Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.915
Filtrar
2.
Rev Bras Enferm ; 73(suppl 2): e20200260, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32965401

RESUMO

OBJECTIVE: to develop a protocol of recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes. METHOD: a study of experts' recommendations using a structured form applied through the Delphi Technique, obtaining 100% agreement among professionals after four rounds of analysis. The population comprised six nurses members of the Scientific Department of Gerontological Nursing of the Brazilian Association of Nursing (Associação Brasileira de Enfermagem). RESULTS: the protocol was structured in a nucleus of nursing interventions to face the spread of COVID-19 in Nursing Homes, consisting of 8 actions. FINAL CONSIDERATIONS: the protocol can help nurse managers to organize assistance to face the pandemic, which can be adaptable to each reality, making training nurses and health teams easier.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Instituição de Longa Permanência para Idosos , Avaliação em Enfermagem/métodos , Casas de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Brasil/epidemiologia , Comunicação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Infecções por Coronavirus/transmissão , Técnica Delfos , Desinfecção/métodos , Desinfecção/normas , Família , Feminino , Enfermagem Geriátrica , Educação em Saúde , Humanos , Masculino , Eliminação de Resíduos de Serviços de Saúde/métodos , Pessoa de Meia-Idade , Práticas Mortuárias/métodos , Avaliação em Enfermagem/organização & administração , Avaliação em Enfermagem/normas , Saúde do Trabalhador , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Pneumonia Viral/transmissão
3.
Rev Bras Enferm ; 73(suppl 2): e20200350, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32965403

RESUMO

OBJECTIVE: to report the experience of telemonitoring Brazilian nursing homes before coronavirus and COVID-19 infections. METHODS: a descriptive experience report that occurred between March 18 and April 25, 2020 through telemonitoring nursing homes in Salvador, Bahia, following a script previously prepared for first contact and follow-up. The telemonitoring was carried out by professors from the School of Nursing of Universidade Federal da Bahia and Graduate Program students for four weeks. RESULTS: thirty-two institutions were followed for four weeks. Some facilities and difficulties appeared during the monitoring. FINAL CONSIDERATIOS: as nursing homes are collective households, their residents are vulnerable to transmission of infections. In addition, the diversity of structures and economic, social and human resources needs of these locations reveal their fragility and urgency of public policies that address such diversities.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Doenças Profissionais/epidemiologia , Pneumonia Viral/epidemiologia , Telefone , Idoso , Brasil/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/estatística & dados numéricos , Humanos , Doenças Profissionais/diagnóstico , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Vigilância da População/métodos , Habilidades Sociais , Telefone/estatística & dados numéricos , Fatores de Tempo
6.
Artigo em Inglês | MEDLINE | ID: mdl-32981492

RESUMO

Cumulatively to 13 September there have been 26,753 case notifications and 674 deaths. The number of new cases reported nationally this fortnight was 764, a 61% decrease from the previous fortnight (1,948). On average this represented 55 cases diagnosed each day over the reporting period, a decrease from 125 cases per day over the previous reporting period. 84% of all cases (640/764) were reported in Victoria, with a smaller number of cases reported from New South Wales (95), Queensland (22), Western Australia (4) and South Australia (3). In Victoria, 97% of cases (621) were locally acquired and were mostly reported from residential aged care facilities; and 3% of cases (19) were reported as under investigation at the date of extract this reporting period. Excluding Victoria, 124 cases were reported nationally, 32% (40) were overseas acquired; 65% (81) were locally acquired, predominantly in New South Wales (62); and 2% (3) of cases were under investigation at this time, all reported in Queensland. The continued decrease in new cases observed this fortnight in Victoria is likely associated with the enhanced public health measures that are currently in place in Victoria. Locally-acquired cases which were predominantly associated with several interconnected clusters continued to be reported in New South Wales. In Queensland, 82% of cases (18/22) were reported as locally acquired from two clusters associated with immigration centres or correctional facilities. A total of 6 deaths were reported from cases diagnosed in this reporting period-all from Victoria, all aged 50 years or older, three male and three female. Although testing rates have declined gradually over the past month they remain high at 14.5 tests per 1,000 population per week. The overall positivity rate for the reporting period was 0.13%. Victoria reported a positivity rate of 0.39% for this reporting period while in all other jurisdictions the positivity rate was 0.05% or lower. For this report, "In focus" is paediatric inflammatory multisystem syndrome temporally associated with SARS-COV-2 (PIMS-TS). A review of Australia's public health response to COVID-19 (as at 13 September 2020) is at Appendix A.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas , Austrália/epidemiologia , Betacoronavirus , Criança , Pré-Escolar , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/transmissão , Feminino , Instituição de Longa Permanência para Idosos , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/transmissão , Queensland/epidemiologia , Austrália do Sul/epidemiologia , Vitória/epidemiologia , Austrália Ocidental/epidemiologia , Adulto Jovem
7.
Monaldi Arch Chest Dis ; 90(3)2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32875776

RESUMO

Lung Ultrasound (LUS) is regarded to be potentially useful to diagnose lung injury in older adults living in nursing homes with suspected COVID-19 pneumonia. We aimed at evaluating presence lung injury among senior nursing home residents by LUS performed with portable wireless scanner echography. The study population consisted of 150 residents with a mean age of 88 years (85% female) residing in 12 nursing homes in Northern Italy. Subjects had to have a history of recent onset of symptoms compatible with COVID-19 pneumonia or have been exposed to the contagion of patients carrying the disease. COVID-19 testing was performed with SARS-CoV-2 nasal-pharyngeal (NP) swabs. Positive subjects to LUS scanning were considered those with non-coascelent B-lines in >3 zones, coalescent B-lines in >3 zones and with iperdensed patchy non-consolidated lungs. Sixty-three percent had positive NP testing and 65% had LUS signs of pulmonary injury. LUS had a sensitivity of 79% in predicting positive NP testing. Sixteen percent of residents tested negative for SARSCoV-2 carried the signs of COVID-19 lung injury at LUS. There were 92 patients (61%) with current or recent symptoms.Positivity to LUS scanning was reported in 73% of residents with symptoms, while it was 53% in those without (P=0.016). A positive NP testing was observed in 66% of residents with symptoms and in 57% of those without (P=0.27). We conclude that assessment of LUS by portable wireless scanner echography can be profitability utilized to diagnose lung injury among senior nursing home residents with or without symptoms compatible with COVID-19 pneumonia.


Assuntos
Infecções por Coronavirus , Lesão Pulmonar/diagnóstico por imagem , Pandemias , Pneumonia Viral/diagnóstico , Testes Imediatos , Ultrassonografia , Idoso de 80 Anos ou mais , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Feminino , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Itália/epidemiologia , Masculino , Casas de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Pneumonia Viral/fisiopatologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Tecnologia sem Fio
8.
Cien Saude Colet ; 25(9): 3437-3444, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876245

RESUMO

The COVID-19 pandemic poses difficulties for long-term care institutions for the elderly, with increased mortality rates for the residents. This study aims to estimate the impact of COVID-19 on mortality of institutionalized elderly in Brazil. Estimates of the percentage of elderly deaths occurring in care homes were calculated for Brazil, States and Regions using estimates for the total number of deaths. The estimation was based upon information available for other countries. The weighted percentage was 44.7% and 107,538 COVID-19 deaths were estimated for the elderly in these institutions in Brazil in 2020. Higher numbers of deaths were expected in the Southeast Region (48,779 deaths), followed by the Northeast Region (28,451 deaths); São Paulo was the most affected State (24,500 deaths). The strong impact of COVID-19 on the elderly population living in long-term care facilities is clear. Estimates for the country exceeded 100,000 elderly people, potentially the most fragile and vulnerable, and are based upon a conservative number of total deaths, in view of other estimates and the alarming situation of death growth in Brazil from COVID-19.


Assuntos
Infecções por Coronavirus/mortalidade , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Assistência de Longa Duração , Pneumonia Viral/mortalidade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Simulação por Computador , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Humanos , Institucionalização/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia
9.
Cien Saude Colet ; 25(9): 3445-3458, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876277

RESUMO

An infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the 2019 Novel Coronavirus Disease (COVID-19) pandemic has unveiled a hitherto hidden reality: the vulnerability of the population living in long-term care facilities for the elderly (LTCF). To date, several scientific publications have revealed a concentration of up to 60% of deaths attributed to COVID-19 in such institutions. Most LTFC residents share the primary risk factors currently associated with increased morbimortality due to the COVID-19 infection. It is crucial to define actions to prevent SARS-CoV-2 spread in this environment, besides the usual measures of social distancing and isolation of the carriers of this disease. This paper proposes strategies for the investigation of this infection in LTCF residents and workers using laboratory tests available in Brazil. The early identification of individuals with SARS-CoV-2, who may actively and continuously spread the virus, allows adopting measures aimed at interrupting the local transmission cycle of this infection.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Programas de Rastreamento/métodos , Pneumonia Viral/epidemiologia , Idoso , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde , Humanos , Assistência de Longa Duração , Pandemias/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Populações Vulneráveis
10.
Tijdschr Gerontol Geriatr ; 51(3)2020 Apr 23.
Artigo em Holandês | MEDLINE | ID: mdl-32951401

RESUMO

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study.Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems.The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência à Saúde/métodos , Instituição de Longa Permanência para Idosos/organização & administração , Casas de Saúde/organização & administração , Pneumonia Viral/epidemiologia , Idoso , Betacoronavirus , Comunicação , Demência , Desastres , Humanos , Pandemias , Qualidade de Vida
11.
Geriatr Gerontol Int ; 20(10): 938-942, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32886842

RESUMO

AIM: The policy enforcing visiting restriction during the COVID-19 pandemic may cause feelings of social isolation among residents in long-term care facilities. This study aimed to explore family members' concerns for their relatives during the lockdown period, assess their level of acceptance of the visiting restriction policy and determine the associated factors. METHODS: From the 156 family members interviewed, demographic data, satisfaction with overall care quality, worry and concerns for their relatives, acceptance of the visiting restriction and arrangement for the residents if cluster infections occur in the facility were recorded. RESULTS: Among the members interviewed, 83 (53.2%) were men; mean age of members was 56.3 ± 9.8; most were offspring of residents in the facility (n = 121, 77.6%), most visited the residents at least once a week (n = 113, 72.4%) before the lockdown. The most common concerns of the family members for their relatives were psychological stress (38.5%), followed by nursing care (26.9%) and daily activity (21.1%). Nearly 84.6% of those interviewed accepted the visiting restriction policy, and a higher satisfaction rating independently associated with acceptance of the visiting restriction policy (odds ratio 2.15). CONCLUSIONS: During the lockdown period, staff members should provide more psychological information about residents to their family members. Higher satisfaction rating was found to be independent of the acceptance of the visiting restriction policy. Therefore, good quality of care of the facility wins the trust of family members, and this might mitigate the tension between the family members and staff during a major crisis. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2020; 20: 938-942.


Assuntos
Infecções por Coronavirus/psicologia , Família/psicologia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Pneumonia Viral/psicologia , Visitas a Pacientes/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Feminino , Humanos , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Pandemias , Satisfação Pessoal , Relações Profissional-Família , Isolamento Social , Estresse Psicológico , Taiwan
12.
BMJ Open Qual ; 9(3)2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32883676

RESUMO

BACKGROUND: To analyse a medical accident, much time and experience are needed. However, people without experience in analysis have difficulty understanding its conditions and methods, and as a result it takes longer to establish countermeasures. It must be noted that understanding conditions by simply aligning occurrences in the accident in a chronological order is difficult. PURPOSE: A workflow chart that considers time was proposed so that individuals without adequate experience in analysis could easily carry out root cause analysis. METHODS: In the 'workflow chart (WFC)', the time sequence was described horizontally. On the vertical axis, the business manual, the occurrence of the accident, and the time of the occurrence are displayed. In the bottom column of patient event, information regarding damage to patients was written in accordance with time axis. Regarding the degree of damage, the time of error until the accident was identified was connected using a straight line (when the patient was not affected, a dotted line was used) in order to show the overall picture of the accident. RESULTS: According to the time flow chart, hints to identify potential risks were proposed. Focus was placed not only on the error event, but also on keywords such as manual inadequacy, time gap, degree of error and so on to easily lead to the question 'why?' To visualise this, I proposed an operation flow chart. By using time-WFC, even beginners can easily develop accident countermeasure strategies. CONCLUSION: Using a WFC that considers time, time of error and the occurrence of accident could be visualised. As a result, even individuals without experience in analysis could easily perform an analysis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/transmissão , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Pneumonia Viral/transmissão , Análise de Causa Fundamental/métodos , Humanos , Pandemias
13.
Medicine (Baltimore) ; 99(37): e22154, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925774

RESUMO

The cognitive function of nursing home (NH) residents with cognitive impairment (CI) tends to decline over time. An effective multimodal non-pharmacological intervention (MNPI) strategy is needed to improve the cognitive function of NH residents with CI.The aim of this study was to clarify the cognitive function characteristics of NH residents with CI in whom a non-pharmacological intervention (NPI) can be implemented, consisting of MNPI using a Bayesian analysis, and to incorporate suggestions to make the MNPI strategy as effective as possible.This study had a cross-sectional design. The 61 subjects were selected from the residents of 5 NHs, of whom 90.16% were female, and the mean (standard deviation) age was 87.20 ±â€Š6.90. Analyses were performed using a hierarchical Bayesian model, and the global and specific cognitive functions as assessed by the Japanese version of the Neurobehavioral Cognitive Status Examination were the response variables. Three types of NPI (cognitive enhancement NPI, physical NPI, psychological and psychosocial NPI), and activities of daily living (ADL), as assessed by the Barthel index, were the explanatory variables.Cognitive enhancement NPI was revealed to have no association with any cognitive function. Physical NPI was negatively associated with orientation [OR 0.31 (95% credible interval (95% CI) -2.33, -0.10)], comprehension [OR 0.16 (95% CI -2.78, -0.95)] and naming [OR 0.49 (95% CI -1.47, -0.02)]. Psychological and psychosocial NPI was positively associated with comprehension [OR 3.67 (95% CI 0.52, 2.13)]. Barthel index was positively associated with total Japanese version of the Neurobehavioral Cognitive Status Examination [OR 1.74 (95% CI 0.08, 2.12)], comprehension [OR 3.49 (95% CI 0.45, 4.67)], repetition [OR 10.07 (95% CI 0.53, 9.01)], naming [OR 2.24 (95% CI 0.07, 3.20)], and calculations [OR 18.82 (95% CI 2.71, 9.40)].The implementation of MNPI should be preceded by cognitive enhancement NPI and physical NPI. Providing ADL enhancing NPI in response to cognitive improvement may be an effective strategy. Providing cognitive enhancement NPI, physical NPI, psychological, and psychosocial NPI, as well as ADL-enhancing NPI at the same time, is also an effective strategy for subjects with mild dementia who are considered to have relatively high cognitive functions.


Assuntos
Disfunção Cognitiva/terapia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Terapia Combinada , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Masculino , Testes Neuropsicológicos , Participação Social
17.
JAMA Netw Open ; 3(8): e2017533, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32789517

RESUMO

Importance: Coronavirus disease 2019 (COVID-19) is a major threat to nursing homes. During the COVID-19 pandemic wave that hit France in March and April 2020, staff members of some French nursing homes decided to confine themselves with their residents on a voluntary basis to reduce the risk of entry of the severe acute respiratory syndrome coronavirus 2 into the facility. Objective: To investigate COVID-19-related outcomes in French nursing homes that implemented voluntary staff confinement with residents. Design, Setting, and Participants: This retrospective cohort study was conducted in French nursing homes from March 1 to May 11, 2020. Participants included residents and staff members of the nursing homes where staff participated in voluntary self-confinement as well as those of the facilities for elderly people where staff did not practice self-confinement. Rates of COVID-19 cases and mortality in the cohort of nursing homes with self confinement were compared with those derived from a population-based survey of nursing homes conducted by French health authorities. Exposures: Nursing homes with staff who self-confined were identified from the media and included if the confinement period of staff with residents was longer than 7 days. Main Outcomes and Measures: Mortality related to COVID-19 among residents and COVID-19 cases among residents and staff members. COVID-19 was diagnosed by primary care or hospital physicians on the basis of fever and respiratory signs (eg, cough, dyspnea) or a clinical illness compatible with COVID-19; COVID-19 diagnoses were considered confirmed if real-time reverse transcriptase-polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 on nasopharyngeal swab was positive and considered possible if the test had not been performed or results were negative. Cases of COVID-19 were recorded by a telephone interview with the directors of nursing homes with staff who self-confined and by a nationwide declaration survey to health authorities for all facilities. Results: This study included 17 nursing homes in which 794 staff members confined themselves to the facility with their 1250 residents. The national survey included 9513 facilities with 385 290 staff members and 695 060 residents. Only 1 nursing home with staff who self-confined (5.8%) had cases of COVID-19 among residents, compared with 4599 facilities in the national survey (48.3%) (P < .001). Five residents (0.4%) in the nursing homes with staff who self-confined had confirmed COVID-19, compared with 30 569 residents (4.4%) with confirmed COVID-19 in the national survey (P < .001); no residents of facilities with self-confinement had possible COVID-19, compared with 31 799 residents (4.6%) with possible COVID-19 in the national survey (P < .001). Five residents (0.4%) in the nursing homes with staff who self-confined died of COVID-19, compared with 12 516 (1.8%) in the national survey (odds ratio, 0.22; 95% CI, 0.09-0.53; P < .001). Twelve staff members (1.6%) from the facilties with self-confinement had confirmed or possible COVID-19, compared with 29 463 staff members (7.6%) in the national survey (P < .001). Conclusions and Relevance: In this cohort study of French nursing homes during the COVID-19 pandemic, mortality rates related to COVID-19 were lower among nursing homes that implemented staff confinement with residents compared with those in a national survey. These findings suggest that self-confinement of staff members with residents may help protect nursing home residents from mortality related to COVID-19 and residents and staff from COVID-19 infection.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Instituição de Longa Permanência para Idosos , Casas de Saúde , Recursos Humanos de Enfermagem , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Isolamento Social , Adulto , Idoso , Idoso de 80 Anos ou mais , Coronavirus , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , França/epidemiologia , Humanos , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Estudos Retrospectivos , Instituições de Cuidados Especializados de Enfermagem , Inquéritos e Questionários
18.
Tidsskr Nor Laegeforen ; 140(11)2020 08 18.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-32815356

RESUMO

BACKGROUND: Nursing home residents are generally old and frail, and at high risk that COVID-19 will take a serious course. Outbreaks of COVID-19 have not previously been described in Norway, and it is important to identify mechanisms for spread of the infection and course of disease for nursing home residents with this pandemic disease. MATERIAL AND METHOD: We included residents from three nursing homes with outbreaks of COVID-19 in a retrospective observational study, and we retrieved information on the number of staff for whom SARS-CoV-2 was confirmed or who were placed in quarantine. We present resident characteristics, course of disease and mortality associated with COVID-19 in the nursing homes, as well as providing a brief description of the outbreaks. RESULTS: Forty residents were included, 26 of whom were women. The average age was 86.2 years. Thirty-seven of the residents had atypical symptoms, nine of them were asymptomatic at the time of diagnosis, and 21 died during the coronavirus infection. Contact tracing indicated that the outbreaks may have originated from staff in the pre-symptomatic or early and mild phase of the disease. SARS-CoV-2 was detected in forty-two staff members, and a further 115 were placed in quarantine. INTERPRETATION: Many residents had atypical disease presentation, and the mortality from COVID-19 was high. Spread of infection may have originated from staff, also before they displayed obvious symptoms, and contributed to extensive spread of SARS-CoV-2 in the three nursing homes.


Assuntos
Infecções por Coronavirus/epidemiologia , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Idoso de 80 Anos ou mais , Betacoronavirus , Surtos de Doenças , Feminino , Humanos , Masculino , Noruega/epidemiologia , Pandemias , Estudos Retrospectivos
19.
Psychiatry Res ; 291: 113294, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32763552

RESUMO

To cope with Covid-19 and limits its spread among residents, retirement homes have prohibited physical contact between residents and families and friend and, in some cases, even between residents or between residents and caregivers. We investigated the effects of measures against Covid-19 on the mental health of participants with Alzheimer's disease (AD) who live in retirement homes in France. We instructed on-site caregivers to assess depression and anxiety in participants with mild AD who live in retirement homes. Fifty-eight participants consented to participate in the study. The participants rated their depression and anxiety during and before the Covid-19 crisis. Participants reported higher depression (p = .005) and anxiety (p = .004) during than before the Covid-19 crisis. These increases can be attributed to the isolation of the residents and/or to the drastic changes in their daily life and care they receive. While, in their effort to prevent infections, retirement homes are forced to physically separate residents from the outside world and to drastically reduce residents' activities, these decisions are likely to come at a cost to residents with AD and their mental health.


Assuntos
Doença de Alzheimer/complicações , Ansiedade/diagnóstico , Infecções por Coronavirus , Depressão/diagnóstico , Instituição de Longa Permanência para Idosos , Pandemias , Pneumonia Viral , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Ansiedade/complicações , Ansiedade/psicologia , Betacoronavirus , Cuidadores , Depressão/complicações , Depressão/psicologia , Feminino , França , Humanos , Masculino , Casas de Saúde , Índice de Gravidade de Doença
20.
Med Care ; 58(9): 833-841, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32826748

RESUMO

BACKGROUND: Although one third of Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans, there is limited information about the cost of treating Alzheimer disease and related dementias (ADRD) in these settings. OBJECTIVE: The objective of this study was to estimate direct health care costs attributable to ADRD among older adults within a large MA plan. RESEARCH DESIGN: A retrospective cohort design was used to estimate direct total, outpatient, inpatient, ambulatory pharmacy, and nursing home costs for 3 years before and after an incident ADRD diagnosis for 927 individuals diagnosed with ADRD relative to a sex-matched and birth year-matched set of 2945 controls. SUBJECT: Adults 65 years of age and older enrolled in the Kaiser Permanente Washington MA plan and the Adult Changes in Thought (ACT) Study, a prospective longitudinal cohort study of ADRD and brain aging. MEASURES: Data on monthly health service use obtained from health system electronic medical records for the period 1992-2012. RESULTS: Total monthly health care costs for individuals with ADRD are statistically greater (P<0.05) than controls beginning in the third month before diagnosis and remain significantly greater through the eighth month following diagnosis. Greater total health costs are driven by significantly (P<0.05) greater nursing home costs among individuals diagnosed with ADRD beginning in the third month prediagnosis. Although total costs were no longer significantly greater at 8 months following diagnosis, nursing home costs remained higher for the people with dementia through the 3 years postdiagnosis we analyzed. CONCLUSION: Greater total health care costs among individuals with ADRD are primarily driven by nursing home costs.


Assuntos
Demência/economia , Gastos em Saúde/estatística & dados numéricos , Serviços de Saúde/economia , Medicare Part C/economia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/economia , Feminino , Serviços de Saúde/estatística & dados numéricos , Instituição de Longa Permanência para Idosos/economia , Humanos , Estudos Longitudinais , Masculino , Casas de Saúde/economia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Estudos Prospectivos , Estados Unidos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA