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4.
Br J Nurs ; 29(4): 190-198, 2020 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-32105542

RESUMEN

BACKGROUND: Patients with lymphoedema referred to a lymphoedema service from care homes in one health board area in Wales were often complex cases, with repeated cellulitis, a history of falls and other complications. A pilot project was initiated to develop education and raise awareness of lymphoedema among care home staff. AIMS: To enable care staff to identify residents with lymphoedema, promote prompt referrals, raise the importance of skin care and exercise in the management of lymphoedema and estimate the likely costs from complications associated with lymphoedema. METHODS: An education tool was developed and 47 care homes were asked to participate. A lymphoedema therapist carried out a scoping review of the residents. RESULTS: Forty-four care homes agreed to participate in the project with 1216 education packs being issued to care home staff. Initial findings suggest that of the 960 residents reviewed, 262 had lymphoedema (27%); 4% suffered with frequent falls, 1% had wounds and 3% had recurrent cellulitis. Only 13% (35/262) of residents with lymphoedema were known to the local lymphoedema service. Of the 31 residents reporting cellulitis, 81% had lymphoedema; of the 11 residents identified with a wound, 100% had lymphoedema and of the 40 residents reporting falls, 70% had lymphoedema. CONCLUSION: This educational project has identified the value of raising awareness of lymphoedema within care homes.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Hogares para Ancianos/organización & administración , Linfedema/enfermería , Casas de Salud/organización & administración , Personal de Enfermería/educación , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación en Evaluación de Enfermería , Proyectos Piloto , Gales
5.
Health Qual Life Outcomes ; 18(1): 1, 2020 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-31898546

RESUMEN

BACKGROUND: Well-adapted and validated quality-of-life measurement models for the nursing home population are scarce. Therefore, the aim of this study was to test the psychometrical properties of the OPQoL-brief questionnaire among cognitively intact nursing home residents. The research question addressed evidence related to the dimensionality, reliability and construct validity, all of which considered interrelated measurement properties. METHODS: Cross-sectional data were collected during 2017-2018, in 27 nursing homes representing four different Norwegian municipalities, located in Western and Mid-Norway. The total sample comprised 188 of 204 (92% response rate) long-term nursing home residents who met the inclusion criteria: (1) municipality authority's decision of long-term nursing home care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. RESULTS: Principal component analysis and confirmative factor analyses indicated a unidimensional solution. Five of the original 13 items showed low reliability and validity; excluding these items revealed a good model fit for the one-dimensional 8-items measurement model, showing good internal consistency and validity for these 8 items. CONCLUSION: Five out of the 13 original items were not high-quality indicators of quality-of-life showing low reliability and validity in this nursing home population. Significant factor loadings, goodness-of-fit indices and significant correlations in the expected directions with the selected constructs (anxiety, depression, self-transcendence, meaning-in-life, nurse-patient interaction, and joy-of-life) supported the psychometric properties of the OPQoL-brief questionnaire. Exploring the essence of quality-of-life when residing in a nursing home is highly warranted, followed by development and validation of new tools assessing quality-of-life in this population. Such knowledge and well-adapted scales for the nursing home population are beneficial and important for the further development of care quality in nursing homes, and consequently for quality-of-life and wellbeing in this population.


Asunto(s)
Hogares para Ancianos , Casas de Salud , Calidad de Vida/psicología , Encuestas y Cuestionarios/normas , Anciano , Anciano de 80 o más Años , Estudios Transversales , Análisis Factorial , Femenino , Evaluación Geriátrica/métodos , Humanos , Masculino , Noruega , Análisis de Componente Principal , Psicometría , Reproducibilidad de los Resultados
7.
J Clin Nurs ; 29(1-2): 172-183, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31612556

RESUMEN

AIMS AND OBJECTIVES: To explore how managers describe leading towards person-centred care in Swedish nursing homes. BACKGROUND: Although a growing body of research knowledge exists highlighting the importance of leadership to promote person-centred care, studies focused on nursing home managers' own descriptions of leading their staff towards providing person-centred care is lacking. DESIGN: Descriptive interview study. COREQ guidelines have been applied. METHODS: The study consisted of semi-structured interviews with 12 nursing home managers within 11 highly person-centred nursing homes purposively selected from a nationwide survey of nursing homes in Sweden. Data collection was performed in April 2017, and the data were analysed using content analysis. RESULTS: Leading towards person-centred care involved a main category; embodying person-centred being and doing, with four related categories: operationalising person-centred objectives; promoting a person-centred atmosphere; maximising person-centred team potential; and optimising person-centred support structures. CONCLUSIONS: The findings revealed that leading towards person-centred care was described as having a personal understanding of the PCC concept and how to translate it into practice, and maximising the potential of and providing support to care staff, within a trustful and innovative work place. The findings also describe how managers co-ordinate several aspects of care simultaneously, such as facilitating, evaluating and refining the translation of person-centred philosophy into synchronised care actions. RELEVANCE TO CLINICAL PRACTICE: The findings can be used to inspire nursing home leaders' practices and may serve as a framework for implementing person-centred care within facilities. A reasonable implication of these findings is that if organisations are committed to person-centred care provision, care may need to be organised in a way that enables managers to be present on the units, to enact these strategies and lead person-centred care.


Asunto(s)
Hogares para Ancianos/organización & administración , Casas de Salud/organización & administración , Atención Dirigida al Paciente/organización & administración , Adulto , Femenino , Humanos , Entrevistas como Asunto , Liderazgo , Masculino , Persona de Mediana Edad , Atención Dirigida al Paciente/métodos , Encuestas y Cuestionarios , Suecia
8.
Arch Gerontol Geriatr ; 86: 103955, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31561064

RESUMEN

BACKGROUND: Increased awareness of the clinical course of nursing home residents with advanced dementia and advance care planning (ACP) has become the cornerstone of good palliative care. OBJECTIVE: The aim of our study is to describe changes in ACP in the form of physician treatment orders (PTOs), symptom prevalence and possible burdensome interventions among nursing home (NH) residents who died between 2004-2009 and 2010-2013 METHODS: Retrospective study RESULTS: The number of PTOs regarding forgoing antibiotics or parenteral antibiotics, forgoing artificial nutrition or hydration or forgoing hospitalisation doubled between 2004-2009 and 2010-2013 (38.1% vs. 64.9%, p < 0.001; 40.0% vs. 81.7%, p < 0.001; 28.1% vs. 69.5%, p < 0.001, respectively). PTOs were also done significantly earlier in 2010-2013 than in 2004-2009. The prevalence of distressing symptoms and possible burdensome interventions remained unchanged, although the prevalence of consistency with the PTOs was high. CONCLUSION: Despite the increased number of PTOs, this had little effect on symptom prevalence and possible burdensome interventions experienced by NH residents in the last days of life.


Asunto(s)
Planificación Anticipada de Atención/tendencias , Directivas Anticipadas/estadística & datos numéricos , Demencia/terapia , Casas de Salud/estadística & datos numéricos , Cuidados Paliativos/estadística & datos numéricos , Cuidado Terminal/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Muerte , Demencia/mortalidad , Demencia/psicología , Femenino , Finlandia/epidemiología , Hogares para Ancianos/estadística & datos numéricos , Hospitalización , Humanos , Masculino , Prevalencia , Estudios Retrospectivos
9.
Maturitas ; 131: 72-77, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31787150

RESUMEN

OBJECTIVES: To determine the effects of a multicomponent physical exercise program on cognitive and affective functioning among nursing home residents and to clarify whether there are any changes in serum levels of brain-derived neurotrophic factor (BDNF) among participants. STUDY DESIGN: This was a single-blind randomized controlled trial in ten nursing homes in Gipuzkoa, Spain. The study included 112 men and women. Participants in the control group engaged in routine activities while those in the intervention group participated in a six-month individualized, progressive, multicomponent physical exercise program focused on strength, balance, and walking. MAIN OUTCOME MEASURES: Cognitive and affective functions were assessed at baseline and at six months. Serum BDNF levels were assessed via ELISA. RESULTS: After six months, a group by time interaction in favor of the intervention group was observed on the Montreal Cognitive Assessment (MOCA), symbol search and De Jong-Gierveld Loneliness Scale (P < 0.05). The control group scored more poorly on the MOCA, WAIS-IV (coding and symbol search), verbal fluency, and semantic fluency tests after six months (P < 0.05) than they did at baseline. The intervention group showed poorer results on the coding test (P < 0.05). Loneliness perception was reduced in the intervention group (P < 0.05). No changes in serum BDNF were observed (group x time and within groups, P > 0.05). CONCLUSION: A six-month individualized, progressive, multicomponent physical exercise intervention is effective at maintaining cognitive function and decreasing perceptions of loneliness among nursing home residents. Blood levels of BDNF were not affected by the intervention.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo/sangre , Cognición/fisiología , Terapia por Ejercicio/métodos , Hogares para Ancianos , Casas de Salud , Anciano , Anciano de 80 o más Años , Ensayo de Inmunoadsorción Enzimática , Ejercicio/psicología , Femenino , Estado de Salud , Humanos , Masculino , Calidad de Vida , Método Simple Ciego , España/epidemiología , Resultado del Tratamiento , Caminata
10.
Clin Interv Aging ; 14: 1797-1815, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31695349

RESUMEN

Purpose: The main objective of this study was to investigate abuse of residents with either dementia or Alzheimer's disease in long-term care settings, to identify facilitators and barriers surrounding implementation of systems to prevent such occurrences, and to draw conclusions on combating the issue of abuse. Patients and methods: A systematic review was conducted using the Medline, CINAHL, and Academic Search Ultimate databases. With the use of key terms via Boolean search, 30 articles were obtained which were determined to be germane to research objectives. The review was conducted and structured based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Residents with dementia or Alzheimer's disease are at greater risk of abuse. The growing population could increase this problem exponentially. The most common facilitators were the introduction of policies/programs in the facility, education, and working conditions. The most cited barriers were poor training, lack of research, and working conditions in the long-term care setting. Conclusion: The examples given would be useful in minimizing the potential for abuse in the long-term care setting. Leadership can take an active role in the prevention of abuse of the elderly through their actions, education of employees, and changes in the work environment.


Asunto(s)
Enfermedad de Alzheimer , Maltrato al Anciano/prevención & control , Personal de Salud/educación , Política Organizacional , Lugar de Trabajo/organización & administración , Anciano , Enfermedad de Alzheimer/psicología , Demencia/psicología , Hogares para Ancianos/organización & administración , Humanos , Cuidados a Largo Plazo , Casas de Salud/organización & administración , Factores Protectores , Factores de Riesgo
11.
Artículo en Inglés | MEDLINE | ID: mdl-31717812

RESUMEN

The oral health of an ageing population, especially that of the institutionalized elderly population, constitutes a significant concern because it is closely linked to general health and the quality of life. Shared common risk factors drive the development and worsening of poor oral health and non-communicable diseases, which eventually lead to self-care inability. Several studies have reported on the poor oral health of the institutionalized elderly population. However, few comprehensive reports exist regarding the relationship between poor oral health, the oral health-related quality of life (OHRQoL) and the associated factors in this specific population. Objective: The objective is to describe recently reported oral health levels, the OHRQoL and the associated factors among older institutional residents. Methods: Studies published between July 2009 and June 2019 in MEDLINE, EMBASE and CINAHL were searched. The population, intervention, comparison and outcome (PICO) strategy was used as a guide. The reported factors related to poor oral health were identified (i.e., age, gender, educational level, acquired systemic conditions or dementia/cognitive impairment). Results: Twenty-five surveys (or study series) from 19 countries were included. The level of evidence reported by these studies was generally moderate to strong. The reported oral cleanliness and health of the surveyed institutionalized elderly were poor (>50% of residents had calculus; denture hygiene index > 80%). Gum (approximately 30% of dentate residents had moderate to severe periodontitis), teeth (decayed, missing or filled teeth >20), mucosa (>10% had mucosal lesions) and denture problems (up to 40%) were prevalent and were associated with a poor OHRQoL, especially in females, socially deprived residents or those with mild or above cognitive impairment. Those with a poor OHRQoL might show signs of poor nutrition. Conclusions: This report reviewed evidence-based knowledge on oral health, the OHRQoL and the associated factors among elderly institutional residents. Further research is needed to confirm these observations. For improved oral health, a better OHRQoL and the general well-being of older residents, clinical trials are needed, targeting modifiable factors, such as social inequality, oral healthcare accessibility, and/or nursing home service quality. The relationship between oral health, the OHRQoL and nutrition in this at-risk population also warrants exploration.


Asunto(s)
Hogares para Ancianos/estadística & datos numéricos , Casas de Salud/estadística & datos numéricos , Salud Bucal/estadística & datos numéricos , Anciano , Humanos , Calidad de Vida
12.
BMC Health Serv Res ; 19(1): 775, 2019 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-31666063

RESUMEN

BACKGROUND: This study aims to estimate the direct and indirect effects of the unit environment alongside individual and nursing care variables on eating dependence among residents who are cognitively impaired and living in a nursing home. METHOD: A multicentre observational study was carried out in 2017: 13 Italian nursing homes were involved in data collection. Included residents were aged > 65 at baseline, living in the considered facility for the last 6 months and during the entire study period and having received at least one comprehensive assessment. Data were collected (a) at the individual level: eating dependence using the Edinburgh Feeding Evaluation in Dementia Scale and other clinical variables; (b) at the nursing care level with daily interventions to maintain eating independence assessed with a checklist; and (c) at the nursing home level, using the Therapeutic Environment Screening Survey for Nursing Homes. RESULTS: One thousand twenty-seven residents were included with an average age of 85.32 years old (95% CI: 84.74-85.89), mainly female (781; 76%). The path analysis explained the 57.7% variance in eating dependence. Factors preventing eating dependence were: (a) at the individual level, increased functional dependence measured with the Barthel Index (ß - 2.374); eating in the dining room surrounded by residents (ß - 1.802) as compared to eating alone in bed; and having a close relationship with family relatives (ß - 0.854), (b) at the nursing care level, the increased number of interventions aimed at promoting independence (ß - 0.524); and (c) at the NH level, high scores in 'Space setting' (ß - 4.446), 'Safety' (ß - 3.053), 'Lighting' (ß - 2.848) and 'Outdoor access' (ß - 1.225). However, environmental factors at the unit level were found to have also indirect effects by influencing the degree of functional dependence, the occurrence of night restlessness and the number of daily interventions performed by the nursing staff. CONCLUSION: Eating dependence is a complex phenomenon requiring interventions targeting individual, nursing care, and environmental levels. The NH environment had the largest direct and indirect effect on residents' eating dependence, thus suggesting that at this level appropriate interventions should be designed and implemented.


Asunto(s)
Disfunción Cognitiva , Ingestión de Alimentos/psicología , Ambiente de Instituciones de Salud , Hogares para Ancianos , Casas de Salud , Anciano , Anciano de 80 o más Años , Ingestión de Alimentos/fisiología , Femenino , Humanos , Italia , Masculino , Encuestas y Cuestionarios
13.
Artículo en Inglés | MEDLINE | ID: mdl-31601042

RESUMEN

Assessments of Indoor Environment Quality (IEQ) present a very significant challenge when analyses are undertaken mainly in buildings that include a particularly sensitive and vulnerable population, such as elderly people. In order to maintain an indoor environment that is adequate for occupants, it is necessary to comply with a set of requirements (for TVOC, the Portuguese threshold values) regarding concentrations of airborne pollutants and hygrothermal comfort conditions. This paper studies IEQ in compartments in 3 buildings in two cities in central Portugal, Viseu and Covilhã, which hold elderly care centers. The following environmental parameters were continuously recorded: air temperature, relative humidity, concentration of carbon dioxide, formaldehyde, and total volatile organic compounds and ventilation rates. An analysis of the obtained results was performed, taking recommended guidelines and threshold values into account, thus making it possible to evaluate the IEQ conditions and hygrothermal comfort in the selected indoor spaces. On the basis of the conclusions reached and the observed problems of hygrothermal comfort and indoor pollutants in the indoor spaces, a number of recommendations are proposed, specifically in terms of climate control, ventilation, and maintenance, in order to obtain an overall improvement of IEQ.


Asunto(s)
Contaminantes Atmosféricos/química , Contaminación del Aire Interior/análisis , Hogares para Ancianos , Compuestos Orgánicos Volátiles/análisis , Anciano , Contaminantes Atmosféricos/toxicidad , Dióxido de Carbono/análisis , Ciudades , Formaldehído/análisis , Humanos , Portugal , Temperatura Ambiental , Ventilación
14.
Nutr. hosp ; 36(5): 1074-1080, sept.-oct. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-184629

RESUMEN

Antecedentes: la definición y metodología recomendadas para diagnosticar sarcopenia ha ido evolucionando. El consenso más utilizado es el del Grupo Europeo de Trabajo en Sarcopenia en Personas Mayores publicado en 2010 (EWGSOP1), que ha sido actualizado en 2019 (EWGSOP2). Objetivos: determinar la prevalencia de sarcopenia en personas mayores institucionalizadas usando el algoritmo del EWGSOP2 y comparar dichos resultados con los obtenidos en el Granada Sarcopenia Study al aplicar el algoritmo del EWGSOP1. Métodos: para evaluar la sarcopenia se midieron la masa muscular con un impedanciómetro, la fuerza muscular con un dinamómetro y la velocidad de la marcha en un recorrido de cuatro metros. Para la comparación de los resultados se realizó un análisis de sensibilidad y especificidad utilizando la versión 20 de SPSS. Resultados: según el EWGSOP2, el 60,1% tenía sarcopenia y el 58,1% tenía sarcopenia grave, resultados sin diferencias estadísticamente significativas al compararlos con los obtenidos según el EWGSOP1 (63% tenía sarcopenia y 61,2%, sarcopenia grave). Tampoco se hallaron diferencias significativas al comparar los sujetos con baja masa muscular según las fórmulas propuestas en uno y otro consenso, mientras que sí las hubo al comparar los sujetos con baja fuerza muscular debido a la variación en los puntos de corte. Conclusiones: la prevalencia de sarcopenia en personas mayores institucionalizadas es alta, destacando una gran mayoría de sujetos con baja fuerza muscular y bajo rendimiento físico. La utilización de la metodología propuesta por el EWGSOP2 no influyó en los resultados de prevalencia de sarcopenia obtenidos al aplicar el EWGSOP1


Background: the definition and methodology recommended for the diagnosis of sarcopenia has been changing. The mostly applied consensus is the one published by the European Working Group in Older People in 2010 (EWGSOP1), which was updated in 2019 (EWGSOP2). Objectives: assessing the prevalence of sarcopenia in institutionalized older adults using the EWGSOP2 algorithm and comparing these results with the EWGSOP1 algorithm results. Methods: in order to diagnose sarcopenia, muscle mass was assessed using an impedanciometer, muscle strength with a dynamometer and walking speed over a four-meter course. For the comparison of the results, a sensitivity and specificity analysis were performed with the version 20 of SPSS. Results: according to the EWGSOP2, 60.1% of the participants had sarcopenia and 58.1% had severe sarcopenia, results with no statistical differences when they are compared to the results according to the EWGSOP1 (63% had sarcopenia and 61.2%, severe sarcopenia). Neither were statistical differences found when comparing subjects with low muscle mass according to the formulas suggested by both consensus, while there were differences when comparing subjects with low muscle strength due to the variation of cut-off points. Conclusions: the prevalence of sarcopenia in institutionalized older adults is high, being remarkable that the majority of the participants had low muscle strength and low physical performance. The utilization of the methodology proposed by the EWGSOP2 did not have influence in the results of prevalence of sarcopenia obtained when the EWGSOP1 recommendations were applied


Asunto(s)
Humanos , Anciano , Anciano de 80 o más Años , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Hogares para Ancianos/estadística & datos numéricos , Consenso , Índice de Masa Corporal , Algoritmos , Fuerza Muscular , Absorciometría de Fotón , Estudios Transversales , Antropometría , Rendimiento Físico Funcional , Repertorio de Barthel
15.
Cien Saude Colet ; 24(9): 3275-3282, 2019 Sep 09.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31508748

RESUMEN

OBJECTIVE: To determine the prevalence and factors associated with depressive symptoms in institutionalized elderly. METHODS: This is an epidemiological cross-sectional study with 42 elderly in a Long-Term Care Institution for the Elderly (LTCIE). Data was collected from April to December 2014 through a questionnaire with information on demographic and socioeconomic aspects, the Geriatric Depression Scale short version (GDS-15) and the Mini Mental State Examination (MMSE). RESULTS: Of the elderly studied, 54.8% had depressive symptoms and were predominantly females (64.7%). There was a significant association between depressive symptoms and variables retired (p = 0.043); urinary incontinence (p = 0.028); self-perceived health (p-value = 0.042) and sleep quality (p-value = 0.000). CONCLUSION: The study found a high prevalence of depressive symptoms in institutionalized elderly, associated with the presence of urinary incontinence, (negative) self-perceived health, (poor) quality of sleep and retirement (yes). Following the study and in the face of the needs of this population, it is necessary to seek measures that act directly on the modifiable variables, preventing and treating them.


Asunto(s)
Depresión/epidemiología , Institucionalización/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Hogares para Ancianos , Humanos , Masculino , Pruebas de Estado Mental y Demencia , Persona de Mediana Edad , Casas de Salud/estadística & datos numéricos , Prevalencia , Jubilación/estadística & datos numéricos , Factores de Riesgo , Sueño/fisiología , Encuestas y Cuestionarios , Incontinencia Urinaria/epidemiología
17.
Expert Opin Drug Saf ; 18(11): 1091-1098, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31524003

RESUMEN

Objectives: Inappropriate prescription is a problem related to aging and deprescription could be a possible strategy. The aim of this study was to adapt the available evidence on deprescribing to the medication management of older people living in long-term care facilities. Methods: The authors carried out a bibliographic search based on the most prevalent drugs in our context to develop a specific deprescribing intervention. A committee of experts reviewed this intervention which was later validated through an interobserver variability study. Finally, the authors evaluated it in a sample of patients through a controlled before-after study. Results: The authors included 119 subjects living in a public elderly long-term care center and 122 controls living in a center with similar clinical characteristics. The authors evaluated 852 medications, identifying a total of 175 (20.5%) potentially inappropriate medications and 162 (92.5%) drugs were deprescribed (1.4 per patient). The application of the intervention meant an annual saving of 9.525.25 €. Conclusion: The implementation of a deprescribing intervention aimed at the most prevalent drugs prescribed in a particular setting improves the appropriateness of pharmacotherapy in the patients.


Asunto(s)
Deprescripciones , Prescripción Inadecuada/prevención & control , Administración del Tratamiento Farmacológico/organización & administración , Lista de Medicamentos Potencialmente Inapropiados , Factores de Edad , Anciano , Anciano de 80 o más Años , Costos de los Medicamentos , Femenino , Hogares para Ancianos , Humanos , Prescripción Inadecuada/economía , Cuidados a Largo Plazo/normas , Masculino , Casas de Salud , Pautas de la Práctica en Medicina/normas
18.
Healthc Q ; 22(2): 55-62, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31556381

RESUMEN

In this paper, individually reported long-term care (LTC) quality indicators have been supplemented with the composite Qindex measure and applied to 614 homes in Ontario, Canada. This study (1) describes the overall quality performance of LTC homes across five years (2012-2017) and (2) determines if organizational factors impact quality performance. The results demonstrate significant, continuous sector-wide improvement in overall quality performance (as assessed by the Qindex) over time and significant differences in quality based on home size, operator size and ownership. This paper positions the Qindex, a global metric of quality, as a valuable tool for quality measurement and management in the LTC sector.


Asunto(s)
Hogares para Ancianos/normas , Casas de Salud/normas , Garantía de la Calidad de Atención de Salud , Hogares para Ancianos/organización & administración , Humanos , Cuidados a Largo Plazo/organización & administración , Cuidados a Largo Plazo/normas , Estudios Longitudinales , Casas de Salud/organización & administración , Ontario , Mejoramiento de la Calidad/estadística & datos numéricos
19.
Artículo en Inglés | MEDLINE | ID: mdl-31546837

RESUMEN

The oral health state plays an important role in the concept of 'elderly frailty', since institutionalized older people are prone to suffering from bad oral conditions. The aim of this study is to assess the state of oral health in the older residents of nursing homes and to measure its potential association with the cognitive state, the degree of functional autonomy, and the malnutrition risk. Methods: We enrolled 176 subjects from 292 residents in five nursing homes in Florence. For each subject, we performed the Malnutrition Universal Screening Tool, the Pfeiffer test, the Minimum Data Set-Long Form, a dental examination, and the Geriatric Oral Health Assessment Index questionnaire. The results show that the oral condition was poor in 43.8% of cases, medium in 38.1%, and good in 18.2%. A worse oral health state was significantly associated (p < 0.05) with a worse cognitive state and with a higher dependency in daily living activities. The malnutrition score among the older people was unrelated to the oral health condition (p = 0.128). It can be concluded that the oral health condition in older institutionalized subjects is an open challenge for the public healthcare system, since the maintenance of adequate good oral health is an essential element of good physical as well as cognitive and psychological health.


Asunto(s)
Anciano Frágil/estadística & datos numéricos , Hogares para Ancianos/estadística & datos numéricos , Casas de Salud/estadística & datos numéricos , Salud Bucal/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Italia , Masculino
20.
Nutrients ; 11(9)2019 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-31527530

RESUMEN

The methodology used in dietary surveys could, to a large extent, follow the instructions of the European Food Safety Authority (EFSA), where 24-h dietary recall (24HDR) is recommended for (sub) population studies. However, it is necessary to examine the suitability of 24HDR for indicative dietary intake in older adults. This study aimed to compare participants' dietary intakes with the recommendations and to compare dietary intakes derived from a 24HDR using an OPEN web-based application to those obtained from reference weighed food records (WFRs). Forty-nine Slovenian residential home residents completed both assessments, and a comparison with dietary reference values was performed. Estimates from these two methods were compared and the correlations between them were assessed. The findings revealed that dietary intakes derived from the WFR method mostly differed from the recommended intakes. The 24HDR underestimated dietary intake compared to the WFR for 66% of monitored parameters, while 75% of these parameters were correlated, mostly at a moderate level (0.3-0.69). In conclusion, the diets of residential home residents in this study mostly differed from recommendations. Both methods for dietary intake assessment provided comparable results for most of the monitored parameters in expected deviations. A web-based 24HDR could be a valid tool for the indicative assessment of dietary intake in older adults. However, further validations are required.


Asunto(s)
Registros de Dieta , Ingestión de Alimentos , Conducta Alimentaria , Evaluación Geriátrica/métodos , Internet , Recuerdo Mental , Evaluación Nutricional , Estado Nutricional , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Hogares para Ancianos , Humanos , Masculino , Casas de Salud , Reproducibilidad de los Resultados , Eslovenia , Factores de Tiempo
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