farrelly
- Midlands Regional Hospital, Tullamore, County Offaly, Republic of Ireland
| | - Louise Daly
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
7
|
Oduro JK. The well-being equation: How inner fulfilment drives the impact of older persons on the Ghanaian society. Int J Older People Nurs 2024; 19:e12614. [PMID: 38711209 DOI: 10.1111/opn.12614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/25/2024] [Accepted: 04/20/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Understanding and managing the complex processes of ageing is a critical function of gerontological nursing, especially when it comes to older people's well-being and their contributions to society. Globally, older persons contribute in many ways to families and communities. However, the relationship between older person's overall well-being and their propensity to contribute to society remains an important gap in research. OBJECTIVE The study examined the association between well-being and the impact of older persons on Ghanaian society. METHODS A secondary analysis of longitudinal survey data of the 2014/15 Study on Global Ageing and Adult Health (SAGE Wave 2) conducted by the World Health Organization was used. The multilevel logistic regression technique was used to examine four dimensions of well-being and their associations with high social contribution among older persons. The output was reported as odds ratios (OR). RESULTS The results show that older persons who had high physical and psychological well-being were more likely to contribute to society (OR = 1.25, 95% CI = 0.93, 1.68), (OR = 1.75, 95% CI = 1.32, 2.33). However, those with high levels of emotional and spiritual well-being were less likely to make social contributions (OR = 0.66, 95% CI = 0.49, 0.88), (OR = 0.88, 95% CI = 0.66, 1.18). CONCLUSION This study shows a positive association between well-being and older persons' societal impact. Good mental and physical health encourage societal involvement among older persons, while high emotional and spiritual well-being may lead to less societal contribution. IMPLICATIONS FOR PRACTICE These findings are important for nursing policies promoting social contribution and well-being among older persons 60 years and over in Ghana.
Collapse
Affiliation(s)
- Joseph Kojo Oduro
- Department of Population and Health, University of Cape Coast, Cape Coast, Central Region, Ghana
| |
Collapse
|
8
|
Prabahar K, Alhawiti MS, Yosef AM, Alqarni RS, Sayd FY, Alsharif MO, Subramani V, Alshareef H, Hamdan AME, Alqifari S, Alqarni GS, Yousuf SM. Potentially Inappropriate Medications in Hospitalized Older Patients in Tabuk, Saudi Arabia Using 2023 Beers Criteria: A Retrospective Multi-Centric Study. J Multidiscip Healthc 2024; 17:1971-1979. [PMID: 38706504 PMCID: PMC11070160 DOI: 10.2147/jmdh.s461180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/23/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose Older persons are frequently prescribed several medications; therefore, inappropriate medication prescriptions are common. Prescribing potentially inappropriate medications (PIMs) poses a serious risk and hence, we aimed to assess the PIMs in older patients in Tabuk, using the 2023 Beers criteria. Patients and Methods A retrospective cross-sectional study was carried out, including older persons ≥65 years of age admitted in two government hospitals from June 2022 to May 2023, and prescribed with five or more medications. PIMs were assessed using the 2023 Beers criteria. Descriptive analysis was performed for the categorical and continuous variables. Logistic regression was used to assess the influence of age, gender, number of medications and comorbidities on PIMs using SPSS version 27. Results The study included 420 patients. The mean age of the participants was 75.52 ± 8.70 years (range, 65-105 years). There was a slightly higher proportion of females (52%). The prevalence of PIMs was 81.43%, where 35.41% were prescribed one PIM, 26.48% were prescribed two PIMs, and 17.32% were prescribed three PIMs. The proportion of medications considered potentially inappropriate among older patients was 70.11%, and proton pump inhibitors were the most commonly prescribed medication (52.99%). The proportion of medications to be used with caution was 19.55%, with diuretics being the most frequently administered medication (91.43%). Gender and comorbidity did not influence PIMs, but age and number of medications significantly influenced the likelihood of PIMs. Conclusion PIMs are prevalent among older people and are significantly associated with age and multiple medications. Caution should be exercised while prescribing medications to older persons. Frequent audits should be performed to assess PIMs, and clinicians should be informed of the same to avoid serious outcomes associated with PIMs. Interventions designed to reduce PIM need to be initiated.
Collapse
Affiliation(s)
- Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | | | | | | | - Fai Yahya Sayd
- Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | | | - Vikashini Subramani
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Nilgiris, TN, India
| | - Hanan Alshareef
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Ahmed M E Hamdan
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Saleh Alqifari
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | | | | |
Collapse
|
9
|
Temane MD, Mbele SK, Tsawe M. Determinants of self-reported chronic disease diagnoses among older persons in South Africa. Afr J Prim Health Care Fam Med 2024; 16:e1-e9. [PMID: 38708726 PMCID: PMC11079353 DOI: 10.4102/phcfm.v16i1.4425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/30/2024] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Chronic diseases tend to affect the quality of life for older persons worldwide, especially in resource-constrained developing countries. Chronic diseases contribute to a large number of deaths among the population of South Africa. AIM This study examines the determinants of self-reported chronic disease diagnoses among older persons in South Africa. SETTING The study setting was South Africa. METHODS Cross-sectional data from the 2019 South Africa General Household Survey were analysed (n [weighted] = 4 887 334). We fitted a binary logistic regression model to determine the relationship between socio-demographic factors and being diagnosed with self-reported chronic diseases. RESULTS We found that at least 5 in 10 older persons were diagnosed with self-reported chronic disease. The bivariate findings showed that age, population group, sex, marital status, level of education, disability status, household composition and province were significantly associated with self-reported chronic disease diagnoses. At the multivariate level, we found that age, sex, population group, marital status, educational level, disability status, household wealth status, household composition and province were key predictors of self-reported chronic disease diagnoses. CONCLUSION We found that various factors were key determinants of being diagnosed with self-reported chronic diseases. This study offers important insights into the main correlations between older adults and self-reported chronic illness diagnoses. More study is required on the health of the elderly as it will help direct policy discussions and improve the development of health policies about the elderly.Contribution: This study highlights the need for a better understanding of, and continued research into, the determinants health among older populations to guide future healthcare strategies.
Collapse
Affiliation(s)
- Maatla D Temane
- Research Unit, Centre for Statistical Analysis and Research, Johannesburg Department of Population Studies and Demography, Faculty of Humanities, North-West University, Mafikeng.
| | | | | |
Collapse
|
10
|
Bökberg C, Lindhardt T, Björkman E, Ahlström G. Caring and Health of Close Family Members of Frail Older Persons Recently Discharged from Acute Hospital Care: A Comparative Cross-Sectional Study. Nurs Rep 2024; 14:901-912. [PMID: 38651481 PMCID: PMC11036298 DOI: 10.3390/nursrep14020069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
Multimorbidity in older people is strongly linked to the need for acute hospital care, and caregiving activities usually become more complex after patients are discharged from hospital. This may negatively impact the health of close family members, although this has not been comprehensively investigated. This study aimed to explore the general and mental health of close family members caring for frail older (>65) persons recently discharged from acute hospital care, making assessments in terms of gender, relationship to the older person, and aspects of caring. A comparative cross-sectional study was conducted involving 360 close family members caring for frail older persons recently discharged from hospital. The statistical analyses included subgroup comparisons and associations to caring were examined. Half of the family members reported that their general and mental health was poor, with spouses reporting the poorest health. Female participants had significantly more severe anxiety, while males had significantly more severe depression. Providing care for more than six hours per week was associated with poor general health (OR 2.31) and depression (OR 2.59). Feelings of powerless were associated with poor general health (OR 2.63), anxiety (6.95), and depression (3.29). This knowledge may provide healthcare professionals with better tools in order to individualise support, preventing family members from exceeding their resources during these demanding periods.
Collapse
Affiliation(s)
- Christina Bökberg
- Department of Health Sciences, Faculty of Medicine, Lund University, 221 00 Lund, Sweden;
| | - Tove Lindhardt
- Research Unit for Clinical Nursing, Department of Internal Medicine, Copenhagen University Hospital Herlev and Gentofte, Herlev Ringvej 75, 2730 Herlev, Denmark;
| | - Eva Björkman
- Department of Care Science, Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden;
| | - Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, 221 00 Lund, Sweden;
| |
Collapse
|
11
|
Suwannapong K, Thanasilp S, Pudtong N, Akkayagorn L, Stithyudhakarn S, Tantitrakul W, Doutrich D, Upasen R. Influencing Factors on Death Acceptance Among Thai Older Persons. Clin Gerontol 2024:1-8. [PMID: 38557283 DOI: 10.1080/07317115.2024.2337118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVES This study aimed to investigate both the direct and indirect effects of various factors on the acceptance of death. METHODS This cross-sectional study included 800 older Buddhist persons in Thailand, who were recruited through a multistage sampling method. Data were collected using six questionnaires and analyzed through path analysis using the MPlus program. RESULTS Death anxiety was the main factor influencing death acceptance, with death anxiety exerting a negative direct effect on death acceptance. Buddhist beliefs about death demonstrated both a positive direct effect on death acceptance and a positive indirect effect on death acceptance through Buddhist practices. Furthermore, Buddhist practices exhibited a positive direct effect on death acceptance, while social support also showed a positive direct effect on death acceptance. CONCLUSIONS This study highlights the significant direct and indirect effects on death acceptance among older Thai Buddhists. CLINICAL IMPLICATIONS Buddhist-aligned interventions may be more effective and readily embraced by Thai older persons. For those who are receptive, nurses can foster death acceptance by developing interventions that reduce death anxiety and promote Buddhist beliefs about death, Buddhist practices, and social support.
Collapse
Affiliation(s)
- Kanoklekha Suwannapong
- Royal Thai Navy College of Nursing, and Asian Wisdom Care Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Sureeporn Thanasilp
- Asian Wisdom Care Research Unit, Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Noppamat Pudtong
- Asian Wisdom Care Research Unit, Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Lanchasak Akkayagorn
- Cheewabhibaln Center, King Chulalongkorn Memorial Hospital, and Asian Wisdom Care, Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Sudaporn Stithyudhakarn
- Asian Wisdom Care Research Unit, Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Wilailuck Tantitrakul
- Hospital of Excellence in Thai Traditional and Complementary Medicine for Cancer at Sakonnakhon Khampramong Temple, and Asian Wisdom Care Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Dawn Doutrich
- College of Nursing, Washington State University, Pullman, Washington, USA
| | - Ratchaneekorn Upasen
- Asian Wisdom Care Research Unit, Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
12
|
McGrane N, Dunbar P, Keyes LM. Contributing Factors to Adverse Events in Long-Term Care Facilities in Ireland, a Content Analysis. J Am Med Dir Assoc 2024; 25:633-638.e3. [PMID: 38141662 DOI: 10.1016/j.jamda.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES There is substantial research on contributing factors to adverse events (AEs) in acute settings. Little is known about AEs in long-term care facilities (LTCFs). Our aim was to identify contributing factors to AEs from LTCFs for older persons and people with disability to inform quality improvement. DESIGN Content analysis of statutory notifications of AEs from LTCFs using a modified version of the Human Factors Analysis and Classifications System (HFACS) applied to health care. SETTING A sample of high risk-rated notifications of AEs received by the regulator in 2018 and 2019 was drawn from the Database of Statutory Notifications from Social Care in Ireland (n = 156). METHODS Two researchers independently analyzed notifications to identify contributing factors using our modified HFACS. The number of factors identified in each level, subcategory, and nanocode of the HFACS was calculated along with percentage representation of factors within notifications and percentage contribution of individual factors to the total number of factors identified. The number and percentage contributions of factors were also calculated, disaggregated by notification type. RESULTS Contributing factors from all levels of the HFACS were identified. The most common contributing factor was "Resident factors" followed by "Unsafe acts." No contributing factors were attributed to 68 notifications (43.6%). Multiple contributing factors were attributed to 45 notifications (28.8%). The largest percentage of factors was identified in notifications of serious injuries (27.4%). CONCLUSION AND IMPLICATIONS It is the responsibility of LTCFs to account for "Resident factors" in system design, risk management, and care plans. Developing systems and processes that identify where residents have higher risk of harm may reduce the occurrence of high-risk events and thus improve resident safety. The large proportion of notifications where no contributing factors were identified suggests the need for improved reflection and reporting from LTCFs and for more specific questions on notification forms.
Collapse
Affiliation(s)
- Niall McGrane
- Health Information and Quality Authority, Cork, Ireland
| | - Paul Dunbar
- Health Information and Quality Authority, Cork, Ireland
| | - Laura M Keyes
- Health Information and Quality Authority, Cork, Ireland.
| |
Collapse
|
13
|
Adedeji IA, Lawal SA, Aluko-Arowolo S. Qualitative Analysis of Coping Strategies Among Older Persons During COVID-19 Lockdown in Nigeria: Considerations for Community Health Promotion. Community Health Equity Res Policy 2024; 44:253-263. [PMID: 37118649 PMCID: PMC10149519 DOI: 10.1177/2752535x231173527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Background: The challenge of COVID-19 and the disease control restrictions in Nigeria directly affected social life. Older adults were disproportionately affected because of social vulnerabilities, socio-economic dependency, and the high risk of COVID-19 infectious disease in the population.Purpose: To this end, the study explored the instrumental coping strategies of older adults duirng the COVID-19 lockdown in Nigeria.Research Design: An exploratory research design using qualitative approach based on in-depth interviews was adopted.Study Sample: Twenty-seven (27) older adults aged 60 years and more in Ibadan, Nigeria were purposively selected for participation in the research.Data Collection and/or Analysis: Community living older adults participated in in-depth telephone interviews during the COVID-19 restrictions. Using Atlas ti 8.4, the 27 transcripts were analyzed and validated through content analysis.Results: Older adults coped with fear, anxiety, depression, and other health challenges, and three major themes emerged as problem-focused coping strategies. Older adults explored spirituality, engaged in their social networks through telephones, and focused on a healthy diet and physical activities.Conclusions: Community health promotion strategies for older adults should explore the identified problem-focused coping strategies to optimize the health and wellbeing of older adults.
Collapse
Affiliation(s)
- Isaac A. Adedeji
- Department of Gerontology, Simon Fraser University, Columbia, Canada
| | - Saheed Akinmayowa Lawal
- Department of Public Health, School of Public and Allied Health
Babcock University, Ilishan-Remo, Nigeria
| | - Sola Aluko-Arowolo
- Department of Sociology, Olabisi Onabanjo
University, Ago-Iwoye, Nigeria
| |
Collapse
|
14
|
Dixon CA, Roos V, Katjene M, Hoffman J. Effective Relationships Between Younger Caregivers and Older Care Recipients Across a Continuum of Formal Residential Care Settings: A Scoping Review and a Critical Analysis. Public Health Rev 2024; 45:1606562. [PMID: 38601905 PMCID: PMC11004294 DOI: 10.3389/phrs.2024.1606562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024] Open
Abstract
Objective: This article aims to conduct a scoping review of what constitutes effective relational interactions between caregivers (CGs) and older persons (OPs) across formal residential care settings. Methods: A scoping review of publications between January 2000 and December 2021 yielded 10,929 articles, and after removing duplicates and applying exclusion criteria, 36 articles were analysed. Results: Articles were scrutinised for interactions involving both CGs and OPs, using a thematic framework analysis to identify effective relational constructs. Four themes emerged: 1) Diverse perspectives on the same context: for OPs it is home, and for CGs, workplace. 2) CGs move for a one-up position and OPs submit to a one-down, or as friends. 3) Relational qualities have been mostly associated with CGs, confirming care as a unidirectional action 4). Relationships between CGs and OPs result either in effective or ineffective care outcomes. Conclusion: The dual meanings attached to the same context limit the authentic interactions between CGs and OPs. We propose a relational caregiving approach by considering the interactions of both CGs and OPs, changing the relational definition, and demonstrating effective relational qualities.
Collapse
Affiliation(s)
- Carol-Ann Dixon
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
| | - Vera Roos
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
| | - Matthews Katjene
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
| | - Jaco Hoffman
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
- Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
15
|
Martani A, Tian YJA, Felber N, Wangmo T. Gerontechnologies, ethics, and care phases: Secondary analysis of qualitative interviews. Nurs Ethics 2024:9697330241238340. [PMID: 38470960 DOI: 10.1177/09697330241238340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Gerontechnologies are increasingly used in the care for older people. Many studies on their acceptability and ethical implications are conducted, but mainly from the perspective of principlism. This narrows our ethical gaze on the implications the use of these technologies have. RESEARCH QUESTION How do participants speak about the impact that gerontechnologies have on the different phases of care, and care as a process? What are the moral implications from an ethic of care perspective? RESEARCH DESIGN Secondary analysis of semi-structure interviews, whose segments on specific technologies were analysed through reflexive thematic analysis. PARTICIPANTS AND RESEARCH CONTEXT Sixty-seven Swiss stakeholders involved in the use of gerontechnologies, including professional caregivers, informal caregivers, and older persons themselves. ETHICAL CONSIDERATIONS The research study was evaluated by the Ethics Commission of Northwest and Central Switzerland (EKNZ). All participants received an information document before the interview date detailing the purpose, procedure, and anonymization measures. After explaining the study during the agreed upon interview time and upon receiving their written informed consent, the interview process began. FINDINGS/RESULTS Four themes are identified: Identifying care needs, Taking responsibility, Hands-on work, Responding to care. As part of these themes, many codes highlighting the ambivalent impact of gerontechnologies are created, ranging from 'Expanded capacity for…identifying care needs' to 'Create new & (un)necessary…hands-on work'. The moral implications of these results from the care ethics perspective are discussed, through the ethical elements of: attentiveness, responsibility, competence, and responsiveness. CONCLUSIONS The moral implications of gerontechnologies on care phases from the care ethics perspective open up several questions on whether they actually help give care a central role in social life and provide more competent care.
Collapse
|
16
|
De Witte J, Noten S, Vinckers F, Stoop A, Hovenga N, Landeweer E, Van Regenmortel T. "You Needed to Accept the Situation": Resilience of Nursing Home Residents in Times of COVID-19. Can J Aging 2024; 43:75-83. [PMID: 37665004 DOI: 10.1017/s0714980823000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
The restrictive measures taken by nursing homes during the COVID-19 outbreak in 2020 (e.g., quarantine) may have been important stressors for which residents needed resilience to safeguard their well-being. Based on 30 semi-structured interviews with nursing home residents and close relatives, this study explored the lived experiences with respect to the restrictive measures. The data were collected in psychogeriatric, somatic, and mixed wards in The Netherlands and Flanders, Belgium. The restrictive measures were important stressors for residents, indicated by feelings of loneliness, sadness, and powerlessness. To deal with these measures, residents used various resources, which were determined by factors in the individual (e.g., health), interactional (e.g., possibilities for social interactions) and contextual (e.g. nursing home policy) domains. Because the lived experiences with respect to the restrictive measures seemed to relate to the resilience of nursing home residents, it is crucial to reinforce resources in the individual, interactional, and contextual domains.
Collapse
Affiliation(s)
| | - Suzie Noten
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Floor Vinckers
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Annerieke Stoop
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Nina Hovenga
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Elleke Landeweer
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Tine Van Regenmortel
- HIVA KU Leuven, Leuven, Belgium
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
17
|
Kong Y, Zhang X, Li Z, Qie Y, Zhang L, Peng Y, Jia H. [Evaluating the dietary quality of 454 rural elderly aged 65 years and above in Luzhou City in 2023]. Wei Sheng Yan Jiu 2024; 53:223-228. [PMID: 38604957 DOI: 10.19813/j.cnki.weishengyanjiu.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
OBJECTIVE To evaluate the dietary quality of the rural elderly aged 65 years and above. METHODS In February-March 2023, a convenience sampling method was adopted to select 454 rural elderly aged 65 years and above in a township of Luzhou City. The dietary survey was conducted using a semi-quantitative food frequency questionnaire(FFQ-25), and the questionnaire information was collected by face-to-face interviews. Dietary quality was evaluated using the Dietary Balance Index-16(DBI-16) score. RESULTS The proportion of older people in the region with moderate and high dietary imbalances was 79.7%. Inadequate and excessive dietary intake coexisted. The average daily intake of cereals and potatoes and livestock and meat foods were 356.7 g and 76.2 g, exceeding the recommended intake. The average daily intake of fruit, milk and fish and shrimp intake was 22.8 g, 36 g and 3.7 g, respectively, which was only 10% of the recommended amount, and the intake was seriously insufficient. In addition, the degree of food diversity is relatively low, with most of the average daily intake of food types ranging from five to eight, and only 4.6% of the elderly having more than eight. A total of seven dietary patterns were found among the rural elderly in the region, including a certain degree of under-consumption pattern, a severe under-consumption pattern, a certain degree of over-consumption pattern, and a pattern of both under-consumption and over-consumption. That was dominated by the pattern of severe underconsumption and the pattern of some degree of underconsumption and higher degree of overconsumption, which accounted for 72.3% of the total. CONCLUSION The rural elderly aged 65 years and above in Luzhou City have a serious dietary imbalance, with a high proportion of insufficient intake of vegetables, fruits and milk, as well as aquatic products and eggs; and excessive intake of livestock, poultry, meat and cereals and potatoes.
Collapse
Affiliation(s)
- Yuan Kong
- School of Public Health, Southwest Medical University, Luzhou 646000, China
| | - Xue Zhang
- School of Public Health, Southwest Medical University, Luzhou 646000, China
| | - Zetian Li
- School of Public Health, Southwest Medical University, Luzhou 646000, China
| | - Yaling Qie
- School of Public Health, Southwest Medical University, Luzhou 646000, China
| | - Liangchuan Zhang
- School of Public Health, Southwest Medical University, Luzhou 646000, China
| | - Yating Peng
- School of Public Health, Southwest Medical University, Luzhou 646000, China
| | - Hong Jia
- School of Public Health, Southwest Medical University, Luzhou 646000, China Southwest Medical University Healthcare Big Data Collaboration Center, Luzhou 646000, China
| |
Collapse
|
18
|
Ongoh M, Afranie S, Ohemeng F, Abekah-Carter K, Godi AH. Planning for retirement during active service in Ghana: Insights from pensioners in the Greater Accra Region. J Aging Soc Policy 2024:1-19. [PMID: 38402598 DOI: 10.1080/08959420.2024.2320045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 11/30/2023] [Indexed: 02/27/2024]
Abstract
Workers often participate in pre-retirement planning activities to gain awareness of the likely changes they may experience when they retire to enable them to prepare accordingly. Although pre-retirement planning is essential for successful retirement and healthy aging, studies on pre-retirement planning activities among older adults in Ghana are limited. This study explored pre-retirement planning actions that were taken by Social Security and National Insurance Trust (SSNIT) pensioners in the Greater Accra Region of Ghana. A sequential explanatory mixed-methods approach was adopted to gather data from 437 pensioners aged 60 years and above through surveys, interviews, and focus group discussions. The results indicate that while in active service, many (309) pensioners were not motivated to plan for retirement due to issues, such as low income, and distrust of financial institutions. When planning did take place, the pensioners favored financial planning over social, mental, and physical planning. The respondents also revealed that they did not prepare adequately for retirement due to low salaries, as well as low knowledge on pre-retirement planning. Policies are needed to encourage pre-retirement planning among workers in Ghana to enable them to have an appreciable quality of life in old age.
Collapse
Affiliation(s)
- Myles Ongoh
- LEAP Management Secretariat, Ministry of Gender, Children and Social Protection, Accra, Ghana
- Centre for Social Policy Studies, University of Ghana, Legon, Accra, Ghana
| | - Stephen Afranie
- Centre for Social Policy Studies, University of Ghana, Legon, Accra, Ghana
| | - Fedelia Ohemeng
- Department of Sociology, University of Ghana, Legon, Accra, Ghana
| | | | - Anthony H Godi
- Department of Biostatistics, School of Public Health, University of Ghana, Legon, Accra, Ghana
| |
Collapse
|
19
|
Ji RX, Duan ZY. Reevaluating elevated HDL cholesterol levels in healthy older persons as a risk factor for various disease states. Am J Clin Exp Immunol 2024; 13:53-55. [PMID: 38496358 PMCID: PMC10944359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/28/2024] [Indexed: 03/19/2024]
Abstract
This article reviews the role of high-density lipoprotein cholesterol (HDL-C) in the elderly population, questioning the established view that advocates the ubiquitous health benefits of HDL cholesterol. High levels of HDL-C have been found to be associated with an increased risk of debilitating fractures, dementia, and cardiovascular disease, predominantly affecting older men, through the use of large population-based studies such as the ASPREE trial and the UK Biobank. Possible mechanisms are closely linked to cholesterol crystallization and altered HDL particle function. These findings call for a refinement of the understanding of high-density lipoprotein cholesterol (HDL-C), which implies adjustments to clinical guidelines and risk assessment strategies in older populations.
Collapse
Affiliation(s)
- Ren-Xin Ji
- The School of International Medical Technology of Shanghai Sanda UniversityShanghai 201209, China
| | - Zhou-Ying Duan
- Department of Rehabilitation, Shanghai General Hospital, Shanghai Jiaotong UniversityNo. 100, Haining Road, Shanghai 200080, China
| |
Collapse
|
20
|
Hurtado Y, Hernández OA, De Leon DPA, Duque G. Challenges in Delivering Effective Care for Older Persons with Fragility Fractures. Clin Interv Aging 2024; 19:133-140. [PMID: 38283764 PMCID: PMC10822128 DOI: 10.2147/cia.s433999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/19/2024] [Indexed: 01/30/2024] Open
Abstract
Fragility fractures occur because of low-impact trauma or even spontaneously in individuals with osteoporosis. Caring for older persons with fragility fractures can present several challenges due to the unique needs and vulnerabilities of this population. Older individuals commonly have multiple medical conditions, such as osteoporosis, arthritis, cardiovascular diseases, and diabetes. These comorbidities can complicate fracture management and increase the risk of complications. Fracture repair through surgery may be more complex in older patients due to poor bone quality, decreased tissue elasticity, and higher chances of anesthesia complications. In addition, mobility and functional limitations post-fracture are highly prevalent in this population, affecting their independence and increasing their risk of institutionalization. Addressing these challenges requires a multidisciplinary approach involving orthopedic surgeons, geriatricians, physical and rehabilitation physicians, physiotherapists, occupational therapists, dieticians, social workers, and caregivers. Preventive measures, such as fall prevention strategies and osteoporosis management, can also play a vital role in reducing the incidence of fragility fractures in older persons.
Collapse
Affiliation(s)
- Yesid Hurtado
- Division of Endocrinology, Hospital San José, Bogotá, Colombia
| | | | | | - Gustavo Duque
- Bone, Muscle & Geroscience Research Group, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
21
|
Shi L, Zhou X, Gao Y, Li X, Fang R, Deng X. Corrigendum: Evaluation of the correlation between depression and physical activity among older persons with osteoporosis: a cross-sectional study. Front Psychiatry 2024; 14:1340469. [PMID: 38288057 PMCID: PMC10823537 DOI: 10.3389/fpsyt.2023.1340469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2023.1193072.].
Collapse
Affiliation(s)
- Linjun Shi
- West China School of Nursing/General Practice Ward, International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoping Zhou
- West China School of Nursing/General Practice Ward, International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yueshan Gao
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xia Li
- West China School of Nursing/General Practice Ward, International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ronghua Fang
- West China School of Nursing/General Practice Ward, International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xuexue Deng
- West China School of Nursing/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
22
|
Qi H, Li Z, Ma T, Jiang Y, Ren C, Xu Y, Huang Q, Zhang K, Lu Y, Li M. Robot Navigation System Assisted PFNA Fixation of Femoral Intertrochanteric Fractures in the Elderly: A Retrospective Clinical Study. Clin Interv Aging 2024; 19:11-19. [PMID: 38204959 PMCID: PMC10777025 DOI: 10.2147/cia.s412397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 12/01/2023] [Indexed: 01/12/2024] Open
Abstract
Objective The incidence of hip fracture in the elderly is increasing. Robot navigation technology has the advantages of minimally invasive and accurate. To explore the difference between the clinical effects of proximal femoral anti-rotation intramedullary nail (PFNA) assisted by robot navigation in the treatment of femoral intertrochanteric fracture and traditional PFNA in the treatment of femoral intertrochanteric fracture in the elderly; analyze the advantages and feasibility of PFNA assisted by robot navigation in the treatment of femoral intertrochanteric fracture in the elderly. Patients and Methods From February 2021 to October 2022, the elderly (>65 years old) with femoral intertrochanteric fracture underwent surgery in our center. Divided the patients included in the study into 2 groups based on the surgical method. The surgical method of robot group was PFNA fixation assisted by robot navigation, while the surgical method of traditional group was classic PFNA fixation, Baseline data (general condition, Evans classification, time from injury to operation, preoperative hemoglobin) and observation indicators (intraoperative bleeding, operation time, the length of incision for mail nail insertion, postoperative hemoglobin drop, blood transfusion rate and the Harris score of hip joint 1 year after operation) of the two groups were collected to compare whether there were differences between the two groups. Results There was no statistical difference in baseline data between the two groups (P>0.05). The intraoperative bleeding in the robot group was 68.17±10.66 mL, the intraoperative bleeding in the traditional group was 174±8.11mL (P<0.001). The operation time in the robot group was 68.81 ± 6.89 min, in the traditional group, the operation time was 76.94 ± 8.18 min (P<0.001). The length of incision for mail nail insertion in the robot group was 3.53 ± 0.63 cm, the length of the incision for mail nail insertion in the traditional group was 4.23 ± 0.71 cm (P<0.001). 5 patients (13.9%) in the robot group received blood transfusion treatment, and 13 patients (36.1%) in the traditional group received blood transfusion treatment (P=0.029). The hemoglobin in the robot group decreased by 14.81 ± 3.27 g/l after operation compared with that before operation, while that in the traditional group decreased by 16.69 ± 3.32 g/l (P=0.018). The Harris score of the hip joint of the affected limb in the robot group was excellent in 25 cases, good in 8 cases and poor in 3 cases one year after the operation; In the traditional group, Harris scores were excellent in 18 cases, good in 11 cases and poor in 7 cases (P=0.021). Conclusion PFNA fixation of femoral intertrochanteric fracture with robot navigation assistance has the advantages of minimally invasive and accurate, shorter operation time, less bleeding and lower blood transfusion rate than traditional surgical methods, and has certain advantages in reducing postoperative complications of elderly patients.
Collapse
Affiliation(s)
- Hongfei Qi
- Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, 710000, People’s Republic of China
| | - Zhong Li
- Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, 710000, People’s Republic of China
| | - Teng Ma
- Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, 710000, People’s Republic of China
| | - Yangyang Jiang
- Xi’an Medical College, Xi’an, Shaanxi, 710000, People’s Republic of China
| | - Cheng Ren
- Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, 710000, People’s Republic of China
| | - Yibo Xu
- Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, 710000, People’s Republic of China
| | - Qiang Huang
- Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, 710000, People’s Republic of China
| | - Kun Zhang
- Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, 710000, People’s Republic of China
| | - Yao Lu
- Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, 710000, People’s Republic of China
| | - Ming Li
- Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, 710000, People’s Republic of China
| |
Collapse
|
23
|
De Groote M, De Raedt S, Van Humbeeck L, Van Hoeyweghen R, Nobels A, Van Den Noortgate N, Piers R. How strong is the will-to-live in frail older persons? A survey study in acute geriatric wards and nursing homes in Belgium. Aging Ment Health 2024; 28:302-306. [PMID: 37534457 DOI: 10.1080/13607863.2023.2242302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Will-to-live is defined as the psychological expression of one's commitment to life and the desire to continue living. It is an important indicator of subjective wellbeing. This study aimed to assess the will-to-live in frail older hospitalized patients and nursing home residents as well as to evaluate its association with physical frailty, tiredness of life, depression and wish-to-die. METHODS Between March and September 2021, we interviewed 186 older adults in six nursing homes and two acute geriatric wards across Belgium. Will-to-live was assessed using a single-item numeric rating scale from 0 to 5. A linear regression analysis was performed to assess the association between will-to-live and frailty (Clinical Frailty Scale) with adjustment for age, gender and setting. Mann-Whitney U test was used to evaluate the association between will-to-live and depression, tiredness of life and wish-to-die. RESULTS Mean age was 85 (± 6.2) years. Mean score on the Clinical Frailty Scale was five (± 1.5) and four on the will-to-live (± 1.3). No statistical significant association was found between will-to-live and age (p = 0.991), gender (p = 0.272), setting (p = 0.627) and frailty (p = 0.629). Multiple linear regression showed no significant association with Clinical Frailty Scale (p = 0.660), after adjustment for age, gender and setting. Will-to-live was negatively associated with tiredness of life (p = 0.020) and wish-to-die (p < 0.001), but not with depression (p = 0.186). DISCUSSION Both nursing home residents and older hospitalized patients expressed a strong or very strong will-to-live. Will-to-live was not associated with physical frailty as measured by the Clinical Frailty Scale. Nursing home residents with a weak will-to-live were more likely to have depressive symptoms. Most nursing home residents with a wish-to-die had also a low will-to-live, although some residents had both a high will-to-live and wish-to-die.
Collapse
Affiliation(s)
- Marie De Groote
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| | - Soetkin De Raedt
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| | | | | | - Anne Nobels
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | | | - Ruth Piers
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
24
|
Wen P, Sun L, Cheng L, Zhou C, Wang Z, Wang Z. Fall status and risk factors in older Chinese adults: A cross-sectional study. J Clin Nurs 2023. [PMID: 38108248 DOI: 10.1111/jocn.16965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 10/18/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
AIM To analyse the risk factors and incidence of falls in geriatric outpatients in a university hospital ward in Hangzhou, China. METHODS From May 2020 to August 2022, 1712 geriatric outpatients in a university hospital ward in Hangzhou, China, were screened using a socio-demographic questionnaire (e.g. gender, age, living arrangement, etc.) and assessment scales. The correlation between each factor and falls was preliminarily analysed by chi-squared tests. Finally, binary logistic regression analysis was conducted to further analyse the risk factors of falls. The STROBE checklist was used in reporting this study. RESULTS Of the 1712 geriatric outpatients recruited, 1626 participants (60-79 and ≥ 80 years old) with complete questionnaire and assessment data were included. The occurrence of falls for those in the 60-79 age group was 8.4%, and for those in the ≥80 age group it was 13.4%. Age (p = .007), use of a walking assistance device (p < .001), the Stay Independent Brochure Questionnaire (SIB) (OR = 7.751, 95% CI = 5.089-11.806, p < .001), living arrangement (p = .004), timed up and go test (TUGT) (p = .007) and three diseases or above (OR = 2.496, 95% CI = 1.358-11.4.586, p = .003) reached statistical significance. CONCLUSIONS Older people have a high incidence of falls. In this study, age, disease history, SIB scores (≥4 points), living arrangement, TUGT and walking assistance device increased the probability of falls in older Chinese adults. Personalised interventions should be carried out according to the specific situation of older people to effectively reduce their incidence of falls and improve their quality of life. RELEVANCE TO CLINICAL PRACTICE The basic characteristics and fall risk factors of the older can help nurses identify fall risk, and early intervention by caregivers can reduce fall-related injuries, which has practical significance for promoting healthy aging. PATIENT OR PUBLIC CONTRIBUTION The subjects of this study were older patients ≥60 years old, and the demographic characteristics and fall-related information of patients were obtained by questionnaire. The team worked closely with a team of experts in the field of health care. Some researchers collect data and rewrite them, while other researchers analyse the information and write a paper. All authors read and approved the final manuscript.
Collapse
Affiliation(s)
- Peiting Wen
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lili Sun
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lijuan Cheng
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chunxia Zhou
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhejia Wang
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhaodi Wang
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
25
|
Nobels A, Meersman C, Lemmens G, Keygnaert I. "Just something that happened?": Mental health impact of disclosure and framing of sexual violence in older victims. Int J Geriatr Psychiatry 2023; 38:e6036. [PMID: 38088814 DOI: 10.1002/gps.6036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Despite the important impact of sexual violence (SV) on mental health, few victims disclose their experiences. Although research in adult victims suggests that SV disclosure could protect against long-term mental health problems, studies in older adults are lacking. OBJECTIVES To establish the prevalence of depression, anxiety, posttraumatic stress disorder (PTSD), suicide attempts, and self-harm, their association with SV disclosure, and the moderating effect of sociodemographic characteristics and SV framing in the relation between SV disclosure and the different mental health outcomes in older SV victims. METHODS Data on sexual victimisation, mental health, SV framing, and disclosure were collected through structured face-to-face interviews with 171 randomly selected sexually victimised adults of 70 years and older living in Belgium. SV was measured using behaviourally specific questions based on a broad definition. Mental health outcomes were measured using validated scales. RESULTS Depression, anxiety and PTSD were reported by 34%, 33% and 9% of participants respectively, 5% had attempted suicide and 1% reported self-harm during lifetime. SV framing was associated with the kind of help victims consulted. SV disclosure was not linked with depression and anxiety, but was associated with an increase of PTSD symptoms in older victims with care dependency (p = 0.004) or a chronic illness and/or disability (p = 0.025). CONCLUSIONS SV disclosure in itself does not protect against adverse mental health outcomes in old age. Capacity building of professionals trough training and development of clinical guidelines and care procedures may increase appropriate response to SV disclosure by older victims.
Collapse
Affiliation(s)
- Anne Nobels
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Women's Clinic, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
26
|
Andreasen P, Forma L, Pietilä I. Factors associated with living will among older persons receiving long-term care in Finland. Palliat Care Soc Pract 2023; 17:26323524231212513. [PMID: 38033875 PMCID: PMC10687943 DOI: 10.1177/26323524231212513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023] Open
Abstract
Background A living will document is known to be an important tool for preparing for future care together with healthcare professionals. A living will supports an older person's self-determination and autonomy. Only a few studies have approached the underlying factors of a living will document among older long-term care recipients. Objectives To explore how common having a living will was among older persons receiving home care or round-the-clock long-term care, as well as to evaluate associations between socio-demographical factors and functional capacity with a living will. Design The study population consisted of older persons receiving long-term care in Finland in 2016-2017. Data were collected via individual assessments at home or at a care facility. The questions in the assessment covered health, functional capacity, service use, and social support. Methods Primary outcome 'living will' and associated factors were identified for each person aged 65 or older from RAI-assessment data (Resident Assessment Instrument, RAI). Cross-tabulations with χ²-tests and adjusted binary logistic regression models were performed to evaluate the association between the factors and a living will. Results Of the 10,178 participants, 21% had a living will - a greater proportion were female (22%) than male (18%), and a greater proportion of residents in assisted living (25%) and residential care homes (20%) compared with home care residents (15%) had a living will. Female gender (p < 0.001), having a proxy decision-maker (p = 0.001), increasing age (p = 0.003), impairing functional capacity (activities of daily living hierarchy p < 0.001, Cognitive Performance Scale p < 0.001), instability of health status (Changes in Health, End-Stage Disease and Signs and Symptoms p < 0.001), and closeness of death (p < 0.001) were significantly associated with a living will among older persons. Extensive differences in results were found between home care clients and clients of round-the-clock long-term care. Conclusion Preparedness for the future with a living will varies according to services and on individual level. To reduce inequalities in end-of-life care, actions for advance care planning with appropriate timing are warranted.
Collapse
Affiliation(s)
- Paula Andreasen
- University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Leena Forma
- Faculty of Social Sciences and Gerontology Research Center, Tampere University, Tampere, Finland
- Leena Forma is also affiliated with Laurea University of Applied Sciences, Vantaa, Finland
| | | |
Collapse
|
27
|
Sharwood LN, Waller M, Draper B, Shand F. Exploring community mental health service use following hospital-treated intentional self-harm among older Australians: a survival analysis. Int Psychogeriatr 2023:1-10. [PMID: 37960921 DOI: 10.1017/s1041610223000959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
OBJECTIVES This study aimed to examine the impact of community mental health (CMH) care following index hospital-treated intentional self-harm (ISH) on all-cause mortality. A secondary aim was to describe patterns of CMH care surrounding index hospital-treated ISH. DESIGN A longitudinal whole-of-population record linkage study was conducted (2014-2019), with index ISH hospitalization (Emergency Department and/or hospital admissions) linked to all available hospital, deaths/cause of death, and CMH data. SETTING Australia's most populous state, New South Wales (NSW) comprised approximately 7.7 million people during the study period. CMH services are provided statewide, to assess and treat non-admitted patients, including post-discharge review. PARTICIPANTS Individuals with an index hospital presentation in NSW of ISH during the study period, aged 45 years or older. INTERVENTION CMH care within 14 days from index, versus not. MEASUREMENTS Cox-proportionate hazards regression analysis evaluated all-cause mortality risk, adjusted for relevant covariates. RESULTS Totally, 24,544 persons aged 45 years or older experienced a nonfatal hospital-treated ISH diagnosis between 2014 and 2019. CMH care was received by 56% within 14 days from index. Survival analysis demonstrated this was associated with 34% lower risk of death, adjusted for age, sex, marital status, index diagnosis, and 14-day hospital readmission (HR 0.66, 95% CI 0.58, 0.74, p < 0.001). Older males and chronic injury conveyed significantly greater risk of death overall. CONCLUSIONS CMH care within 14 days of index presentation for self-harm may reduce the risk of all-cause mortality. Greater effort is needed to engage older males presenting for self-harm in ongoing community mental health care.
Collapse
Affiliation(s)
- Lisa N Sharwood
- Black Dog Institute, University of New South Wales, Sydney, Kensington, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- School of Engineering, University of Technology Sydney, Sydney, NSW, Australia
- School of Population Health, University of NSW, Sydney
| | | | - Brian Draper
- Eastern Suburbs Older Persons' Mental Health Service, Randwick, NSW, 2031, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales,Sydney, NSW, Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Sydney, Kensington, NSW, Australia
| |
Collapse
|
28
|
Smith CL, Kasza J, Woods RL, Lockery JE, Kirpach B, Reid CM, Storey E, Nelson MR, Shah RC, Orchard SG, Ernst ME, Tonkin AM, Murray AM, McNeil JJ, Wolfe R. Compliance-Adjusted Estimates of Aspirin Effects Among Older Persons in the ASPREE Randomized Trial. Am J Epidemiol 2023; 192:2063-2074. [PMID: 37552955 PMCID: PMC10988226 DOI: 10.1093/aje/kwad168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 06/09/2023] [Accepted: 08/03/2023] [Indexed: 08/10/2023] Open
Abstract
The Aspirin in Reducing Events in the Elderly (ASPREE) Trial recruited 19,114 participants across Australia and the United States during 2010-2014. Participants were randomized to receive either 100 mg of aspirin daily or matching placebo, with disability-free survival as the primary outcome. During a median 4.7 years of follow-up, 37% of participants in the aspirin group permanently ceased taking their study medication and 10% commenced open-label aspirin use. In the placebo group, 35% and 11% ceased using study medication and commenced open-label aspirin use, respectively. In order to estimate compliance-adjusted effects of aspirin, we applied rank-preserving structural failure time models. The results for disability-free survival and most secondary endpoints were similar in intention-to-treat and compliance-adjusted analyses. For major hemorrhage, cancer mortality, and all-cause mortality, compliance-adjusted effects of aspirin indicated greater risks than were seen in intention-to-treat analyses. These findings were robust in a range of sensitivity analyses. In accordance with the original trial analyses, compliance-adjusted results showed an absence of benefit with aspirin for primary prevention in older people, along with an elevated risk of clinically significant bleeding.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - R Wolfe
- Correspondence to Dr. Rory Wolfe, School of Public Health and Preventive Medicine, 553 St. Kilda Road, Monash University, Melbourne, VIC 3004, Australia (e-mail: )
| |
Collapse
|
29
|
Schluter PJ, Jamieson HA. Multimorbidity associated with urinary incontinence among older women and men with complex needs in Aotearoa | New Zealand. Neurourol Urodyn 2023; 42:1745-1755. [PMID: 37675660 DOI: 10.1002/nau.25279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/01/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
AIMS To investigate the association between multimorbidity and urinary incontinence (UI) among community living older adults with complex needs in sex-specific crude and adjusted analyses. METHODS Since 2012 in Aotearoa | New Zealand (NZ) all community-living older people with complex needs who require publicly funded assistance undergo a comprehensive standardized geriatric needs assessment using the interRAI-HC instrument. Consenting adults aged ≥65 years who undertook this assessment between July 5, 2012 and December 31, 2020 were investigated. Multimorbidity was defined as having ≥2 chronic conditions. Recent bladder incontinence episodes were elicited and UI dichotomized into continent and incontinent groups. RESULTS The study included 140 401 participants with an average age of 82.0 years (range: 65-107 years), of whom 85 746 (61.1%) were female. Overall, 36 185 (42.2%) females and 17 988 (32.9%) males reported UI. Participants had a median of 3 (range: 0-12) chronic conditions, with 109 135 (77.9%) classified as having multimorbidity. In adjusted modified Poisson regression analyses, the prevalence ratio for UI was 1.21 (95% confidence interval [CI]: 1.19, 1.24) times higher in females and 1.18 (95% CI: 1.14, 1.22) times higher for males with multimorbidity compared to those without multimorbidity. CONCLUSIONS Although significant, the estimated sex-specific effect sizes were modest for the association between multimorbidity and UI in this population. However, despite using the comprehensive interRAI-HC instrument, several potentially core chronic conditions were not adequately captured. Although increasingly recognized as an important and growing public health issue, capturing all relevant chronic conditions challenges many epidemiological investigations into multimorbidity.
Collapse
Affiliation(s)
- Philip J Schluter
- Te Kaupeka Oranga, Faculty of Health, Te Whare Wānanga o Waitaha, University of Canterbury, Ōtautahi, Christchurch, Aotearoa, New Zealand
- School of Clinical Medicine, Primary Care Clinical Unit, The University of Queensland, Brisbane, Queensland, Australia
| | - Hamish A Jamieson
- Department of Medicine, Te Whare Wānanga o Otāgo, University of Otago, Ōtautahi, Christchurch, Aotearoa, New Zealand
- Older Person's Health, Te Whatu Ora, Health New Zealand, Waitaha Canterbury, Ōtautahi, Christchurch, Aotearoa, New Zealand
| |
Collapse
|
30
|
Vrettos I, Voukelatou P, Kyvetos A, Makrilakis K, Sfikakis PP, Raptis A, Niakas D. The role of frailty among the predictors of depression on informal caregivers of older adults: a mediation analysis. Psychogeriatrics 2023; 23:973-984. [PMID: 37704194 DOI: 10.1111/psyg.13018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/01/2023] [Accepted: 08/16/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Providing care for older adults has been associated with the presence of depressive symptoms among their informal caregivers. Numerous caregivers and older adults' characteristics have been mentioned as predictors of caregivers' depression. However, studies dealing with the impact of older adults' frailty status on caregivers' depression are scarce. This study was conducted to clarify the precise relationship between caregivers' depression, caregivers' burden, caregivers' characteristics and patients' characteristics, including frailty, among the variables that may have an impact on caregivers' depression. METHODS In this cross-sectional study, patients and caregivers' characteristics were recorded for 311 patient-caregiver dyads, when the patient was admitted to the hospital. For the purpose of the study, a mediation analysis was used with patients and caregiver characteristics considered to be predictors, subjective caregivers' burden as the mediator, and caregivers' depression as the outcome variable. RESULTS Only patients' frailty and caregivers' subjective burden had a direct effect on caregivers' depression. Moreover, caregivers' gender, patients' frailty status and comorbidity, duration of caregiving, and the relationship with the patient, had an indirect effect through caregivers' burden that acted as mediator. Regarding total effects, caregivers burden followed by patients' frailty status had the greater impact on caregivers' depression. CONCLUSIONS By organising interventions to reduce caregivers' depression, patients' frailty status could be among the targets of those interventions considering that frailty might be delayed or reversed.
Collapse
Affiliation(s)
- Ioannis Vrettos
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia 'Agioi Anargyroi', Athens, Greece
| | - Panagiota Voukelatou
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia 'Agioi Anargyroi', Athens, Greece
| | - Andreas Kyvetos
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia 'Agioi Anargyroi', Athens, Greece
| | - Konstantinos Makrilakis
- 1st Department of Propedeutic Internal Medicine, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- 1st Department of Propedeutic Internal Medicine-Rheumatology Unit, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Raptis
- 2nd Department of Propedeutic Internal Medicine, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Niakas
- Department of Health Economics, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
31
|
Bhagwat AP, Deodhe NP. The Effect of Perturbation-Based Balance Training vs Step Training on Reaction Time in Older Persons: A Review. Cureus 2023; 15:e48104. [PMID: 38046742 PMCID: PMC10691396 DOI: 10.7759/cureus.48104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
As the global population ages, understanding the impact of aging on cognitive abilities becomes increasingly crucial. One such cognitive function that exhibits significant changes with advancing age is reaction time (RT). This article presents a comprehensive analysis of RT in older adults, examining its underlying mechanisms, age-related changes, and implications for cognitive functioning. Through a review of existing literature, this study explores various factors influencing RT in older individuals, including sensory, motor, and cognitive processes. It highlights how age-related changes in the central nervous system, such as declines in processing speed and neural efficiency, play a significant role in prolonging RTs. Additionally, the role of cumulative life experiences and environmental factors in shaping reaction time in older adults is discussed.
Collapse
Affiliation(s)
- Anushka P Bhagwat
- Department of Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nishigandha P Deodhe
- Department of Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
32
|
Phi PM, Giang LT, Pham TTH. Unmet needs for care for activities of daily living among older adults with functional disabilities in Vietnam. Front Public Health 2023; 11:1216785. [PMID: 37849716 PMCID: PMC10578490 DOI: 10.3389/fpubh.2023.1216785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/31/2023] [Indexed: 10/19/2023] Open
Abstract
Background Given its low-middle-income status, Vietnam is experiencing a rapidly aging population. Along with this demographic trend, the care needs of older adults, particularly those with functional disabilities, have become an emerging policy issue. Purpose This study examined the prevalence of unmet needs for care in activities of daily living (ADLs) among Vietnamese older adults with functional disabilities. Methods We used data from the Population Change and Family Planning Survey (PCS) in 2021, which was a nationally representative survey. Cross-tabulations and logistic regressions were applied to identify older adults' individual and household factors associated with their unmet care needs. Results Overall, 4.80% of older adults with at least one functional disability needing care to perform one or more ADLs suffered from unmet needs, of whom 2.32% did not receive any care and 3.05% received insufficient assistance. Logistic regression results revealed that age, sex, place of residence, ethnicity, marital status, education levels, and self-rated health were significantly associated with unmet needs. The higher risk of having unmet needs is associated with those in middle age (70-79), men, rural residents, ethnic minorities, currently unmarried people, those with less than a primary educational level, and those with normal or poor self-rated health. Conclusion Attention should be paid to vulnerable older adults, such as those living in rural areas with poor health status, in order to reduce their unmet needs for ADL assistance.
Collapse
Affiliation(s)
- Phong Manh Phi
- Faculty of Political Studies, Hanoi University of Mining and Geology, Hanoi, Vietnam
| | - Long Thanh Giang
- Faculty of Economics, National Economics University, Hanoi, Vietnam
| | - Tham Thi Hong Pham
- Faculty of Mathematical Economics, National Economics University, Hanoi, Vietnam
| |
Collapse
|
33
|
Kokorelias KM, Grosse A, Kazberouk A, Sinha SK. Exacerbated inequalities: A scoping review of the experiences of older persons during conflict situations. J Am Geriatr Soc 2023; 71:3287-3296. [PMID: 37337641 DOI: 10.1111/jgs.18486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND We conducted the first known comprehensive literature review to (1) identify, categorize, and summarize the existing knowledge about the experiences of older persons and their caregivers during conflict situations; (2) identify the support needs of older persons and their caregivers, and; (3) identify gaps in the literature and understanding that may inform future research. METHODS A scoping review methodology of academic peer-reviewed and gray English language literature was employed using six academic literature databases and one gray literature database. We further performed comprehensive searches of relevant search engines and organization websites and bibliographic hand searches to identify additional academic and gray literature. Two authors screened for eligibility of identified studies and documents. One reviewer extracted data regarding authors, article type, geographic origin, key participant characteristics, aims, study design and data collection method, results, conclusions and limitations. Data were analyzed thematically. RESULTS 83 documents met this review's inclusion criteria, including 21 academic documents and 62 from the gray literature. Thematic analysis revealed that conflict situations exacerbate existing inequalities experienced by older persons. Within this overarching theme were three interconnected sub-themes: (1) Older adults are particularly vulnerable during conflict situations; (2) Older persons are inadequately supported in conflict situations; (3) In the face of great challenges, many older adults still manage to endure through conflict situations. We identified 15 recommendations from the reviewed documents to better support older adults in conflict situations. CONCLUSIONS Existing inequalities, such as ageism and ableism, targeted discrimination, and poor health outcomes, become exacerbated during conflict situations, resulting in older persons being less able to flee and meet their daily needs with sufficient access to necessities and healthcare. Little is known of the experiences and needs of family caregivers during conflict situations. We identified several opportunities to improve the experience and support of older persons in conflict situations.
Collapse
Affiliation(s)
- Kristina M Kokorelias
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
- Department of Occupational Sciences and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- National Institute on Ageing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Anna Grosse
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
- National Institute on Ageing, Toronto Metropolitan University, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alexander Kazberouk
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Samir K Sinha
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
- National Institute on Ageing, Toronto Metropolitan University, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
34
|
Petry H, Ernst J, Naef R. Participatory development and implementation of a dementia care pathway with intervention bundles in acute care during the coronavirus pandemic: A process evaluation study. J Clin Nurs 2023; 32:7193-7208. [PMID: 37317613 DOI: 10.1111/jocn.16799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/13/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Abstract
AIMS To explore the implementation of a dementia care pathway in an acute care setting. BACKGROUND Dementia care in acute settings is often constrained by contextual factors. We developed an evidence-based care pathway with intervention bundles, and implemented it on two trauma units, with the aim to empower staff and improve quality care. DESIGN Process evaluation using quantitative and qualitative methods. METHODS Pre-implementation, unit staff completed a survey (n = 72) assessing family and dementia care skills and level of evidence-based dementia care. Post-implementation, champions (n = 7) completed the same survey, with additional questions on acceptability, appropriateness and feasibility, and participated in a focus group interview. Data were analysed using descriptive statistics and content analysis guided by the Consolidated Framework for Implementation Research (CFIR). REPORTING GUIDELINE Standards for Reporting Qualitative Research Checklist. RESULTS Pre-implementation, staff's perceived skills in family and dementia care were moderate overall, with high skills in 'building relationships' and 'sustaining personhood'. Evidence-based interventions were delivered seldom to frequent, with 'individualized care' scoring lowest and 'assessing cognition' scoring highest. Implementation of the care pathway/intervention bundles was overshadowed by the pandemic, and failed due to major organisational- and process-related barriers. Acceptability scored highest and feasibility lowest, with concerns relating to complexity and compatibility of pathways/bundles when introduced into clinical routines. CONCLUSIONS Our study implies that organisational and process factors are the most influential determinants to the implementation of dementia care in acute settings. Future implementation efforts should draw on the evolving evidence within implementation science and dementia care research to ensure effective integration and improvement process. RELEVANCE TO CLINICAL PRACTICE Our study provides important learning around improving care for persons with dementia and their families in hospitals. PATIENT OR PUBLIC CONTRIBUTION A family caregiver was involved in the development of the education and training programme.
Collapse
Affiliation(s)
- Heidi Petry
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Jutta Ernst
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Rahel Naef
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
| |
Collapse
|
35
|
García-Hernández H, García-Chanes RE, Pérez-Zepeda MU, García-Peña C. Association between the changes in socialsecurity continuity condition and mortality: MHAS 2001-2018 analysis. Salud Publica Mex 2023; 65:504-512. [PMID: 38060919 PMCID: PMC10751061 DOI: 10.21149/14727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/26/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE To analyze the association of changes in social security (SS) continuity and mortality, using the Mexican Health and Aging Study (MHAS) in people aged 60 years and more. MATERIALS AND METHODS Retrospective cohort. We analyzed the SS continuity condition -classified as stable, unstable with SS, unstable without SS, and without SS- and its relation with mortality; a probit regression model was utilized to obtain marginal effects, taking into consideration covariates related to mortality. RESULTS Unstable continuity with and without SS and multimorbidity (two or more diseases) increased the probability of dying by 52.9% (p = 0.000, 95%CI: 0.508,0.551), 50.3% (p = 0.000, 95%CI: 0.474,0.531) and 13.3% (p = 0.000, 95%CI: 0.108,0.159), respectively. Meanwhile, being woman, at least one year of formal education, and marriage reduced it in 8.8% (p = 0.000, 95%CI: -0.106,-0.071), 7% (p = 0.000, 95%CI: -0.091,-0.050) and 7.8% (p = 0.000, 95%CI: -0.096,-0.061), respectively. CONCLUSION Belonging to SS was associated with higher mortality, compared to other social health determinants, like education.
Collapse
Affiliation(s)
| | | | - Mario Ulises Pérez-Zepeda
- Dirección de Investigación, Instituto Nacional de Geriatría. Mexico City, Mexico. Centro de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Anáhuac México Campus Norte. Estado de México, Mexico..
| | - Carmen García-Peña
- Dirección General, Instituto Nacional de Geriatría. Mexico City, Mexico..
| |
Collapse
|
36
|
Sandoval Garrido FA, Bolt T, Taniguchi Y, Lloyd-Sherlock P. The relationship of perceived discrimination in healthcare and future falls among community-dwelling older persons from an English longitudinal cohort. F1000Res 2023; 12:1134. [PMID: 38585229 PMCID: PMC10997987 DOI: 10.12688/f1000research.140302.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The objective of this study is to examine the relation between the perceived discrimination suffered by older adults aged 60 and over during a healthcare encounter and its effects on the likelihood of falling 4 and 8 years later. METHODS To identify discrimination, we used the English Longitudinal Study of Ageing (ELSA) data collected in 2010-2011 (wave 5) that asked respondents about feeling discriminated against by doctors or at hospitals in the past year. Falls were assessed by the question: "Have you fallen down in the last two years?" in subsequent waves. We performed longitudinal analyses using the 2014-2015 (wave 7) and 2018-2019 (wave 9) follow-ups. Multivariable logistic regression was used to estimate the odds ratios of falling. RESULTS At baseline, 707 (15.1%) of all respondents experienced healthcare discrimination. Those suffering from discrimination in health care had 64% higher chances of falling 4 years later (odds ratio: 1.637, 95% confidence interval: 1.131-2.368) compared to those who did not, adjusting for age, sex, marital status, wealth, ethnicity, education levels, self-perceived health, depressive symptoms, and difficulties with basic and/or instrumental activities of daily living (ADL/IADL) and difficulties with walking. After 8 years, the effect was not statistically significant. Older age was the only significant detrimental factor at both 4 and 8 years. CONCLUSIONS Understanding discrimination in health care is important to enable safe and welcoming environments for the timely future use of services. These results remind us of the physical risk and the complex panorama of bio-psychosocial determinants involved in tackling discrimination over time.
Collapse
Affiliation(s)
- Felipe Alfonso Sandoval Garrido
- Health Services Research Department, University of Tsukuba, Tsukuba, Ibaraki Prefecture, 3057583, Japan
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki Prefecture, 3058573, Japan
| | - Timothy Bolt
- Faculty of Economics, Saitama University, Saitama, Saitama Prefecture, 3388570, Japan
| | - Yuta Taniguchi
- Health Services Research Department, University of Tsukuba, Tsukuba, Ibaraki Prefecture, 3057583, Japan
| | - Peter Lloyd-Sherlock
- School of International Development, University of East Anglia, Norwich, England, NR4 7TJ, UK
| |
Collapse
|
37
|
Hjalmarsson A, Östlund G, Asp M, Kerstis B, Holmberg M. Balancing power: Ambulance personnel's lived experience of older persons' participation in care in the presence of municipal care personnel. Scand J Caring Sci 2023; 37:766-776. [PMID: 36908069 DOI: 10.1111/scs.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Patient participation is considered to promote well-being and is, therefore, central in care contexts. Care-dependent older persons living at home constitute a vulnerable population with increased ambulance care needs. Care transfers risk challenging participation in care, a challenge that can be accentuated in situations involving acute illness. AIM To illuminate meanings of older persons' participation in ambulance care in the presence of municipal care personnel from the perspective of ambulance personnel. METHOD A phenomenological hermeneutical method was used to analyse transcripts of narrative interviews with 11 ambulance personnel. RESULTS The ambulance personnel's lived experience of older persons' participation includes passive and active dimensions and involves a balancing act between an exercise of power that impedes participation and equalisation of power that empowers participation. The main theme 'Balancing dignity in relation to manipulating the body' included the themes Providing a safe haven and Complying with bodily expressions, which means shouldering responsibility for existential well-being and being guided by reactions. The main theme 'Balancing influence in relation to perceived health risks' included the themes Agreeing on a common perspective, Directing decision-making mandate, and Sharing responsibility for well-being, which means shouldering responsibility for health focusing on risks. Influence is conditional and includes performance requirements for both the older person and municipal care personnel. CONCLUSION Care-dependent older persons' participation in care from the perspective of ambulance personnel means recognising passive and active dimensions involving human dignity, the ability to influence care, and optimising care efforts through collaboration. This study provides a deepened understanding of the balancing of power involved in ambulance care determining participation, where power is equalised or exercised depending on personal engagement, health risks, and available care options. The knowledge provided holds the potential to improve ambulance care to benefit older persons in critical life situations.
Collapse
Affiliation(s)
- Anna Hjalmarsson
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden
| | - Gunnel Östlund
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden
| | - Margareta Asp
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden
| | - Birgitta Kerstis
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden
| | - Mats Holmberg
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- Department of Ambulance Services, Region Sörmland, Katrineholm, Sweden
| |
Collapse
|
38
|
Loke SXY, Chew EYH, Siew AL, Glass GF, Chan EY. Transiting Back Home: Caregivers' Lived Experiences in Caring for Loved Ones on the Nasogastric Tube in the Home-Setting in Singapore. J Transcult Nurs 2023; 34:343-355. [PMID: 37226459 DOI: 10.1177/10436596231175163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION Little is understood about caregivers' lived experiences when first caring for patients on the nasogastric tube at home in an Asian setting. To enhance understanding, our study aimed to chart these caregivers' psycho-emotional evolutions felt during such caregiving experiences in Singapore. METHOD Utilizing purposive sampling, a descriptive phenomenological study was performed, with semi-structured interviews of 10 caregivers of persons on nasogastric tube feeding conducted. Thematic analysis was utilized. RESULTS Our findings chart four psycho-emotional transitions of a caregiver's journey in nasogastric tube feeding and the cultural dynamics involved-(a) Disruption of Caregivers' Normality: Attempting to Grasp Reality, (b) Encountering Road-Blocks: Despondency Arises and Frustrations Abound, (c) Adjusting to the New Normal: Reclaiming Confidence and Positivity, (d) Thriving and Integrating into the New Normal, and (e) Cultural Dynamics At Play. DISCUSSION Our findings illuminate the understanding of caregivers' varying needs, guiding delivery of culturally-congruent caregiver support targeted at each psycho-emotional evolution.
Collapse
Affiliation(s)
| | | | | | | | - Ee Yuee Chan
- Tan Tock Seng Hospital, Singapore
- Geriatric Education and Research Institute, Singapore
| |
Collapse
|
39
|
Touma Sawaya R, Touma M, Gutierrez-Martinez L, Josephy-Hernandez S, Chemali Z. The impact of COVID-19 on older minority adults in the United States: challenges and potential solutions. Psychogeriatrics 2023; 23:891-893. [PMID: 37437923 DOI: 10.1111/psyg.13005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/01/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023]
Affiliation(s)
| | - Mia Touma
- Boston University School of Public Health, Boston, MA, USA
| | | | - Sylvia Josephy-Hernandez
- Hospital Dr. Maximiliano Peralta Jiménez, Caja Costarricense de Seguro Social, Cartago, Costa Rica
| | - Zeina Chemali
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Division of Neuropsychiatry and Neuromodulation, MGH, Boston, MA, USA
| |
Collapse
|
40
|
Blain H, Annweiler C, Berrut G, Bernard PL, Bousquet J, Dargent-Molina P, Friocourt P, Puisieux F, Robiaud JB, Rolland Y. [Anti-fall plan for the elderly in France 2022-2024: objectives and methodology]. Geriatr Psychol Neuropsychiatr Vieil 2023; 21:286-294. [PMID: 38093564 DOI: 10.1684/pnv.2023.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Falls and fall-related injuries are a major public health problem in industrialized countries. Faced with this challenge, a French national plan was launched in 2022 aiming to reduce by 20% the incidence of falls-related hospitalizations or deaths. OBJECTIVES To describe the main pillars of the 2022-2024 French national plan against falls in older persons. Methods and assessment: The six pillars of the plan are: 1) screening and monitoring risks of falls and alert health and care workers; 2) home safety assessment and getting out safely; 3) developing technical aids for mobility and the use of assistive technologies at home; 4) appropriate physical activity, best weapon against falls; 5) tele-assistance devices for all older persons; 6) a cross-cutting pillar: Informing, raising awareness, training, and involving local actors. The plan, deployed in the 18 French regions, will provide a unique opportunity to determine the best strategies to achieve the objectives and the barriers encountered. CONCLUSIONS The deployment of the French national plan will bring useful data for considering a long-term strategy in France and helping countries or regions wishing to implement a fall prevention plan on their territory.
Collapse
Affiliation(s)
- Hubert Blain
- Department of Internal Medicine and Geriatrics, MUSE University, Montpellier, France
| | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Centre on Autonomy and Longevity, Angers University Hospital; UNIV Angers, UPRES EA 4638, University of Angers, Angers, France
| | - Gilles Berrut
- Pôle hospitalo-universitaire de gérontologie clinique, CHU Nantes, France, Union des Gérontopôles de France
| | | | - Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany, MASK-air, Montpellier, France
| | - Patricia Dargent-Molina
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, Paris, France
| | - Patrick Friocourt
- Pôle autonomie, neurologie et prise en charge du vieillissement, centre hospitalier, Blois, France
| | - François Puisieux
- Pôle de gérontologie, hôpital gériatrique Les Bateliers, CHU de Lille, université de Lille, Lille, France
| | - Jean-Baptiste Robiaud
- Department of Internal Medicine and Geriatrics, MUSE University, Montpellier, France
| | - Yves Rolland
- Gerontopole of Toulouse, Institute on Aging, Toulouse University Hospital (CHU Toulouse), Cité de la Santé, CHU de Toulouse, France, CERPOP (Centre d'épidémiologie et de recherche en santé des populations) UPS/Inserm UMR 1295, Toulouse, France
| |
Collapse
|
41
|
Shi L, Zhou X, Gao Y, Li X, Fang R, Deng X. Evaluation of the correlation between depression and physical activity among older persons with osteoporosis: a cross-sectional study. Front Psychiatry 2023; 14:1193072. [PMID: 37711420 PMCID: PMC10499236 DOI: 10.3389/fpsyt.2023.1193072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/16/2023] [Indexed: 09/16/2023] Open
Abstract
Background Osteoporosis is a common chronic disease in older persons. Physical activity can prevent chronic diseases as well as many diseases associated with aging. Older persons often suffer from depression and other psychological problems. However, there are few studies on the correlation between depression and physical activity in older persons with osteoporosis in China. Methods This cross-sectional study was conducted from June 1 to December 28, 2021. A total of 207 subjects who met the inclusion and were exclusion criteria were selected from the outpatient department of West China Hospital and evaluated using a self-designed demographic data questionnaire, the Self-rating Depression Scale (SDS), and the Physical Activity Scale for the Elderly (PASE). Multivariate linear regression was performed to analyze the factors affecting physical activity, and multivariate logistic regression analysis was performed to analyze the factors affecting depression. Spearman's correlation coefficients were calculated to analyze the correlation between depression and physical activity in older persons with osteoporosis. Results A total of 173 valid questionnaires were statistically analyzed. A total of 122 (70.5%) participants were identified as having depression (SDS ≥ 50 points). The median depression score was 62.5 (24.38), and the median PASE score was 69.29 (116.64). Multivariate logistic regression model results showed that physical activity and pain were the main risk factors for depression in older persons with osteoporosis (p < 0.05). Multivariate linear regression model results showed that gender, participation in social activities, activities of daily living status (ADLs), and depression status were the main risk factors associated with physical activity in older persons with osteoporosis (p < 0.05). The results of the correlation analysis showed that physical activity was negatively correlated with depression (R = -0.510, p = 0.000). Conclusion We found that depression was negatively correlated with physical activity in older persons with osteoporosis in China. This means that the less physical activity there is, the more serious the depression status and having depression may result in reduced physical activity in older persons with osteoporosis. To better help older persons with osteoporosis, medical staff should give more attention to influencing factors of depression and physical activity.
Collapse
Affiliation(s)
- Linjun Shi
- West China School of Nursing/General Practice Ward, International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoping Zhou
- West China School of Nursing/General Practice Ward, International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yueshan Gao
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xia Li
- West China School of Nursing/General Practice Ward, International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ronghua Fang
- West China School of Nursing/General Practice Ward, International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xuexue Deng
- West China School of Nursing/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
42
|
Layton N, Harper K, Hill K. Digital Capabilities of Older People and Uptake of Online Healthy Ageing Interventions: An Australian Study. Stud Health Technol Inform 2023; 306:359-363. [PMID: 37638936 DOI: 10.3233/shti230644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
The promise of digital health interventions is tempered by the realities of digital capabilities and infrastructure, especially for older persons. This paper critically examines learnings from a rapid evidence review of digital information tools along with a study evaluating the uptake of a digitally-based healthy ageing intervention by 53 older Australians. Findings suggest that digital literacy is an important precursor to engagement with digital information tools, and that digital information tools must be designed with digital literacy in mind. To achieve digital health equity and realise the potential outcomes that digital tools offer, it may well be necessary to support consumers with the basics of mastering digital platforms.
Collapse
Affiliation(s)
- Natasha Layton
- RAIL Research Centre, Monash University, Frankston, Australia
| | - Kristy Harper
- Independent Living Assessment Incorporated, Perth, Australia
| | - Keith Hill
- RAIL Research Centre, Monash University, Frankston, Australia
| |
Collapse
|
43
|
Krishnapillai A, Kee CC, Ariaratnam S, Jaffar A, Omar MA, Sanaudi RB, Sooryanarayana R, Kiau HB, Ghazali SS, Mohd Tohit N, Zainal Abidin SI. Social Support among Older Persons and Its Association with Smoking: Findings from the National Health and Morbidity Survey 2018. Healthcare (Basel) 2023; 11:2249. [PMID: 37628448 PMCID: PMC10454005 DOI: 10.3390/healthcare11162249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Globally, the average age of the world's population of older people continues to rise and having a good social support network becomes increasingly relevant with the aging populace. Overall, in Malaysia, social support prevalence was low among older persons. This study was conducted to determine the association between social support and smoking status among the older Malaysian population. METHODS Data were obtained from the National Health and Morbidity (NHMS) 2018 survey on the health of older Malaysian adults and analyzed. This cross-sectional population-based study used a two-stage stratified random sampling design. Sociodemographic characteristics, smoking status, and social support data were collected from respondents aged 60 years and more. A validated Malay language interviewer-administered questionnaire of 11-items, the Duke Social Support Index, was utilized to assess the social support status. A multivariable logistic regression analysis was used to assess the association of social support and smoking status among the respondents. RESULTS The prevalence of good social support was significantly higher among the 60-69 years old (73.1%) compared to the ≥80 years old respondents (50%). Multivariate logistic regression analysis showed that respondents aged ≥80 years old were 1.7 times more likely to have poor social support compared to those aged 60-69 years. Respondents with no formal education were 1.93 times more likely to have poor social support compared to respondents who had tertiary education. Respondents with an income of MYR 3000. Former smokers had good social support compared to current smokers (73.6% vs. 78.7%). For current smokers, they had poor social support, which is almost 1.42 times higher than that for non-smokers. CONCLUSION There was poor social support among older people who were current smokers, had an increased age, had no formal education and had a low income. The findings obtained from this study could assist policymakers to develop relevant strategies at the national level to enhance the social support status among older smokers and aid in their smoking cessation efforts.
Collapse
Affiliation(s)
- Ambigga Krishnapillai
- Department of Family Medicine, Faculty of Medicine and Health, National Defense, University of Malaysia, Sg. Besi 57000, Malaysia;
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (M.A.O.); (R.B.S.)
| | - Suthahar Ariaratnam
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sg. Buloh 47000, Malaysia;
| | - Aida Jaffar
- Department of Family Medicine, Faculty of Medicine and Health, National Defense, University of Malaysia, Sg. Besi 57000, Malaysia;
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (M.A.O.); (R.B.S.)
| | - Ridwan B. Sanaudi
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (M.A.O.); (R.B.S.)
| | - Rajini Sooryanarayana
- Family Health Development Division, Ministry of Health Malaysia, Putrajaya 62590, Malaysia; (R.S.); (S.I.Z.A.)
| | - Ho Bee Kiau
- Klinik Kesihatan Bandar Botanik, Ministry of Health Malaysia, Klang 42000, Malaysia;
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
- Laboratory of Medical Gerontology, Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | | |
Collapse
|
44
|
de Carvalho ARB, de Sousa AR, da Silva MDF, de Freitas DRJ, Moura MEB. Global research trends related to coronavirus disease 2019 and the aged: a bibliometric analysis. SAO PAULO MED J 2023; 142:e2022662. [PMID: 37556683 PMCID: PMC10403196 DOI: 10.1590/1516-3180.2022.0662.r1.190523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/29/2023] [Accepted: 05/19/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND A bibliometric analysis covering only the production of original studies or considering world production until 2022 has yet to be conducted. The creation and advancement of vaccines have also influenced research priorities, demonstrating the need for a new approach to this subject. OBJECTIVES To analyze worldwide scientific production related to coronavirus disease 2019 (COVID-19) and the aged and to describe what has already been produced. DESIGN AND SETTING Bibliometric analysis with a quantitative approach. METHOD The search terms "COVID-19," "SARS-CoV-2," "Aged," and "Elderly" were used to retrieve articles from the Web of Science database. A total of 684 articles were included in the analysis. Data were imported into RStudio Desktop Software and linked to R Software. The Bibliometrix R package and VOSviewer software were used for analysis. RESULTS Most articles were published in 2020. These were produced by 4,937 authors and published in 379 journals. The keyword most used by the authors was "COVID-19." Publications from 77 countries were obtained. China had the highest article production ranking, and Spain collaborated the most. The articles addressed the implications of the pandemic on the aged, the relationship between vaccination in the aged, and the implications for the disease itself. CONCLUSION Further research should be conducted, mainly concerning vaccines and vaccination of the aged, owing to the need for and importance of immunization in this risk group, including assessing the long-term effects of vaccines.
Collapse
Affiliation(s)
| | - Antonio Rosa de Sousa
- Nurse and Master's Student, Postgraduate Nursing Program,
Universidade Federal do Piauí (UFPI), Teresina (PI), Brazil
| | | | | | - Maria Eliete Batista Moura
- PhD. Nurse and Professor, Postgraduate Nursing Program,
Universidade Federal do Piauí (UFPI), Teresina (PI), Brazil
| |
Collapse
|
45
|
Söderman M, Bondesson A, Pettersson T, Gustafsson LK. "Intensive-Home-Rehabilitation" Intervention for Older Persons: A Follow-Up Study of Team Members' Perceptions. J Multidiscip Healthc 2023; 16:2207-2216. [PMID: 37551340 PMCID: PMC10404402 DOI: 10.2147/jmdh.s409879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/02/2023] [Indexed: 08/09/2023] Open
Abstract
Background Reablement as a concept includes a health-promoting perspective with the goal of strengthening health and the ability to perform and participate in daily activities, a broader perspective than in general home care and rehabilitation. Reablement interventions have shown to be both more effective and to a greater extent improve the function and health-related quality of life of older persons when compared to traditional home-based care. Success factors for intensive-home-rehabilitation (IHR), an intervention based on the reablement concept, have been described earlier; however, there is a lack of knowledge about why some persons do not recover despite receiving IHR. Aim The aim was to shed light on the older persons' conditions during IHR from the perspective of the rehabilitation team members and to describe obstacles to recovery. Methods Qualitative analysis of health and care records of persons (65+) who received IHR (n=19) performed by an interprofessional team. Results The analysis revealed various problematic situations, dilemmas, that occurred in the older persons' lives during IHR, as well as their consequences and the strategies employed by the older persons as a result. IHR aspects perceived as successful by the older persons also emerged, as well as differences in experiences of the physical and mental aspects of the IHR. Analysis also revealed reasons why the IHR might be experienced as broadly successful. Conclusion The older persons seemed to be satisfied with IHR and achieved their goals; however, some seemed to need more time to reach their goals. Background factors such as having additional diagnoses and living alone might affect the rehabilitation process. Implication for Practice The study provides knowledge regarding the importance of IHR for the recovery process for the increasing numbers of older persons, which might also be useful in other patient groups requiring otherwise long-term rehabilitation and recovery such as after covid-19 infection.
Collapse
Affiliation(s)
- Mirkka Söderman
- Division of Caring Science, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Anna Bondesson
- Division of Caring Science, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Tina Pettersson
- Division of Caring Science, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Lena-Karin Gustafsson
- Division of Caring Science, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| |
Collapse
|
46
|
Kasa AS, Drury P, Chang HCR, Lee SC, Traynor V. Cross-Cultural Adaptation, Validity, and Reliability Testing of the Tilburg Frailty Indicator (TFI) Amharic Version for Screening Frailty in Community-Dwelling Ethiopian Older People. Clin Interv Aging 2023; 18:1115-1127. [PMID: 37522070 PMCID: PMC10377638 DOI: 10.2147/cia.s416942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Frailty is a global health problem, including in African countries. Despite this, no reliable or valid frailty instruments incorporate any African language, and no research exists to cross-culturally adapt and test the validity and reliability of instruments commonly used in other countries for use within African countries. The Tilburg Frailty Indicator (TFI) is a reliable and validated instrument with the potential to be relevant for older populations living in Africa. This study aimed to develop the TFI Amharic (TFI-AM) version for use within Ethiopia. METHODS This study employed psychometric testing and the evaluation of a translated and adapted instrument. The original English language version of the TFI was translated and culturally adapted into Amharic using the World Health Organization process of translation and adaptation of an instrument. A convenience sample of ninety-six community-dwelling older people 60 years and over was recruited. Cronbach's alpha was used for the analysis of the internal consistency of the TFI Amharic (TFI-AM) version using IBM SPSS 26.0 (IBM Corp., Armonk, NY, USA). Face and content validities of the TFI-AM were determined. RESULTS The TFI-AM total mean score was 5.76 (±2.89). The internal consistency of the TFI-AM was very good with an overall Cronbach alpha value of 0.82. The physical domain showed the highest reliability with a 0.75 Cronbach's alpha value while the social domain was the lowest with a 0.68 Cronbach's alpha value. The Cronbach's alpha reliability coefficients of the instrument ranged from 0.68 to 0.75. The item content validity index value ranged from 0.83 to 1.0 and the total content validity index average for the instrument was 0.91. CONCLUSION The TFI-AM is reliable, valid, and reproducible for the assessment of frailty among community-dwelling older populations in Ethiopia. TFI-AM proved an easy-to-administer, applicable and fast instrument for assessing frailty in community-dwelling older populations.
Collapse
Affiliation(s)
- Ayele Semachew Kasa
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Peta Drury
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
- School of Nursing and Midwifery, Western Sydney University, Parramatta South Campus, Parramatta, New South Wales, Australia
| | - Shu-Chun Lee
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
| |
Collapse
|
47
|
Pourhassan M, Cederholm T, Donini LM, Poggiogalle E, Schwab U, Nielsen RL, Andersen AL, Małgorzewicz S, Volkert D, Wirth R. Severity of Inflammation Is Associated with Food Intake in Hospitalized Geriatric Patients-A Merged Data Analysis. Nutrients 2023; 15:3079. [PMID: 37513497 PMCID: PMC10385000 DOI: 10.3390/nu15143079] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
The extent to which inflammation impacts food intake remains unclear, serving as a key risk factor for malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). To address this, we analyzed a large, merged dataset of geriatric hospitalized patients across Europe. The study included 1650 consecutive patients aged ≥65 year from Germany, Italy, Finland, Denmark, and Poland. Nutritional intake was assessed using the first item of the Mini Nutritional Assessment Short Form; C-reactive protein (CRP) levels were measured using standard procedures. In total (age 79.6 ± 7.4 year, 1047 females), 23% exhibited moderate to severe inflammation, and 12% showed severe inflammation; 35% showed moderate reductions in food intake, and 28% were considered malnourished. Median CRP levels differed significantly between patients with severe, moderate, and no decrease in food intake. Among patients with a CRP level of 3.0-4.99 mg/dL, 19% experienced a severe decrease in food intake, while 66% experienced moderate to severe decreases. Regression analysis revealed that inflammation was the most prominent risk factor for low food intake and malnutrition, surpassing other factors such as age, gender, infection, and comorbidity. A CRP level of ≥3.0 mg/dL is associated with reduced food intake during last 3 months in two thirds of hospitalized geriatric patients and therefore indicative for a high risk of malnutrition.
Collapse
Affiliation(s)
- Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, 44625 Herne, Germany
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, 75122 Uppsala, Sweden
- Theme Inflammation & Aging, Karolinska University Hospital, 14186 Stockholm, Sweden
| | - Lorenzo M Donini
- Department of Experimental Medicine, University of Rome "Sapienza", 00185 Rome, Italy
| | - Eleonora Poggiogalle
- Department of Experimental Medicine, University of Rome "Sapienza", 00185 Rome, Italy
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70210 Kuopio, Finland
| | - Rikke Lundsgaard Nielsen
- Department of Clinical Research, ACUTE-CAG, Copenhagen University Hospital, 2650 Hvidovre, Denmark
| | - Aino Leegaard Andersen
- Department of Clinical Research, ACUTE-CAG, Copenhagen University Hospital, 2650 Hvidovre, Denmark
| | - Sylwia Małgorzewicz
- Department of Clinical Nutrition, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, 90403 Nuremberg, Germany
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, 44625 Herne, Germany
| |
Collapse
|
48
|
Verderber S, Koyabashi U, Cruz CD, Sadat A, Anderson DC. Residential Environments for Older Persons: A Comprehensive Literature Review (2005-2022). HERD 2023; 16:291-337. [PMID: 37078127 PMCID: PMC10328148 DOI: 10.1177/19375867231152611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND Independent noninstitutional and institutional residential long-term care environments for older persons have been the subject of significant empirical and qualitative research in the 2005-2022 period. A comprehensive review of this literature is reported, summarizing recent advancements in this rapidly expanding body of knowledge. PURPOSE AND AIM This comprehensive review conceptually structures the recent literature on environment and aging to provide conceptual clarity and identify current and future trends. METHOD AND RESULT Each source reviewed was classified as one of the five types-opinion piece/essay, cross-sectional empirical investigation, nonrandomized comparative investigation, randomized study, and policy review essay-within eight content categories: community-based aging in place; residentialism; nature, landscape, and biophilia; dementia special care units; voluntary/involuntary relocation; infection control/COVID-19, safety/environmental stress; ecological and cost-effective best practices; and recent design trends and prognostications. CONCLUSIONS Among the findings embodied in the 204 literature sources reviewed, all-private room long-term care residential units are generally safer and provide greater privacy and personal autonomy to residents, the deleterious impacts of involuntary relocation continue, family engagement in policy making and daily routines has increased, multigenerational independent living alternatives are increasing, the therapeutic role of nature and landscape is increasingly well-documented, ecological sustainability has increased in priority, and infection control measures are of high priority in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review sets the stage for further research and design advancements on this subject in light of the rapid aging of societies around the globe.
Collapse
Affiliation(s)
- Stephen Verderber
- Centre for Design + Health Innovation, John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Umi Koyabashi
- Centre for Design + Health Innovation, John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Catherine Dela Cruz
- John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Aseel Sadat
- John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Diana C. Anderson
- Boston University School of Medicine, MA, USA
- Jacobs, Dallas, TX, USA
| |
Collapse
|
49
|
Sturm J, Dierick A, Christianen M, van Gelder M, Wouters E. Possibilities, Patience, and Perseverance: A Preliminary Analysis of the Needs and Experiences of Ten Older Adults Regarding Their Use of Digital Health Technology. Healthcare (Basel) 2023; 11:healthcare11111612. [PMID: 37297752 DOI: 10.3390/healthcare11111612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/12/2023] Open
Abstract
The COVID-19 pandemic created the need to use digital health resources (DR), as they sometimes were the only option to receive healthcare or social interaction. The aim of this research is to provide insight into the experiences during the lockdown of older people using DR for health in general and the points of improvement they see. A qualitative study was carried out using semi-structured interviews with older persons by telephone. A total of 10 older adults participated, with a median age of 78 years, the majority having a chronic disease. The most important themes for motivation to use health-related DR were 'urgency' and 'usefulness'. Experiences with DR were related to the themes 'human contact' and 'communication', which were experienced by respondents as facilitated by DR, and 'time and energy', which was two-sided. Additionally, most older persons worried about accessibility of DR by all older persons and the support needed. In conclusion, older persons are convinced of the urgency and the usefulness of digital technology for health and healthcare. Time and energy constraints can be alleviated by using DR on the one hand, but this can also be challenging if older persons are less digitally skilled or lack digital literacy. Good and sustained human support is therefore mandatory.
Collapse
Affiliation(s)
- Janienke Sturm
- School of HRM and Applied Psychology, Fontys University of Applied Science, P.O. Box 347, 5600 AH Eindhoven, The Netherlands
| | - Angelique Dierick
- Department of People and Health Sciences, Fontys University of Applied Sciences, P.O. Box 347, 5600 AH Eindhoven, The Netherlands
- Department of Research and Education, Catharina Hospital, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands
| | - Marilène Christianen
- School of Allied Health Professions, Fontys University of Applied Science, P.O. Box 347, 5600 AH Eindhoven, The Netherlands
| | - Marjolijn van Gelder
- School of Allied Health Professions, Fontys University of Applied Science, P.O. Box 347, 5600 AH Eindhoven, The Netherlands
| | - Eveline Wouters
- School of Allied Health Professions, Fontys University of Applied Science, P.O. Box 347, 5600 AH Eindhoven, The Netherlands
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands
| |
Collapse
|
50
|
Blusi M, Lindgren H, Nilsson I. Factors to Consider when Introducing Digital Social Activities to Older Persons with Home Care. Stud Health Technol Inform 2023; 302:453-457. [PMID: 37203715 DOI: 10.3233/shti230171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Social isolation and loneliness have become everyday concerns for populations all over the world as these factors are affecting both physical and mental health in a negative way. Feelings of isolation and loneliness are increasingly acknowledged as a health risk among older persons. ICTs have been recognized as effective tools to combat social isolation among older people. The aim of this study was to explore factors of significance when introducing a tablet-based system providing digital social activities for older persons with home care. Participants were 17 persons, age 70 and older, who lived alone and had assistance from home care. This exploratory study used cross-sectional qualitative data analyzed through thematic analysis. Three themes were generated: 1) lacking vocabulary related to the context, 2) intuitive user interface may replace extensive instructions and 3) unwillingness to commit to a pre-defined measure of performance.
Collapse
Affiliation(s)
| | | | - Ingeborg Nilsson
- Department of Community Medicine and Rehabilitation, Umeå University, Sweden
| |
Collapse
|