Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.629
Filtrar
1.
BMC Health Serv Res ; 19(1): 775, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666063

RESUMO

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


Assuntos
Disfunção Cognitiva , Ingestão de Alimentos/psicologia , Ambiente de Instituições de Saúde , Instituição de Longa Permanência para Idosos , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Ingestão de Alimentos/fisiologia , Feminino , Humanos , Itália , Masculino , Inquéritos e Questionários
2.
Clin Interv Aging ; 14: 1797-1815, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31695349

RESUMO

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


Assuntos
Doença de Alzheimer , Maus-Tratos ao Idoso/prevenção & controle , Pessoal de Saúde/educação , Política Organizacional , Local de Trabalho/organização & administração , Idoso , Doença de Alzheimer/psicologia , Demência/psicologia , Instituição de Longa Permanência para Idosos/organização & administração , Humanos , Assistência de Longa Duração , Casas de Saúde/organização & administração , Fatores de Proteção , Fatores de Risco
3.
Nutr. hosp ; 36(5): 1074-1080, sept.-oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184629

RESUMO

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


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


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Consenso , Índice de Massa Corporal , Algoritmos , Força Muscular , Absorciometria de Fóton , Estudos Transversais , Antropometria , Desempenho Físico Funcional , Repertório de Barthel
4.
Georgian Med News ; (292-293): 21-25, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31560657

RESUMO

The aim of the study was to assess oral health status and its correlations with the general health in older adults living in residential houses in Georgia. The study was conducted in 2017-2018 years based on WHO recommendations. The study got approval from bioethical council of National Center for Disease Control and Public Health, protocol #2017-039, 28.06.2017y. 300 voluntary residents from various residential houses for older people (aged 65 years and more) were observed in regions of Georgia: "Basiliada" (Tbilisi), residential home of municipality of Samtredia, (Imereti), residential home "Carefree old age" (Kakheti). Age groups were divided as following: 65-74; 75-84; 85<. Statistical Package for Social Sciences (SPSS) version 22.0 was used for statistical analysis. DMFT was assessed to be 28.74. Significantly high prevalence of needs of prosthetic treatment 91.1% (p=0.0005), full edentulism 36.2% (p=0.0049), participants with the extraction of more than 20 teeth 81.3% (p=0.0000) and unsatisfactory oral hygiene 39.3% (p=0.0003) were observed. Prevalence of systemic diseases was assessed as the following: cardiovascular disease - 56%, gastroenterologycal diseases - 6%, diabetes - 2.9%, respiratory disease - 8.4%, oncological disease - 6.7%, dementia - 24.2 %.( p<0.005). Cardiovascular system diseases appeared to be one of the most commonly encountered diseases in dental practice. Based on the study results new program was created "Improve of oral hygiene of older adults living in residential homes in Georgia" in order to increase their access to the dental care, including preventive dental care and improve oral health related quality of life.


Assuntos
Nível de Saúde , Saúde Bucal , Higiene Bucal , Doenças Periodontais/epidemiologia , Idoso , Idoso de 80 Anos ou mais , República da Geórgia , Instalações de Saúde , Serviços de Saúde para Idosos , Instituição de Longa Permanência para Idosos , Humanos , Casas de Saúde , Doenças Periodontais/patologia , Qualidade de Vida
5.
Artigo em Inglês | MEDLINE | ID: mdl-31546837

RESUMO

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


Assuntos
Idoso Fragilizado/estatística & dados numéricos , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Itália , Masculino
6.
Expert Opin Drug Saf ; 18(11): 1091-1098, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31524003

RESUMO

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


Assuntos
Desprescrições , Prescrição Inadequada/prevenção & controle , Conduta do Tratamento Medicamentoso/organização & administração , Lista de Medicamentos Potencialmente Inapropriados , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Custos de Medicamentos , Feminino , Instituição de Longa Permanência para Idosos , Humanos , Prescrição Inadequada/economia , Assistência de Longa Duração/normas , Masculino , Casas de Saúde , Padrões de Prática Médica/normas
7.
BMC Public Health ; 19(1): 1199, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31470875

RESUMO

BACKGROUND: By 2030, 30% of the European population will be aged 60 or over and those aged 80 and above will be the fastest growing cohort. An increasing number of people will die at an advanced age with multiple chronic diseases. In Europe at present, between 12 and 38% of the oldest people die in a long-term care facility. The lack of nationally representative empirical data, either demographic or clinical, about people who die in long-term care facilities makes appropriate policy responses more difficult. Additionally, there is a lack of comparable cross-country data; the opportunity to compare and contrast data internationally would allow for a better understanding of both common issues and country-specific challenges and could help generate hypotheses about different options regarding policy, health care organization and provision. The objectives of this study are to describe the demographic, facility stay and clinical characteristics of residents dying in long-term care facilities and the differences between countries. METHODS: Epidemiological study (2015) in a proportionally stratified random sample of 322 facilities in Belgium, Finland, Italy, the Netherlands, Poland and England. The final sample included 1384 deceased residents. The sampled facilities received a letter introducing the project and asking for voluntary participation. Facility manager, nursing staff member and treating physician completed structured questionnaires for all deaths in the preceding 3 months. RESULTS: Of 1384 residents the average age at death ranged from 81 (Poland) to 87 (Belgium, England) (p < 0.001) and length of stay from 6 months (Poland, Italy) to 2 years (Belgium) (p < 0.05); 47% (the Netherlands) to 74% (Italy) had more than two morbidities and 60% (England) to 83% (Finland) dementia, with a significant difference between countries (p < 0.001). Italy and Poland had the highest percentages with poor functional and cognitive status 1 month before death (BANS-S score of 21.8 and 21.9 respectively). Clinical complications occurred often during the final month (51.9% England, 66.4% Finland and Poland). CONCLUSIONS: The population dying in long-term care facilities is complex, displaying multiple diseases with cognitive and functional impairment and high levels of dementia. We recommend future policy should include integration of high-quality palliative and dementia care.


Assuntos
Morte , Instituição de Longa Permanência para Idosos , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Estudos Epidemiológicos , Europa (Continente)/epidemiologia , Feminino , Humanos , Assistência de Longa Duração , Masculino , Inquéritos e Questionários
8.
Diagn. tratamento ; 24(3): [111-118], jul - set. 2019. fig, tab
Artigo em Português | LILACS | ID: biblio-1026700

RESUMO

Introdução: A dinapenia é caracterizada pela redução da força muscular que acontece durante o processo de envelhecimento. Objetivo: Analisar a prevalência e os fatores associados à dinapenia em idosos institucionalizados. Métodos: Foram avaliados idosos institucionalizados de São Caetano do Sul. A dinapenia foi caracterizada pela reduzida força de preensão manual combinada com reduzida força de membros inferiores. As variáveis independentes avaliadas foram sexo, idade, tempo de institucionalização, medicamentos, satisfação com a vida, depressão, suspeita de deficit cognitivo e número de passos por dia. A análise de regressão logística estimou o odds ratio (OR) com intervalo de confiança de 95% (IC 95%). Resultados: A prevalência de dinapenia foi de 36% entre os idosos. Um dos fatores associados à dinapenia foi a pior satisfação com a vida. Idosos com menor circunferência de panturrilha apresentaram maior chance de dinapenia (OR = 2,44; IC 95%: 1,14-5,25); por outro lado, o excesso de peso mostrou-se um fator protetor para a dinapenia (OR = 0,09; IC 95%: 0,02-0,57). Além desses fatores, idosos com alterações nas atividades da vida diária apresentaram maior chance de dinapenia (OR: 3,73; IC 95%: 1,54-9,05). Conclusão: Idosos dinapênicos institucionalizados apresentaram redução nas atividades da vida diárias, na satisfação com a vida e a menor circunferência da panturrilha. Por outro lado, o excesso de peso mostrou ser importante fator protetor para a reduzida força muscular neste grupo.


Assuntos
Envelhecimento , Aptidão Física , Autonomia Pessoal , Força Muscular , Instituição de Longa Permanência para Idosos
9.
BMC Res Notes ; 12(1): 508, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412910

RESUMO

OBJECTIVE: Care homes are a common place of death for older adults, especially those with complex health needs or dementia. Representative, internationally comparable data on care home facilities and their residents is needed to monitor health and wellbeing in this population. Identification and collection of data from care homes can be challenging and often underreported. This paper draws on the experiences of the PACE study, a cross sectional mortality follow back study conducted in six European countries. RESULTS: Multiple challenges were encountered in creating a sampling framework and contacting, recruiting and retaining care homes in the PACE study. Recruiting a randomly identified, representative cohort from a stratified sampling framework was problematic, as was engaging with care homes to ensure high response rates. Variation in the funding of care homes across the six countries involved in the study may explain the additional challenges encountered in England. Awareness of the challenges encountered in England in implementing an international study in care homes can inform the design and implementation of future studies within care homes. Further discussion is needed to determine the barriers and facilitators to conducting research in care homes, and how this is shaped by the focus of the study.


Assuntos
Demência/terapia , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Cuidados Paliativos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Coleta de Dados/métodos , Coleta de Dados/estatística & dados numéricos , Demência/diagnóstico , Demência/mortalidade , Europa (Continente) , Feminino , Humanos , Masculino , Cuidados Paliativos/métodos , Projetos de Pesquisa , Taxa de Sobrevida
10.
Artigo em Inglês | MEDLINE | ID: mdl-31394752

RESUMO

Public involvement (PI) is of great interest. However, little is known about this topic in the design, development, and/or implementation of health interventions in geriatric facilities. This study aimed to provide a critical overview of the involvement of caregivers and end-users in interventions in these facilities, based on Rifkin's analytical framework. This systematic review, supplemented by a questionnaire to the corresponding authors, covered non-drug intervention reports targeting nurses, doctors, residents, and their relatives. Articles were published in Pubmed, Medline, Scopus, and Cinahl, from January 2016 to April 2018. Ninety-seven articles were included. The review shows a low level or partial PI in geriatric facilities where it exists. These results are further supported by the authors' responses to the questionnaire. PI remains uncommon in geriatric institutions and consists of a consumerist model, suggesting the need for improved practices. More efforts are needed to experiment with recommendations to meet the challenges of PI and enhance the public ownership of interventions. The protocol was registered on Prospero under the number CRD42018098504.


Assuntos
Cuidadores/estatística & dados numéricos , Assistência à Saúde/métodos , Serviços de Saúde para Idosos/estatística & dados numéricos , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Protocolos Clínicos
11.
J Clin Nurs ; 28(23-24): 4504-4512, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31429131

RESUMO

AIMS AND OBJECTIVES: This study applied structural equation modelling to explore the relationships among agitated behaviours, depression, cognitive function and activities of daily living, as well as associations between these factors and urinary incontinence). BACKGROUND: A high prevalence of urinary incontinence is found among institutional older adults with dementia. People with urinary incontinence suffer from increased financial burden and social isolation and experience reduced quality of life. DESIGN: Cross-sectional correlational research. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. METHODS: In total, 226 older adults with dementia were recruited through convenience sampling at 15 long-term care facilities in southern Taiwan. The urinary incontinence frequency, agitated behaviours, depression, cognitive function and activities of daily living were evaluated using bladder records, the Cohen-Mansfield Agitation Inventory, the Cornell Scale for Depression in Dementia, the Mini-Mental State Examination and the Barthel Index, respectively. RESULTS: Activities of daily living performance was found to be significantly associated with urinary incontinence; however, age, cognitive function, depression and agitated behaviours were not significantly related to urinary incontinence. Age did not have effects on any of the variables tested in this model, whereas activities of daily living performance was significantly associated with cognitive function and depression. Results further showed that cognitive function and depression were mediators between activities of daily living and agitated behaviours. CONCLUSION: Enhanced activities of daily living independency directly reduced urinary incontinence, improved cognitive function, decreased degrees of depression and indirectly reduced agitated behaviours. RELEVANCE TO CLINICAL PRACTICE: The findings could serve as a valuable reference for long-term care facilities in providing effective urinary incontinence care and prevention to older adults with dementia.


Assuntos
Atividades Cotidianas , Demência/epidemiologia , Incontinência Urinária/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Demência/psicologia , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Masculino , Casas de Saúde/estatística & dados numéricos , Prevalência , Testes Psicológicos , Qualidade de Vida , Taiwan , Incontinência Urinária/psicologia
12.
Clin Interv Aging ; 14: 1361-1369, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31440041

RESUMO

Background: Transfer fractures in the lower limbs of bedridden and chair-bound nursing home patients can result from trauma induced by the usual lifting, moving, turning, or transferring maneuvers. Treatment entails immobilization for pain control and position change; however, splints/hard casts increase the risk of pressure sores. Therefore, we evaluated the use of a sponge cast. Materials and methods: Between March 2011 and October 2017, 17 patients with a lower limb transfer fracture due to transferring maneuvers in a nursing home were recruited. We evaluated the improvement in pseudo-motion and divided the patients as having bony union, fibrous union, or remaining pseudo-motion. We also investigated the occurrence of pressure sores due to immobilization up until the final follow-up. Results: Femur fractures occurred in 15 patients and lower leg fractures in two. Six of the 15 femur fractures were periprosthetic (four hip arthroplasty and two knee arthroplasty). Pseudo-motion was improved in 15 of 17 cases, within an average of 17.3 weeks for the improvement (14-23 weeks; bony union: 11 cases and fibrous union: four cases). Pseudo-motion remained in two cases: one periprosthetic fracture around the knee arthroplasty and the other, a femur neck fracture. No pressure sores occurred. Conclusions: A sponge cast appears to be one of the effective treatment options available for bedridden or chair-bound patients with a lower limb fracture due to its low risk of complications and satisfactory clinical results.


Assuntos
Fraturas Ósseas/terapia , Instituição de Longa Permanência para Idosos , Extremidade Inferior/lesões , Movimentação e Reposicionamento de Pacientes/efeitos adversos , Casas de Saúde , Contenções , Adulto , Idoso , Idoso de 80 Anos ou mais , Tratamento Conservador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento
13.
Rech Soins Infirm ; 137(2): 77-90, 2019 06.
Artigo em Francês | MEDLINE | ID: mdl-31453675

RESUMO

Activity programs are described in institutional policies as an added benefit in the lives of residents in that such activities are assumed to maintain health through the process of socialization. The purpose of this study is to describe the determining factors in the socialization process of elderly residents in retirement homes. A qualitative study, in nursing study using anthropological methodology was carried out from April 2016 to May 2018 in ten retirement homes in the Limousin and on Reunion Island. territory. Fifty-eight semi-structured interviews have been analyzed using NVivo 11Plus® software. The socialization process of the elderly in the context of institutional regulation is complex. Attendance at social activities is often used to measure the degree of socialization and integration in the institution, but, on its own, it is not a significant indicator. Other elements involved in the complex socialization process of the elderly in retirement homes include : family, relations with other residents, and interaction with caregivers plays a major role. An elderly person can remain isolated in his or her room, never participate in activities, and yet feel perfectly integrated and socialized within the institution. Future research will focus on the relationship between residents and caregivers as a factor in the socialization process, including the knowledge and skills of the caregivers.


Assuntos
Instituição de Longa Permanência para Idosos , Casas de Saúde , Socialização , Idoso , Feminino , Humanos , Masculino , Pesquisa Qualitativa
14.
Nurs Older People ; 31(2): 32-39, 2019 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-31468782

RESUMO

BACKGROUND: Annual influenza vaccination is recommended for all healthcare workers (HCWs) to help reduce the risk of contracting the virus and transmitting it to vulnerable people, especially older adults in residential care facilities. Vaccination uptake among HCWs remains low. AIM: To investigate HCWs' attitudes towards, and beliefs about, seasonal influenza vaccination in a residential care facility for older adults in the Republic of Ireland. METHOD: Data were collected using a self-administered questionnaire. RESULTS: A total of 95 questionnaires were distributed, and 35 (37%) HCWs completed and returned them. During the 2016-17 flu season, 20 (57%) respondents were vaccinated. Primary predictors of vaccination acceptance were the belief that being healthy should not mitigate against requiring the vaccine ( r =0.7, P =0.01), protection of self and family ( r =0.67, P =0.01), protection of patients ( r =0.592, P =0.01) and agreement with mandatory vaccination ( r =0.351, P =0.039). Reasons for vaccination avoidance were misconceptions about the need for vaccination among healthy HCWs (67%), efficacy of the vaccine (60%), lack of trust in the vaccine (47%) and a belief that the vaccine may cause flu (47%). CONCLUSION: Addressing HCWs' beliefs relating to the personal benefits of vaccination while simultaneously correcting misconceptions may help to increase uptake among those working in residential care settings for older adults.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vacinação/psicologia , Idoso , Instituição de Longa Permanência para Idosos , Humanos , Irlanda , Casas de Saúde , Estações do Ano , Inquéritos e Questionários , Vacinação/estatística & dados numéricos
15.
BMC Health Serv Res ; 19(1): 607, 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31464630

RESUMO

BACKGROUND: Most health care services are provided in the primary health care sector, and an increasing number of elderly is in need of these services. Nonetheless, the research on patient safety culture in home care services and nursing homes remains scarce. This study describes staff perceptions of patient safety culture in Norwegian home care services and nursing homes, and assesses how various patient safety culture dimensions contribute to explaining overall perceptions of patient safety. METHODS: Cross-sectional surveys were conducted among healthcare professionals in Norwegian home care services (N = 139) and nursing homes (N = 165) in 2018, response rates being 67.5% and 65%, respectively. A Norwegian version of the international recognized Nursing Home Survey on Patient Safety Culture was used. Descriptive statistics and t-tests were used to explore staff perceptions of patient safety culture. We used multiple regression analyses to explore the degree to which patient safety culture dimensions could explain overall perceptions of patient safety. RESULTS: The number of patient safety dimensions having an average score of more than 60% positive responses was seven out of 10 in nursing homes, and nine out of 10 in home care. Staffing had the lowest scores in both health care services. Home care services scored significantly higher than nursing homes on teamwork (eta squared = .053), while nursing homes scored somewhat higher on handover (eta squared = .027). In home care, total explained variance of overall perceptions of patient safety was 45%, with teamwork, staffing, and handoffs as significant predictors. The explained variance in nursing homes was 42.7%, with staffing and communication openness as significant predictors. CONCLUSIONS: There are differences in perceptions of patient safety culture between nursing homes and home care services. Staffing is important for patient safety perceptions in both health care services. In home care, teamwork seems to be a significant contributing factor to patient safety, and building sound teams with mutual trust and collaboration should therefore be an essential part of managers' work with patient safety. In nursing homes, the main focus when building a good patient safety culture should be on open communication, ensuring that staff's ideas and suggestions are valued.


Assuntos
Serviços de Assistência Domiciliar/normas , Instituição de Longa Permanência para Idosos/normas , Casas de Saúde/normas , Segurança do Paciente/normas , Gestão da Segurança/normas , Adulto , Idoso , Atitude do Pessoal de Saúde , Comunicação , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Serviços de Saúde , Serviços de Assistência Domiciliar/estatística & dados numéricos , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Casas de Saúde/estatística & dados numéricos , Equipe de Assistência ao Paciente/normas , Equipe de Assistência ao Paciente/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
16.
Z Evid Fortbild Qual Gesundhwes ; 146: 7-14, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31375396

RESUMO

BACKGROUND: Reducing adverse drug events in nursing homes is a central patient safety concern. The aim of this study was to assess how often selected medication processes to increase medication safety are already implemented in Swiss nursing homes and to examine how nursing homes that have not yet implemented these processes can be characterized based on their organizational features. METHODS: Cross-sectional survey study among directors of nursing in Swiss nursing homes. RESULTS: 420 of 1,525 invited individuals participated in the survey (response rate: 27.5 %). Of these, 65.0 % stated that regular systematic medication reviews have been provided in their institution. 9.5 % of the nursing homes use a list to identify potentially inappropriate medication, and 6.7 % of the nursing homes have a standardized process to monitor side effects of medications. 66.0 % of the participating nursing homes have implemented at least one of these three processes, 34.0 % of the participating nursing homes have not implemented any of the three processes. Statistically significant differences in process implementation were found according to the geographical location of the nursing home, the type of documentation used for medications, the physician model, the number of external general practitioners, as well as the medication supply channel and the legal obligation to cooperate with pharmacists. No differences were found with regard to the nursing home size. CONCLUSION: In Swiss nursing homes, central safety-relevant medication processes have not yet been implemented nationwide. In particular, implementation is not widespread in nursing homes where medical care for their residents is provided by many different external general practitioners. The organizational features need to be taken into account to successfully implement quality improvement measures.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Prescrição Inadequada/estatística & dados numéricos , Casas de Saúde , Segurança do Paciente , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Alemanha , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Masculino , Erros de Medicação/prevenção & controle , Casas de Saúde/estatística & dados numéricos
17.
Cien Saude Colet ; 24(8): 2859-2870, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389534

RESUMO

This paper aimed to identify and analyze in national and international literature whether and how the theme of violence is addressed in the studies of public policies for older adults in Long-Term Care Institutions (LTCI). We conducted an integrative review of the published literature between 2010 and August 2016. The primary bibliographic databases were consulted using descriptors "idoso", "políticas públicas", "instituição de longa permanência para idosos", "asilo", "casa de repouso" and "ILPI" in Portuguese and their equivalent in English and Spanish. A total of 77 papers were analyzed, of which 12 were Brazilian and 65 were foreign (of these, 30 were from the U.S.). The analysis showed that many countries have long-term care policies governing the modalities of service providers. Only eight works addressed the issue of violence within LTCIs within older adults' protection policies, and affirm that countries in Latin America and Asia must advance this agenda and place the issue of violence against seniors on the agenda of priorities. No Brazilian paper addressed the issue directly, although it has become clear that neglect and other forms of violence hang over Long-Term Care Institutions for the Elderly (LTCIEs).


Assuntos
Assistência de Longa Duração/normas , Política Pública , Violência/estatística & dados numéricos , Idoso , Brasil , Instituição de Longa Permanência para Idosos/normas , Humanos , Casas de Saúde/normas
18.
Trials ; 20(1): 424, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31296264

RESUMO

BACKGROUND: Depression is the second most common psychiatric illness in old people. Up to 30% of nursing home residents have minor or major depression. Although depressive disorders in old age can be improved and even cured with adequate therapy, they often go unnoticed in nursing home residents and remain untreated. This highlights a striking deficit in health care and might result not only in lower quality of life among those concerned but also in poor physical functioning, premature mortality, and increased hospitalization rates. METHODS: The aims of the interdisciplinary research project DAVOS are to implement an innovative and stepped structural case management program to improve depression treatment for nursing home residents by a modularized intervention and to assess it in terms of its effectiveness. Intervention modules are in line with recommendations given by the German national treatment guidelines for depression (S3 guidelines). Ten nursing homes in Frankfurt, Germany, will participate in the project, which aims to recruit a study population of 380. The recruitment will continue throughout the trial (open cohort). Persons (>60 years) who live in a nursing home, have no medical diagnosis of dementia, and can provide their informed consent to participate are eligible for inclusion in the study. Residents with a clinical diagnosis of dementia, alcohol or substance-related disorders, or other serious psychiatric illnesses will be excluded. DAVOS is a controlled cluster-randomized study that employs a stepped-wedge design. DISCUSSION: Our main hypothesis is that the implementation of the intervention will lead to a decline in the prevalence of depression and a reduction in depression symptoms among the home residents. In addition, we expect the intervention to have a positive impact on secondary outcomes such as level of functioning, quality of life, and social participation. The project's results can make an important contribution toward improving the health care of nursing home residents who have late-life depression. TRIAL REGISTRATION: DRKS, DRKS00015686 , Oct. 10, 2018.


Assuntos
Envelhecimento/psicologia , Administração de Caso , Depressão/terapia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Fatores Etários , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Alemanha/epidemiologia , Humanos , Estudos Multicêntricos como Assunto , Prevalência , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento
19.
Z Gerontol Geriatr ; 52(8): 730-736, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31297589

RESUMO

BACKGROUND: The publication of quality indicators is used internationally to compare the quality of nursing homes and initiate quality improvement processes. From 2019 onwards, Switzerland will nationally measure and subsequently publish the results of six quality indicators on four measurement topics (use of physical restraint measures, malnutrition, polypharmacy, self-assessed and observed pain). OBJECTIVE: To assess the reliability of data collection as well as the understandability and usability of the newly developed quality indicators from the perspective of healthcare providers. MATERIAL AND METHODS: An online survey in a convenience sample from 155 Swiss nursing homes was conducted. The participants answered the items used to measure the quality indicators based on five case study examples. They assessed the understandability of the items and the usability of the indicators for internal quality improvement as well as benchmarking with other nursing homes with a 4-point agreement Likert scale. RESULTS: A total of 303 persons from 127 nursing homes completed the survey. In 4 out of the 5 case studies the rating of more than 90% of the respondents led to a correct classification of the quality indicator. The counting of active ingredients for polypharmacy and the assessment of observed pain proved to be difficult. More than 80% of the respondents found the items understandable. The respondents agreed more with the usability of the quality indicators for internal quality improvement (78-91%) than for external benchmarking (63-79%). CONCLUSION: The majority of the quality indicators were correctly classified and rated as useful. For polypharmacy, an electronic support for counting the active ingredients is recommended and for the external assessment of pain the use of a validated pain intensity scale.


Assuntos
Instituição de Longa Permanência para Idosos , Casas de Saúde , Idoso , Humanos , Indicadores e Reagentes , Casas de Saúde/normas , Indicadores de Qualidade em Assistência à Saúde , Reprodutibilidade dos Testes , Inquéritos e Questionários , Suíça
20.
Br J Nurs ; 28(13): 833-837, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31303040

RESUMO

People in nursing and residential homes are more likely to suffer frailty. Registered nurses are a crucial component of the care delivery service and can offer support to patients who have complex care needs and comorbidities and are at risk of unplanned admissions to secondary care. This article explores frailty and the role of the nurse in assessing for frailty. Three aspects of patient care-nutrition status, polypharmacy and exercise and cognitive function-are discussed as areas where nurses can target their interventions in order to support those considered as frail, aiming to reduce the impact of frailty and negative health outcomes.


Assuntos
Fragilidade/enfermagem , Instituição de Longa Permanência para Idosos , Papel do Profissional de Enfermagem , Enfermeiras e Enfermeiros , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Humanos , Avaliação em Enfermagem , Reino Unido
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA