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Keyvanloo Shahrestanaki S, Sharifi F, Shahsavari H, Ghonoodi F, Philp I, Bahramnezhad F, Navab E. Predicting The Risk of Fall in Community-Dwelling Older Adults in Iran. JOURNAL OF AGING AND ENVIRONMENT 2022. [DOI: 10.1080/26892618.2021.1918813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sahar Keyvanloo Shahrestanaki
- Geriatric Nursing Department, School of Nursing and Midwifery, Tehran University of medical sciences, Tehran, Iran
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooman Shahsavari
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of medical sciences, Tehran, Iran
| | - Fatemeh Ghonoodi
- Geriatric Nursing Department, School of Nursing and Midwifery, Tehran University of medical sciences, Tehran, Iran
| | - Ian Philp
- Honorary Professor in Healthcare for the Elderly, University of Suffolk, UK
| | - Fatemeh Bahramnezhad
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Spiritual Health Group, Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Navab
- Critical care and Geriatric Nursing Department, School of Nursing and Midwifery, Tehran University of medical sciences, Tehran, Iran
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Wojszel ZB, Politynska B. The structure and functional correlates of social support networks of people in advanced old age living in chosen urban and rural areas in Poland: a cross-sectional study. Eur J Ageing 2021; 18:345-355. [PMID: 34483799 PMCID: PMC8377102 DOI: 10.1007/s10433-020-00583-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 11/26/2022] Open
Abstract
The purpose of the study was to identify the different types of social support networks (SSNs) among community-dwelling people aged 75+ years in selected areas of Poland, and to evaluate any associations between the network type and demographic and health variables of the population studied. The two most prevalent SSN types identified using the Practitioner Assessment of Network Type were “family dependent” (35.8%) and “locally integrated” (32.2%). “Local self-contained” (6.4%), “wider community focused” (2.8%) and “private restricted” (5.6%) SSNs were observed less frequently. In 17.2% of cases, it was not possible to identify the type of network unequivocally. Older people with a locally integrated SSN, in contrast to the family dependent type, were generally younger, living alone, and less likely to be homebound, rate their health as poor, suffer from depression or dementia, and had lower levels of functional disability. Locally integrated SSNs are recognized in the literature as being the most robust in terms of facilitating well-being and providing sufficient support to help maintain the older person in the community. This may reflect the higher levels of independence of older people able to sustain these support networks, which are then transformed into family-dependent types as their health deteriorates, but confirmation of this would require prospective studies. An improved understanding of the prevalence of different types of social networks among older people in Poland would help to guide a systematic approach to recognizing unmet needs in this population and provide crucial information in the planning of formal services.
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Affiliation(s)
- Z. B. Wojszel
- Department of Geriatrics, Medical University of Bialystok, Fabryczna str. 27, 15-471 Bialystok, Poland
- Department of Geriatrics, Hospital of the Ministry of Interior in Bialystok, Bialystok, Poland
| | - B. Politynska
- Department of Philosophy and Human Psychology, Medical University of Bialystok, Szpitalna str. 37, Bialystok, Poland
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Cowdell F, Dyson J, Long J, Macleod U. Self-reported skin concerns: An epidemiological study of community-dwelling older people. Int J Older People Nurs 2018; 13:e12195. [DOI: 10.1111/opn.12195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 02/15/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Fiona Cowdell
- Faculty of Health, Education and Life Sciences; Birmingham City University; Birmingham UK
| | - Judith Dyson
- School Health and Social Work; University of Hull; Hull UK
| | - Judith Long
- Hull and East Yorkshire Hospitals NHS Trust; Hull UK
| | - Una Macleod
- Hull York Medical School; University of Hull; Hull UK
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Fougère B, Cesari M, Arai H, Woo J, Merchant RA, Flicker L, Cherubini A, Bauer JM, Vellas B, Morley JE. Editorial: Involving Primary Care Health Professionals in Geriatric Assessment. J Nutr Health Aging 2018; 22:566-568. [PMID: 29717754 DOI: 10.1007/s12603-018-1001-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- B Fougère
- B. Fougère, Institut du Vieillissement, Gérontopôle, Université Toulouse III Paul Sabatier, 37 Allées Jules Guesde, 31000 Toulouse, France, Tel: +33561145657 ; fax: +33561145640, E-mail:
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Integrated Care: Enhancing the Role of the Primary Health Care Professional in Preventing Functional Decline: A Systematic Review. J Am Med Dir Assoc 2017; 18:489-494. [DOI: 10.1016/j.jamda.2017.03.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 03/28/2017] [Indexed: 11/18/2022]
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Validity of the EASYCare Standard 2010 assessment instrument for self-assessment of health, independence, and well-being of older people living at home in Poland. Eur J Ageing 2017. [PMID: 29531519 PMCID: PMC5840086 DOI: 10.1007/s10433-017-0422-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
EASYCare Standard 2010 is a brief instrument identifying concerns in health, functional independence, and well-being, from older persons’ perspective. It has not previously been validated for self-assessment. Our aim was to determine whether self-assessment (EC1) can give comparable results to an evaluation performed by professionals (EC2), for older people living at home. The study included community-dwelling individuals (aged at least 60 years, n = 100; 67 females) without dementia (abbreviated mental test score [AMTS] above 6). It comprised two assessments (self and professional), including summarising indexes: Independence score [IS], Risk of breakdown in care [RBC], Risk of falls [RF], performed within a period between 1 and 2 weeks. Additionally, during EC1, reference tests of physical and mental function (Barthel Index: 96.3 ± 6.5, Lawton scale: 6.7 ± 2.0, geriatric depression scale: 3.0 ± 2.7, AMTS: 10.2 ± 1.0) were applied to test for concurrent validity. Cohen’s kappa values (self-assessment vs. professional assessment) across all EASYCare domains were high (0.89–0.95). Results of all summarising indexes derived from self-assessment correlated strongly with reference tests. No differences were found in IS and RBC between EC1 and EC2 (8.6 ± 12.0 vs. 9.0 ± 12.7 and 1.0 ± 1.1 vs. 1.2 ± 1.4). Results of RF were higher in EC2 (1.0 ± 1.1 vs. 1.1 ± 1.4; p = 0.005), due to a different response to the item “Do you feel safe outside your home?” We conclude that self-assessment with EASYCare Standard in older people without severe functional impairment living at home can deliver valid results, similar to those obtained through professional assessment, thus providing an efficient system for assessment of relatively independent individuals.
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Kaehr E, Abele P, Little M. Utility of the Easy-Care Standard 2010 in the Comprehensive Geriatric Assessment of Adults Aging with Developmental Disabilities. J Am Med Dir Assoc 2016; 17:1159-1160. [PMID: 27751800 DOI: 10.1016/j.jamda.2016.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 08/31/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Ellen Kaehr
- Department of Geriatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Patricia Abele
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
| | - Milta Little
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
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Mouratidis H, Manson G, Philp I. A Novel Agent-Based System to Support the Single Assessment Process of Older People. Health Informatics J 2016. [DOI: 10.1177/14604582030093003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Older people often have a complex mixture of health and social care needs and several different health and social care professionals are involved in their care. National policy in England is to promote the single assessment process (SAP), an integrated assessment of health and social care needs of older people. However, most of the current information systems do not adequately provide the functionality that is required by health and social care professionals. In this paper we discuss the suitability of agent technology, explaining why we selected it as offering the greatest potential for efficient and flexible information collection and sharing, and for supporting effective care planning. Also, we point out benefits derived from the use of agent technology in the development of health and social care systems, such as the minimization of health and social care professionals' workload. In addition, we describe how we have developed a model for an integrated information system, based on agent technology, for health and social care needs assessment of older people. Finally, we discuss issues, such as security and mobility, involved in the development of such a system, which will need to be designed and tested prior to its implementation in health and social care practice.
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Affiliation(s)
- H. Mouratidis
- Computer Science Department Regent Court, 211 Portobello Street Sheffield, S1 4DP, UK,
| | - G. Manson
- Computer Science Department Regent Court, 211 Portobello Street Sheffield, S1 4DP, UK,
| | - I. Philp
- Sheffield Institute for Studies on Ageing Community Sciences Centre Northern General Hospital, Herries Sheffield, S5 7AU,
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A T J, Dias A, Philp I, Beard J, Patel V, Prince M. Identifying common impairments in frail and dependent older people: validation of the COPE assessment for non-specialised health workers in low resource primary health care settings. BMC Geriatr 2015; 15:123. [PMID: 26467913 PMCID: PMC4607017 DOI: 10.1186/s12877-015-0121-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 10/06/2015] [Indexed: 12/14/2022] Open
Abstract
Background Frail and dependent older people in resource-poor settings are poorly served by health systems that lack outreach capacity. The COPE (Caring for Older PEople) multidimensional assessment tool is designed to help community health workers (CHWs) identify clinically significant impairments and deliver evidence-based interventions Methods Older people (n = 150) identified by CHWs as frail or dependent, were assessed at home by the CHW using the structured COPE assessment tool, generating information on impairments in nutrition, mobility, vision, hearing, continence, cognition, mood and behaviour. The older people were reassessed by local physicians who reached a clinical judgment regarding the presence or absence of the same impairments based upon clinical examination guided by the EASY-Care assessment tool. Results The COPE tool was considered easy to administer, and gave CHWs a sense of empowerment to understand and act upon the needs of older people. Agreement between COPE assessment by CHW and clinician assessors was modest (ranged from 45.8 to 91.3 %) for most impairments. However, the prevalence of impairments was generally higher according to clinicians, particularly for visual impairment (98.7 vs 45.8 %), cognitive impairment (78.4 vs. 38.2 %) and depression (82.0 vs. 59.9 %). Most cases identified by WHO-COPE were clinician confirmed (positive predictive values - 72.2 to 98.5 %), and levels of disability and needs for care among those identified by COPE were higher than those additionally identified by the clinician alone. Conclusions The COPE is a feasible tool for the identification of specific impairments in frail dependent older people in the community. Those identified are likely to be confirmed as having clinically relevant problems by clinicians working in the same service, and the COPE may be particularly effective at targeting attention upon those with the most substantial unmet needs. Electronic supplementary material The online version of this article (doi:10.1186/s12877-015-0121-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jotheeswaran A T
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland. .,Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland.
| | - Amit Dias
- Department of Preventive and Social Medicine, Goa Medical College, Goa, India. .,Sangath, Goa, India.
| | - Ian Philp
- Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
| | - John Beard
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland.
| | - Vikram Patel
- Public Health Foundation of India, New Delhi, India. .,Sangath, Goa, India. .,Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK.
| | - Martin Prince
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland.
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Craig C, Chadborn N, Sands G, Tuomainen H, Gladman J. Systematic review of EASY-care needs assessment for community-dwelling older people. Age Ageing 2015; 44:559-65. [PMID: 25911539 PMCID: PMC4476847 DOI: 10.1093/ageing/afv050] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 02/04/2015] [Indexed: 11/13/2022] Open
Abstract
Background: undertaking comprehensive geriatric assessments (CGAs) combined with long-term health and social care management can improve the quality of life of older people [
1]. The EASY-Care tool is a CGA instrument designed for assessing the physical, mental and social functioning and unmet health and social needs of older people in community settings or primary care. It has also been used as a frailty assessment tool and for gathering population-level data. Objective: to review the evidence of reliability, validity and acceptability of EASY-Care and its appropriateness for assessing the needs of community-dwelling older people. Methods: systematic search of literature databases using pre-defined search terms (January 1994—May 2014) for English language articles reporting on the reliability, validity, acceptability and implementation of EASY-Care in primary care and community settings. Eligible articles were critically reviewed. Discussion papers mapping professionals' use of the tool were also included as these could be considered an aspect of validity. Results: twenty-nine papers met the inclusion criteria and underwent data extraction. A narrative synthesis was performed, because there was a variety of quantitative and qualitative outcomes and characteristics. Reliability evidence for EASY-Care is minimal. Evidence for validity is good, and it has received numerous positive endorsements of acceptability in international settings from older people and practitioners. Conclusion: evidence supports the use of EASY-Care for individual needs assessment; further research is needed for other uses. Of the papers that made statements about who should administer EASY-Care, the majority indicated that nurses were preferable to self-completion.
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Affiliation(s)
- Christopher Craig
- National Institute for Health Research, CLAHRC East Midlands, University of Nottingham, Nottingham, UK
| | - Neil Chadborn
- National Institute for Health Research, CLAHRC East Midlands, University of Nottingham, Nottingham, UK
| | - Gina Sands
- National Institute for Health Research, CLAHRC East Midlands, University of Nottingham, Nottingham, UK
| | - Helena Tuomainen
- Warwick Medical School, Division of Mental Health and Well-being, University of Warwick, Warwick, UK
| | - John Gladman
- National Institute for Health Research, CLAHRC East Midlands, University of Nottingham, Nottingham, UK
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Sharifi F, Fakhrzadeh H, Memari A, Najafi B, Nazari N, Khoee MA, Arzaghi SM, Bakhtiari F, Ghasemi S, Salavatian SN, Mehrdad N, Fadaayevatan R, Alizad V, Philp I. Predicting risk of the fall among aged adult residents of a nursing home. Arch Gerontol Geriatr 2015; 61:124-30. [PMID: 26139578 DOI: 10.1016/j.archger.2015.06.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 06/18/2015] [Accepted: 06/19/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fall is one of the most important outcomes of geriatric medicine. The European Assessment System (EASY) Care Standard provides a tool for assessing the risk of the falls. We aimed to evaluate the validity of the Easy-Care risk of the falls (ECRF) sub-score among the residents of a large nursing home. METHOD A longitudinal study was conducted within a maximum of 34 months following up for falling in Kahrizak Charity Foundation. At the baseline the demographic, mental status and the depression data of 194 subjects aged ≥60 was collected. The Easy-Care standard tools and Performance-Oriented Mobility Assessment (POMA) were also used for data collecting. The time, location, and cause of the falls were recorded immediately after each fall incident. The Correlation between POMA and ECRF scores and the factor analysis of ECRF were considered as the concurrent and construct validity respectively. The Factor affecting the fall occurrence was assessed using the Cox-regression model. RESULT The mean age of the participants was 76.02 (SD 8.82). Fifty two individuals (27.3%) fell at least once during the mean 756 (SD 187)-day follow up. The Spearman correlation coefficient between ECRF and POMA scores was -0.458 (P<0.01). Three components were detected in the factor analysis of the ECRF. In the univariate Cox-regression model, the hazard ratio was 1.04 (CI: 1.00-1.07) for each score increase of the ECRF. For the six-month follow-up, at the ECRF cut-off point two of eight, the sensitivity and specificity were calculated as 85.7% and 64.5% respectively. CONCLUSION It seems that the ECRF is a valid tool for predicting the next 6 months' fall incidents in older adults.
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Affiliation(s)
- Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Baharak Najafi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Neda Nazari
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Kahrizak Charity Foundation, Tehran, Iran
| | - Mahtab Alizadeh Khoee
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Siamak Ghasemi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Nahaleh Salavatian
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mehrdad
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Fadaayevatan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Vida Alizad
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ian Philp
- Hull and East Yorkshire NHS Hospitals Trust, East Riding of Yorkshire, UK
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Lee LL, Lin SH, Philp I. Health needs of older Aboriginal people in Taiwan: a community-based assessment using a multidimensional instrument. J Clin Nurs 2015; 24:2514-21. [PMID: 25899876 DOI: 10.1111/jocn.12842] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2015] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore the health needs of older Aboriginal people, using a multidimensional instrument. The gender differences related to their health needs were also addressed. BACKGROUND Health status and life expectancy between Aborigines and non-Aborigines have been shown to differ. The investigation of the health needs of Aboriginal people is however scarce, particularly among the older adult population. There is a need to address unmet health needs and improve information on the health needs assessment of the older Aboriginal population. DESIGN A cross-sectional design was used. METHODS Aboriginal people aged 65 and over were randomly sampled to take part in the present study. A multidimensional instrument consisting of eight domains and three cross-domain categories was used to assess their health needs. RESULTS A group of older Aboriginal people was recruited (n = 90, mean age = 73·5). The top three identified needs were 'mental health and well-being', 'staying healthy' and 'social participation'. The female participants had statistically significant higher scores for the 'mental health and well-being', 'getting around' domains and in the 'risk of falls' than the male ones. A regression model demonstrated that the health need of 'looking after oneself' was associated with all cross-domain categories of health need, which are 'independence', 'risk of breakdown in care' and 'risk of falls'. CONCLUSIONS The present study has revealed major health needs among older Aboriginal people and found that older female Aborigines have more health needs than older male Aborigines. Further study to identify effective approaches to address these needs among this group is warranted. RELEVANCE TO CLINICAL PRACTICE The findings can be used to identify effective approaches to addressing health needs among older Aboriginal people with a consideration of gender. Only then can resources be allocated and prioritised in a culturally sensitive and gender-specific manner nationally and globally.
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Affiliation(s)
- Ling-Ling Lee
- Department of Nursing and Research Centre for Environment and Physical Activity, Tzu Chi College of Technology, Hualien, Taiwan
| | - Shu-Huan Lin
- Community Health Centre, Department of Community Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Ian Philp
- Hull and East Yorkshire NHS Hospitals Trust, UK
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Spoorenberg SLW, Reijneveld SA, Middel B, Uittenbroek RJ, Kremer HPH, Wynia K. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation. Disabil Rehabil 2015; 37:2337-43. [PMID: 25784203 DOI: 10.3109/09638288.2015.1024337] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. METHODS A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. RESULTS Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. CONCLUSION The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most prevalent problems in community-living older adults.
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Affiliation(s)
| | | | - Berrie Middel
- a Department of Health Sciences , Community and Occupational Medicine and
| | | | - Hubertus P H Kremer
- b Department of Neurology , University Medical Center Groningen, University of Groningen , Groningen , the Netherlands
| | - Klaske Wynia
- a Department of Health Sciences , Community and Occupational Medicine and.,b Department of Neurology , University Medical Center Groningen, University of Groningen , Groningen , the Netherlands
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Philip KE, Alizad V, Oates A, Donkin DB, Pitsillides C, Syddall SP, Philp I. Development of EASY-Care, for Brief Standardized Assessment of the Health and Care Needs of Older People; With Latest Information About Cross-National Acceptability. J Am Med Dir Assoc 2014; 15:42-6. [DOI: 10.1016/j.jamda.2013.09.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 09/05/2013] [Indexed: 10/26/2022]
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Marques A, Martins A, Jácome C, Figueiredo D. Linking the EASY-care standard to the international classification of functioning, disability and health. Disabil Rehabil 2013; 36:593-9. [PMID: 23786348 DOI: 10.3109/09638288.2013.804598] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study aimed to document the content of the EASY-Care Standard questionnaire to the International Classification of Functioning, Disability and Health (ICF) and present its ICF Core Set. METHOD The EASY-Care was linked to the ICF by two trained health professionals according to the established linking rules. The agreement between the health professionals was determined using the Cohen's kappa. RESULTS The agreement between the two health professionals was almost perfect for each level of the ICF (Cohen's kappas between 0.91 and 0.97). The 65 items of the EASY-Care were linked to 61 different ICF categories, 16 (26%) from the Body functions component, 3 from the Body structures (5%), 30 from the Activities and participation (49%) and 12 from the Environmental factors (20%). Twelve concepts could not be linked to the ICF at all: 6 were classified as Personal factors, 1 as not defined-general health and 5 were not classified. CONCLUSIONS The integration of the universal language of the ICF in the EASY-Care illustrates the potential of use this instrument in primary care settings at community level. IMPLICATIONS FOR REHABILITATION The integration of the universal language of the ICF in the EASY-Care potentiates the use of this comprehensive instrument in assessing older people needs at primary care settings. The information obtained with the EASY-Care Standard can be worldwide understood and can be used to plan rehabilitation interventions at community settings for older adults.
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Affiliation(s)
- Alda Marques
- School of Health Sciences, University of Aveiro (ESSUA) , Aveiro , Portugal
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Olde-Rikkert MGM, Long JF, Philp I. Development and evidence base of a new efficient assessment instrument for international use by nurses in community settings with older people. Int J Nurs Stud 2012; 50:1180-3. [PMID: 22980483 DOI: 10.1016/j.ijnurstu.2012.08.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 07/24/2012] [Accepted: 08/08/2012] [Indexed: 10/27/2022]
Abstract
In a world where 12% of the population, and 22% of that of more developed regions, will be older than 65 years by 2030, new targeted programs and social protections will be needed for older people in many countries. As economic and human resources become more scarce, efficient instruments are needed to realize sustainable health care for these large populations of older subjects. To address this need a new assessment instrument was developed. The core of the instrument consists of focused geriatric assessment by a health or social care practitioner working in primary or community care, most often a nurse. The assessment data result in an efficiently targeted care and welfare action plan based on the patients' priorities. This instrument was initially developed, tested and spread within Europe, and then in validation studies across all WHO regions of the world. Because of the urgent societal questions on quality and sustainability of primary health care, especially for older people, we briefly review and summarize the development and evidence base of the instrument, which was called EASY-Care Standard. In a series of studies across many populations it proved to have high acceptability, reliability, validity and cost-effectiveness. Therefore, EASY-Care has great potential as a universal tool for global use in promoting independence in old age, and can make an important contribution to the quality and sustainability of health and social care in our aging societies.
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Tuijl JP, Scholte EM, de Craen AJM, van der Mast RC. Screening for cognitive impairment in older general hospital patients: comparison of the Six-Item Cognitive Impairment Test with the Mini-Mental State Examination. Int J Geriatr Psychiatry 2012; 27:755-62. [PMID: 21919059 DOI: 10.1002/gps.2776] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 07/11/2011] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To investigate the performance and usability of the Six-Item Cognitive Impairment Test (6CIT) as a screening instrument for cognitive impairment in older, general hospital inpatients/outpatients. METHOD In 253 general hospital patients aged ≥ 70 years, diagnostic accuracy of the 6CIT and time required to administer it were assessed using the Mini-Mental State Examination (MMSE) as the criterion standard. RESULTS The (negative) correlation between the 6CIT and the MMSE was very high (r = -0.82). Optimal comparability was found using a MMSE cutoff of ≤19 for lower and ≤23 for higher educated patients, at a cutoff of ≥11 on the 6CIT that was not sensitive to educational level. The sensitivity of the 6CIT was 0.90 and the specificity was 0.96, whereas the positive predictive value was 0.83 and the negative predictive value was 0.98. The area under the curve was 0.95. The mean administration time was 5.8 min for the MMSE and 2.5 min for the 6CIT (p ≤ 0.01). CONCLUSIONS Diagnostic accuracy of the 6CIT was high. As the 6CIT is not sensitive to educational level, does not require advanced language skills, only takes a few minutes to administer and is very easy to use, it appears to be a suitable screening instrument for cognitive impairment in older patients in the general hospital.
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Affiliation(s)
- Jolien P Tuijl
- Department of Geriatrics, Bronovo Hospital, The Hague, The Netherlands.
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Identification and recognition of depression in community care assessments: impact of a national policy in England. Int Psychogeriatr 2012; 24:261-9. [PMID: 21813039 DOI: 10.1017/s1041610211001517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Depression continues to be under-recognized in older people. Most policies addressing this issue focus on the primary health care team. However, recognition may be improved by use of assessment tools and collaboration between secondary health and social care, particularly at the assessment stage. This study aimed to evaluate whether the Single Assessment Process (SAP), introduced in England from April 2004, promoting such processes, improved the identification and correct recognition of depression by enhancing the content of statutory community care assessments by social services care managers. METHODS An observational study compared depression identification and its accuracy ("correct recognition") in samples of older people before and after SAP introduction. Participants were interviewed using standardized measures including the Geriatric Depression Scale (GDS). Depression elicited from the GDS was compared with that recorded in community care assessments with calculation of inter-rater reliabilities (kappa statistic) pre- and post-SAP. Logistic regression examined the associations between the policy's introduction, potential confounding factors (depression, cognitive impairment, function, behavior and characteristics) and the identification and correct recognition of depression. RESULTS Whilst the identification of depression was more likely after SAP, its correct recognition did not improve after the policy, with only slight agreement between GDS and community care assessments. The existence of depression and cognitive impairment made identification, but not correct recognition, more likely. CONCLUSIONS Correct recognition of depression was not improved in these statutory care assessments following the policy. Recognizing and thus responding to depression in a coordinated and appropriate way in the community requires further action.
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Clarkson P, Abendstern M, Sutcliffe C, Hughes J, Challis D. Reliability of needs assessments in the community care of older people: impact of the single assessment process in England. J Public Health (Oxf) 2009; 31:521-9. [DOI: 10.1093/pubmed/fdp035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ross F, O'Tuathail C, Stubberfield D. Towards multidisciplinary assessment of older people: exploring the change process. J Clin Nurs 2005; 14:518-29. [PMID: 15807760 DOI: 10.1111/j.1365-2702.2004.01085.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES This paper discusses the process of change that took place in an intervention study of standardized multidisciplinary assessment guidelines implemented in a female ward for older people in a District General Hospital in South London. This study was one of nine implementation projects in the South Thames Evidence-Based Practice Project. BACKGROUND The relationship between the worlds of research and healthcare practice is uneasy and contested and, as such, is a breeding ground for challenging questions about how evidence can be used to foment change in clinical practice. Recent literature on change highlights the importance of understanding complexity, which informed our approach and analysis. METHODS A multifaceted approach to change that comprised evidence-based guidelines, leadership (project leader) and change management was evaluated before and after the implementation by telephone interviews with patients, a postal survey of community staff and interviews with ward staff. A diagnostic analysis of current assessment practice informed the change process. The project leader collected data on adherence. RESULTS This paper draws on descriptive and qualitative data and addresses the links between contextual issues and the processes and pathways of change, informed by theoretical ideas from the change literature. Key themes emerged: working through others and across boundaries, managing uncertainty and unanticipated challenges. Adherence of ward staff to using the multidisciplinary assessment guidelines was high, with evidence of some dissemination to community staff at follow-up. Three years after the project finished the multidisciplinary assessment is still part of routine clinical practice. CONCLUSIONS The analysis contributes to understanding about the nursing leadership of change within an interprofessional arena of practice. It highlights the importance of understanding the context in relation to the impact and sustainability of change and thus the utility of conducting a diagnostic analysis in the early stages of implementation. This has implications for developing approaches to change in nursing and interprofessional practice in other settings. RELEVANCE TO CLINICAL PRACTICE Using research to change practice needs clinical leaders who are supported by the organization and have the skills to implement research evidence, manage uncertainty and build trust with a range of other professionals.
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Affiliation(s)
- Fiona Ross
- Nursing Research Unit, King's College London, London, UK.
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Sousa L, Galante H, Figueiredo D. [Quality of life and well-being of elderly people: an exploratory study in the Portuguese population]. Rev Saude Publica 2003; 37:364-71. [PMID: 12792689 DOI: 10.1590/s0034-89102003000300016] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To characterize elderly people's perception of quality of life and well-being. METHODS A sample of 1,665 elderly aged 75 years or more living in 13 districts in Portugal were studied. Of them, 311 subjects were excluded because they were not able to convey their opinions. The EASYcare (Elderly Assessment System) was used to collect data from 1,354 (81.3%) of 1,665 subjects. Statistical analysis was based on principal components analysis and cluster analysis. RESULTS EASYcare's showed to have good psychometric proprieties (Cronbach a =0.92). The principal component analysis identified 4 factors: mobility, communication competencies, well-being and daily living activities. Cluster analysis showed 4 groups of elderly people: autonomous (62.8%), almost autonomous (8.5%), almost dependent (4.3%) and dependent (3.2%). CONCLUSIONS Quality of life for most of the elderly is quite positive, and only a small group presents problems related to severe cognitive impairment or some degree of dependence.
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Affiliation(s)
- Liliana Sousa
- Secção Autónoma de Ciências da Saúde, Universidade de Aveiro, Aveiro, Portugal.
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Pomeroy IM, Clark CR, Philp I. The effectiveness of very short scales for depression screening in elderly medical patients. Int J Geriatr Psychiatry 2001; 16:321-6. [PMID: 11288167 DOI: 10.1002/gps.344] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To compare very short scales for screening for depression with longer, widely used scales. METHODS Eighty-seven patients over the age of 60 who were admitted to rehabilitation wards or were attending a day rehabilitation facility at a British teaching hospital were screened for depression using the 1-item mental health inventory, and the 4-item, 15-item and 30-item geriatric depression scales. The sensitivity, specificity, and areas under receiver operating characteristic curves were compared, with the diagnostic criteria for research of ICD-10 providing the criterion diagnosis of depressive episode. RESULTS All the scales had comparable sensitivity (82.4-100%), specificity (60.0-71.4%), and positive predictive values (33.3-42.9%). Comparison of receiver operating characteristic curves for each scale showed no statistically significant difference between them (range 0.80-0.88). CONCLUSIONS The very short scales performed just as well as the widely used longer screening scales in this population. They are worthy of further examination in elderly populations at risk of depression, and may be particularly suitable for older adults due to their brevity and ease of use.
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Affiliation(s)
- I M Pomeroy
- Northern General Hospital, Herriss Road, Sheffield S5 7AU, UK
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Howe A, Bath P, Goudie F, Lothian K, McKee K, Newton P, Philp I, Rowse G, Seymour J, Sivakumar V. Getting the questions right: an example of loss of validity during transfer of a brief screening approach for depression in the elderly. Int J Geriatr Psychiatry 2000; 15:650-5. [PMID: 10918347 DOI: 10.1002/1099-1166(200007)15:7<650::aid-gps186>3.0.co;2-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Screening for depression in the elderly has been advocated to improve detection and management. This article summarises the trend towards briefer screening instruments, and the integration of mental health screening with other assessments. The study aimed to validate a single question depression screen which has previously shown adequate sensitivity and specificity in a new context: a multi-faceted assessment instrument used by nurse practitioners within a community sample of over 75 year olds. The GMS-AGECAT computerised interview assessment was used as a 'gold standard' to determine the accuracy of the depression question in this new setting. Three hundred and twenty-eight patients were screened by their own nurse practitioners, of whom 100 consenting patients underwent a further interview with a research assistant using the GMS-AGECAT. The prevalence of depression was 30%, the sensitivity of the question was 67%, and its specificity 60% (compared with 88% and 71% previously). Responses indicating disability and loneliness were more closely correlated with depression than the depression screen itself. Relevant factors may include: the derivation of the question, the effect of a different sample, altered reliability when used by multiple interviewers, differing patient expectations, and the wording and context of the question within the multi-faceted screening instrument. Depression screening questions need repeated validation when used in different contexts. Patient and staff expectations may influence how screening instruments are used in practice in a way that may also alter reliability. Further studies are needed to establish the causes of loss of validity when screening approaches are used in new settings.
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Affiliation(s)
- A Howe
- DEPSCOPE Validation Study Group, University of Sheffield, UK.
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Affiliation(s)
- P Brooke
- Kingshill Research Centre, Victoria Hospital, Swindon, UK
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