Active involvement in scientific research of persons living with dementia and long-term care users: a systematic review of existing methods with a specific focus on good practices, facilitators and barriers of involvement.

BACKGROUND: Active involvement of persons living with dementia (PLWD) and long-term care (LTC) users in research is essential but less developed compared to other patient groups. However, their involvement in research is not only important but also feasible. This study aims to provide an overview of methods, facilitators, and barriers for involving PLWD and LTC users in scientific research. METHODS: A systematic literature search across 12 databases in December 2020 identified studies involving PLWD, LTC users, or their carers beyond research subjects and describing methods or models for involvement. Qualitative descriptions of involvement methods underwent a risk of bias assessment using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist 2018. A data collection sheet in Microsoft Excel and thematic analysis were used to synthesize the results. RESULTS: The eighteen included studies delineated five core involvement methods spanning all research phases: advisory groups, formal and informal research team meetings, action groups, workshops, and co-conducting interviews. Additionally, two co-research models with PLWD and carers were found, while only two studies detailed LTC user involvement methods. Four distinct involvement roles were identified: consulting and advisory roles, co-analysts, co-researchers, and partners. The review also addressed barriers, facilitators, and good practices in the preparation, execution, and translation phases of research, emphasizing the importance of diversity, bias reduction, and resource allocation. Trust-building, clear roles, ongoing training, and inclusive support were highlighted. CONCLUSIONS: Planning enough time for active involvement is important to ensure that researchers have time to build a trusting relationship and meet personal needs and preferences of PLWD, LTC users and carers. Researchers are advised not to presume the meaning of burden and to avoid a deficit perspective. A flexible or emergent design could aid involved persons' ownership of the research process. TRIAL REGISTRATION: Prospero 2021: CRD42021253736.

The impact of income level on skeletal muscle health in rural Chinese older residents: a study of mediating effects based on dietary knowledge.

China's rural residents have basically solved the problem of subsistence, but due to aging, the prevalence of sarcopenia (abbreviated as sarcopenia) has been increasing year by year, especially the skeletal muscle health of the rural older residents has not been sufficiently paid attention to, so analyses of the impact of income level on the skeletal muscle health of the older people in rural areas of China are of great practical significance. Based on the annual data of the China Health and Nutrition Survey (CHNS) in 2006, 2009, and 2011, we introduced the mediator variable of dietary knowledge and used the Probit model regression, mediation effect model, and instrumental variable regression to assess the skeletal muscle health status of the rural older people in China and explore the mechanism of the influence of the income level on the skeletal muscle health of the rural older residents in China. The primary objectives of this study were to evaluate the impact of income level on the skeletal muscle health status of older adults living in rural areas of China and to investigate the underlying mechanisms. By analyzing the findings of this study, our aim is to establish a correlation between the economic status and skeletal muscle health of older adults in rural communities, as well as elucidate the influence of income level and dietary knowledge on their skeletal muscle health. Through the attainment of these objectives, we hope to provide valuable insights and recommendations for enhancing skeletal muscle health among the rural older population in China. Based on our research findings, it can be inferred that there was a significant association between the financial status of rural older adults and their skeletal muscle health. Additionally, the prevalence of sarcopenia was lower among individuals with higher income levels, and there was a negative correlation between the prevalence of sarcopenia and the level of dietary knowledge among rural older individuals. The knowledge of dietary knowledge level of rural older people plays a mediating role in the income level and the prevalence of sarcopenia. Moreover, with the change in income level and the increase in age, the change in skeletal muscle health status showed obvious heterogeneity, in which the effect on the relatively younger (65-70 years old) samples was greater. Therefore, sustained income growth remains an effective way to improve the skeletal muscle health of older rural residents. At the same time, improving dietary knowledge and dietary quality among the older people is important in preventing a decline in muscle strength and physical function and in preventing the onset of sarcopenia.

The experience of eating for older nursing home residents with dysphagia: A qualitative descriptive study.

BACKGROUND: Understanding the experience of eating for nursing home residents with dysphagia is essential for developing effective and holistic compensatory intervention programmes for older adults with dysphagia. However, there is a lack of studies on the experience of eating for older adults with dysphagia, especially for individuals in Asian cultures. OBJECTIVES: This study aimed to understand the experience of eating for older nursing home residents who have difficulty swallowing (dysphagia), which is often a problem for this population. METHODS: This qualitative descriptive study recruited older nursing home residents with dysphagia from facilities in central Taiwan. Residents were recruited by purposive sampling. Data were collected through individual in-depth semistructured face-to-face interviews. Interviews were audio-recorded and transcribed interview data were analysed with content analysis. RESULTS: A total of 20 residents participated in the study; the mean age was 78.7 years (standard deviation = 8.54 years); male and female residents were equally represented. The main core theme describing the experience of eating for nursing home residents with dysphagia was irregular coughing, which often occurred spontaneously. Three subthemes described how residents responded: making adjustments to eating and swallowing, receiving assistance from NH staff and fear of eating. CONCLUSIONS: Our findings can serve as an evidence-based reference for clinical care aimed at nursing home residents with dysphagia. Support programmes that provide safe swallowing skills and emotional support for managing dysphagia are recommended. IMPLICATIONS FOR PRACTICE: Nursing home residents with dysphagia should receive interventions focussed on self-supporting care, training in swallowing skills and emotional support.

Prevalência de hipertensão arterial e fatores associados em adultos e idosos residentes em Teresina, Piauí: uma análise hierarquizada / Prevalence of hypertension and associated factors in adults and older residents of Teresina, Piauí: a hierarchical analysis / Prevalencia de hipertensión arterial y factores asociados en adultos y ancianos residentes en Teresina, Piauí: un análisis jerárquico

Introdução: A hipertensão arterial sistêmica (HAS) é um problema de saúde pública, com elevada prevalência em âmbito mundial. Inúmeros fatores, tais como idade, sexo, raça/cor, escolaridade, renda, acesso aos serviços de saúde e hábitos de vida são descritos como influenciadores da prevalência da HAS. A maioria deles é considerada modificável e controlável pela adoção de um estilo de vida saudável. Objetivo: Estimar a prevalência de HAS e fatores associados em adultos e idosos residentes em Teresina, Piauí. Métodos: Estudo transversal, de base populacional, com 898 adultos e idosos. A amostragem foi probabilística complexa por conglomerados. O desfecho foi o diagnóstico autorreferido de HAS. Realizou-se análise hierarquizada em três blocos (características sociodemográficas, acompanhamento da saúde e estilo de vida) com cálculo de razão de prevalência (RP) e intervalos de confiança de 95% (IC95%) por regressão múltipla de Poisson. Resultados: A prevalência geral da HAS autorreferida foi de 27,9% e aumentou com a progressão da faixa etária. No modelo final, os fatores associados à HAS autorreferida foram: idade≥60 anos (RP=8,08; IC95% 3,72­17,52), sem escolaridade (RP=1,73; IC95% 1,18­2,54), última aferição da PA<6 meses (RP=2,64; IC95% 1,56­4,47), consumo regular de sal (RP=0,70; IC95% 0,52­0,93), circunferência da cintura alterada (RP=1,56; IC95% 1,29­1,90) e pressão arterial alterada (RP=1,64; IC95% 1,35­2,01). Conclusões: A prevalência da HAS autorreferida foi mais alta comparada com diferentes estudos nacionais e internacionais realizados nos últimos anos, com crescimento linear associado à progressão da faixa etária. Os fatores associados identificados refletem os grupos vulneráveis para HAS já conhecidos e outros podem ser resultados do crescimento da prevalência entre outras camadas sociais de maior renda. Diante da elevada prevalência da HAS em Teresina, da sua alta carga de morbimortalidade e de ser a principal causa evitável de morte prematura, torna-se necessário a intensificação das ações de promoção de saúde, prevenção do agravo e monitoramento do tratamento da HAS no município.

Introduction: Hypertension (HT) is a public health problem with high prevalence worldwide. Countless factors, such as age, sex, race/color, education, income, access to health services and lifestyle habits, are described as influencing the prevalence of HT, most of which are considered modifiable and controllable by the adoption of a healthy lifestyle. Objective: To estimate the prevalence of HT and associated factors in adults and older people living in Teresina, Piauí. Methods: Population-based cross-sectional study with 898 adults and older individuals. Sampling was complex probabilistic by clusters. The outcome was the self-reported diagnosis of HT. A hierarchical analysis was performed in three blocks (sociodemographic characteristics, monitoring of health and lifestyle) with determination of the prevalence ratio (PR) and 95% confidence interval (95%CI) by Poisson multiple regression. Results: The overall prevalence of self-reported HT was 27.9% and increased with age. In the final model, the factors associated with self-reported HT were: age ≥60 years (PR=8.08; 95%CI 3.72­17.52), no education (PR=1.73; 95%CI 1.18­2.54), last blood pressure measurement <6 months prior (PR=2.64; 95%CI 1.56­4.47), regular salt intake (PR=0.70; 95%CI 0.52­0.93), altered waist circumference (PR=1.56; 95%CI 1.29­1.90) and altered blood pressure (PR=1.64; 95%CI 1.35­2.01). Conclusions: The prevalence of self-reported HT was higher, compared to different national and international studies carried out in recent years, with linear growth, associated with age group progression. The associated factors identified reflect the already known vulnerable groups for HT, and others may be the result of the growth in prevalence among other higher income social strata. In view of the high prevalence of HT in Teresina, its high burden of morbidity and mortality and being the main preventable cause of premature death, it is necessary to intensify measures to promote health, prevent the disease and monitor the treatment of HT in the municipality.

Introducción: La hipertensión arterial sistémica (HAS) es un problema de salud pública con alta prevalencia a nivel mundial. Innumerables factores, como la edad, el sexo, la raza/color, la educación, la renta, el acceso a los servicios de salud y los hábitos de vida, se describen como influyentes en la prevalencia de la HAS, la mayoría de los cuales se consideran modificables y controlables mediante la adopción de un estilo de vida saludable. Objetivo: Estimar la prevalencia de hipertensión arterial sistémica (HAS) y factores asociados en adultos y ancianos residentes en Teresina, Piauí. Métodos: Estudio transversal de base poblacional con 898 adultos y ancianos. El muestreo fue complejo probabilístico por conglomerados. El resultado fue el diagnóstico autoinformado de HSA. Se realizó un análisis jerárquico en tres bloques (características sociodemográficas, seguimiento de la salud y estilo de vida) con cálculo de la Razón de Prevalencia (RP) e intervalos de confianza del 95% (IC95%) por regresión múltiple de Poisson. Resultados: La prevalencia general de HSA autoinformada fue del 27,9% y aumentó con la progresión de la edad. En el modelo final, los factores asociados a la HAS autoinformada fueron: edad≥60 años (RP=8,08; IC95% 3,72­17,52), sin escolaridad (RP=1,73; IC95% 1,18­2,54), última Medición de PA<6 meses (RP=2,64; IC95% 1,56­4,47), ingesta regular de sal (RP=0,70; IC95% 0,52­0,93), Circunferencia de Cintura alterada (RP=1,56; IC95% 1,29­1,90) y Presión Arterial Alterada (RP=1,64; IC95% 1,35­2,01). Conclusiones: La prevalencia de HAS autorreferida fue mayor, en comparación con diferentes estudios nacionales e internacionales realizados en los últimos años, con crecimiento lineal, asociado a la progresión por grupos de edad. Los factores asociados identificados reflejan los grupos vulnerables ya conocidos para la HAS y otros pueden ser el resultado del crecimiento de la prevalencia entre otros estratos sociales de mayores ingresos. Ante la alta prevalencia de HAS en Teresina, su alta morbilidad y mortalidad y ser la principal causa evitable de muerte prematura, es necesario intensificar las acciones de promoción de la salud, prevención del agravamiento y seguimiento del tratamiento de la HAS en el municipio.

Depression in nursing home residents and its correlation with meaning of family involvement and depression of family.

OBJECTIVES: This study aimed to investigate the relationship between depression in older nursing home residents and family caregivers' (FCGs) depressive status and reasons for involvement with residents. DESIGN: This study employed a cross-sectional design. SETTING: Eight nursing homes in northern Taiwan. PARTICIPANTS: A total of 139 older resident-FCG pairs were recruited. MEASUREMENTS: Depression was measured with the Geriatric Depression Scale-Short Form for nursing home residents and the Center for Epidemiologic Studies Depression Scale-Short Form for family members. Depression and demographic data were collected with face-to-face interviews. The meaning ascribed to caregivers' nursing home visits was calibrated using the Family Meaning of Nursing-Home Visits scale. Multiple logistic regression was used to understand the factors related to residents' depressive symptoms. RESULTS: Depressive symptoms were present in 58.3% of the nursing home residents (n = 81). Depressive status of family members (Chi-square = 1.46, p = 0.23) or family's visiting frequency (Chi-square = 1.64, p = 0.44) did not differ between residents with or without depressive symptoms. Factors associated with an increased risk of residents having depressive symptoms were age, self-perceived health status, and having a caregiver motivated to visit to assuage their guilt. CONCLUSIONS: Visiting a family member to assuage their guilt was the only caregiver variable associated with depressive symptoms for nursing home residents. This finding suggests that developing interventions to improve personal relationships between nursing home residents and family members might facilitate the emotional support of caregivers and psychological support for older nursing home residents in Taiwan.

Neighbourhood socio-economic status and positive affectivity among older residents in Germany: a cross-sectional analysis with data from the Heinz Nixdorf Recall Study.

BACKGROUND: Physical and social neighbourhood characteristics can vary according to the neighbourhood socio-economic status (SES) and influence residents' perceptions, behaviours and health outcomes both positively and negatively. Neighbourhood SES has been shown to be predictive of mental health, which is relevant for healthy ageing and prevention of dementia or depression. Positive affectivity (PA) is an established indicator of mental health and might indicate a positive emotional response to neighbourhood characteristics. In this study, we focussed on the association of neighbourhood SES with PA among older residents in Germany and considered social integration and environmental perceptions in this association. METHODS: We used questionnaire-based data of the ongoing population-based Heinz Nixdorf Recall Study for our cross-sectional analysis, complemented by secondary data on social welfare rates in the neighbourhood of residents' address. PA was assessed using the Positive and Negative Affect Schedule (PANAS) in 2016. Linear regression models were performed to estimate the associations and adjusted for socio-demographic variables. RESULTS: Higher social welfare rates were associated with lower PA scores. The strongest negative association from the crude model (b = -1.916, 95%-CI [-2.997, -0.835]) was reduced after controlling for socio-demographic variables (b = -1.429, 95%-CI [-2.511, -0.346]). Social integration factors (b = -1.199, 95%-CI [-2.276, -0.121]) and perceived environmental factors (b = -0.875, 95%-CI [-1.971, 0.221]) additionally diminished the association of social welfare rates with PA in the full model (b = -0.945, 95%-CI [-2.037, 0.147]). CONCLUSION: Our results suggest that neighbourhoods have an influence on the occurrence and the extent of PA. Public health interventions that address socio-economic disadvantage in the neighbourhood environment could be an effective and far-reaching way to reduce the risk of depression and depressive symptoms due to low PA in older residents.

[Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future]. / Residencias de ancianos en Portugal durante la COVID-19: desafíos para el futuro.

OBJECTIVE: This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak. METHOD: A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal. RESULTS: The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support. CONCLUSIONS: Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.

Residencias de ancianos en Portugal durante la COVID-19: desafíos para el futuro / Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future

Objetivo:Este estudio pretende explorar la percepción de los especialistas sobre el desempeño de las residencias de ancianos durante la COVID-19.Método:Este es un estudio desarrollado en 2 fases: 1) un grupo focal, con el que se trabajó en mayo 2020, con 5 especialistas y 2) un Delphi modificado, implementado en septiembre 2020 con 22 especialistas, ambos en el área de asistencia en residencias de ancianos del norte y centro de Portugal.Resultados:Los resultados permitieron identificar 3 áreas principales que influenciaron el desempeño de las residencias de ancianos desde el inicio del brote de la COVID-19: modelos de organización y recursos; salud física y mental de los residentes y; la familia como apoyo.Conclusiones:Las personas mayores que residen en residencias para ancianos quedan particularmente vulnerables a la COVID-19, pues esta enfermedad puede tener para ellos consecuencias muy graves o incluso conducirle a la muerte. Es importante que las residencias prevengan la fragilidad física y mental de los ancianos, así como la soledad que muy probablemente les asola debido a las circunstancias pandémicas. Los responsables por las residencias de ancianos deben percibir que las personas mayores que viven en ellas tienen. por lo general. problemas de salud, lo que debería determinar la implementación de nuevas estrategias, entre ellas el aumento del número de profesionales debidamente capacitados.

Objective:This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak.Method:A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal.Results:The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support.Conclusions:Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.

[Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future]. / Residencias de ancianos en Portugal durante la COVID-19: desafíos para el futuro.

Objective: This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak. Method: A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal. Results: The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support. Conclusions: Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.

Factors Associated With COVID-19 Hospitalizations and Deaths in French Nursing Homes.

OBJECTIVES: To describe the clinical characteristics and management of residents in French nursing homes with suspected or confirmed coronavirus disease 2019 (COVID-19) and to determine the risk factors for COVID-19-related hospitalization and death in this population. DESIGN: A retrospective multicenter cohort study. SETTING AND PARTICIPANTS: Four hundred eighty nursing home residents with suspected or confirmed COVID-19 between March 1 and May 20, 2020, were enrolled and followed until June 2, 2020, in 15 nursing homes in Marseille's greater metropolitan area. METHODS: Demographic, clinical, laboratory, treatment type, and clinical outcome data were collected from patients' medical records. Multivariable analysis was used to determine factors associated with COVID-19-related hospitalization and death. For the former, the competing risk analysis-based on Fine and Gray's model-took death into account. RESULTS: A total of 480 residents were included. Median age was 88 years (IQR 80-93), and 330 residents were women. A total of 371 residents were symptomatic (77.3%), the most common symptoms being asthenia (47.9%), fever or hypothermia (48.1%), and dyspnea (35.6%). One hundred twenty-three patients (25.6%) were hospitalized and 96 (20%) died. Male gender [specific hazard ratio (sHR) 1.63, 95% confidence interval (CI) 1.12-2.35], diabetes (sHR 1.69, 95% CI 1.15-2.50), an altered level of consciousness (sHR 2.36, 95% CI 1.40-3.98), and dyspnea (sHR 1.69, 95% CI 1.09-2.62) were all associated with a greater risk of COVID-19-related hospitalization. Male gender [odds ratio (OR) 6.63, 95% CI 1.04-42.39], thermal dysregulation (OR 2.64, 95% CI 1.60-4.38), falls (2.21 95% CI 1.02-4.75), and being aged >85 years (OR 2.36, 95% CI 1.32-4.24) were all associated with increased COVID-19-related mortality risk, whereas polymedication (OR 0.46, 95% CI 0.27-0.77) and preventive anticoagulation (OR 0.46, 95% CI 0.27-0.79) were protective prognostic factors. CONCLUSIONS AND IMPLICATIONS: Male gender, being aged >85 years old, diabetes, dyspnea, thermal dysregulation, an altered level of consciousness, and falls must all be considered when identifying and protecting nursing home residents who are at greatest risk of COVID-19-related hospitalization and death.

Pain prevalence among residents living in nursing homes and its association with quality of life and well-being.

BACKGROUND: Pain is common and often more complex to assess among nursing homes residents with cognitive impairments. Thus, more research is needed of different pain assessment methods in elderly care and how these assessments outcomes are related to quality of life, as there mostly should be a negative relationship. There is a risk that pain are under diagnosed among persons with cognitive impairment. AIM: The aim was to describe and compare pain prevalence among nursing home residents (1) using different pain assessment methods (2) in relation to cognitive status and to (3) examine associations between pain and quality of life or well-being. METHODS: A cross-sectional correlational design was used, participants were 213 nursing home residents and data were collected through interviews using standardised protocols. Instrument used were Katz index of ADL, Mini-Mental-State-Examination, Quality of Life in Late-Stage Dementia scale, WHO-5 well-being index, Numeric Rating Scale and Doloplus-2 scale. RESULTS: The results showed high pain prevalence, but no significant difference based on cognitive level. Pain classification at the individual level varied somewhat when different instruments are used. The results indicated that use of a single-item proxy-measure for pain tends to show higher pain prevalence and was not statistically significant related to quality of life. The relationship with quality of life was statistically significant when self-rated pain instruments or multi-component observation were used. CONCLUSIONS: The study shows that it is difficult to estimate pain in residents living at nursing homes and that it continues to be a challenge to solve. Self-rated pain should be used primarily to assess pain, and a multi-component observation scale for pain should be used when residents are cognitively impaired. Both self-rated pain and multi-component observation also support the well-known link between pain and quality of life. Single-item proxy assessments should only be used in exceptional cases.

Comparison of revised EWGSOP criteria and four other diagnostic criteria of sarcopenia in Chinese community-dwelling elderly residents.

OBJECTIVES: To compare the prevalence and associated factors of sarcopenia defined by the revised European Working Group on Sarcopenia in Older People (EWGSOP2) criteria with the initial European Working Group on Sarcopenia in Older People (EWGSOP1) criteria, the Asia Working Group for Sarcopenia (AWGS), the International Working Group on Sarcopenia (IWGS), and the National Institutes of Health (FNIH) Sarcopenia Project criteria among Chinese community-dwelling older adults. DESIGN: A cross-sectional study. SETTING: Two community health centers in Urumqi, China. PARTICIPANTS: A total of 483 participants aged 60 years and older from the community. MEASUREMENT: Anthropometry, skeletal muscle mass, handgrip strength, 4-m walking speed, and biochemical markers. Questionnaire collected information included demographics, lifestyle, and quality of life. RESULTS: The prevalence of EWGSOP2-defined sarcopenia (men: 6.5%; women: 3.3%) was lower than that defined by the EWGSOP1 (men: 22.3%; women 11.7%), AWGS (men: 10.9%; women: 8.0%), and IWGS (men: 24.5%; women: 11.0%) criteria, but higher than FNIH criteria (men: 6.0%; women: 1.7%). The positive percent agreement was lower (men: 15.6%-63.6%; women: 15.2%-40.0%), while negative percent agreement was higher (men: 96.4%-100.0%; women: 97.3%-99.6%). Sex (OR 0.31, 95% CI 0.12-0.81), education level (OR 0.49, 95% CI 0.29-0.83), and body mass index (BMI, OR 0.73, 95% CI 0.62-0.86) were associated with sarcopenia defined by the EWGSOP2 criteria. No consistent pattern of risk factors associated with sarcopenia in EWGSOP2 and four other diagnostic criteria was present. CONCLUSIONS AND IMPLICATIONS: The EWGSOP2 criteria did not agree with the EWGSOP1, AWGS, IWGA, and FNIH criteria defining sarcopenia. Risk factors associated with the EWGSOP2-defined sarcopenia have no consistent patterns with the EWGSOP1, AWGS, IWGA, and FNIH criteria. Therefore, the validity of the EWGSOP2 consensus needs to be confirmed in further prospective studies.

Exploring resident-staff relationships in nursing homes in Lebanon.

Objectives: To explore the prevailing relationships between residents and staff in nursing homes in Lebanon, and to elicit factors that influence these relationships.Method: Using a qualitative phenomenological design, this study was conducted to explore the lived experience of residents, especially pertaining to their relationships with staff. The study included 13 residents aged 65 and above with no cognitive impairment. Data were collected using semi-structured interviews and were analysed using the Giorgi method.Findings: Two main themes representing resident perceptions about their interactions with the nurses emerged: (1) relationships to satisfy the need for physical care, (2) relationships that foster a bond of caring and trust.Discussion: Reflecting about resident-nurse relationships and examining factors that promote trust and stronger bonding help caregivers understand the importance of fostering a stronger relationship with residents. These findings have implications for developing policy and practice in nursing homes in Lebanon and elsewhere.Conclusion: This is the first study conducted by a nurse researcher in Lebanon that has explicitly explored the nature of relationships between caregivers and care-receivers in nursing homes. The contribution of this study is not solely restricted to experiences and outcomes of care, but also includes implications for policy and practice.

Hydration Interventions for older people living in residential and nursing care homes: overview of the literature.

INTRODUCTION: Care home populations experiencing high levels of multi-morbidity and dementia require support from caregivers to meet their hydration requirements. This article provides an overview of literature related to hydration interventions and highlights gaps in knowledge. SOURCES OF DATA: This paper draws on UK-focused literature from Applied Social Sciences Index and Abstracts (ASSIA), CINAHL, Medline, Proquest Hospital Premium Collection, Cochrane Library and RCN databases on hydration interventions for older people living with multi-morbidity and dementia in care homes. AREAS OF AGREEMENT: Fluid intake is too low in care home residents, and no single hydration intervention is effective in addressing the complex problems that older residents present. AREAS OF CONTROVERSY: There is a lack of consensus about how much fluid an older person should consume daily for optimum health. There is also lack of agreement about what interventions are effective in supporting individuals with complex physical and cognitive problems to achieve daily fluid intake targets. GROWING POINTS: To improve hydration care for residents, care home teams should be competent in the delivery of hydration care, and work closely with integrated multi-professional healthcare specialists to provide proactive case management. AREAS TIMELY FOR DEVELOPING RESEARCH: There is a need for understanding of what hydration practices and processes are effective for care home residents and including these in multi-component interventions.

Nurses' perceptions regarding providing psychological care for older residents in long-term care facilities: A qualitative study.

AIMS AND OBJECTIVES: To explore nurses' perceptions regarding providing psychological health care for older residents in long-term care facilities (LTCFs). BACKGROUND: Loneliness and depressive symptoms are commonly observed among older residents living in LTCFs. Nurses are expected to provide holistic care including physical, psychological and social care for older residents in LTCFs to fulfil their needs. Therefore, understanding nurses' feelings and thoughts regarding providing care for older residents who feel lonely, sad, unhappy or depressed is important for delivering better care. DESIGN: A qualitative research design was employed. The Standards for Reporting Qualitative Research (SRQR) was used to enhance for reporting quality. METHODS: Purposive sampling and snowball sampling were applied in Northern Taiwan. One-to-one in-depth interviews were conducted using a semi-structured interview guide. Twenty-one nurses with a mean age of 38.4 years were interviewed. Content analysis was performed for data analysis. FINDINGS: Four themes were generated from the data: "insufficient psychological healthcare competency," "having a willing heart but not adequate support," "families playing an essential role in residents' mood" and "physical-oriented care model." CONCLUSIONS: Long-term care facilitie nurses felt that they were not adequately prepared for taking care of older adults' psychological problems before their nursing career or during their practice. Unreasonable nurse-to-resident ratios and an absence of care consensus among healthcare providers can make nurses feel that they have a willing heart but not adequate support. Family members are essential in older residents' emotional status within the Taiwanese cultural context. Physical care evaluation indicators emphasised by LTCF accreditation resulted in the current care practice model. IMPLICATIONS FOR PRACTICE: This study provides valuable information for LTCF nurses, managers and directors to develop appropriate strategies to assist nurses in providing better psychological health care for older residents. Evaluation indicators required by LTCF accreditation in Taiwan must be re-examined at the earliest stage.

Efficacy of a horticultural activity program for reducing depression and loneliness in older residents of nursing homes in Taiwan.

Promoting psychological health in older populations is important. This study evaluated a horticultural activity program for reducing depression and loneliness in older residents of nursing homes in Taiwan. A convenience sample of 150 older residents of three nursing homes were recruited and randomly assigned to either an experimental group or a control group. The experimental group (n = 75) participated in an 8-week horticultural activity program. The control group (n = 75) received routine care. Generalized estimating equations analyses revealed significant time by treatment interaction effects for depression (p < .001) and loneliness (p < .001). This study provides a reference for improving psychological health in older people.

Does geriatric nursing staff burnout predict well-being of LTC residents?

Nursing staff in residential settings are exposed to a large number of stressors. This study examined the relationship between geriatric nursing staff (GNS) burnout and the well-being of residents in long-term care (LTC) facilities. Data were obtained concerning 590 older residents who were served by 315 GNS in 172 LTC facilities in Taiwan, using multilevel modeling. The depersonalization (DP) dimension of burnout in GNS was consistently related to various resident well-being outcomes. Higher DP among GNS was associated with lower residential satisfaction and perceived quality-of-life, as well as more depressive symptoms among older LTC residents. The findings support the claim that DP among GNS has a greater role in determining LTC resident well-being than other dimensions of burnout. Efforts should be made to mitigate the emergence of DP among GNS. Support and education are also needed to enable GNS to foster positive interactions and relationships with LTC residents.

Occupation-based differences in shared perceptions of older resident needs within multidisciplinary care teams: a cross-sectional study of care workers, nurses, and therapists linked to older residents.

[Purpose] To examine whether the needs of older individuals are commonly understood by multidisciplinary team members at elderly care facilities. [Subjects and Methods] A questionnaire survey with care workers, nurses, and therapists linked to residents and structured interviews with residents were conducted at eight facilities in Japan. The questionnaire comprised 25 items regarding basic activities of daily living, instrumental activities of daily living (IADL), environment and lifestyle (EL), and emotion. [Results] The data of 88 residents (83.0% female, 86.4% aged ≥75 years) and 125 staff members (63 care workers, 36 nurses, and 26 therapists) were analyzed. Perceptions regarding the subjective needs of residents differed significantly by occupation with regard to pace of eating, pace of dressing, and freedom to brush at any time; shaving or putting on make-up; personal space, role performance, and health exercises; and feeling good. All three occupations underestimated the subjective needs of residents for household chores. [Conclusion] Staff members had insufficient understanding of the subjective needs of residents, with a tendency to underestimate IADL and EL needs. Perceived subjective needs also differed by occupation. Sharing the understanding of subjective needs of older individuals within multidisciplinary care teams is desired.

Urban-rural differences in social capital in relation to self-rated health and subjective well-being in older residents of six regions in Poland.

The aim of the study was to assess the differences between rural and urban areas as regards the role of social capital and its effect on self-rated health and subjective well-being among older people in Poland. The sample was selected on the basis of multi-stage clustered design from the non-institutionalized adult population. Analysis was based on 1,299 elderly people aged 65 and over from the general Polish population who participated in the COURAGE in Europe project. Six regions of Poland were distinguished according to first level of Nomenclature of Units for Territorial Statistics (NUTS) classification . As an indicator of social capital, the COURAGE Social Network Index, the OSLO-3 Social Support Scale, and the three item UCLA Loneliness scale were used, as well as social participation and trust was assessed. Self-rated health (SRH) was measured by WHO-Europe recommended version (ranging from 'very good' to 'very bad'). Well-being was assessed by the Day Reconstruction Method. Results: The results showed that in urban areas, social network and social participation supported positive self-rated health; in rural, older residents the number of years of education and social support played the same role, while self-rated health decreased with an increasing level of loneliness. Self-rated health decreased in both groups of older people with a growing number of diseases. The multivariate linear regression model of predictors of well-being in older age also confirmed differences between urban and rural elderly residents. In rural residents, subjective well-being significantly increased with the positive effect of the social network. In both urban and rural areas, poor assessment of subjective well-being in older age increased with a higher level of loneliness and growing number of chronic diseases.