Analysis of the barrier-free levels of village clinics of a city in the aging era / 中华医院管理杂志

Objective:To evaluate the barrier-free level of village clinics of a city in the aging era, for references in improving the barrier-free medical environment for the elderlies.Methods:The village dectors of 156 village clinics in 12 counties of a city were selected as the objects of a questionnaire survey from Dec.2020 to Jan.2021, with 6 evaluation indexes established, each set with 1-10 points. This questionnaires was used to survey the barrier-free construction levels of village clinics. The data were statistically analyzed by rank sum ratio and quadrant graph model.Results:The barrier-free buildings of such clinics scored 32.86 points in average. Among the six indexes, the barrier-free access and doors(7.21 points) scored the highest, and the barrier-free parking space(4.71points) and toilets(3.28 points) scored the lowest. All the counties of the city fell into four categories, including 2 counties with high degree of aging-high level of accessibility, 4 counties with low degree of aging-high level of accessibility, 4 counties with low degree of aging-low level of accessibility, and 2 counties with high degree of aging-low level of accessibility, according to the quadrant graph model built based on the aging degrees and the barrier-free levels of village clinics.Conclusions:The barrier-free level of the village clinics in a city needs to be further improved, and the barrier-free transformation of parking space and toilets should also be strengthened in the future. The government should take different measures in view of conditions of each county to improve the accessibility of village clinics and facilitate the health care-seeking of elderlies.

Puntos de encuentro entre Teorías de Swanson y Roy en el cuidado continuo del adulto mayor con cáncer prostático / Meeting Points between Swanson's and Roy´s Theories in Continuous Care for the Elderly with Prostate Cancer

Introducción: La gestión del cuidado de enfermería, en las personas mayores es un desafío actual para la profesión. Lo que implica planificar y coordinar cuidados seguros y de calidad. Donde se atribuye la necesidad de integrar el enfoque de las teorías y su práctica en el cuidado sistémico y dinámico a la persona en su realidad total. Objetivo: Analizar los puntos de encuentro entre las teorías de Swanson y Roy en el cuidado continuo del adulto mayor con cáncer de próstata. Métodos: Revisión bibliográfica sistemática, durante 2019, de artículos publicados desde 2009 hasta 2019 en las bases de datos SciELO y Google académico. La pregunta guía se elaboró a través del acrónimo PICo. La estrategia de búsqueda se realizó mediante aceptación de los descriptores en Ciencias de la Salud (DeCS) "Teorías de enfermería", "Modelo de adaptación de Callista Roy", "Teoría de Kristen Swanson", "Cuidados continuos", "Adulto mayor", "Neoplasia de la próstata" y "Enfermedades crónicas" con el operador booleano AND, se utilizó el diagrama de flujo (PRISMA). El análisis de contenido permitió interpretar los referentes teóricos y la organización del conocimiento de las 13 bibliografías seleccionadas. Conclusiones: Resulta limitada la producción científica encontrada en relación al alcance de las teorías de Swanson y Roy en la atención al paciente con cáncer. Ambas teorías tienen implícitas, en la fundamentación de sus componentes, un acercamiento biopsicosocial al modo de cuidar en la práctica clínica y la cultura del cuidado continuo en el adulto mayor con cáncer de próstata, desde la perspectiva de enfermería(AU)

Introduction: Nursing care management in the elderly is a current challenge for the profession. This implies planning and coordinating safe and quality care, processes requiring to integrate theoretical approach and their praxis into systemic and dynamic care to the person in a total reality. Objective: To analyze the meeting points between the theories of Swanson and Roy in the continuous care of the elderly with prostate cancer. Methods: Systematic bibliographic review, carried out during 2019, of articles published from 2009 to 2019 in the SciELO and Google Scholar databases. The guiding question was developed through the acronym PICO. The search strategy was carried out by accepting the following descriptors in Health Sciences (DeCS): teorías de enfermería [nursing theories], modelo de adaptación de Callista Roy [Callista Roy's adaptation model], teoría de Kristen Swanson [Kristen Swanson's theory], cuidados continuos [continuous cares], adulto mayor [elderly], neoplasia de la próstata [prostate neoplasm] and enfermedades crónicas [chronic diseases] with the Boolean operator AND. The flow diagram (PRISMA) was used. Content analysis allowed to interpret the theoretical references and to organize knowledge of the thirteen selected bibliographies. Conclusions: There is limited scientific production found about the scope of Swanson's and Roy´s theories regarding the care of patients with cancer. Both theories include implicitly, in the foundation of their components, a biopsychosocial approach to the way of caring, in clinical praxis, as well as the culture of continuous care for the elderly with prostate cancer, from the nursing perspective(AU)

Survey on the demand for long-term care services by elderlies with different activity of daily living / 中华医院管理杂志

Objective:To explore the aging care willingness and requirements for long-term care services among elderlies with different activity of living(ADL).Methods:7 070 elderlies aged 60 years and above were subject to a questionnaire survey using stratified multistage random cluster sampling in three municipalities of Shandong province from August through September, 2017. Data information was obtained by a customized questionnaire and ADL scale. Rank sum test and multivariate logistic regression were used for statistical analysis.Results:According to the ADL scoring, the participants were divided into 3 groups: normal, decreased function, and dysfunction, with 5 467(77.3%), 1 283(18.2%), and 320(4.5%)people respectively. Elderlies with different ADL had different aging care willingness, and the difference was statistically significant( Z=8.704, P<0.05). The factors influencing long-term care services need varied with the degree of ADL. The willingness was a common factor for long-term care services needs of the three elderly groups. The age and living arrangements were factors among the normal ADL group. The living arrangements and chronic diseases were those among the decreased function group, and the education and self-rated economic status were those among the dysfunction group. Conclusions:The demand for long-term care service were diversified with the degree of ADL. Targeted interventions should be taken to meet the needs of elderlies of different ADL.

Efectividad de una intervención educativa en nivel de conocimientos de cuidadores no formales de adultos mayores / Effectiveness of an Educational Intervention about the Level of Knowledge of Informal Caregivers of Elderlies

Introducción: La transición demográfica y el envejecimiento poblacional son fenómenos que traen consigo el aumento del número de los adultos mayores dependientes de cuidado, acompañados de cuidadores no formales con desconocimiento sobre los cuidados geriátricos básicos en la comunidad. Objetivo: Demostrar la efectividad de una intervención educativa en el nivel de conocimientos de cuidadores no formales de adultos mayores. Métodos: Estudio cuasi experimental de intervención educativa en el Policlínico "José Martí Pérez", Santiago de Cuba, en el periodo de julio a diciembre de 2018. El universo estuvo constituido por 25 cuidadores no formales. Desarrollado en tres etapas (evaluación del nivel de conocimiento de los cuidados geriátricos antes y después de la intervención, se clasificaron los conocimientos en adecuados e inadecuados; intervención y evaluación). Se realizó análisis descriptivo de la información que incluyó frecuencias absolutas y porcentajes para variables cualitativas; medias, medianas y desviaciones estándar con intervalos de confianza (95 por ciento para variables cuantitativas). Para estudiar la efectividad de la intervención se compararon los resultados mediante la Prueba de McNemar. Resultados: El 100 por ciento fueron cuidadoras, amas de casa, predominó el grupo etario entre 46-55 años de edad (48 por ciento). conocimientos sobre cuidados geriátricos, antes de la intervención, fueron inadecuados en el 76 por ciento y después de la intervención en el 28 por ciento, con un nivel de confiabilidad del 95 por ciento, con la aplicación de la prueba de probabilidad de McNemar (p < 0.05). Conclusiones: La intervención educativa fue efectiva para mejorar el nivel de conocimientos de los cuidadores no formales sobre cuidados geriátricos básicos en el adulto mayor en estado de necesidad(AU)

Introduction: Demographic transition and population aging are phenomenons that provoke the increase in the number of care-dependent elderlies, accompanied by informal caregivers with no knowledge about basic geriatric care in the community. Objective: To demonstrate the effectiveness of an educational intervention about the level of knowledge of informal caregivers of elderlies. Methods: Quasi-experimental study of educational intervention carried out at José Martí Pérez Polyclinic, in Santiago de Cuba, in the period from July to December 2018. The study population consisted of 25 informal caregivers. Developed in three stages (assessment of the level of knowledge of geriatric care before and after the intervention, knowledge was classified as adequate and inadequate; intervention and evaluation). Descriptive analysis of the information was performed, which included absolute frequencies and percentages for qualitative variables; means, medians and standard deviations with confidence intervals (95 percent for quantitative variables). To study the effectiveness of the intervention, the results were compared using McNemar's test. Results: 100 percent were caregivers, housewives, with a predominance of the age group between 46-55 years of age (48.00 percent). Knowledge about geriatric care, before the intervention, was inadequate in 76.00 percent and, after the intervention, in 28.00 percent, with a 95 percent reliability level, with the application of McNemar's probability test (p < 0.05). Conclusions: The educational intervention was effective in improving the level of knowledge of informal caregivers about basic geriatric care in the elderly in need(AU)

Una concepción de cuidador familiar de anciano / A Conceptualization about Family Caregiver of the Elderly

Introducción: El envejecimiento, fenómeno social y de salud que afecta la contemporaneidad, hace que investigadores se enfoquen en este grupo poblacional, las necesidades y respuestas humanas crecientes que los caracterizan, así como a los seres humanos que dedican tiempo al cuidado de los ancianos. Sin embargo, no se identifican referentes ni una definición actualizada que se configure desde la enfermería, por lo que es necesario analizar los enfoques en el contexto internacional y nacional relacionado con este sujeto. Objetivo: Sistematizar el término cuidador familiar de anciano para lograr su contextualización en el ámbito de la enfermería. Métodos: Se realizó una revisión sistemática para un análisis crítico reflexivo de contenido de documentos publicados durante 10 años, desde 2005 al 2015, con una clara metodología y referencial teórico seleccionado, durante el mes de julio del 2019. Se utilizaron las palabras clave identificadas en DeCS y operadores booleanos: "cuidadores" AND "anciano" OR "adulto mayor" AND "enfermería". La búsqueda fue realizada en la base de datos SciELO, redalyc y medigraphic. Se utilizó el diagrama de flujo (PRISMA) para contribuir a la formulación de la estrategia de búsqueda. Conclusiones: La sistematización permitió la definición operacional de cuidador familiar de anciano desde una perspectiva de la enfermería, esta se concibe como: Persona adulta allegada o con vínculo de parentesco, que asiste o ayuda y toma decisiones sobre los cuidados crecientes de un miembro de la familia de 60 años o más, cuyo estado de salud e inadaptación a los cambios del entorno, demanda de la satisfacción de necesidades(AU)

Introduction: Aging, a social and health phenomenon that affects contemporaneity, makes researchers focus on this population group, the growing human needs and responses that characterize them, as well as the human beings who spend time caring for the elderly. However, no references or any updated definition are identified as supported from the field of nursing, so it is necessary to analyze the approaches in the international and national context related to this subject. Objective: To systematize the term family caregiver of the elderly to achieve its contextualization in the field of nursing. Methods: A systematic review was carried out for a critical reflexive content analysis of documents published for 10 years, from 2005 to 2015, with a clear methodology and selected theoretical reference, during the month of July 2019. The following keywords identified in DeCS and Boolean operators were used: "cuidadores" AND "anciano" OR "adulto mayor" AND "enfermería" [in English, "caregivers" AND "elderly" OR "elderly" AND "nursing"]. The search was carried out in the database SciELO, redalyc and medigraphic. The flow chart (PRISMA) was used to contribute to the formulation of the search strategy. Conclusions: The systematization allowed the operational definition of family caregivers of the elderly from a nursing perspective, this is conceived as: An adult person close to or related by kinship, who assists or helps and makes decisions about the growing care of a member of the family aged 60 years or more, whose state of health and lack of adaptation to changes in the environment demand for the fulfillment of needs(AU)

Testing The Effectiveness Of Integrated Elderly Care Model On Quality Of Care And Health Outcomes Among Hospitalized Elderlies In West Bank

@#The rapid increase in the ageing population and health conditions are imposing a higher challenge to the health care system that requires multidisciplinary teamwork utilizing coordinated care approach. This study examined the effects of integrated care model on quality of care received by older hospitalized patients in West Bank. A quantitative interrupted time series design (pretest and posttest multiple time series, quasi-experiment design) was used. The study examined the effects of integrated care model on admitted older patients (n=32) in the West Bank measuring ten dimensions of quality of care and four health indicators. There was a significant improvement in the dimensions of quality of care: dimensions: nurses’ communications with patients, physicians’ communications with patients, staff response to patients’ needs, pain management, explanations on medications, amount of information given on discharge plan, patients' area cleanliness, patients' area quietness, rating of the hospital, and willingness to recommend the hospital. Incidence of falls and incidence of pressure ulcer improved after implementing the model, while readmission rate and average length of stay did not improve. This study contributed to the limited body of knowledge related to the effect of integrated care model on hospitalized older patients’ quality of care in Palestine/ West Bank. Integrated care has the potential to improve care outcomes among hospitalized older patients.

Vivências e desafios ao cuidar de familiar idoso com acidente vascular cerebral / Experiencias y retos al cuidar de un familiar anciano con accidente cerebrovascular / Experiences and Challenges When Caring for an Elderly Family Member with Cerebrovascular Accident

Introdução: O Acidente Vascular Cerebral é uma das principais causas de mortes e incapacidades entre idosos. Os cuidados após Acidente Vascular Cerebral, comumente, são assumidos pela família, que possui pouco conhecimento acerca da doença e capacidades para desempenhar o cuidado no domicílio. Objetivo: Conhecer as vivências e desafios enfrentados por cuidadores familiares de pessoas idosas dependentes de cuidados após Acidente Vascular Cerebral, sobre as atividades de cuidado realizadas no domicílio. Métodos: Estudo qualitativo por meio da técnica de grupo focal, realizado com cinco cuidadores familiares de idosos com Acidente Vascular Cerebral, em acompanhamento na Linha de Cuidado do Acidente Vascular Cerebral de um hospital da região sul do Brasil. Realizaram-se três encontros em abril de 2018. Utilizou-se a Análise Temática para interpretação dos resultados. O estudo foi aprovado por Comitê de Ética em Pesquisa sob nº 18007. Resultados: Emergiram quatro categorias: Tornar-se cuidador de um familiar após Acidente Vascular Cerebral; Dificuldades vivenciadas; Despreparo para lidar com o familiar dependente; e Estratégias de enfrentamento. Conclusões: As vivências e desafios relatados fornecem evidências para estruturar e qualificar programas de atenção a cuidadores partindo das necessidades dos mesmos(AU)

Introducción: El accidente vascular cerebral es una de las principales causas de muerte e incapacidad entre ancianos. Los cuidados después del accidente vascular cerebral, comúnmente, son asumidos por la familia, que tiene poco conocimiento acerca de la enfermedad y capacidades para desempeñar el cuidado en el domicilio. Objetivo: Conocer las vivencias y desafíos en las actividades de cuidado realizadas en el domicilio enfrentados por los cuidadores familiares de personas ancianas dependientes de cuidados tras accidente vascular cerebral. Métodos: Estudio cualitativo por medio de la técnica de grupo focal, realizado con cinco cuidadores familiares de ancianos con accidente vascular cerebral, en seguimiento en la Línea de Cuidado do Accidente Vascular Cerebral de un hospital de la región sur de Brasil. Se realizaron tres encuentros en abril de 2018. Se utilizó el análisis temático para la interpretación de los resultados. el estudio fue aprobado por el comité de ética en investigación con el número 18007. Resultados: Emergieron cuatro categorías: hacerse cuidador de un familiar después de accidente vascular cerebral; dificultades vivenciadas; no preparación para tratar con el familiar dependiente y estrategias de enfrentamiento. Conclusiones: Las vivencias y desafíos relatados proporcionan evidencias para estructurar y calificar programas de atención a cuidadores partiendo de las necesidades de los mismos(AU)

Introduction: Cerebrovascular accident is one of the main causes of death and disability among the elderly. The cares following cerebrovascular accident are commonly undertaken by the family, with little knowledge about the disease and few capacities to provide care at home. Objective: To know the experiences and challenges in the care-related activities performed at home and undertaken by the family caregivers of elderly people dependent on care after cerebrovascular accident. Methods: Qualitative study carried out using the focus group technique and with five family caregivers of elderly people with cerebrovascular accident under follow-up by the Cerebral Vascular Accident Care Line of a hospital in the southern region of Brazil. Three meetings were held in April 2018. Thematic analysis was used for the interpretation of the results. The study was approved by the Research Ethics Committee under number 18007. Results: Four categories emerged: becoming a caregiver for a family member after cerebrovascular accident, difficulties experienced, no preparation for managing the dependent family member, and coping strategies. Conclusions: The experiences and challenges reported provide evidence for structuring and qualifying care programs for caregivers based on their needs(AU)

Intervenções não farmacológicas de manejo na agitação de idosos com demência em ambiente doméstico / Intervenciones no farmacológicas de manejo de la agitación en ancianos con demencia en ambiente doméstico / Nonpharmacological Interventions for Managing Agitation in Elderlies with Dementia in the Home Setting

Introdução: A agitação é um sintoma neuropsiquiátrico recorrente em idosos com demência. No ambiente doméstico, essa condição impõe aos familiares cuidadores o desafio de intervir adequada e precocemente a fim de minimizar visitas às emergências, internações ou até mesmo institucionalizações de longa permanência. Objetivo: Identificar as intervenções não farmacológicas utilizadas por familiares cuidadores no manejo da agitação em idosos com demência. Métodos: Pesquisa qualitativa realizada com 11 familiares cuidadores de idosos em Minas Gerais, Brasil. Foram realizadas entrevistas com roteiro semiestruturado e, para a análise, foi empregada a técnica de análise de conteúdo. Resultados: As intervenções mais utilizadas foram: a conversa, a escuta, a distração, o uso de brinquedos, a música/canto e a leitura da Bíblia para acessar a espiritualidade/religiosidade. Verificou-se que, diante dos desafios impostos pela demência ao cuidado e dos desgastes físico e emocional experimentados, os familiares esforçaram-se para acolher e oferecer suporte humano ao idoso, além de sentirem-se satisfeitos por terem a oportunidade de retribuir o cuidado que receberam. Conclusão: Não há uma intervenção capaz de responder a todos os comportamentos agitados. A experiência e o vínculo desenvolvido entre familiares cuidadores e idosos ajudaram a guiar a escolha individual de intervenções não farmacológicas mais eficazes, provavelmente, por facultar certa antecipação das respostas dos idosos(AU)

Introducción: La agitación es un síntoma neuropsiquiátrico recurrente en ancianos con demencia. En el cotidiano del ambiente doméstico, esta condición impone a los familiares cuidadores el desafío de encontrar estrategias adecuadas de manejo a fin de evitar las visitas a emergencias, hospitalizaciones o incluso la institucionalización a largo plazo. Objetivo: Identificar las estrategias no farmacológicas utilizadas por los familiares cuidadores en el manejo de la agitación en ancianos con demencia. Métodos: Investigación cualitativa realizada con 11 familiares cuidadores de ancianos en Minas Gerais, Brasil. La recolección de datos fue realizada a través de entrevistas con guión semiestructurado. Para la interpretación de los datos se utilizó la técnica de análisis de contenido. Resultados: Se identificaron como estrategias más utilizadas para el manejo de la agitación: la conversación, la escucha, la distracción, el uso de juguetes, la música/canto y la lectura de la Biblia para acceder a la espiritualidad/religiosidad. Se verificó que, frente a los desafíos impuestos por la demencia al cuidado y el desgaste físico y emocional experimentado, los familiares cuidadores se esforzaron para acoger y brindar apoyo humano al familiar anciano, además de sentirse satisfechos por tener la oportunidad de retribuir el cuidado que recibieron. Conclusiones: No hay una intervención capaz de responder efectivamente a todos los comportamientos agitados. Sin embargo, la experiencia y el vínculo desarrollado entre familiares cuidadores y ancianos guiaron la elección individual de las intervenciones no farmacológicas más efectivas, probablemente al proporcionar cierta anticipación de las respuestas de los ancianos(AU)

Introduction: Agitation is a neuropsychiatric symptom recurrent in elderly people with dementia. In the daily life of the home setting, this condition imposes on the family caregivers the challenge of finding appropriate management strategies for avoiding visits to the emergency room, hospitalizations, or even long-term institutionalization. Objective: To identify the nonpharmacological strategies used by family caregivers in the management of agitation in elderly people with dementia. Methods: Qualitative research carried out with 11 family caregivers of elderly people in Minas Gerais, Brazil. The data collection was carried out through interviews with semi-structured repertory of quotations. The content analysis technique was used to interpret the data. Results: The most commonly used strategies for agitation management were identified. These were conversation, listening, distraction, use of toys, music/singing, and reading the Bible for accessing spirituality or religiosity. It was verified that, in the face of the challenges imposed by dementia onto the care and the physical and emotional outwearing experienced, family caregivers strived to welcome and provide human support to the elderly relative, in addition to feeling satisfied to have the opportunity to give back the care received Conclusions: There is no intervention capable of responding effectively to all agitation-related behaviors. However, the experience and the relationship developed between family caregivers and the elderly guided the individual choice for the most effective nonpharmacological interventions, probably by providing some anticipation to the elderly's responses(AU)

El envejecimiento desde la perspectiva del modelo conductual de Dorothy E. Johnson / Aging from the Behavioral Model Approach of Dorothy E. Johnson

RESUMEN Introducción: El envejecimiento poblacional es un aspecto a tener en cuenta a partir de las particularidades de la sociedad actual. Los servicios de salud deben prepararse para un aumento de pacientes ancianos, y el análisis multidisciplinar del fenómeno deviene en una necesidad de la enfermería como ciencia. Esta categoría es abordada por diferentes autores, por lo que se hace necesario un análisis valorativo de sus enfoques en el contexto internacional y nacional. Objetivo: Analizar el envejecimiento desde la perspectiva del modelo conductual de Dorothy E. Johnson, al considerar sus relaciones en las condiciones actuales de salud de una población vulnerable como el paciente anciano. Métodos: Se realizó una revisión bibliográfica sistemática para desarrollar un análisis crítico reflexivo del contenido de documentos, donde se consideraron artículos originales y de revisión. Las palabras clave utilizadas fueron "envejecimiento", "modelo conductual", "ancianos", "Teorías de Enfermería", identificadas a través de DECs o de MeSH. Los criterios de inclusión para la selección de los artículos fueron: Artículos en español disponibles en los portales de datos seleccionados que presentaban adherencia a la temática, publicados entre los años 2003 y 2016 que presentaran claramente el referencial teórico seleccionado. Conclusiones: La indagación sobre el envejecimiento y los sistemas conductuales permitió contextualizar este fenómeno desde la perspectiva de una teoría foránea. Muchos autores la abordan; no obstante, los problemas naturales que desafían la salud del paciente anciano en el contexto cubano condicionan la necesidad de promover la actualización del conocimiento en correspondencia con la situación internacional(AU)

ABSTRACT Introduction: Population aging is an aspect to take into account based on the particularities of today's society. Health services must prepare for an increase in elderly patients, and the multidisciplinary analysis of the phenomenon becomes a necessity for nursing as a science. This category is addressed by different authors, so it is necessary to evaluate their approaches in the international and national context. Objective: To analyze aging from the perspective of the behavioral model of Dorothy E. Johnson, considering its relationships in the current health conditions of a vulnerable population as the elderly patient. Methods: A systematic bibliographic review was carried out to develop a reflexive critical analysis of the content of documents, for which original and review articles were considered. The keywords used were envejecimiento [aging], modelo conductual [behavioral model], ancianos [elderlies], teorías de enfermería [nursing theories], identified in DECs or MeSH. The inclusion criteria for the selection of the articles were: articles in Spanish available in the web portals of selected data, presenting adherence to the topic, published between 2003 and 2016, and clearly treating the theoretical referential selected. Conclusions: The research on aging and behavioral systems allowed us to contextualize this phenomenon from the perspective of a foreign theory. Many authors approach it; nevertheless, the natural problems that challenge the health of the elderly patient in the Cuban context condition the need to promote the updating of knowledge in correspondence with the international situation(AU)

Efficacy of Cognitive Health Promotion Workbook for Community-Dwelling Elderlies with Mild Cognitive Impairment or Dementia Performed by Trained Dementia Partners

OBJECTIVE: The aim of this study is to assess the efficacy of cognitive health promotion workbook for community-dwelling elderlies with mild cognitive impairment and dementia performed by trained dementia partners. METHODS: The trained dementia partners performed cognitive training program with the workbook developed by Incheon Metropolitan Dementia Center to 36 participants with mild cognitive impairment or dementia at their home. The cognitive training program consisted of 60-minute sessions held twice weekly for 10 weeks. We evaluated their cognitive performances at baseline and after intervention. Pre- and post-intervention measures included Korean version of Mini-Mental Status Examination for Dementia Screening (MMSE-DS), Global Deterioration Scale, Korea Activities of Daily Living Scale, Korea Instrumental Activities of Daily Living Scale, Korean Version of Short Form Geriatric Depression Scale (SGDS-K) and Korean Quality of Life-Alzheimer's Disease (KQoL-AD). RESULTS: Participants showed significant improvements compared with their baseline in MMSE-DS (p=0.002), SGDS-K (p=0.001) and KQoL-AD (p<0.001). There were no significant differences of improvement between high cognitive function group (MMSE ≤20, n=16) and low cognitive function group (MMSE ≤20, n=20). CONCLUSION: These findings suggest that the cognitive training program with cognitive health promotion workbook can improve cognitive function, quality of life and depression for community-dwelling elderlies with mild cognitive impairment and dementia and it would be efficient that trained dementia partners perform the cognitive training program regularly at their home.

Utilization of inpatient health care and its influencing factors among elderlies in Shandong province / 中华医院管理杂志

Objective@#To investigate the utilization of inpatient health care among the elderlies in Shandong province, and to analyze the factors affecting the inpatient services utilization, so as to provide reference for the elderlies to utilize the inpatient services reasonably.@*Methods@#The survey was conducted in Shandong province in August 2017. Multi-stage stratified cluster random sampling method was used to select 7 070 residents aged 60 and above in 6 counties and districts of Shandong province as the objects of the survey. The survey included the basic family and personal information of the elderlies as well as the utilization of hospitalization services. Chi-square test and rank sum test were used for univariate analysis, and logistic regression was applied for influencing factors.@*Results@#The annual hospitalization rate of the elderlies in Shandong province was 18.1%, and 9.6% of those in need of hospitalization failed to enjoy the service. The annual hospitalization rate of the elderlies aged 80 years and over was 19.9%, and 5.5% of the patients in need had not been hospitalized. Among the inpatient institutions, the proportion of township health centers/community health service centers, county-level(district) medical institutions, prefecture-level medical institutions and provincial-level medical institutions was 29.2%, 29.1%, 37.7% and 1.4%, respectively.Factors influencing the utilization of hospitalization services for the elderlies included age, self-assessment of health, physical examination, chronic diseases, type of medical insurance and income level.@*Conclusions@#More attention should be paid to the hospitalization services for the elderlies aged 80 years and over. Effective measures should be taken to guide the elderlies to fully use primary medical resources. The prevention and control of chronic diseases should be strengthened to promote the rational use of inpatient health services among the elderlies. In addition, more attention should be paid to low-income elderlies to meet their hospitalization needs.

Investigation on service needs of the elderlies among different healthcare and elderly care modes in Hubei province / 中华医院管理杂志

Objective@#To understand the healthcare and elderly care needs of the elderlies.@*Methods@#From July to December 2018, a questionnaire survey was conducted to investigate the healthcare and elderly care status and characteristics of the elderly under different modes of combination of medical care and elderly care, and to analyze their objective needs for both cares.@*Results@#There was an outstanding need for daily life care for the elderlies in the healthcare plus elderly care mode. 71.8% of them were senior elderlies, and 61.1% had obvious disabilities. It was found that elderly-adaptive transformation was required for their living environment in the home care mode, as 41.7% of them live in elevator-free buildings, and 48.2% use squat-type toilets. The elderlies need in general cultural services, and widowhood and solitary living were common. The home care mode required disease prevention services, as 43.6% of them had weight problems, and smoking and drinking rates were very high(9.4%, 13.7%). The elderly care in medical mode required medical services, because the proportion of two or more chronic diseases was very high(27.2%).@*Conclusions@#The healthcare and elderly care modes vary in terms of needs, thus it is necessary to adapt to specific conditions.

Método Pilates na comunidade: efeito sobre a postura corporal de idosas / El método Pilates en la comunidad: el efecto sobre la postura corporal de ancianas / Pilates method in the community: effect on the body posture of elderly women

RESUMO O objetivo deste estudo foi verificar o efeito do método Pilates (MP) na postura de idosas em uma comunidade. Realizou-se um ensaio clínico controlado, não randomizado, em amostra de 40 idosas de idades entre 60 e 80 anos, divididas igualmente em Grupo Pilates (GP) e Grupo Controle (GC). Os grupos responderam questionário sociodemográfico e foram avaliados, em momentos pré e pós-intervenção, utilizando biofotogrametria, a partir do software SAPO. O GP executou um protocolo de 12 exercícios do MP, duas vezes por semana, durante 50 minutos, por 12 semanas. Realizou-se análise estatística não paramétrica aplicando-se o teste U Mann-Whitney com valor p<0,05 para significância. Os resultados obtidos mostraram que, na visão anterior, no momento antes da intervenção, a distância entre os acrômios, epicôndilos e processo estiloide foram menores no GC, em relação ao GP. Verificou-se que após a intervenção não houve diferença significativa entre os grupos. Na visão posterior observou-se diferença estatisticamente significativa nas variáveis: distância do ângulo superior (p=0,01) e inferior da escápula (p=0,02) do GP em relação ao GC. Concluiu-se que o MP promoveu efeito positivo em algumas variáveis do perfil postural de idosas, podendo ser empregado em grupos de práticas corporais comunitárias.

RESUMEN El objetivo de este estudio ha sido certificar el efecto del método Pilates (MP) en la postura de ancianas en una comunidad. Se ha realizado un ensayo clínico controlado, no aleatorizado, en muestra de 40 ancianas de edades entre 60 y 80 años, divididas igualmente en Grupo Pilates (GP) y Grupo control (GC). Los grupos han respondido cuestionario sociodemográfico y han sido evaluados, en momentos pre y pos intervención, utilizando bio fotogrametría, desde el programa SAPO. El GP ha ejecutado un protocolo de 12 ejercicios del MP, dos veces por semana, durante 50 minutos, por 12 semanas. Se ha realizado el análisis estadístico no paramétrico aplicándose la prueba U Mann-Whitney con valor p<0,05 para significancia. Los resultados que han sido obtenidos han mostrado que, en la visión anterior, en el momento antes de la intervención, la distancia entre los acromios, epicóndilos y proceso estiloide han sido menores en el GC, en relación al GP. Se ha certificado que después de la intervención no hubo diferencia significativa entre los grupos. En la visión posterior se ha observado la diferencia estadísticamente significativa en las variables: la distancia del ángulo superior (p=0,01) e inferior de la escápula (p=0,02) del GP en relación al GC. Se ha concluido que el MP ha promocionado efecto positivo en algunas variables del perfil postural de ancianas, pudiendo ser empleado en grupos de prácticas corporales comunitarias.

ABSTRACT This study aimed to verify the effect of the Pilates method (PM) on the body posture of elderly women in a community. A non-randomized controlled clinical trial was conducted in 40 elderly women aged between 60 and 80 years, divided equally into Intervention Group (IG) and Control Group (CG). The groups answered a sociodemographic questionnaire and were evaluated, in pre- and post-intervention moments, using biophotogrammetry, through the software SAPO. The IG performed a program of 12 Pilates exercises, twice a week, with duration of 50 minutes, for 12 weeks. A nonparametric statistical analysis was performed using Mann-Whitney test with significance value of p<0.05. The results showed before the intervention the distance between the acromions, epicondyles and styloid process were lower in the CG, in relation to the IG; however, after the intervention, no significant difference was observed between the groups. After the intervention, a statistically significant difference was observed in the variables: distance from the superior (p=0.01) and inferior angle of scapula (p=0.02) of the IG in relation to the CG. The conclusion was that Pilates promoted a positive effect on some variables of the postural profile of the elderly women, being suitable for community groups for practice of physical activities.

A cohort study on elderly individuals newly certified as requiring long-term care: comparison of rates of care-needs certifications between basic checklist respondents/specific health examinees and non-respondents/non-examinees of 37,000 elderlies in a city / Journal of Rural Medicine

Objective: The rates of care-needs certification were mainly compared between two cohorts: 7,820 specific health checkup examinees/basic checklist respondents and 29,234 non-examinees/non-respondents.Subjects and Methods: Among approximately 37,000 elderly citizens of X City, the number of individuals newly certified as requiring long-term care were observed from the date of the first specific health checkup in 2008 to March 31, 2013. The aggregated totals of these individuals and associated factors were evaluated.Results: 1. Support Required 1, Support Required 2, and Long-term Care Required (level 1) certified individuals accounted for approximately 80% of newly certified individuals aged 65–74 years. Newly certified individuals aged 75 years and over had similar results with 37.2% of them being certified Support Required 1, 19.4% certified Support Required 2, and 22.9% certified Long-term Care Required (level 1). 2. The primary factors for care-needs certification in individuals aged 65–74 years were arthritic disorder in 27.6%, falls and bone fractures in 11.3%, and malignant neoplasm and cerebrovascular disease, among others. This was similar for individuals aged 75 years or over. 3. Of the 7,820 specific health checkup examinees/basic checklist respondents, 1,280 were newly certified as requiring long-term care (16.4%) compared to 7,878 (26.9%) of the 29,234 non-examinees/non-respondents. Therefore, the latter cohort had a significantly higher rate of individuals who were newly certified as requiring long-term care.Conclusion: Both specific health checkups and basic checklists are effective health policies to protect frailty in community elderlies.

The relationship between the houseboundedness and frailty of community-dwelling elderly persons / Journal of Rural Medicine

This study aimed to verify whether the incidence of frailty in elderly individuals is higher among those who are housebound than those who are not. This study found no correlation between elderly people’s houseboundedeness and physical, mental, social, and overall frailty. However, the Tilburg Frailty Indicator (TFI) frailty score and grip strength value were higher in non-housebound elderly persons than in housebound elderly ones. This suggests that being housebound may lead to frailty. On the other hand, it is thought that individual interaction with family and friends, and lack of anxiety about falls correlates with the prevention of frailty in housebound elderly persons. The results of the study also suggest that the basic checklist may be effective for ascertaining the actual situation of housebound elderly people who may be manifesting frailty.

Establishing Reference Intervals for Complete Blood Cell Count in Healthy Korean Elderly Individuals

BACKGROUND: Different age groups may have different reference intervals. However, the currently used reference interval for complete blood count (CBC) in clinical laboratories is based on results from healthy adults between 20 and 50 years of age. In this study, we aimed to establish reference intervals for 16 CBC parameters in Korean healthy elderly individuals. METHODS: A total of 3,359 healthy adults were selected from 4,253 adults (aged ≥20 years) who underwent regular health check-ups, based on a medical examination by interview. The reference intervals for CBC in two groups (aged <60 and ≥60 years), and the partitioning of reference intervals between the two age groups were established. RESULTS: Most CBC parameters showed no significant differences in reference intervals between the two age groups. Among the men, platelet distribution width (PDW) was the only parameter that required a separate reference interval between the two age groups. Among the women, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and eosinophil % required separate reference intervals between the two age groups. CONCLUSIONS: The reference intervals for most CBC parameters were not significantly different between the two age groups. Except for PDW in men and MCV, MCHC, RDW, and eosinophil % in women, reference intervals for CBC parameters in individuals younger than 60 years of age could also be applied to those that are 60 years of age or older.

Opportunities and challenges for nurses in the face of elderly care with medical support / 中华医院管理杂志

The authors analyzed the opportunities and challenges faced by nurses in the time of elderly care with medical support using SWOT analysis, for the purpose of suggestions for the development of nurses to cope with such new scenario. Advantages of the nurses in such a time are as follows: professional nursing care, holistic care ability, and standardized assessment skill. Their disadvantages include: poor team leadership, insufficient business and management skills, and poor motivation for personal development. Their opportunities include: guidance of the national strategy, innovation of " Internet plus", and flexible working hours. Their challenges include: room of improvements for both quantity and quality of nursing personnel, better efficiency for integration and allocation of resources, and better capability to leverage" Smart elderly care". Four suggestions are raised in this regard, i. e., to strengthen the ability for elderly care with medical support, to improve multidisciplinary coordination, to cultivate their entrepreneurship, and to improving the ability of information application.

Development strategy of nursing assistants in the scenario of elderly care with medical support / 中华医院管理杂志

The huge shortage of nursing assistants in the industry, has made it imperative and feasible to build and develop a team of nursing assistants. This paper studied the present situation and problems of the nursing assistants in China, naming such setbacks as the personnel shortage, low competence, and poor professionalism. In comparison, overseas experiences in teambuilding were introduced with recommendations raised for China. These recommendations include higher social approval of elderly care industry, innovative development mechanism of nursing assistants, appraisal mechanism for nursing assistants performance, and better fund raising mechanisms for their incentives and training.

Survey and analysis on the demands and supply of the elderly care with medical support in Hangzhou / 中华医院管理杂志

Objective To understand the demands of elderlies in a community in Hangzhou for the elder care with medical support and the current supply, and analyze the influencing factors. Methods A questionnaire survey was conducted among 1 416 elderlies at 12 communities of 3 neighborhoods in Jianggan district of Hangzhou city, using stratification sampling. Results For the elderlies with demands for medical care, such services as medical advice in community, pharmacy in community and annual physical examination were made available and the highest satisfactions, being 70. 4%, 67. 1% and 64. 0% respectively. In contrary, less than 30% of the rest eight medical care demands were met. For the elderlies with demands for nursing care in community, supply of nine elderly care services fell below 30%. For the elderlies with demands for rehabilitation services, supply of six community rehabilitation services fell below 15%. Age, self-care ability and the number of chronic diseases were the main factors affecting old people′s demand for medical-nursing combined care(P ＜0. 05). Conclusions A gap is found between elderlies′demands for elderly care with medical support and the services available. Medical care, nursing care and rehabilitation service deserve further development efforts. Those of advanced age, with declining self-care ability, and those afflicted with many diseases should attract major attention.

Os públicos experientes que habitam o Sesc em São Paulo / The experienced publics that inhabit Sesc in São Paulo / Los públicos experimentados que habitan el Sesc en São Paulo

Neste artigo, a pesquisa O Trabalho Social com Idosos no Sesc - realização do Sesc São Paulo, em parceria com o Centro Brasileiro de Análise e Planejamento/CEBRAP - é o ponto de partida para identificação do público idoso que frequenta os Centros Culturais e Desportivos do Sesc no estado de São Paulo, considerando-se que pesquisas quantitativas e qualitativas oferecem referências importantes para as ações dos programas sociais e para refletir sobre a relevância dos trabalhos. Além do reconhecimento do Programa Trabalho Social com idosos, criado em 1963, o perfil socioeconômico, alguns estereótipos e as demandas sociais dos idosos fazem parte deste recorte que propõe reflexões preliminares com outras pesquisas que trazem informações sobre o cidadão idoso em Idosos no Brasil e a Pesquisa Hábitos Culturais dos Paulistas.

In this article the Trabalho Social com Idosos research - realization of the SESC São Paulo in partnership with the Centro Brasileiro de Análise e Planejamento/CEBRAP - is starting point for identification of elderly assisted by Sesc São Paulo, considering that quantitative and qualitative research provide important references for the actions of social programs and to reflect on the relevance of the action. Recognition of Trabalho Social com idosos, created in 1963, the socioeconomic profile , stereotypes and social demands of the elderly are part of this reflection proposes a dialogue with other important research that has the senior citizen as the center: Idosos no Brasil and Hábitos Culturais dos Paulistas.

En este artículo, la investigación El Trabajo Social con los ancianos en el Sesc -realización del Sesc São Paulo, en asociación con el Centro Brasileño de Análisis y Planificación / CEBRAP - es el punto de partida para la identificación del público anciano que frecuenta los Centros Culturales y, Deportivos del Sesc en el estado de São Paulo, considerando que investigaciones cuantitativas y cualitativas ofrecen referencias importantes para las acciones de los programas sociales y para reflexionar sobre la relevancia de los trabajos. Además del reconocimiento del Programa Trabajo Social con ancianos, creado en 1963, el perfil socioeconómico, algunos estereotipos y las demandas sociales de los ancianos forman parte de este recorte que propone reflexiones preliminares con otras investigaciones que traen informaciones sobre el ciudadano anciano en los ancianos en Brasil y la Búsqueda Hábitos Culturales de los Paulistas.