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2.
Nutrients ; 13(10)2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34684566

RESUMO

The role of foodservices in aged care is difficult to understand, and strategies to improve the nutritional care of residents are often unsustainable. In particular, food-first strategies such as food fortification are poorly executed in everyday practice and its execution relies upon the foodservice system in aged care homes. The aim of this study was to explore the perspective of staff on the role of foodservices in aged care and gauge the level of skills, education, access, time, and ability to deliver food fortification. Semi-structured interviews were conducted with foodservice managers, foodservice workers, dietitians, carers, and other managers who work in aged care homes across Australia. Participants were recruited purposively through email and through snowballing. Interviews (n = 21) were recorded, transcribed verbatim, and analyzed using inductive thematic analysis. Three themes and six sub-themes were identified. The three themes include the role of foodservices being more than just serving food, teamwork between all staff to champion nutrition, and workplace culture that values continuous improvement. These themes identify how staff perceive the role of foodservices in aged care and provide an important perspective on the long-term sustainability of food fortification strategies and how to improve current practice.


Assuntos
Serviços de Alimentação , Instituição de Longa Permanência para Idosos , Apoio Nutricional , Pesquisa Qualitativa , Instituições Residenciais , Participação dos Interessados , Adulto , Idoso , Feminino , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Pessoal
3.
Medicine (Baltimore) ; 100(40): e27488, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34622881

RESUMO

ABSTRACT: Pneumonia is a common disease-causing hospitalization. When a healthcare-associated infection is suspected, antibiotics that provide coverage for multi-drug resistant (MDR) or extended-spectrum beta-lactamase (ESBL) bacteria are frequently prescribed. Limited data is available for guidance on using meropenem as a first-line empiric antimicrobial in hospitalized patients with risk factors for MDR/ESBL bacterial infections.This was a single-center, retrospective study designed and conducted to identify factors associated with positive cultures for MDR/ESBL pathogens in hospitalized patients with suspected healthcare-associated pneumonia.Of the 246 patients, 103 patients (41%) received meropenem. Among patients prescribed meropenem, MDR/ESBL pathogens were detected in only 20 patients (13%). Patients admitted from a skilled nursing facility/long-term acute care (SNF/LTAC) or with a history of a positive culture for MDR/ESBL pathogens were significantly associated with positive cultures of MDR/ESBL pathogens during the hospitalization (odds ratio [95% confidence intervals], 31.40 [5.20-189.6] in SNF/LTAC and 18.50 [2.98-115.1] in history of culture-positive MDR/ESBL pathogen). There was no significant difference in mortality between the 3 antibiotic groups.Admission from a SNF/LTAC or having a history of cultures positive for MDR/ESBL pathogens were significantly associated with a positive culture for MDR/ESBL pathogens during the subsequent admission. We did not detect significant association between meropenem use as a first-line drug and morbidity and mortality for patients admitted to the hospital with suspected healthcare-associated pneumonia, and further prospective studies with larger sample size are needed to confirm our findings.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana Múltipla , Pneumonia Associada a Assistência à Saúde/tratamento farmacológico , Hospitalização/estatística & dados numéricos , Meropeném/uso terapêutico , Idoso , Antibacterianos/administração & dosagem , Uso de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Masculino , Meropeném/administração & dosagem , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Instituições Residenciais/estatística & dados numéricos , Estudos Retrospectivos
4.
NCHS Data Brief ; (404): 1-8, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34570695

RESUMO

Residential care communities provide housing for persons who cannot live independently but generally do not require the skilled care provided by nursing homes. On any given day in 2018, an estimated 918,700 residents lived in residential care communities (1,2). With the aging of the U.S. population, the numbers of residential care community residents will likely increase, becoming a substantial segment of the long-term care population. This report presents national estimates of selected characteristics of residential care community residents in 2018.


Assuntos
Moradias Assistidas , Envelhecimento , Humanos , Assistência de Longa Duração , Instituições Residenciais , Estados Unidos
6.
Artigo em Inglês | MEDLINE | ID: mdl-34444433

RESUMO

Unmarried mothers living in residential facilities (UMLFs) in Korea face complex and challenging physical, psychological, and socioeconomic issues. This study developed a physical and mental health promotion program using urban forests for UMLFs based on the transtheoretical model and evidence. We utilized an intervention mapping approach (IMA) and assessed the needs of UMLFs by analyzing previous quantitative studies. Moreover, we conducted a qualitative hermeneutic phenomenological study involving nine participants. Based on the needs assessment, important and changeable determinants were identified; further, the program performance and change objectives were classified to achieve the program goals and establish the intervention strategy. We found that physical activity using forests, self-reflection using metaphors, five-sense activities, achievement activities using natural objects, building interpersonal relationships in the forest, and designing future plans, are desirable methods for improving the health of UMLFs. The IMA was deemed appropriate for the systematic development of health promotion programs for UMLFs through clear links among change objectives, theoretical methods, and practice strategies. These results should be applied to future intervention studies.


Assuntos
Ilegitimidade , Modelo Transteórico , Florestas , Promoção da Saúde , Humanos , Instituições Residenciais
7.
Nervenarzt ; 92(9): 941-947, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34345930

RESUMO

BACKGROUND: The United Nations Convention on the Rights of Persons with Disabilities and the Federal Participation Act state that all human beings have the right to choose where to live. This human right is compromised by the institutional limitations of the community psychiatric system, where persons with severe mental illnesses and with intensive support needs are often housed in closed (i.e. physically locked) living contexts. How can the concept of person-centered care help to solve this conflict? OBJECTIVE: Description of the nationwide situation of closed residential facilities and discussion of the person-centered approach as a solution to the problem of closed living contexts. METHODS: Summary of current knowledge on the structural and procedural data of closed residential facilities in Germany, which were collated within the framework of the "Coercive measures in the psychiatric care system-Collation and reduction" (ZIPHER) study. RESULTS: The empirical data indicate a great need for regionally based care of the target group and a lack of individual arrangements as alternatives to closed living contexts. The necessity for regional care obligations is highlighted by the example of Mecklenburg-Western Pomerania. CONCLUSION: The avoidance and reduction of closed accommodation can primarily be achieved by individual arrangements within the framework of person-centered and flexible proposal landscapes. For this the service providers of integration assistance, including the psychiatric hospitals, must be committed to the care of all people in their region. An appropriate accompaniment and refunding by the service provider are also necessary.


Assuntos
Pessoas com Deficiência , Transtornos Mentais , Alemanha , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Assistência Centrada no Paciente , Instituições Residenciais
8.
Z Kinder Jugendpsychiatr Psychother ; 49(4): 273-283, 2021 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-34240619

RESUMO

Freedom-restricting measures in Bavarian residential facilities for children, adolescents, and young adults with intellectual disabilities Abstract. Objective: In Bavaria, around 10 % of youths with an intellectual disability (ID) live in residential facilities. In 2015, media raised accusations of inadmissible use of coercive measures. The REDUGIA project carried out a representative survey in Bavarian facilities regarding coercive measures (FeM), challenging behavior (hfV), and employee stress (MaB). Method: We sent a questionnaire concerning structural conditions, MaB, hfV and FeM to 65 Bavarian facilities for young people with ID. In addition to preparing descriptive evaluations, we performed correlative and regression analyses concerning the relationship between hfV, FeM, and MaB. Results: We retrieved data from 1,839 subjects in 61 facilities. 84.3 % of facilities reported low rates of hfV and FeM, while 15.7 % reported an increased incidence of hfV and FeM. For n = 1809 full-time position equivalents there were 639 physical attacks by residents over the course of 14 days. We observed 85 instances of sick leave and 33 transfer apllications/resignation associated with hfV. The frequency of hfV predicted the frequency of FeM (R² = 0.307, F = 21.719, p < .001). MaB correlated positively with hfV (r = 0.507, p < .001). Conclusions: The descriptive data indicate that hfV and FeM are not general phenomena but occur mainly in a circumscript number of highly specialized facilities. This emphasizes the need for prevention of hfV and FeM.


Assuntos
Deficiência Intelectual , Adolescente , Criança , Liberdade , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/epidemiologia , Instituições Residenciais , Inquéritos e Questionários , Adulto Jovem
9.
Healthc Q ; 24(2): 38-39, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34297662

RESUMO

Clinical environments that provide mental health and addictions care have been challenged during the COVID-19 pandemic due to health human resource shortages. This paper provides some insights gleaned from nurse and physician leaders working together during the pandemic in the mental health context to tackle some of these challenges. Key takeaways are provided.


Assuntos
COVID-19/epidemiologia , Serviços de Saúde Mental/organização & administração , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Tomada de Decisões Gerenciais , Humanos , Liderança , Ontário/epidemiologia , Instituições Residenciais/organização & administração , Telemedicina , Recusa de Vacinação
11.
MMWR Morb Mortal Wkly Rep ; 70(30): 1036-1039, 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34324478

RESUMO

Residents of long-term care facilities (LTCFs) and health care personnel (HCP) working in these facilities are at high risk for COVID-19-associated mortality. As of March 2021, deaths among LTCF residents and HCP have accounted for almost one third (approximately 182,000) of COVID-19-associated deaths in the United States (1). Accordingly, LTCF residents and HCP were prioritized for early receipt of COVID-19 vaccination and were targeted for on-site vaccination through the federal Pharmacy Partnership for Long-Term Care Program (2). In December 2020, CDC's National Healthcare Safety Network (NHSN) launched COVID-19 vaccination modules, which allow U.S. LTCFs to voluntarily submit weekly facility-level COVID-19 vaccination data.* CDC analyzed data submitted during March 1-April 4, 2021, to describe COVID-19 vaccination coverage among a convenience sample of HCP working in LTCFs, by job category, and compare HCP vaccination coverage rates with social vulnerability metrics of the surrounding community using zip code tabulation area (zip code area) estimates. Through April 4, 2021, a total of 300 LTCFs nationwide, representing approximately 1.8% of LTCFs enrolled in NHSN, reported that 22,825 (56.8%) of 40,212 HCP completed COVID-19 vaccination.† Vaccination coverage was highest among physicians and advanced practice providers (75.1%) and lowest among nurses (56.7%) and aides (45.6%). Among aides (including certified nursing assistants, nurse aides, medication aides, and medication assistants), coverage was lower in facilities located in zip code areas with higher social vulnerability (social and structural factors associated with adverse health outcomes), corresponding to vaccination disparities present in the wider community (3). Additional efforts are needed to improve LTCF immunization policies and practices, build confidence in COVID-19 vaccines, and promote COVID-19 vaccination. CDC and partners have prepared education and training resources to help educate HCP and promote COVID-19 vaccination coverage among LTCF staff members.§.


Assuntos
Vacinas contra COVID-19/administração & dosagem , Pessoal de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde , Ocupações/estatística & dados numéricos , Instituições Residenciais , Cobertura Vacinal/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Estados Unidos/epidemiologia
12.
Health Technol Assess ; 25(39): 1-74, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34142943

RESUMO

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes coronavirus disease 2019 (COVID-19), which at the time of writing (January 2021) was responsible for more than 2.25 million deaths worldwide and over 100,000 deaths in the UK. SARS-CoV-2 appears to be highly transmissible and could rapidly spread in residential care homes. OBJECTIVE: The work undertaken aimed to estimate the clinical effectiveness and cost-effectiveness of viral detection point-of-care tests for detecting SARS-CoV-2 compared with laboratory-based tests in the setting of a hypothetical care home facility for elderly residents. PERSPECTIVE/SETTING: The perspective was that of the NHS in 2020. The setting was a hypothetical care home facility for elderly residents. Care homes with en suite rooms and with shared facilities were modelled separately. METHODS: A discrete event simulation model was constructed to model individual residents and simulate the spread of SARS-CoV-2 once it had entered the residential care facility. The numbers of COVID-19-related deaths and critical cases were recorded in addition to the number of days spent in isolation. Thirteen strategies involving different hypothetical SARS-CoV-2 tests were modelled. Recently published desirable and acceptable target product profiles for SARS-CoV-2 point-of-care tests and for hospital-based SARS-CoV-2 tests were modelled. Scenario analyses modelled early release from isolation based on receipt of a negative SARS-CoV-2 test result and the impact of vaccination. Incremental analyses were undertaken using both incremental cost-effectiveness ratios and net monetary benefits. RESULTS: Cost-effectiveness results depended on the proportion of residential care facilities penetrated by SARS-CoV-2. SARS-CoV-2 point-of-care tests with desirable target product profiles appear to have high net monetary benefit values. In contrast, SARS-CoV-2 point-of-care tests with acceptable target product profiles had low net monetary benefit values because of unnecessary isolations. The benefit of allowing early release from isolation depended on whether or not the facility had en suite rooms. The greater the assumed efficacy of vaccination, the lower the net monetary benefit values associated with SARS-CoV-2 point-of-care tests, when assuming that a vaccine lowers the risk of contracting SARS-CoV-2. LIMITATIONS: There is considerable uncertainty in the values for key parameters within the model, although calibration was undertaken in an attempt to mitigate this. Some degree of Monte Carlo sampling error persists because of the timelines of the project. The example care home simulated will also not match those of decision-makers deciding on the clinical effectiveness and cost-effectiveness of introducing SARS-CoV-2 point-of-care tests. Given these limitations, the results should be taken as indicative rather than definitive, particularly the cost-effectiveness results when the relative cost per SARS-CoV-2 point-of-care test is uncertain. CONCLUSIONS: SARS-CoV-2 point-of-care tests have considerable potential for benefit for use in residential care facilities, but whether or not this materialises depends on the diagnostic accuracy and costs of forthcoming SARS-CoV-2 point-of-care tests. FUTURE WORK: More accurate results would be obtained when there is more certainty on the diagnostic accuracy of and the reduction in time to test result associated with SARS-CoV-2 point-of-care tests when used in the context of residential care facilities, the proportion of care home penetrated by SARS-CoV-2 and the levels of immunity once vaccination is administered. These parameters are currently uncertain. FUNDING: This report was commissioned by the National Institute for Health Research (NIHR) Evidence Synthesis programme as project number 132154. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 39. See the NIHR Journals Library website for further project information.


Assuntos
Teste para COVID-19 , Análise Custo-Benefício , Modelos Teóricos , Testes Imediatos , Instituições Residenciais , Idoso , COVID-19 , Teste para COVID-19/normas , Humanos , Avaliação da Tecnologia Biomédica
13.
JAMA Netw Open ; 4(6): e2112862, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34100935

RESUMO

Importance: Although there is evidence of more severe COVID-19 outcomes, there is no information describing the risk factors for COVID-19 diagnosis and/or mortality among people with intellectual and developmental disabilities (IDD) receiving residential support services in the US. Objective: To identify associations between demographic characteristics, residential characteristics, and/or preexisting health conditions and COVID-19 diagnosis and mortality for people with IDD receiving residential support services. Design, Setting, and Participants: This cohort study tracked COVID-19 outcomes for 543 individuals with IDD. Participants were receiving support services from a single organization providing residential services in the 5 boroughs of New York City from March 1 to October 1, 2020. Statistical analysis was performed from December 2020 to February 2021. Exposures: Resident-level characteristics, including age, sex, race/ethnicity, disability status, residential characteristics, and preexisting medical conditions. Main Outcomes and Measures: COVID-19 diagnosis was confirmed by laboratory test. COVID-19 mortality indicated that the individual died from COVID-19 during the course of the study. Logistic regression models were used to evaluate associations between demographic characteristics, residential characteristics, and preexisting health conditions and COVID-19 diagnosis and mortality. Results: Among the 543 individuals with IDD in the study, the median (interquartile range) age was 57.0 (45-65) years; 217 (40.0%) were female, and 274 (50.5%) were Black, Asian/Pacific Islander, American Indian or Alaskan Native, or Hispanic. The case rate was 16 759 (95% CI, 13 853-20 131) per 100 000; the mortality rate was 6446 (95% CI, 4671-8832) per 100 000; and the case-fatality rate was 38.5% (95% CI, 29.1%-48.7%). Increased age (odds ratio [OR], 1.04; 95% CI, 1.02-1.06), Down syndrome (OR, 2.91; 95% CI, 1.49-5.69), an increased number of residents (OR, 1.07; 95% CI, 1.00-1.14), and chronic kidney disease (OR, 4.17; 95% CI, 1.90-9.15) were associated with COVID-19 diagnosis. Heart disease (OR, 10.60; 95% CI, 2.68-41.90) was associated with COVID-19 mortality. Conclusions and Relevance: This study found that, similar to the general population, increased age and preexisting health conditions were associated with COVID-19 outcomes for people with IDD receiving residential support services in New York City. As with older adults living in nursing homes, number of residents was also associated with more severe COVID-19 outcomes. Unique to people with IDD was an increased risk of COVID-19 diagnosis for people with Down syndrome.


Assuntos
COVID-19/epidemiologia , Deficiências do Desenvolvimento/epidemiologia , Deficiência Intelectual/epidemiologia , Pandemias , Instituições Residenciais , Fatores Etários , Idoso , COVID-19/mortalidade , Causas de Morte , Estudos de Coortes , Comorbidade , Síndrome de Down , Grupos Étnicos , Feminino , Habitação , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Razão de Chances , Fatores de Risco , SARS-CoV-2
14.
Sci Rep ; 11(1): 11939, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-34099747

RESUMO

Amyotrophic lateral sclerosis (ALS) is neurodegenerative disease characterized by a fatal prognosis and still unknown etiology. Some environmental risk factors have been suggested, including exposure to magnetic fields. Studies have suggested positive associations in occupationally-exposed populations, but the link with residential exposure is still debated as is the shape of such relation. Due to recent availability of advanced biostatistical tools for dose-response meta-analysis, we carried out a systematic review in order to assess the dose-response association between ALS and residential exposure to magnetic fields. We performed an online literature searching through April 30, 2021. Studies were included if they assessed residential exposure to electromagnetic fields, based either on distance from overhead power lines or on magnetic field modelling techniques, and if they reported risk estimates for ALS. We identified six eligible studies, four using distance-based and one modelling-based exposure assessment, and one both methods. Both distance-based and particularly modelling-based exposure estimates appeared to be associated with a decreased ALS risk in the highest exposure category, although estimates were very imprecise (summary RRs 0.87, 95% CI 0.63-1.20, and 0.27, 95% CI 0.05-1.36). Dose-response meta-analysis also showed little association between distance from power lines and ALS, with no evidence of any threshold. Overall, we found scant evidence of a positive association between residential magnetic fields exposure and ALS, although the available data were too limited to conduct a dose-response analysis for the modelled magnetic field estimates or to perform stratified analyses.


Assuntos
Esclerose Amiotrófica Lateral/diagnóstico , Campos Eletromagnéticos/efeitos adversos , Exposição Ambiental/efeitos adversos , Doenças Neurodegenerativas/diagnóstico , Esclerose Amiotrófica Lateral/etiologia , Habitação , Humanos , Doenças Neurodegenerativas/etiologia , Doses de Radiação , Instituições Residenciais , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco
15.
J Prev Alzheimers Dis ; 8(3): 362-370, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34101795

RESUMO

BACKGROUND: Alzheimer's Disease is the most common cause of dementia, affecting memory, thinking and behavior. Symptoms eventually grow severe enough to interfere with daily tasks. AD is predicted to increase healthcare spending and costs associated with formal and informal caregiving. The aim of this study was to identify and quantify the contribution of the different cost components associated with AD. METHODS: A structured literature review was conducted to identify studies reporting the economic burden of Alzheimer`s Disease beyond the healthcare setting. The search was conducted in Medline, Embase and EconLit and limited to studies published in the last 10 years. For each identified cost component, frequency weighted mean costs were calculated across countries to estimate the percentage contribution of each component by care setting and disease severity. Results obtained by each costing approach were also compared. RESULTS: For community-dwelling adults, the percentage of healthcare, social care and indirect costs to total costs were 13.9%, 17.4% and 68.7%, respectively. The percentage of costs varied by disease severity with 26.0% and 10.4% of costs spent on healthcare for mild and severe disease, respectively. The proportion of total spending on indirect costs changed from 60.7% to 72.5% as disease progressed. For those in residential care, the contribution of each cost component was similar between moderate and severe disease. Social care accounted on average for 85.9% of total costs. CONCLUSION: The contribution of healthcare costs to the overall burden was not negligible; but was generally exceeded by social and informal care costs.


Assuntos
Doença de Alzheimer/economia , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Vida Independente/economia , Instituições Residenciais/economia , Índice de Gravidade de Doença , Cuidadores/economia , Humanos
16.
PLoS One ; 16(5): e0250761, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34014948

RESUMO

Due to financial and mobility barriers, a majority of older adults living in collective dwellings are no longer able to engage in tourism, a leisure activity that contributes to quality of life and wellbeing. Immersive Virtual Reality (VR) may serve as a programmatic tool to facilitate tourism. This pilot study examined the effects of VR tourism exposure on indices of psychosocial wellbeing among older adults living in residential care. Using a mixed-methods study design, 18 older adults were exposed to VR tourism three times a week, over six weeks. Participants reported decreased anxiety and fatigue immediately following exposure, and increased social engagement and quality of life following six weeks of VR tourism. Qualitative data offered additional insight on the process by which VR tourism may enhance wellbeing. Findings suggest that immersive VR tourism may be a viable program for older adults in residential care.


Assuntos
Instituições Residenciais , Turismo , Realidade Virtual , Idoso , Feminino , Humanos , Masculino , Qualidade de Vida
17.
J Korean Acad Nurs ; 51(2): 173-187, 2021 Apr.
Artigo em Coreano | MEDLINE | ID: mdl-33993124

RESUMO

PURPOSE: To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities. METHODS: A three-group pre- and post-test design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22). Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ² test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0. RESULTS: Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET. CONCLUSION: Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant's physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.


Assuntos
Acidentes por Quedas/prevenção & controle , Terapia por Exercício/métodos , Exercício Físico , Educação de Pacientes como Assunto , Equilíbrio Postural , Idoso , Feminino , Idoso Fragilizado , Humanos , Masculino , Força Muscular , Instituições Residenciais , Caminhada
18.
Psychiatr Pol ; 55(1): 101-112, 2021 Feb 28.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-34021549

RESUMO

This study concerns measuring the quality of health services in long-term residential mental health care. The issue of measuring the quality of health services has been limited to services at residential health care centers (ZOL). The aim of the study is to propose measures associated with the provision of services in long-term residential mental health care. Currently, there are no tools for measuring the psychiatric services provided. The consequence of that isthat the monitoring-supervisory-control mechanism that should ensure the required level of quality of services provided in this area of psychiatric care is inefficient. The aim of the deliberations made in this study is presenting an appropriate set of measures to assess the performance of aresidential health care provider, taking into account the specificity of long-term mental health care (ZOL). The application of the Team Patient Functioning Scale allows for the specification of the changes occurring in the patient's functioning and comparing them at time intervals, and indirectly causes the Team Patient Functioning Scale to be used to draw conclusions about the aggravation, stabilization, or regression of the illness, and to prove the effectiveness of the therapeutic team. The presented results of the application of the proposed measures may constitute a reference base - as a benchmark - for the improvement and development of the quality of health services for patients in residential health care centers in Poland.


Assuntos
Transtornos Mentais/terapia , Serviços de Saúde Mental , Qualidade da Assistência à Saúde , Instituições Residenciais , Humanos , Polônia
19.
J Alzheimers Dis ; 81(4): 1375-1379, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33896844

RESUMO

We assessed depression in 72 patients with Alzheimer's disease (AD) who live in retirement homes during the COVID-19-related lockdown. We invited caregivers of 72 patients with AD who live in retirement homes to rate depression in the patients both before and during the lockdown. Analysis demonstrated increased depression in the patients during the lockdown. We attribute this increased depression to the restrictive measures on activities, visits, and physical contact between patients with AD and family members during the lockdown.


Assuntos
Doença de Alzheimer/psicologia , Técnicas de Observação do Comportamento , COVID-19 , Depressão , Relações Familiares/psicologia , Controle de Infecções/métodos , Isolamento Social/psicologia , Idoso , Doença de Alzheimer/epidemiologia , Técnicas de Observação do Comportamento/métodos , Técnicas de Observação do Comportamento/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Cuidadores , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/etiologia , Feminino , França/epidemiologia , Humanos , Atividades de Lazer/psicologia , Masculino , Distanciamento Físico , Instituições Residenciais/estatística & dados numéricos , SARS-CoV-2 , Visitas a Pacientes/psicologia , Visitas a Pacientes/estatística & dados numéricos
20.
J Am Med Dir Assoc ; 22(6): 1142-1145, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33865795

RESUMO

OBJECTIVES: The Coronavirus 2019 (COVID-19) pandemic caused a considerable mortality in long-term care facilities (LTCFs), including residential care setting and nursing homes. This study aimed to estimate COVID-19 incidence and mortality in residential care facilities and to compare them with those recorded in nursing homes. DESIGN: Nationwide observational study conducted by French health authorities. SETTINGS AND PARTICIPANTS: Since March 1, 2020, all LTCFs in France reported all COVID-19 cases and COVID-19-related deaths among their residents. METHODS: Possible cases were those with COVID-19-related symptoms without laboratory confirmation and confirmed cases those with a reverse transcriptase polymerase chain reaction test or serology positive for SARS-CoV-2. We included facilities with at least 1 confirmed case of COVID-19 and estimated the cumulative incidence of COVID-19 cases and mortality due to COVID-19 reported until June 30, 2020, using the maximum bed capacity as a denominator. RESULTS: Of the 2288 residential care facilities, 310 (14%) and, of the 7688 nursing homes, 3110 (40%) reported COVID-19 cases among residents (P < .001). The cumulative incidence of COVID-19 was significantly lower in residential care facilities as compared with nursing homes (1.10 vs 9.97 per 100 beds, P < .001). Mortality due to COVID-19 was also lower in residential care facilities compared with nursing homes (0.07 vs 1.29 per 100 beds, P < .001). Case fatality was lower in residential care facilities (6.49% vs 12.93%, P < .001). CONCLUSION AND IMPLICATIONS: French residential care facilities experienced a much lower burden from COVID-19 than nursing homes. Our findings may inform the implementation of better infection control practices in these settings.


Assuntos
COVID-19 , Casas de Saúde , Instituições Residenciais , COVID-19/epidemiologia , França/epidemiologia , Humanos , Pandemias , SARS-CoV-2
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