Caring and Health of Close Family Members of Frail Older Persons Recently Discharged from Acute Hospital Care: A Comparative Cross-Sectional Study.

Multimorbidity in older people is strongly linked to the need for acute hospital care, and caregiving activities usually become more complex after patients are discharged from hospital. This may negatively impact the health of close family members, although this has not been comprehensively investigated. This study aimed to explore the general and mental health of close family members caring for frail older (>65) persons recently discharged from acute hospital care, making assessments in terms of gender, relationship to the older person, and aspects of caring. A comparative cross-sectional study was conducted involving 360 close family members caring for frail older persons recently discharged from hospital. The statistical analyses included subgroup comparisons and associations to caring were examined. Half of the family members reported that their general and mental health was poor, with spouses reporting the poorest health. Female participants had significantly more severe anxiety, while males had significantly more severe depression. Providing care for more than six hours per week was associated with poor general health (OR 2.31) and depression (OR 2.59). Feelings of powerless were associated with poor general health (OR 2.63), anxiety (6.95), and depression (3.29). This knowledge may provide healthcare professionals with better tools in order to individualise support, preventing family members from exceeding their resources during these demanding periods.

A Psychometric Evaluation of the Family Collaboration Scale and an Investigation of How the Close Family of Frail Older Patients Perceive the Collaboration with Healthcare Professionals on Acute Medical Wards at Hospitals in Sweden.

The inclusion of family members in the acute care of older persons with complex needs results in better coordination of care and reduces the frequency and/or duration of rehospitalisation. Therefore, healthcare professionals need a tool to assess the collaboration with family members on acute hospital wards. The aims were to test the psychometric properties of the Swedish version of the Family Collaboration Scale (FCS), to investigate family members' perception of collaboration with healthcare professionals on acute medical wards in Sweden and to compare the data with the corresponding Danish results. Three hundred and sixty family members of frail patients aged 65 or older from 13 acute medical wards answered the FCS questionnaire. In addition to descriptive statistics, psychometric methods were applied. The internal consistency of the Swedish version of the FCS was excellent, and confirmatory factor analysis revealed that its factor structure was equivalent to that of the original Danish FCS. The respondents' ratings indicated better perceived collaboration than in the Danish case. Older age than 60 was associated with worse collaboration with healthcare professionals regarding Influence on discharge than younger respondents. Those with compulsory and health or nursing education showed better collaboration. The Swedish version of the FCS should be further evaluated for its retest reliability and as an outcome measure in intervention studies.

Mental health and reactions to caregiving among next of kin of older people (65+) with multi-morbidity discharged home after hospitalization.

BACKGROUND: Older people with multi-morbidity are major users of healthcare and are often discharged from hospital with ongoing care needs. This care is frequently provided by informal caregivers and the time immediately after discharge is challenging for caregivers with new and/or additional tasks, resulting in anxiety and stress. AIM: This study aimed to describe mental health, with particular reference to anxiety and depression and reactions to caregiving, and to investigate any associations between the two, in next of kin of older people with multi-morbidity after hospitalisation. It also aimed to explore the association between the demographic characteristics of the study group and mental health and reactions to caregiving. METHODS: This was a cross-sectional questionnaire study using the Hospital Anxiety and Depression Scale and the Caregiver Reaction Assessment. The study group consisted of 345 next of kin of older people (65+) with multi-morbidity discharged home from 13 medical wards in Sweden. Data were analysed using descriptive and analytical statistics. To identify whether reactions to caregiving and next of kin characteristics were associated with anxiety and depression, a univariate logistic regression analysis was performed. RESULTS: More than one quarter of respondents showed severe anxiety and nearly one in 10 had severe depressive symptoms. The frequencies of anxiety and depression increased significantly with increased negative reactions to caregiving and decreased significantly with positive reactions to caregiving. Regarding caregiving reactions, the scores were highest for the positive domain Caregiver esteem, followed by the negative domain Impact on health. Women scored significantly higher than men on Impact on health and spouses scored highest for Impact on schedule and Caregiver esteem. CONCLUSIONS: Nurses and other healthcare professionals may need to provide additional support to informal caregivers before and after discharging older people with significant care needs from hospital. This might include person-centred information, education and training.

Iron oxide nanoparticles embedded in activated carbons prepared from hydrothermally treated waste biomass.

Particles of iron oxide (Fe3O4 ; 20­40 nm) were embedded within activated carbons during the activation of hydrothermally carbonized (HTC) biomasses in a flow of CO2. Four different HTC biomass samples (horse manure, grass cuttings, beer production waste, and biosludge) were used as precursors for the activated carbons. Nanoparticles of iron oxide formed from iron catalyst included in the HTC biomasses. After systematic optimization, the activated carbons had specific surface areas of about 800 m2g1. The pore size distributions of the activated carbons depended strongly on the degree of carbonization of the precursors. Activated carbons prepared from highly carbonized precursors had mainly micropores, whereas those prepared from less carbonized precursors contained mainly mesopores. Given the strong magnetism of the activated carbon­nano-Fe3O4 composites, they could be particularly useful for water purification.

Fe3O4 and gamma-Fe2O3 nanoparticles for the adsorption of Co2+ from aqueous solution.

The adsorption of Co2+ ions from nitrate solutions using iron oxide nanoparticles of magnetite (Fe3O4) and maghemite (gamma-Fe2O3) has been studied. The adsorption of Co2+ ions on the surface of the particles was investigated under different conditions of oxide content, contact time, solution pH, and initial Co2+ ion concentration. It has been found that the equilibrium can be attained in less than 5 min. The maximum loading capacity of Fe3O4 and gamma-Fe2O3 nanoparticles is 5.8 x 10(-5) and 3.7 x 10(-5) mol m(-2), respectively, which are much higher than the previously studied, iron oxides and conventional ion exchange resins. Co2+ ions were also recovered by dilute nitric acid from the loaded gamma-Fe2O3 and Fe3O4 with an efficiency of 86 and 30%, respectively. That has been explained by the different mechanisms by including both the surface and structural loadings of Co2+ ions. The surface adsorption of Co2+ on Fe3O4 and gamma-Fe2O3 nanoparticles has been found to have the same mechanism of ion exchange reaction between Co2+ in the solution and proton bonded on the particle surface. The conditional equilibrium constants of surface adsorption of Co2+ on Fe3O4 and gamma-Fe2O3 nanoparticles have been determined to be log K=-3.3+/-0.3 and -3.1+/-0.2, respectively. The structural loading of Co2+ ions into Fe3O4 lattice has been found to be the ion exchange reaction between Co2+ and Fe2+ while that into gamma-Fe2O3 lattice to fill its vacancy. The effect of temperature on the adsorption of Co2+ was also investigated, and the value of enthalpy change was determined to be 19 kJ mol(-1).