Sleep Quality in Older People: The Impact of Age, Professional Activity, Financial Situation, and Chronic Diseases During the SARS-CoV-2 Pandemic.

BACKGROUND The SARS-CoV-2 pandemic negatively affected health and social life, notably deteriorating sleep quality in older adults. Studies report inconsistent findings on sleep disturbances during this period, influenced by various physiological, emotional, and sociodemographic factors. This study aimed to identify these determining factors. MATERIAL AND METHODS The study was conducted among 342 people 60 years of age or older participating in online classes of randomly selected Senior Clubs and the University of the Third Age in the southern regions of Poland. RESULTS Sleep problems (PSQI >5 points) were diagnosed in 250 subjects (83.6%). Logistic regression analysis showed that the quality of sleep significantly depends on: age, as people aged 66-70 were more likely to have better sleep quality than people aged 60-65 (OR=3.07), and those over 70 scored better than people aged 60-65 (OR=2.87); current job - employed people have a better chance of better sleep quality (OR=3.08) than unemployed people; financial situation, people assessing their financial situation as very good/good had a better chance of better sleep quality (OR=2.00) compared to people assessing their financial situation as very bad, bad/average; chronic diseases, people without chronic diseases had a chance of better sleep quality (OR=2.45) than people with chronic diseases. CONCLUSIONS Age, financial situation, current job, and chronic disease were the most important factors determining sleep quality in older people. The identification of factors affecting sleep quality can be used as important data to develop interventions and programs to improve sleep quality.

Factors Correlating with Functional Capacity in Older People with Chronic Pain.

INTRODUCTION: Chronic pain in older people is a global health problem not only in terms of a negative subjective feeling, but also as a social and economic factor. Deterioration of functional capacity is one of the main symptoms of chronic pain; therefore, it should be assessed as a basic parameter in the life of older people. The aim of the study was to analyze the factors which have an impact on the functional capacity of older people with chronic pain. MATERIAL AND METHODS: The study was conducted among 181 people over 65 suffering from chronic pain lasting more than 6 months. The study used a questionnaire that included questions about demographic and social characteristics and the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Pain Measure-24 (GPM-24). RESULTS: In the study group, a positive correlation was found between: coexisting diseases and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A positive correlation was also found between the Geriatric Depression Scale (GDS) and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A significantly negative correlation was found between: AMTS, ADL, IADL performance and: withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of total GPM-24 score. CONCLUSIONS: Chronic pain is more common in people with disabilities in basic and complex activities of daily living, with limited efficiency in cognitive functions and an increased sense of depression. The standard in everyday practice and clinical trials should be taking a history of chronic pain in every older person, monitoring the pain's intensity and accompanying characteristics by using a multidimensional scale for assessing pain in older people.

Education and attitudes toward geriatric care: Impact for nursing graduates and their career decisions - study protocol.

The demanding and challenging nature of care for geriatric patients requires appropriate preparation of health care professionals. However, the willingness of nursing students to work in geriatric nursing care is mostly at a low level. The EAging_C project has been developed to investigate the relationship between nursing teachers' and students' attitudes towards older people and its impact on career decisions regarding working in a geriatric setting. This study uses an explanatory sequential mixed-method. The study has been conducted in a Polish academic setting in teams of geriatric nursing practical training teachers and their students. Quantitative and qualitative data have been collected in three stages. Kogan's Attitudes Towards Older People questionnaire has been used to collect quantitative data among teachers and students. By developing two questionnaires for the semi-structured interviews (one for students and one for teachers) qualitative data was collected that deepened the quantitative data collected. The investigation conducted in this project allows us to provide an insight into the issue of the unwillingness to work in a geriatric setting by nursing graduates. Based on the identified variables that are crucial to promoting work with older people, further research can be carried out based on testing the intervention.

Implications of the Metabolic Control of Diabetes in Patients with Frailty Syndrome.

Introduction: Frailty syndrome occurs more frequently in patients with diabetes than in the general population. The reasons for this more frequent occurrence and the interdependence of the two conditions are not well understood. To date, there is no fully effective method for the diagnosis, prevention, and monitoring of frailty syndrome. This study aimed to assess the degree of metabolic control of diabetes in patients with frailty syndrome and to determine the impact of frailty on the course of diabetes using a retrospective analysis. Materials and Methods: A total of 103 individuals aged 60+ with diabetes were studied. The study population included 65 women (63.1%) and 38 men (36.9%). The mean age was 72.96 years (SD 7.55). The study was conducted in the practice of a general practitioner in Wielkopolska in 2018−2019. The research instrument was the authors' original medical history questionnaire. The questions of the questionnaire were related to age, education, and sociodemographic situation of the respondents, as well as their dietary habits, health status, and use of stimulants. Other instruments used were: the Mini-Mental State Examination (MMSE), Lawton Scale (IADL­Instrumental Activities of Daily Living), Katz Scale (ADL­Activities of Daily Living), Geriatric Depression Rating Scale (GDS), and SHARE-FI scale (Survey of Health, Aging, and Retirement in Europe). Anthropometric and biochemical tests were performed. Results: In the study, frailty syndrome was diagnosed using the SHARE-FI scale in 26 individuals (25%): 32 (31.1%) were pre-frailty and 45 (43.7%) represented a non-frailty group. Statistical analysis revealed that elevated HbA1c levels were associated with a statistically significant risk of developing frailty syndrome (p = 0.048). In addition, the co-occurrence of diabetes and frailty syndrome was found to be a risk factor for loss of functional capacity or limitation in older adults (p = 0.00) and was associated with the risk of developing depression (p < 0.001) and cognitive impairment (p < 0.001). Conclusions: Concerning metabolic control of diabetes, higher HbA1c levels in the elderly are a predictive factor for the development of frailty syndrome. No statistical significance was found for the other parameters of metabolic control in diabetes. People with frailty syndrome scored significantly higher on the Geriatric Depression Rating Scale and lower on the MMSE cognitive rating scale than the comparison group. This suggests that frailty is a predictive factor for depression and cognitive impairment. Patients with frailty and diabetes have significantly lower scores on the Basic Activities of Daily Living Rating Scale and the Complex Activities of Daily Living Rating Scale, which are associated with loss or limitation of functioning. Frailty syndrome is a predictive factor for loss of functional capacity in the elderly.

Narrative in Older People Care-Concepts and Issues in Patients with Dementia.

Medical sciences in their classic approach focus on objectively measured dimensions of human functioning and its disorders. Therefore, they are often far removed from the unique identity, experiences and needs of older people. The solution to this type of focusing on the biological, psychological or social dimension of the life of older people may be the inclusion of the narrative in the daily practice of medical care. Narrative medicine supports the development of a holistic approach to care that allows older people to present their own life story, which helps to recognize their uniqueness and to show a genuine interest in the narrative. Attention is increasingly drawn to the fact that the narrative of older people should be recognized and taken into account when planning and providing care in institutions, including long-term care facilities (LTCFs). Despite the fact that LTCFs are often attended by people with multiple diseases and with cognitive impairment, the recognition, respect and maintenance of personal identity should constitute the foundation of caring activities. The basic premise of narration is the recognition that the development of identity does not stop at any age but continues throughout life, and that narrative is an important form of self-expression. The aim of this paper is to present selected issues related to the practice of narrative medicine in caring for older people.

Socio-Demographic, Clinical and Psychological Profile of Frailty Patients Living in the Home Environment and Nursing Homes: A Cross-Sectional Study.

Introduction: Frailty syndrome, as a physiological syndrome, is characterized by a gradual decline in physiological reserve and a lowered resistance to stress-inducing factors, leading to an increased risk of adverse outcomes. It is significantly connected with dependence on care and frequent hospitalizations. Objectives: The aim of the study was to describe socio-demographic, clinical and psychological profile of frailty older adults living in their own homes and to nursing homes. Methods: The study was conducted with 180 patients who were over 60 years of age, the mean (±SD) was 74.1 (±8.8) years. Among the subjects, 90 individuals were community-dwelling older adults. The survey used a list of socio-demographic questions, as well as the following scales: Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), SHARE-FI, and The World Health Organization Quality of Life (WHOQOL-Bref). Results: Pre-frailty was confirmed in 49 (27.2%) patients, and frailty syndrome was noticed in 47 patients (26.1%). The prevalence of frailty syndrome in the study group was related to: place of living (p < 0.001), age (p < 0.001), widowhood (p < 0.001), a poor economic situation (p < 0.001), basic education level (p < 0.001), living alone (p < 0.001), longer duration of illness (p < 0.001), comorbidities (p < 0.001), more medications taken (p < 0.001), deterioration of hearing (p = 0.003), impairment of cognitive functions (p < 0.001), depression (p < 0.001), and decreased quality of life (p < 0.001). Discussion: A lot of socio-demographic and medical factors, particularly cognitive and mental functioning were connected with the prevalence and progression of frailty syndrome in the study group. Quality of life was significantly dependent on the presence of frailty syndrome, both in homes and in nursing homes.

Analysis of the Interventions of Medical Emergency Teams in Older Patients in Selected Polish Cities with County Status: A Retrospective Cohort Study.

INTRODUCTION: Geriatric patients account for a large proportion of interventions of medical emergency teams (METs). The aim of this study was to analyse medical emergency interventions in the Biala Podlaska and Chelm (Poland) between 2016 and 2018 in a group of patients ≥ 65 years of age. MATERIALS AND METHODS: We analysed medical records of 1200 older patients treated by METs in Biala Podlaska and Chelm (Lublin Province, Poland). The research was conducted from June 2019 to March 2020 at the Emergency Medical Service Station in Biala Podlaska and the Medical Rescue Station in Chelm (Independent Public Complex of Health Care Facilities). RESULTS: A total of 92.5% of medical emergency service interventions took place at the patient's home. The mean time of stay at the scene was 20 min. The highest number of interventions occurred between 8:00 p.m. and 8:59 p.m. There were no statistically significant differences in the type of ambulance used depending on the patient's sex, while there was a statistically significant relationship between priority code and sex. Cardiovascular diseases were diagnosed in 40% of patients, and the symptoms were not precisely classified in almost the same percentage of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the hospital emergency department in 69.1% of cases. CONCLUSIONS: METs were called for a variety of diseases due to the fact that geriatric patients are not able to distinguish a life-threatening condition. Medical procedures performed by METs from Biala Podlaska and Chelm were closely related to the initial diagnoses made by these teams. It was irrelevant whether a specialist or non-specialist medical emergency service was used. Paramedics are very well trained to practice their profession and are able to provide treatment to older patients in a state of sudden life threat.

Assessment of Functional Status and Quality of Life of Elderly Patients Undergoing Radiotherapy and Radiotherapy Combined with Chemotherapy - A Cross-Sectional Study.

BACKGROUND: Aging is associated with various diseases, a plethora of which are oncological. Selected treatment methods influence the performance status and the adaptability to changing circumstances. OBJECTIVE: The aim of the study was to assess the functional status, quality of life, and adaptation to disease of elderly patients who underwent only radiotherapy or chemotherapy combined with radiotherapy. PATIENTS AND METHODS: The cross-sectional study was conducted in a sample of 76 patients diagnosed with cancer, over 60 years of age (mean 69.3/SD 6.8) who were hospitalized in the Radiotherapy Department at the Ludwik Rydygier Hospital in Krakow. Standardized research tools were: Functional Assessment of Chronic Illness Therapy (FACIT-F), Mental Adjustment to Cancer Scale (Mini-MAC), Lawton Instrumental Activity of Daily Living (IADL), Yesavage Geriatric Depression Scale (GDS), an assessment scale of the post radiation reaction devised by Eastern Cooperative Oncology Group (ECOG). RESULTS: Most (n=37) patients were treated with a combination of radiotherapy and chemotherapy (48.6%), whereas 21 patients underwent only radiotherapy (27.6%). More than half of the respondents were male (68.4%, n = 52), whereas 24 (31.6%) were female. The assessment of the participants' performance status yielded results indicating an average level of all domains. Men performed better in terms of physical condition compared to a group of women (p=0.010). Women experienced fatigue more frequently than men (p=0.012). Patients who had received radiation therapy combined with chemotherapy achieved on average better results in functional well-being (FWB) than the patients who had undergone radiotherapy only (p=0.046). Depression had a significant impact on all spheres of functioning (p<0.001) except social/family well-being. CONCLUSION: The results pointed to the essential elements that should be taken into consideration in relation to treatment planning and providing care. Particular attention should be paid to women who suffered from depression and negative adaptation strategies that directly affect their functioning.

Sociodemographic Factors Affecting Older People's Care Dependency in Their Daily Living Environment According to Care Dependency Scale (CDS).

The aim of the research was to determine the influence of sociodemographic factors on older people's care dependency in their living environment according to the Care Dependency Scale (CDS). Methods: The research was conducted in a group of 151 older people staying in their own homes. The methods applied in the research included a sociodemographic questionnaire and scales including the Abbreviated Mental Test Score (AMTS), CDS, Katz Index of Independence in Activities of Daily Living (ADL), Lawton's Instrumental Activities of Daily Living (I-ADL), Mini Nutritional Assessment (MNA), and Geriatric Depression Scale (GDS). Results: Gender had a significant impact on the level of care dependency. The surveyed females obtained the medium or high level of dependency more often than males (22.4% vs. 6.1%), and the low level of dependency was significantly more frequent among men than women (p = 0.006). Moreover, the age of the respondents determined their level of care dependency. The subjects with a medium or high level of care dependency were significantly older (p = 0.001). The subjects with a low level of care dependency were more likely to be married than people with a medium/high level (p < 0.001). The level of education had a significant impact on care dependency. A higher level of education correlated with a medium/high level of dependency (p = 0.003). Conclusions: The survey results confirmed that sociodemographic factors have a significant impact on the level of care dependency. When planning care in the home environment, special attention should be paid to older women, who are more likely to lose their independence than men. These women should be given additional support.

Stress and Coping Strategies of Nurses Working with Patients Infected with and Not Infected with SARS-CoV-2 Virus.

INTRODUCTION: Working during the COVID-19 pandemic is a particular challenge for nurses because, while performing their daily routines, they are exposed to physical and social consequences of the SARS-CoV-2 virus, which is accompanied by intensified stress. The aim of this study was to assess the intensity of stress and coping strategies applied by nurses working with both infected and non-infected patients with SARS-CoV-2 virus during the COVID-19 pandemic. MATERIALS AND METHODS: The study was conducted between January and March 2021. Due to the epidemiological situation, the questionnaire was posted on Facebook in nurses' groups and sent out via the "Messenger" and "WhatsApp" applications. Stress intensity was assessed by means of the Perceived Stress Scale (PSS-10), whereas coping strategies were assessed using the Mini-COPE stress coping inventory. RESULTS: Among 151 surveyed nurses, more than half (52.3%) worked with infected patients and the remaining ones (47.7%) worked with non-infected patients. The level of stress perceived by nurses working with infected patients was higher than among nurses working with patients without SARS-CoV-2 infection (22.22 ± 5.94 vs. 20.21 ± 5.68, p = 0.03). The nurses working with infected patients were most likely to choose coping strategies focused on the problem (2.00 ± 0.62) and emotions (2.01 ± 0.69), whereas those working with non-infected patients usually chose strategies focused only on the problem (2.11 ± 0.58). CONCLUSIONS: During the COVID-19 pandemic, nurses working with SARS-CoV-2 patients experienced more intense stress than those working with non-infected patients. Nurses working with SARS-CoV-2 patients tended to cope with stress using strategies focused on the problem and on emotions, while those working with non-infected patients were more likely to choose strategies focused only on the problem.

Analysis of Medical Management in Geriatric Patients in the Hospital Emergency Department by Example of Selected Cities with County Status in Poland: A Retrospective Cohort Study.

The aim of this study was to analyse medical management in geriatric patients in the Hospital Emergency Departments in the Biala Podlaska County and Chelm County (Poland) between 2016 and 2018 in a group of patients ≥65 years of age. We analysed medical records of 829 patients transported to Hospital Emergency Departments by Medical Emergency Teams. The research was conducted in the period from June 2019 to March 2020. We analysed emergency medical procedure forms and medical records of patients transported to the hospitals. Cardiovascular diseases were diagnosed in 40% of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the Hospital Emergency Departments in more than 2/3 of cases. The concordance between the diagnoses made by the Medical Emergency Teams and those made at the Hospital Emergency Departments was confirmed for 78% patients admitted to the department (n = 647), whereas the concordance of classification at the group level was estimated at 71.7% (n = 594). Further in-patient treatment was initiated in some of the patients admitted to the department (n = 385). The mean time of hospital stay was 10.1 days. In conclusion, differences between the initial diagnosis made by the heads of the Medical Emergency Teams and the diagnosis made by the doctor on duty in the Hospital Emergency Departments depended on the chapter of diseases in the ICD-10 classification, but they were acceptable. The majority of the patients were transported to Hospital Emergency Departments. The most common groups of diseases that require Hospital Emergency Departments admission include cardiovascular diseases, injuries due to external causes, and respiratory diseases. A moderate percentage of patients were qualified for further specialist treatment in hospital departments.

Assessment of the relationship between frailty syndrome and the nutritional status of older patients.

Objective: The aim of this study was to assess the relationship between frailty syndrome and the nutritional status of older patients. Material and methods: This cross-sectional study was conducted in a sample of 120 patients hospitalized at the Geriatric Clinic between January 2017 and May 2017. The research tools were the Frailty Instrument of the Survey of Health, Ageing and Retirement in Europe (SHARE-FI), including relevant anthropometric measurements and muscle strength measurement, and the Mini Nutritional Assessment (MNA). All the calculations were performed using the Statistica 10.0 program. The p-values lower than 0.05 were considered as statistically significant. Results: The mean age of the participants was 71 years (SD=9.03). Most participants were from urban areas. More than half of the participants (53.3%) were women. Based on the SHARE-FI, the frailty syndrome was found in 33.3% of the participants. The mean value in the MNA scale was 24.4 points (SD=3.4). The frailty syndrome was significantly correlated to gender (p<0.025), financial status (p=0.036) and MNA (p<0.01) score. A statistically significant difference was observed between gender (p=0.026), financial status (p=0.016), place of living (p=0.046) and MNA score. Conclusion: This study confirmed significant correlations between the frailty syndrome and the nutritional status of older adults. In terms of prevention and clinical application, it seems important to control the nutritional status of older people and the frailty syndrome. The above-mentioned scales should be used to evaluate patients, analyze the risk and plan the intervention for that group of patients.

Utility of the Care Dependency Scale in predicting care needs and health risks of elderly patients admitted to a geriatric unit: a cross-sectional study of 200 consecutive patients.

OBJECTIVE: The aim of the study was to evaluate the usefulness of the Polish version of the Care Dependency Scale (CDS) in predicting care needs and health risks of elderly patients admitted to a geriatric unit. METHODS: This was a cross-sectional study of 200 geriatric patients aged ≥60 years, chronologically admitted to a geriatrics unit in Poland. The study was carried out using the Polish version of the CDS questionnaire to evaluate biopsychosocial needs and the level of care dependency. RESULTS: The mean age of the participating geriatric patients was 81.8±6.6. The mean result of the sum of the CDS index for all the participants was 55.3±15.1. Detailed analysis of the results of evaluation of the respondents' functional condition showed statistically significant differences in the levels of care dependency. Evaluation of the patients' physical performance in terms of the ability to do basic activities of daily living (ADL) and instrumental ADL (I-ADL) showed statistically significant differences between the levels of care dependency. Patients with high dependency were more often prone to pressure ulcers - 13.1±3.3, falls (87.2%), poorer emotional state - 6.9±3.6, mental function - 5.1±2.8, and more often problems with locomotion, vision, and hearing. The results showed that locomotive disability, depression, advanced age, and problem with vision and hearing are connected with increasing care dependency. CONCLUSION: CDS evaluation of each admitted geriatric patient enables us to predict the care needs and health risks that need to be reduced and the disease states to be improved. CDS evaluation should be accompanied by the use of other instruments and assessments to evaluate pressure ulcer risk, fall risk, and actions toward the improvement of subjective well-being, as well as correction of vision and hearing problems where possible and assistive devices for locomotion.

Quality of life of women with breast cancer undergoing radiotherapy using the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire.

OBJECTIVE: Breast cancer is one of the most common cancers in women, particularly among older women. This illness along with its treatment has a great impact on a woman's subjective opinion of her quality of life and functioning in everyday life. The aim of this research was to assess the quality of life in women undergoing radiotherapy for the treatment of breast cancer. PATIENTS AND METHODS: The research was carried out in 120 patients with breast cancer undergoing radiotherapy in the Oncological Center in Bydgoszcz, Poland. Among the 120 examined patients, there were 30 women aged between 20-50 years and the remaining were over 50 years of age, including 42 women over the age of 60. Demographic and clinical data were collected and the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire (version 4) was used to assess health-related quality of life (HRQOL) of the patients. Statistical analyses were conducted using Statistica, version 10.0. RESULTS: Patients with breast cancer undergoing radiotherapy rated their quality of life with an average of 113.83 points. Older patients above 71 years of age also displayed significantly higher HRQOL (122.70 points). A lower level of fatigue was noticed among patients ≤50 years and ≥71 years of age. Education and marital status also had an important impact on HRQOL. Educated women with a good financial situation had a significantly higher HRQOL, compared to those with a lower education and in poor living conditions. CONCLUSION: HRQOL and state of fatigue in breast cancer patients treated with radiotherapy depended upon their age. Both were high among women aged 71 years and above, while younger patients (51-70 years of age) had slightly lower values. Results suggest that sociodemographic factors influence the conditions of life of women treated with radiotherapy for breast cancer in a significant way. Overall, patients tolerated this type of treatment well.

Decreased expression of heme oxygenase is associated with depressive symptoms and may contribute to depressive and hypertensive comorbidity.

BACKGROUND: There is strong evidence that hypertension and depression are comorbid and oxidative stress is implicated in both pathologies. We aimed to elucidate the relationship between biochemical markers of the antioxidant-pro-oxidant equilibrium and depression in hypertension. METHODS: Blood was collected from patients diagnosed with depression, hypertension, or comorbid depression and hypertension and healthy age- and sex-matched controls. Whole blood reduced glutathione, erythrocyte superoxide dismutase (SOD-1), glutathione peroxidase (GPx-1), glutathione reductase (GR), malondialdehyde (MDA), and plasma hydrogen peroxide (H2O2) were assayed using spectrophotometry, and heme oxygenase (HO-1) levels were determined immunoenzymatically. RESULTS: Both hypertension and depression were associated with altered antioxidant-pro-oxidant profiles. Decreased GPx-1 and SOD-1 activities, increased GR activity, increased levels of GSH, and increased concentrations of MDA and H2O2 were observed in patients compared to controls. Inducible HO-1 was specifically decreased in patients with depression and was significantly associated with both the prevalence and severity of depressive symptoms. CONCLUSIONS: Heme oxygenase is a biological factor that might explain the relationship between inflammation, oxidative stress, and the biological and functional changes in brain activity in depression. HO-1 is a candidate depression biomarker and provides an avenue for novel preventative and diagnostic strategies against this disease.

Antioxidant effect of immediate- versus sustained-release melatonin in type 2 diabetes mellitus and healthy controls.

Oxidative damage has been suggested as the primary cause of aging and age-associated diseases including type 2-dependent diabetes mellitus (T2DM) and therefore there is a growing interest in exploring therapeutic potential of antioxidant agents including melatonin. In the present study, we analyzed red blood cell antioxidants and lipid peroxidation after 5 mg/daily immediate-release melatonin treatment of elderly T2DM patients and healthy elderly subjects in comparison with 2 mg/daily sustained-release melatonin treatment of elderly T2DM patients and healthy elderly subjects, to determine the antioxidant effect of different doses and formulations of melatonin in these groups. Our study revealed that there was no significant difference in antioxidant status of red blood cells measured by glutathione concentration and activities of GPx-1, CAT, GR, SOD-1 and MDA levels, after supplementation with 2 mg-sustained release melatonin or with 5 mg-immediate release melatonin, either in T2DM or in healthy elderly subjects. These results suggest that both preparations may exert similar therapeutic effect related to melatonin's action on antioxidant defense system.

Health related quality of life and care dependency among elderly hospital patients: an international comparison.

Many countries in Europe and the world have to cope with an aging population. Although health policy in many countries aims at increasing disability-free life expectancy, elderly patients represent a significant proportion of all patients admitted to different hospital departments. The aim of the research was to investigate the relationship between health-related quality of life (HRQOL) and the care dependency status among elderly hospital patients. In 2012, a descriptive survey was administered to a convenience sample of 325 elderly hospital patients (> 60 years) from The Netherlands (N = 125), from Poland (N = 100), and from Turkey (N = 100). We employed the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System and the Care Dependency Scale. FACIT is a collection of HRQOL questionnaires that assess multidimensional health status in people with various chronic illnesses. From demographic variables, gender (female) (r = -0.13, p < 0.05), age and informal care given by family members (r = -0.27 to 0.27, p < 0.01) were significantly correlated with the care dependency status for the whole samples. All HRQOL variables, hearing aid and duration of illness correlated with care dependency status (r = -0.20 to 0.50, p < 0.01). Moreover, the FACIT sum score (Poland and Turkey) and functional wellbeing (The Netherlands) are significantly associated with the decrease in care dependency status. Thus, the FACIT variables are the most powerful indicators for care dependency. The study provides healthcare professionals insight into improvement of quality of care in all three countries.

Functional assessment of geriatric patients in regard to health-related quality of life (HRQoL).

PURPOSE: The main aim of our research was to evaluate general health, functioning, and performance parameters, as well as care problems of Geriatric Clinic inpatients in relation to deficits in fulfilling needs. The assessment of health-related quality of life was also performed. PATIENTS AND METHODS: The research subjects were patients attending the Clinic of Geriatrics: 149 women and 78 men; 227 persons in total. The research was carried out using a diagnostic poll method, with the application of the Activities of Daily Living questionnaire of assessment of daily efficiency on the basis of the Katz index, the Instrumental Activities of Daily Living questionnaire, the Care Dependency Scale used to measure the level of care dependency and human needs, and the Nottingham Health Profile scale. RESULTS: The results showed that the majority of respondents achieved high and medium levels of functional capability. The main problems associated with the fulfillment of needs were difficulties with the adoption of appropriate body posture, movement restrictions, and problems related to participating in unassisted leisure activities outside the home. The general deficit in fulfilling the needs of the patients was low. The most significant problems were related to sleep disorders, restrictions in freedom of movement, loss of vital energy, and ailments resulting in the observable presence of pain. CONCLUSION: Good daily functioning of elderly patients significantly depended on their intellectual and mental efficiency. Elderly patients require a comprehensive, holistic approach to a variety of problems that occur with aging.

The care dependency scale for measuring basic human needs: an international comparison.

AIM: To report a study conducted to compare the utility of the care dependency scale across four countries. BACKGROUND: The care dependency scale provides a framework for assessing the needs of institutionalized patients for nursing care. Henderson's components of nursing care have been used to specify the variable aspects of the concept of care dependency and to develop the care dependency scale items. DESIGN: The study used a cross-cultural survey design. METHOD: Patients were recruited from four different countries: Japan, The Netherlands, Poland and Turkey. In each of the participating countries, basic human needs were assessed by nurses using a translated version of the original Dutch care dependency scale. Psychometric properties in terms of reliability and validity of the care dependency scale have been assessed using Cronbach's alpha, Guttman's lambda-2, inter-item correlation and principal components analysis. Data were collected in 2008 and 2009. RESULTS: High internal consistency values were demonstrated. Principal component analysis confirmed the one-factor model reported in earlier studies. CONCLUSION: Outcomes confirm Henderson's idea that human needs are fundamental appearing in every patient-nurse relationship, independent of the patient's age, the type of care setting and/or cultural background. The psychometric characteristics of the care dependency scale make this instrument very useful for comparative research across countries.

The sense of coherence (SOC) as an important determinant of life satisfaction, based on own research, and exemplified by the students of University of the Third Age (U3A).

The SOC is an important determinant of life satisfaction of elderly people. It determines the level of coping with various difficult situations, which accompany an old age stage. The aim of the study was to determine the connection between the SOC levels and life satisfaction among the U3A students. Another analyzed relationship was the SOC level against the background of socio-demographic factors. The study comprised 257 students of the U3A in Poland, located in the city of Bydgoszcz. The study group consisted of 237 women and 20 men, at the average age of 64.54 ± 6.01 years. The vast majority of the study group included individuals at the secondary education level, as well as married individuals. Just over half of the group claimed to be in good health, and have no afflictions. All of the respondents were fully mobile. The study was conducted with the diagnostic poll method, using the standardized questionnaires: The Scale SOC-29, WHOQOL-Bref, and the Geriatric Depression Scale (GDS-bref version). The average value of global SOC was 128.77; the standard deviation 21.04; discrepancy 153 (minimum 50 and maximum 203). The SOC indicated significant relationship with quality of life (QoL) in the mental domain, social relationships, and environmental domain; no significant correlation in the physical domain was observed. The QOL reached about 70% of maximum result value, showing equal levels in its specific areas. A moderately decreasing (r=-0.375, p<0.01) relation η=0.376, between global SOC values and depression occurrence, as well as its non-existence was shown in the study. Individual SOC components were also negatively correlated with depression. Another observation was weak correlation between the sense of coherence and the individuals' level of education. No statistically significant effect of age, gender and marital status on the SOC levels of U3A students was found. Higher parameters of SOC and level of education shape significantly higher effects of life satisfaction, and result in better adaptation to old age stage as a phase of multiple challenges, and increasing life difficulties.