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1.
Am J Nurs ; 121(2): 69, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33497135

RESUMO

According to this study: A study of adults age 70 or older without major comorbidities showed that treatment with vitamin D3, omega-3 fatty acids, or a strength training exercise program didn't result in clinically significant changes in blood pressure, nonvertebral fractures, physical performance, infection rates, or cognitive function.


Assuntos
Suplementos Nutricionais/normas , Treinamento de Resistência/normas , Suplementos Nutricionais/estatística & dados numéricos , Método Duplo-Cego , Geriatria/normas , Geriatria/estatística & dados numéricos , Humanos , Placebos , Treinamento de Resistência/estatística & dados numéricos
2.
Healthc (Amst) ; 9(1): 100511, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33340801

RESUMO

The COVID-19 pandemic threatens the health and well-being of older adults with multiple chronic conditions. To date, limited information exists about how Accountable Care Organizations (ACOs) are adapting to manage these patients. We surveyed 78 Medicare ACOs about their concerns for these patients during the pandemic and strategies they are employing to address them. ACOs expressed major concerns about disruptions to necessary care for this population, including the accessibility of social services and long-term care services. While certain strategies like virtual primary and specialty care visits were being used by nearly all ACOs, other services such as virtual social services, home medication delivery, and remote lab monitoring were far less commonly accessible. ACOs expressed that support for telehealth services, investment in remote monitoring capabilities, and funding for new, targeted care innovation initiatives would help them better care for vulnerable patients during this pandemic.


Assuntos
Organizações de Assistência Responsáveis/normas , Doença Crônica/terapia , Geriatria/economia , Organizações de Assistência Responsáveis/organização & administração , Organizações de Assistência Responsáveis/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/economia , Geriatria/métodos , Geriatria/estatística & dados numéricos , Humanos , Inquéritos e Questionários , Estados Unidos
3.
Eur J Clin Microbiol Infect Dis ; 39(11): 2085-2090, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32594325

RESUMO

SARS-CoV-2 dramatically revealed the sudden impact of respiratory viruses in our lives. Influenza and respiratory syncytial virus (RSV) infections are associated with high rates of morbidity, mortality, and an important burden on healthcare systems worldwide, especially in elderly patients. The aim of this study was to identify severity predictors in the oldest-old admitted with influenza and/or RSV infections. This is a multicenter, retrospective study of all oldest-old patients (≥ 85 years old) admitted for laboratory-confirmed influenza and/or RSV infection in three tertiary hospitals in Portugal, Italy, and Cyprus over two consecutive winter seasons. The outcomes included the following: pneumonia on infection presentation, use of non-invasive ventilation (NIV), and in-hospital death (IHD). The association with possible predictors, including clinical features and type of virus infection, was assessed using uni- and multivariable analyses. A total of 251 oldest-old patients were included in the study. Pneumonia was evident in 32.3% (n = 81). NIV was implemented in 8.8% (n = 22), and IHD occurred in 13.9% (n = 35). Multivariable analyses revealed that chronic obstructive pulmonary disease (COPD) or asthma was associated with pneumonia (OR 1.86; 95% CI 1.02-3.43; p = 0.045). COPD or asthma (OR 4.4; 95% CI 1.67-11.6; p = 0.003), RSV (OR 3.12; 95% CI 1.09-8.92; p = 0.023), and influenza B infections (OR 3.77; 95% CI 1.06-13.5; p = 0.041) were associated with NIV use, respectively, while chronic kidney disease was associated with IHD (OR 2.50; 95% CI 1.14-5.51; p = 0.023). Among the oldest-old, chronic organ failure, such as COPD or asthma, and CKD predicted pneumonia and IHD, respectively, beyond the importance of viral virulence itself. These findings could impact on public health policies, such as fostering influenza immunization campaigns, home-based care programs, and end-of-life care. Filling knowledge gaps is crucial to set priorities and advise on transition model of care that best fits the oldest-old.


Assuntos
Geriatria/estatística & dados numéricos , Influenza Humana/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Idoso de 80 Anos ou mais , Europa (Continente)/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Influenza Humana/terapia , Masculino , Ventilação não Invasiva/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Infecções por Vírus Respiratório Sincicial/terapia , Estudos Retrospectivos , Estações do Ano , Centros de Atenção Terciária
4.
Adv Gerontol ; 33(2): 391-396, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32593258

RESUMO

The article analyzes the situation with the development of gerontology in the Kyrgyz Republic. The long-term process of the formation of the gerontological service in the country and its achievements are described in detail. The positive fact is that not only international organizations, but also the state and society itself began to pay attention to the problem of older people. Despite the certain and achieved successes in the development of the service, problems are indicated that require urgent measures to resolve, especially the development of the geriatric service, which today does not meet the modern challenges of aging. The important role of creating the gerontology institute, as a coordinating body in the training of specialized personnel, in the development and implementation of cooperated scientific research and the implementation of their results in healthcare practice was emphasized.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Geriatria/estatística & dados numéricos , Humanos , Quirguistão/epidemiologia
5.
Maturitas ; 134: 47-53, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32143776

RESUMO

OBJECTIVES: We investigated trends in end-of-life hospitalizations among nursing home residents (NHR) over 10 years and looked at differences between age groups and sexes as well as the length of terminal hospital stays. STUDY DESIGN: Retrospective cohort study based on health insurance claims data of the AOK Bremen/Bremerhaven. All NHR aged 65 years or more who died between 2006 and 2015 were included. MAIN OUTCOME MEASURES: We assessed the proportions of decedents who were in hospital on the day of death and during the last 3, 7, 14 and 30 days of life, stratified by two-year periods. Multiple logistic regressions were conducted to study changes over time, adjusting for covariates. RESULTS: A total of 10,781 decedents were included (mean age 86.1 years, 72.1 % females). Overall, 29.2 % died in hospital, with a slight decrease from 30.3 % in 2006-2007 to 28.3 % in 2014-2015 (OR 0.86; 95 % CI 0.75-0.98). Of the 3150 terminal hospitalizations, 35.5 % lasted up to 3 days and the mean length of stay decreased from 9.0 (2006-2007) to 7.5 days (2014-2015). When looking at the last 7, 14 and 30 days of life, no changes over time were found. Male sex and younger age were associated with a higher chance of end-of-life hospitalization in almost all analyses. CONCLUSIONS: End-of-life hospitalizations of NHR are common in Germany. There has been a small decrease during recent years in the proportion of in-hospital deaths, but not of hospitalizations during the last 7, 14 and 30 days of life. This might be explained by shorter durations of hospital stays.


Assuntos
Geriatria/tendências , Tempo de Internação , Casas de Saúde/tendências , Assistência Terminal/tendências , Idoso , Idoso de 80 Anos ou mais , Feminino , Geriatria/estatística & dados numéricos , Alemanha/epidemiologia , Hospitais , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Casas de Saúde/estatística & dados numéricos , Análise de Regressão , Estudos Retrospectivos , Assistência Terminal/estatística & dados numéricos , Fatores de Tempo
6.
Rev Bras Enferm ; 73(1): e20180191, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049235

RESUMO

OBJECTIVE: to describe the mental health profile of the elderly registered in a Family Health Unit in the city of Recife, Pernambuco State. METHOD: it was a descriptive quantitative study, conducted with 159 elderly through the scales Geriatric Depression, Resilience, Social Support, Life Satisfaction, and Positive and Negative Affects, Mini-Mental State Examination, Stressful Events Inventory and Brazil Old Age Shedule. RESULTS: females, young and literate elderly predominated. Most were satisfied with life, 52.2% without depressive symptoms, 68.6% without cognitive impairment, 67.9% high resilience and 95.8% high social support, but 62% of elderly with depressive symptoms showed cognitive deficit. Negative correlation was identified between depression and cognitive impairment, resilience, social support and life satisfaction. CONCLUSION: assessment of these indicators identifies triggers of psychological distress, assisting the nursing staff in the development of preventive and care actions.


Assuntos
Geriatria/classificação , Transtornos Mentais/psicologia , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Geriatria/métodos , Geriatria/estatística & dados numéricos , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Qualidade de Vida/psicologia
7.
Br J Hosp Med (Lond) ; 81(2): 1-9, 2020 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-32097073

RESUMO

The world's population is ageing rapidly, with significant increases in the numbers of the oldest old. This places great pressure on societies to adapt to this changing demography. Pertinent issues include provision of education and resource for long-term conditions. The priorities older people hold need to be fully understood and their contributions to society, often diverse and far-reaching, recognised with sincerity. Currently, health systems for older people can often feel reactive, fragmented and disjointed. These systems can harbour inequity and ageism, and leave both patients and health-care providers dissatisfied. Regarding the global context, the most rapidly ageing populations are in low- and middle-income countries. This partly reflects huge successes in the treatment and control of communicable diseases but gives rise to the challenge of the 'double burden', managing both communicable and non-communicable diseases simultaneously. Moreover, multimorbidity (suffering two or more chronic conditions) is commonplace and presents further challenges with regards to providing coordinated care. In order to harmonise effective and sustainable change, collaboration at local, national and international levels is key in order to foster a platform for learning and information sharing. Therein lies huge opportunities for countries to share their individual experiences, both past and present, to improve preparedness for global ageing.


Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Geriatria/estatística & dados numéricos , Múltiplas Afecções Crônicas/epidemiologia , Doenças não Transmissíveis/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Comportamento Cooperativo , Diversidade Cultural , Pessoas com Deficiência/estatística & dados numéricos , Idoso Fragilizado/estatística & dados numéricos , Alocação de Recursos para a Atenção à Saúde/organização & administração , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Internacionalidade , Pessoa de Meia-Idade , Multimorbidade , Múltiplas Afecções Crônicas/etnologia , Doenças não Transmissíveis/mortalidade
8.
Nurse Educ Pract ; 42: 102684, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31931303

RESUMO

A growing older adult population requires educational programs which prepare nursing students to care for and increase their interest in working with this population. Faculty at a large public university developed a course specific to gerontology to address this need, including designing a service-learning intervention entitled Aging is Very Personal. The purpose of this study was to explore the impact of this course on student attitudes towards working with older adults. Using a convergent parallel mixed-methods design, 79 students completed pre-course and post-course quantitative surveys and open-ended questions using the Senses Framework survey. Quantitative data were analyzed using a paired-sample t-test. Qualitative data were analyzed using Krippendorff's method of qualitative content analysis. Participants showed statistically significant positive changes in attitudes towards working with older adults on 11 of 15 items. Qualitative findings included 5 themes: acknowledgement of preconceptions prior to course; positive shift in perceptions about older adults; growing interest in working with older adults; appreciation of gerontological nursing as a highly skilled profession; and service-learning as a valuable opportunity to form connections with older adults. A designated course in gerontology with a service-learning component can markedly improve student attitudes towards working with older adults.


Assuntos
Atitude do Pessoal de Saúde , Bacharelado em Enfermagem/normas , Geriatria/educação , Estudantes de Enfermagem/psicologia , Adolescente , Currículo/normas , Currículo/tendências , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/estatística & dados numéricos , Feminino , Geriatria/normas , Geriatria/estatística & dados numéricos , Humanos , Masculino , Estudantes de Enfermagem/estatística & dados numéricos , Adulto Jovem
9.
J Med Libr Assoc ; 108(1): 59-66, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31897052

RESUMO

Objective: This bibliometric study investigated literature pertaining to a quickly growing population worldwide: the oldest-old, individuals age eighty-five and older. The current state of research was surveyed, based on top authors, publishers, authorship networks, themes in publication titles and abstracts, and highly cited publications. Methods: Bibliographic data was abstracted from the Web of Science database. Microsoft Excel was used for data analyses related to top author, publishers, and terms. VosViewer bibliographic visualization software was used to identify authorship networks. Results: Publications pertaining to the oldest-old have increased dramatically over the past three decades. The majority of these publications are related to medical or genetics topics. Citations for these publications remain relatively low but may be expected to grow in coming years, based on the publication behavior about and increasing prominence of this population. Claudio Franceschi and the Journal of the American Geriatrics Society were found to be the author and journal with the most publications pertaining to the oldest-old, respectively. Conclusions: The oldest-old is a population of rapidly growing significance. Researchers in library and information science, gerontology, and beyond can benefit themselves and those they serve by participating in research and specialized services to marginalized populations like the oldest-old. This bibliometric study hopefully serves as a launch-point for further inquiry and research in the years to come.


Assuntos
Indexação e Redação de Resumos/estatística & dados numéricos , Autoria , Pesquisa Biomédica/estatística & dados numéricos , Idoso Fragilizado/estatística & dados numéricos , Geriatria/estatística & dados numéricos , Publicações/estatística & dados numéricos , Editoração/estatística & dados numéricos , Idoso de 80 Anos ou mais , Bibliometria , Feminino , Humanos , Masculino
10.
Am J Emerg Med ; 38(4): 780-784, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31272756

RESUMO

PURPOSE: The quick Sepsis-Related Organ Failure Assessment (qSOFA) score was designed to predict mortality among sepsis patients. However, it has never been used to identify prolonged length of hospital stay (pLOS) in geriatric patients with influenza infection. We conducted this study to clarify this issue. METHODS: We conducted a retrospective case-control study, including geriatric patients (aged ≥ 65 years) with influenza infection visiting the emergency department (ED) of a medical center between January 01, 2010 and December 31, 2015. The included patients were divided into two groups on the basis of their qSOFA score: qSOFA < 2, and qSOFA ≥ 2. Data regarding demographics, vital signs, qSOFA score, underlying diseases, subtypes of influenza, and outcomes were included in the analysis. We investigated the association between qSOFA score ≥ 2 and pLOS (>9 days) via logistic regression. RESULTS: Four hundred and nine geriatric patients were included in this study with a mean age of 79.5 (standard deviation [SD], 8.3) years. The median length of stay (LOS) was 7.0 (interquartile range [IQR], 4-12) days, while the rate of pLOS (> 9 days) was 32%. The median LOS in the qSOFA ≥ 2 group, 11.0 (7-15) days, was longer than the qSOFA < 2 group, 6.0 (4-10) days (p-value <0.01). Logistic regression showed that qSOFA ≥ 2 predicts pLOS with an odds ratio of 3.78 (95% confidence interval, 2.04-6.97). CONCLUSION: qSOFA score ≥ 2 is a prompt and simple tool to predict pLOS in geriatric patients with influenza infection.


Assuntos
Geriatria/instrumentação , Influenza Humana/complicações , Tempo de Internação/estatística & dados numéricos , Escores de Disfunção Orgânica , Idoso , Idoso de 80 Anos ou mais , Feminino , Geriatria/métodos , Geriatria/estatística & dados numéricos , Humanos , Influenza Humana/epidemiologia , Influenza Humana/fisiopatologia , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença , Taiwan/epidemiologia
11.
J Gerontol B Psychol Sci Soc Sci ; 75(1): 58-66, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30877301

RESUMO

OBJECTIVES: Nonsignificant p values derived from null hypothesis significance testing do not distinguish between true null effects or cases where the data are insensitive in distinguishing the hypotheses. This study aimed to investigate the prevalence of Bayesian analyses in gerontological psychology, a statistical technique that can distinguish between conclusive and inconclusive nonsignificant results, by using Bayes factors (BFs) to reanalyze nonsignificant results from published gerontological research. METHODS: Nonsignificant results mentioned in abstracts of articles published in 2017 volumes of 10 top gerontological psychology journals were extracted (N = 409) and categorized based on whether Bayesian analyses were conducted. BFs were calculated from nonsignificant t-tests within this sample to determine how frequently the null hypothesis was strongly supported. RESULTS: Nonsignificant results were directly tested with BFs in 1.22% of studies. Bayesian reanalyses of 195 nonsignificant t-tests found that only 7.69% of the findings provided strong evidence in support of the null hypothesis. CONCLUSIONS: Bayesian analyses are rarely used in gerontological research, and a large proportion of null findings were deemed inconclusive when reanalyzed with BFs. Researchers are encouraged to use BFs to test the validity of nonsignificant results and ensure that sufficient sample sizes are used so that the meaningfulness of null findings can be evaluated.


Assuntos
Pesquisa Biomédica/estatística & dados numéricos , Interpretação Estatística de Dados , Geriatria/estatística & dados numéricos , Psicologia/estatística & dados numéricos , Teorema de Bayes , Pesquisa Biomédica/métodos , Geriatria/métodos , Humanos , Psicologia/métodos
12.
Australas Emerg Care ; 23(2): 84-89, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31771840

RESUMO

BACKGROUND: Pneumonia is one of the most common reasons patients over the age of 65 years present to the Emergency Department (ED). There is a 23-valent pneumococcal vaccine (23vPPV) available under the National Immunisation Program (NIP) with demonstrated 61-71% effectiveness against Invasive Pneumococcal Disease (IPD), but only 51% of adults aged over 65 years are vaccinated in Australia. METHODS: Short semi-structured interviews were conducted with emergency nurses working across a Local Health District in Sydney New South Wales (n=9) in order to determine their knowledge, behaviour and attitudes towards immunisation status screening in the elderly who present to the ED with pneumonia. Questions were structured to the COM-B Model (capability, opportunity and motivation to change behaviour), and a thematic analysis was conducted. RESULTS: There were three major themes identified: (1) The importance of routinisation, (2) Low knowledge levels and, (3) The 'vaccination is for children' heuristic, as well as suggestions for future interventions to improve screening. CONCLUSIONS: These findings clarify how to improve vaccine uptake amongst this vulnerable cohort. They suggest that emergency departments should provide education to nurses. In addition, checklists/tick boxes can prompt nurses whilst conducting routine work, which may lead to increased vaccination uptake.


Assuntos
Geriatria/normas , Imunização/classificação , Programas de Rastreamento/normas , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Geriatria/métodos , Geriatria/estatística & dados numéricos , Humanos , Imunização/normas , Imunização/estatística & dados numéricos , Esquemas de Imunização , Entrevistas como Assunto/métodos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , New South Wales , Pesquisa Qualitativa
13.
BMJ Open ; 9(12): e033462, 2019 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-31831549

RESUMO

OBJECTIVES: Fall-related mortality among older adults is a major public health issue, especially for ageing societies. This study aimed to investigate current trends in fall-related mortality in Japan using nationwide population-based data covering 1997-2016. DESIGN: We analysed fall-related deaths among older persons aged ≥65 years using the data provided by the Japanese Ministry of Health, Labour and Welfare. RESULTS: The crude and age-standardised mortality rates were calculated per 100 000 persons by stratifying by age (65-74, 75-84 and ≥85 years) and sex. To identify trend changes, a joinpoint regression model was applied by estimating change points and annual percentage change (APC). The total number of fall-related deaths in Japan increased from 5872 in 1997 to 8030 in 2016, of which 78.8% involved persons aged ≥65 years. The younger population (65-74 years) showed continuous and faster-decreasing trends for both men and women. Average APC among men aged ≥75 years did not decrease. Among middle-aged and older women (75-84 and ≥85 years) decreasing trends were observed. Furthermore, the age-adjusted mortality rate of men was approximately twice that of women, and it showed a faster decrease for women. CONCLUSIONS: Although Japanese healthcare has shown improvement in preventing fall-related deaths over the last two decades, the crude mortality for those aged over 85 years remains high, indicating difficulty in reducing fall-related deaths in the super-aged population. Further investigations to uncover causal factors for falls in older populations are required.


Assuntos
Acidentes por Quedas , Mortalidade/tendências , Acidentes por Quedas/mortalidade , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Geriatria/métodos , Geriatria/estatística & dados numéricos , Política de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Japão/epidemiologia , Masculino , Saúde Pública
14.
Curr Pharm Teach Learn ; 11(12): 1239-1247, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31836148

RESUMO

INTRODUCTION: One in five Americans will be 65 years and older by 2030. Training student pharmacists to provide quality eldercare as healthcare professionals is essential. The objective of the study was to assess pharmacy students' attitudes toward aging and eldercare before and after a geriatrics-focused elective course. METHODS: The University of Arizona Aging and Health Care (UA AHC) survey was modified for pharmacy and administered pre and post to students enrolled in a geriatrics elective course at three United States (US) colleges of pharmacy. Pre and post means were calculated to examine attitudinal changes after course participation. Factor analysis was performed to examine construct validity by identifying the dimensions being measured. RESULTS: Sixteen of 37 questions differed significantly from pre-course to post-course demonstrating improved attitudes after course participation. Students also reported an awareness of how older adults are viewed and treated. Factor analysis identified seven factors with a range of behaviors, skills, training, and attitudes perceived to be important in geriatric care. Two factors, importance of learning about geriatric care and experience/comfort with older adults, showed significant changes confirming positive impact of the course. CONCLUSIONS: Geriatrics-focused elective courses in three colleges of pharmacy had a positive impact on students' perceived importance of learning about geriatric care and experience/comfort with elders. Further research to adapt and validate the UA AHC survey to pharmacy education is needed. The identification of the skills and attitudes necessary to meet the growing needs of older adults is necessary for pharmacy curriculum implementation and practice.


Assuntos
Geriatria/educação , Geriatria/normas , Adulto , Arizona , Atitude do Pessoal de Saúde , Currículo/tendências , Avaliação Educacional/métodos , Feminino , Geriatria/estatística & dados numéricos , Humanos , Masculino , Faculdades de Farmácia/organização & administração , Faculdades de Farmácia/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
15.
Rev Bras Enferm ; 72(suppl 2): 3-13, 2019 Nov.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31826185

RESUMO

OBJECTIVE: To understand how nursing workers perceive care of hypertension (HBP) in older adult within the scope of the Family Health Strategy. METHOD: A qualitative descriptive study carried out in the city of Natal/RN, with 20 nursing workers providing care to older adults with HBP. The data were obtained through a semi-structured interview and analysed by the Thematic Analysis, based on the theoretical support of the integrality, using Atlas.ti 7.0 software. RESULTS: The elements found as facilitators were: territorialization, partnerships, professional proactivity and the user's bond with the team. Among those found as barriers were: disease-centered care; academic education based on the biomedical model; lack of inter-sectorality and discontinuity of care in the care network. FINAL CONSIDERATIONS: Nursing workers perceive that health institutions lack articulated and innovative practices that incorporate new paradigms focused on integrality of care.


Assuntos
Geriatria/normas , Hipertensão/enfermagem , Enfermeiras e Enfermeiros/psicologia , Percepção , Geriatria/métodos , Geriatria/estatística & dados numéricos , Humanos , Hipertensão/complicações , Entrevistas como Assunto/métodos , Enfermeiras e Enfermeiros/estatística & dados numéricos , Pesquisa Qualitativa
16.
Rev Bras Enferm ; 72(suppl 2): 214-220, 2019 Nov.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31826213

RESUMO

OBJECTIVE: to construct and validate an educational booklet for the elderly, with guidelines on sleep hygiene. METHOD: a methodological research with booklet construction; validation by 22 judges and evaluation by 22 elderly people. The content was extracted from the guidelines of the Brazilian Sleep Association and the elderly health manual of the Human Rights Office. The item with Content Validity Index (CVI) greater than 0.8 or whose concordance ratio verified with the Binomial Test was valid and statistically equal to or greater than 80%. RESULTS: the booklet presented 14 guidelines for the elderly about sleep hygiene distributed over 25 pages. All items were evaluated as relevant. The CVI had an average of 0.95 by the judges and 0.95 by the elderly. CONCLUSION: the booklet was constructed and validated as to its content and appearance. It can be used by health professionals in the various services with the elderly.


Assuntos
Geriatria/instrumentação , Geriatria/normas , Folhetos , Higiene do Sono/fisiologia , Brasil , Geriatria/estatística & dados numéricos , Humanos , Higiene do Sono/efeitos dos fármacos , Inquéritos e Questionários , Estudos de Validação como Assunto
17.
Adv Gerontol ; 32(3): 451-455, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31512434

RESUMO

In the article the authors presented the dynamics of the population over the working age (pension) in the Belgorod region, which for 8 years (2010-2017) increased by 17,1% and confirms the trend of aging of the region's population. An increase of 13,3% in the absolute number of patients over the working age treated in hospitals of medical organizations (MO) of the region was shown. There was a decrease of 1,2% in the rate of hospital (hospitalized) morbidity in this age group. The reasons of hospitalization of these patients in the round-the-clock hospitals of MO of the region (structure of hospital morbidity) among which the following classes of diseases prevailed: systems of blood circulation, neoplasm, diseases of digestive, respiratory, eye and its additional apparatus are analyzed. The average length of stay in hospitals on the bed of patients older than working age in the classes of diseases, which for 8 years decreased by 4,8% (from 12,4 to 11,8 days.) In order to reduce the level of hospital morbidity and mortality in the region, increase the active life of the population older than the working age, identified ways of development of gerontological and geriatric care in the region, which will also contribute to the implementation of pension reform.


Assuntos
Geriatria , Morbidade , Idoso , Geriatria/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Tempo de Internação/estatística & dados numéricos
18.
Soc Sci Med ; 240: 112527, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31563760

RESUMO

Social activities in the community help older adults maintain functional ability. Community organizing, based on the assessment of health risks, community assets, and fostering intersectoral organizational partnerships, could increase participation opportunities. Supporting municipality staff members in building their capacity to take those actions might benefit them. Nevertheless, the effectiveness of such support remains unclear. This real-world-setting study evaluated the effectiveness of providing support for municipality health sectors in relation to older residents' social activities. Based on the Japan Gerontological Evaluation Study (JAGES), a nationwide study of community-dwelling older adults, from 2013 to 2016 researchers collaborated with health sector staff members in 13 participating municipalities (intervention group) in utilizing the JAGES-based community assessment data and building organizational partnerships. The remaining 12 municipalities (control) obtained the data only. We analyzed the longitudinal data of 47,106 older residents, performing a difference-in-differences (DID) analysis, weighted by the inverse of propensity to be selected for the intervention group, allowing for a multilevel (municipality/individual) data structure. In the intervention group, the estimated group participation prevalence in men increased by 10.4 percentage points from 47.5% to 57.9%, while in the control group, participation increased by 7.9 percentage points from 47.2% to 55.0% (DID estimated = 0.025, P = 0.011). No statistically significant difference between the two groups was observed among women (P = 0.131). Support for community organizing may improve group participation among older male residents. The community-attributable impact could be large, given that the intervention has the potential to work for all older residents in the municipality.


Assuntos
Geriatria/normas , Participação Social/psicologia , Seguridade Social/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Geriatria/métodos , Geriatria/estatística & dados numéricos , Humanos , Relações Interpessoais , Japão , Masculino , Comportamento Social , Seguridade Social/tendências , Inquéritos e Questionários
19.
J Nurs Manag ; 27(8): 1747-1755, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31529743

RESUMO

BACKGROUND: The work conditions in which the nurses provide care for older adults affect the quality of care. STUDY AIM: (a) To describe the quality of care for older adults as perceived by the nurse; (b) to examine the relationship between occupational stress, work climate, employee development and quality of care for older people; and (c) to determine the predictors of quality of care provided for older adults. METHODS: A descriptive correlational design was used in this study. A multi-strategic sampling technique was used to recruit a sample of 500 nurses providing care for older adults in hospitals and health care centres. RESULTS: Almost 80% of the participating nurses reported that their workplace was insufficiently staffed. Quality of care was significantly associated with occupational stress, nurses' competence and employee development. Significant predictors of quality of care were occupational stress, work climate and employee development. CONCLUSION: Enhancing nurses' work climate, decreasing occupational stress and increasing chances for employee development would improve the quality of care provided for older adults. IMPLICATIONS FOR NURSING MANAGEMENT: Health institutions have the opportunity to implement work environment improvements that increase support for advancing staff knowledge and skills by providing additional support for continuing education regarding the care of older adults.


Assuntos
Geriatria/normas , Qualidade da Assistência à Saúde/normas , Adulto , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Correlação de Dados , Estudos Transversais , Feminino , Geriatria/métodos , Geriatria/estatística & dados numéricos , Humanos , Jordânia , Masculino , Indicadores de Qualidade em Assistência à Saúde , Qualidade da Assistência à Saúde/estatística & dados numéricos
20.
J Emerg Med ; 57(4): 535-542, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31353267

RESUMO

BACKGROUND: It is documented that health professionals from various settings fail to detect > 50% of delirium cases. OBJECTIVE: This study aimed to describe the proportion of unrecognized incident delirium in five emergency departments (EDs). Secondary objectives were to compare the two groups (recognized/unrecognized) and assess the impact of unrecognized delirium at 60 days regarding 1) unplanned consultations and 2) functional and cognitive decline. METHOD: This is a sub-analysis of a multicenter prospective cohort study. Independent patients aged ≥ 65 years who tested negative for delirium on the initial interview with an ED stay ≥ 8 h were enrolled. Patients were assessed twice daily using the Confusion Assessment Method (CAM) and the Delirium Index up to 24 h into hospital admission. Medical records were reviewed to assess whether delirium was recognized or not. RESULTS: The main study reported a positive CAM in 68 patients. Three patients' medical files were incomplete, leaving a sample of 65 patients. Delirium was recognized in 15.4% of our participants. These patients were older (p = 0.03) and female (p = 0.01) but were otherwise similar to those with unrecognized delirium. Delirium Index scores were higher in patients with recognized delirium (p = 0.01) and they experienced a more important functional decline at 60 days (p = 0.02). No association was found between delirium recognition and health care services utilization or decline in cognitive function. CONCLUSIONS: This study confirms reports of high rates of missed or unrecognized delirium (84.6%) in ED patients compared to routine structured screening using the CAM performed by a research assistant. Patients with recognized delirium were older women with a greater severity of symptoms and experienced a more significant functional decline at 60 days.


Assuntos
Delírio/diagnóstico , Geriatria/normas , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Delírio/fisiopatologia , Delírio/psicologia , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Avaliação Geriátrica/métodos , Geriatria/métodos , Geriatria/estatística & dados numéricos , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco
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