Caring for the Elderly Enhances Positive Attitudes Better Than Knowledge in Nursing Students.

Background and Objectives: There is a growing interest in the measurement of attitudes towards older people in healthcare professionals, as there is a need to implement interventions to improve ageist attitudes. A one group pretest-posttest study was carried out to explore the change in nursing student attitudes towards the elderly during their university careers. Materials and Method: A total of 97 nursing students were enrolled. Attitudes were analyzed using Kogan's Attitudes Toward Old People Scale. Results: The attitude was positive from the beginning of the study, with a score of 110.06 (12.92). No differences were observed after completing the subject "Care of the elderly" (106.21 (10.77)), though a significant increase was recorded after the completion of clinical placement (142.88 (12.64)), with a large effect size (η2p = 0.754). The score of the positive items was significantly increased, but not that of the negative items, as ageist attitude was not reduced. Conclusion: The current curricular design, that includes taking the theoretical course before clinical placement in the geriatric area, increases positive attitudes in nursing students but does not reduce ageist attitudes.

Interventions to improve attitudes toward older people in undergraduate health and social sciences students. A systematic review and meta-analysis.

OBJECTIVE: To determine which interventions are the most effective in improving attitudes toward older persons in undergraduate health and social sciences students. DESIGN: Systematic review and meta-analysis. DATA SOURCES: A literature search was made in PubMed, EBSCO and SCOPUS and additional records were identified by manual searching. The selection criteria were studies that evaluated an intervention designed to improve positive attitudes; studies in undergraduate health and social sciences students; and studies using direct instruments to measure attitudes. REVIEW METHODS: Two independent reviewers extracted study-level data from records using a common data collection spreadsheet. Two reviewers also assessed study quality by using the Cochrane Risk of Bias Tool. The primary outcome was the effect of an intervention upon attitudes toward older people, while the secondary outcome was the effect upon knowledge about aging and older people in those studies that had previously assessed subject attitude. The meta-analysis was carried out based on mixed statistical models. RESULTS: The search identified 53 eligible studies published during 1982-2020, comprising 35 pre-post studies and 18 randomized clinical trials, of which 14 were included in the meta-analysis. A strongly significant effect upon attitudes was observed for empathy-based interventions (differences of standardized mean differences (dSMD) = 1.26; 95%CI: 0.04-2.48; p = 0.04), knowledge + empathy-based interventions (dSMD = 0.22; 95%CI: 0.05-0.39; p = 0.01), and knowledge + clinical skills-based interventions (dSMD = 0.22; 95%CI: 0.01-0.43; p = 0.04). The overall effect was dSMD = 0.50; 95%CI: 0.01-0.43; p = 0.004. In addition, a positive effect in terms of increased knowledge about the older was observed after knowledge + empathy-based and knowledge + clinical skills-based interventions (dSMD = 0.24; 95%CI: 0.07-0.40; p = 0.005). CONCLUSIONS: Interventions to improve attitudes in health and social sciences students are effective, with those based on empathy having the greatest impact. Improving attitudes among future professionals could improve the management and quality of care of older people. More rigorous and better designed studies are recommended to determine the effect of the interventions. Registered on PROSPERO ID: CRD42021220677. TWITTABLE ABSTRACT: Ageism is present in healthcare settings. Empathy-based interventions are the most effective strategies in health and social sciences students.

Factors Affecting Attitudes towards Older People in Undergraduate Nursing Students.

BACKGROUND: The population of older people is increasing worldwide. The social and healthcare systems need many nurses to care for the elderly. Positive attitudes increase the preference to work with older people and improve the quality of care. This study describes attitudes towards the elderly in a sample of nursing students, and analyzes the potential factors influencing these attitudes. METHODS: A cross-sectional study was carried out in nursing students during the academic course 2017-2018. Kogan's Attitude Toward Old People Scale was used to assess student attitudes towards older people. RESULTS: The study included 377 undergraduate nursing students, of which 75.9% were women. The mean age was 22.23 (5.69) years. Attitude proved positive, with a mean Kogan's score of 131.04 (12.66). Women had higher scores than men, with a mean difference of 7.76 (95% CI: 4.87-10.66; p < 0.001). The male sex, age ≥ 25 years, and previous experience with institutionalized older adults worsened attitudes, while studying the subject of geriatrics, each higher course within the degree, work placements in hospitals and nursing homes, and previous experience with community older adults or with older relatives favored a more positive attitude. Participants with no interest in working with older adults yielded lower scores. CONCLUSIONS: Attitudes towards the elderly among nursing students are positive. Women have a more positive attitude. Analyzing the factors that improve attitudes in nursing students is suggested, as it may contribute to improve nursing care.

Improved Nutritional Knowledge in the Obese Adult Population Modifies Eating Habits and Serum and Anthropometric Markers.

Multicomponent lifestyle interventions achieve good results in the management of obesity among the adult population. However, their implementation in certain populations poses difficulties. A good level of nutritional knowledge enables people to make changes in their diet that improve their health. This study aims to assess the relationship between nutritional knowledge and nutritional parameters such as dietary intake, anthropometric parameters and biomarkers. A before-after, non-randomized interventional study involving a two-monthly nutritional educational intervention was carried out over 8 months. Anthropometric and biomarker data were collected, and nutritional knowledge was evaluated using the Bach questionnaire and food frequency questionnaire (FFQ). The study comprised 66 overweight and obese adults with mean age of 50.23 years. Females predominated (84.8%). At the end of the intervention, nutritional knowledge increased significantly, with a significant reduction in the consumption of sweets, soft drinks, high-fat products, and processed meats, and an increase in the intake of lean meat and poultry. A 3% decrease in body weight was observed. An intervention for the management of obesity in the adult population based on nutritional education achieves weight loss, modifications in eating habits and reduction of fat intake. Increased nutritional knowledge is associated with healthier eating habits and a decreased cardiovascular risk.

Identifying Predictors of the Visceral Fat Index in the Obese and Overweight Population to Manage Obesity: A Randomized Intervention Study.

INTRODUCTION: Nowadays, obesity is one of the main causes of death and disability. In recent years, it has been shown that the excess and distribution of body fat increases morbidity, with excess visceral fat being the most important factor that triggers pathologies. Thus, estimation of visceral fat makes it possible to identify patients with a higher cardiovascular risk, aiding the management of obesity. The main objective of the study was to identify predictors of the visceral fat index through a lifestyle intervention and to observe the effect of the intervention on dietary habits and functional capacity. METHODS: A randomized intervention, parallel-group study was made. This study included 97 obese and overweight people (control group, n = 48; experimental group, n = 49) with a low socioeconomic status in an 8-month lifestyle intervention. Anthropometric, fitness and nutritional tests were assessed. RESULTS: It was found that being female, eating the recommended daily portions of fruit, gaining strength in the legs and gaining flexibility are factors predictive of a lower visceral fat index. Age over 45 years and eating the recommended weekly portions of cereals and meats, fat and processed meats increases the visceral fat index after a lifestyle intervention. There were changes in the visceral fat index and in the different physical condition variables, but not in eating habits. CONCLUSION: A multicomponent lifestyle intervention reduces the visceral fat index; age over 45 and consuming cereals and meat increases the visceral fat index.

Nutritional Status and Risk Factors for Frailty in Community-Dwelling Older People: A Cross-Sectional Study.

OBJECTIVE: This study aims to assess the relationship that frailty has with nutritional status and functional risk factors in community-dwelling older adults. METHODS: Cross-sectional study in community-dwelling older people, independent for walking and without impaired cognition. Frailty was assessed by Fried criteria. Nutritional status was analyzed by the Mini Nutritional Assessment Short Form (MNA-SF), biochemical markers (albumin, total proteins, cholesterol, lymphocytes, and hemoglobin); and anthropometric parameters (body mass index [BMI], body fat percentage, handgrip, and perimeters). A comprehensive geriatric assessment analyzed other risk factors: functionality, cognition, falls, comorbidity, polypharmacy, physical activity, and quality of life (QoL). RESULTS: We included 564 elderly people with a mean age of 76.05 (standard deviation 3.97) years; 63.1% (n = 356) were women, and 83.9% (n = 473) were prefrail, and frail. The sample presented high functionality and a nutritional status with a predominance of overweight and obesity. Factors associated with frailty (R2 = 0.43) were age over 75 years (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.76, 6.21; p < 0.001), female gender (OR 2.37, 95% CI 1.24, 4.52; p = 0.009), anemia (OR 2.45, 95% CI 1.19, 5.02; p = 0.015), falls (OR 1.94, 95% CI 1.12, 3.25; p = 0.016) and the fear of falling (OR 4.01: 95% CI 1.76, 9.16; p = 0.001). Performing more than 3 weekly hours of physical activity was found to be a protective factor (OR 0.23, 95% CI 0.15, 0.35; p < 0.001). CONCLUSIONS: The relationship between frailty and malnutrition in functionally independent community-dwelling older people is unclear. More studies are needed to know what nutritional markers are related to frailty, cognition, and functionality in order to discriminate the risk factors for community-dwelling older people at risk of malnutrition and dependency.

Effectiveness of a self-myofascial conditioning programme on pain, depression, anxiety and sleep quality in people with Fibromyalgia / Efectividad de un programa de autoacondicionamiento miofascial sobre el dolor, la depresión, la ansiedad y la calidad del sueño en personas con fibromialgias / Efetividade de um programa de auto-condicionamento miofascial na dor, depressão, ansiedade e qualidade do sono em pessoas com fibromialgia

Self-myofascial release can facilitate the diminution or disappearance of the intense pain perceived by the nerve endings located in the myofascial tissue. According to some researchers, fibromyalgia (FM) can be directly related to the "central sensitization" theory. The present study aims to determine the effectiveness of the application of a self-myofascial conditioning programme on pain, depression, anxiety, and quality of sleep in people diagnosed with Fibromyalgia (FM). The sample was randomly assigned to intervention (n = 33) and control groups (n = 33). Subjects in the intervention group took part in a self-myofascial conditioning programme, which consisted of 40 sessions of 50 minutes each. Pre and post-intervention measurements were taken. Results were obtained by a 2x2 ANOVA for repeated measures with two factors (time and group). Results show that, after completing the programme, subjects in the intervention group had seen a significant decrease in general pain (p < 0,01), level of depression (p < 0,05), state (p < 0,01) and trait anxiety (p < 0,01), as well as three subscales related to the quality of sleep, such as "sleep subjective quality" (p < 0,05), "habitual sleep efficiency" (p < 0,05) and "daily dysfunction" (p < 0,001). These results indicate that participating in a self-myofascial conditioning programme regularly and under the control of a physical education and sport professional can affect patients with FM positively both physically and psychologically

La autoliberación miofascial puede facilitar la disminución o desaparición del dolor intenso percibido por las terminaciones nerviosas localizadas en el tejido miofascial. Según algunos investigadores, la fibromialgia (FM) puede estar directamente relacionado con la teoría de la "sensibilización central". El presente estudio tiene como objetivo determinar la efectividad de la aplicación de un programa de autoacondicionamiento miofascial sobre el dolor, la depresión, la ansiedad y la calidad del sueño en personas diagnosticadas con fibromialgia (FM). La muestra se asignó al azar a los grupos de intervención (n =33) y control (n =33). Los sujetos del grupo intervención participaron en un programa de autoacondicionamiento miofascial compuesto por un total de 40 sesiones de 50 minutos cada una de ellas. Se tomaron medidas pre y post intervención. Los resultados se obtuvieron mediante un ANOVA 2x2 de medidas repetidas con dos factores (tiempo y grupo). Los resultados muestran que, después de completar el programa, los sujetos del grupo intervención obtuvieron una disminución significativa en el dolor general (p <0,01), el nivel de depresión (p <0,05), la ansiedad-estado (p <0,01) y rasgo (p <0,01), así como en tres subescalas relacionadas con la calidad del sueño, como son la "calidad subjetiva del sueño" (p <0,05), la "eficiencia habitual del sueño" (p <0,05) y la "disfunción diaria "(p <0,001). Estos resultados indican que participar en un programa de autoacondicionamiento miofascial regularmente, bajo el control de un profesional de educación física y deporte, puede afectar positivamente a los pacientes con FM tanto física como psicológicamente

A auto-liberação miofascial pode facilitar a diminuição ou o desaparecimento da dor intensa percebida pelas terminações nervosas localizadas no tecido miofascial. Segundo alguns pesquisadores, a fibromialgia (FM) pode estar diretamente relacionada à teoria da "sensibilização central". O presente estudo tem como objetivo determinar a eficácia da aplicação de um programa de auto-condicionamento miofascial na dor, depressão, ansiedade e qualidade do sono em pessoas diagnosticadas com fibromialgia (FM). A amostra foi randomizada para os grupos intervenção (n =33) e controle (n =33). Os sujeitos do grupo de intervenção participaram de um programa de auto- condicionamento miofascial composto por um total de 40 sessões de 50 minutos cada. Medidas de intervenção pré e pós foram tomadas. Os resultados foram obtidos por meio de uma ANOVA 2x2 de medidas repetidas com dois fatores (tempo e grupo). Os resultados mostram que, após o término do programa, os sujeitos do grupo de intervenção obtiveram uma diminuição significativa na dor geral (p <0,01), o nível de depressão (p <0,05), estado de ansiedade (p < 0,01) e traço (p <0,01), assim como em três subescalas relacionadas à qualidade do sono, como a "qualidade subjetiva do sono" (p <0,05), a "eficiência habitual do sono" (p <0,05) e "disfunção diária" (p <0,001). Esses resultados indicam que participar de um programa de auto-condicionamento miofascial regularmente, sob o controle de um profissional de educação física e esportes, pode afetar positivamente os pacientes com FM fisicamente e psicologicamente