Gender differences in improvement of older-person-specific quality of life after hearing-aid fitting.

BACKGROUND: Age-related hearing loss is the third most common reason for disability in the world and has a significant impact on quality of life (QoL) amongst older adults. OBJECTIVE: To determine how the QoL assessment in older-person-specific domains differs between older men and women with age-related hearing loss before and after hearing-aid fittings. METHODS: The present study was carried out with 105 hearing-impaired outpatients (aged ≥ 60 years) before and after hearing-aid fittings at the University Hospital Olomouc, Czech Republic. The instrument used was the World Health Organization Quality of Life-Older Adults module (WHOQOL-Old). It was completed before hearing-aid fittings and after the first check-up hearing-aid adjustment. The Wilcoxon paired test multiple logistic regression was used to evaluate changes in the QoL after hearing-aid fittings. The distributions of men a women into three subgroups, improved, unchanged, and worsened in each domain, were compared using Fisher's exact test. RESULTS: A significant QoL improvement when fitting a hearing-aid in the area of Sensory abilities was confirmed in both men and women (p < 0.001). In Autonomy, a significant improvement was recorded only amongst men (p = 0.010). In Past, present and future activities and Social participation, a significant improvement was only recorded amongst women (p = 0.029; p = 0.001). Significant differences were revealed between men and women in changes for Sensory Abilities (p = 0.019), Social Participation (p = 0.036) and Intimacy (p = 0.002). CONCLUSIONS: The findings of this study suggest that there are gender differences in QoL improvement amongst people with age-related hearing loss after hearing-aid fitting.

Dying Care Nursing Intervention in the Institutional Care of End-of-Life Patients.

PURPOSE: To determine the frequency of the Nursing Intervention Classification Dying Care activities performed by nurses with end-of-life (EOL) patients. METHODS: A cross-sectional, descriptive study using a structured questionnaire to determine the frequencies of Dying Care activities performed by 201 Czech nurses. FINDINGS: Nurses reported more frequent use of activities focused on the physical comfort of EOL patients. Significant relationships were found between frequencies in some activities and the nurses' education level, length of work experience, and the department type. CONCLUSIONS: Nurses reported infrequent use of communication activities with patients and relatives, which is related to the length of practice. CLINICAL RELEVANCE: It is necessary to focus on communication and psychosocial needs of EOL patients in both pregradual and lifelong nursing education. CÍL: Zjistit frekvenci aktivit NIC intervence Péce o umírající mezi ceskými sestry u pacientu v záveru zivota. METODY: Prurezová deskriptivní studie vyuzívající strukturovaného dotazníku pro urcení frekvence aktivit Péce o umírající provádené 201 sestrou. VÝSLEDKY: Sestry u pacientu v záveru zivota castejsí vyuzívají aktivity zamerené na fyzický komfort. Významné vztahy byly nalezeny mezi frekvencí nekterých aktivit a úrovní vzdelání sester, délkou praxe a typem pracoviste. ZÁVERY: Sestry uvádely neprílis casté pouzívání komunikacních aktivit s pacienty a príbuznými, coz souvisí s délkou jejich praxe. KLINICKÁ RELEVANCE: Je treba se zamerit na komunikaci a psychosociální potreby pacientu v záveru zivota jak v pregraduálním tak celozivotním vzdelávání sester.

Dying Care Interventions in the Intensive Care Unit.

PURPOSE: Providing high-quality end-of-life care is a challenging area in intensive care practice. The aim of the current study was to assess the practice of registered nurses (RNs) with respect to dying care and spiritual support interventions in intensive care units (ICUs) in the Czech Republic (CR) and find correlations between particular factors or conditions and the frequency of NIC interventions usage. DESIGN AND METHODS: A cross-sectional, descriptive study was designed. A questionnaire with Likert scales included the particular activities of dying care and spiritual support interventions and an evaluation of the factors influencing the implementation of the interventions in the ICU. The group of respondents consisted of 277 RNs working in 29 ICUs in four CR regions. The Mann-Whitney U test and Pearson correlation coefficient were used for statistical evaluation. FINDINGS: The most and least frequently reported RN activities were "treat individuals with dignity and respect" and "facilitate discussion of funeral arrangements," respectively. The frequencies of the activities in the biological, social, psychological, and spiritual dimensions were negatively correlated with the frequency of providing care to dying patients. A larger number of activities were related to longer lengths of stay in the ICU, higher staffing, more positive opinions of the RNs regarding the importance of education in a palliative care setting, and attending a palliative care education course. CONCLUSIONS: The psychosocial and spiritual activities in the care of dying patients are used infrequently by RNs in CR ICUs. The factors limiting the implementation of palliative care interventions and strategies improving implementation warrant further study. CLINICAL RELEVANCE: Assessment of nursing activities implemented in the care of dying patients in the ICU may help identify issues specific to nursing practice.