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Xiong W, Wang D, Ren W, Liu X, Wen R, Luo Y. The global prevalence of and risk factors for fear of falling among older adults: a systematic review and meta-analysis. BMC Geriatr 2024; 24:321. [PMID: 38580924 PMCID: PMC10998426 DOI: 10.1186/s12877-024-04882-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 03/08/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND As a common psychological problem among older adults, fear of falling was found to have a wide range prevalence in different studies. However, the global prevalence of it was unknown and a lack of the large sample confirmed its risk factors. OBJECTIVES To report the global prevalence of fear of falling and to explore its risk factors among older adults for further developing precise interventions to systematically manage FOF. DESIGN A systematic review and meta-analysis was conducted by PRISMA guidelines. METHODS Searches were conducted in PubMed, Web of Science, EMBASE, the Cochrane Library and the manual search in August 20, 2022, updated to September 2, 2023. Observational studies published in English were included and two researchers independently screened and extracted the data. Fixed or random effects mode was used to estimate the pooled prevalence of and risk factors for fear of falling. Heterogeneity resources were analyzed by subgroup and sensitivity analysis. Publication bias was assessed through funnel plots, Egger's test and Begg's test. RESULTS A total of the 153 studies with 200,033 participants from 38 countries worldwide were identified. The global prevalence of fear of falling was 49.60%, ranging from 6.96-90.34%. Subgroup analysis found the estimates pooled prevalence of it was higher in developing countries (53.40%) than in developed countries (46.7%), and higher in patients (52.20%) than in community residents (48.40%). In addition, twenty-eight risk factors were found a significant associations with fear of falling, mainly including demographic characteristics, physical function, chronic diseases and mental problems. CONCLUSION The global prevalence of FOF was high, especially in developing countries and in patients. Demographic characteristics, Physical function, chronic diseases and mental problems were a significant association with FOF. Policy-makers, health care providers and government officials should comprehensively evaluate these risk factors and formulate precise intervention measures to reduce FOF. TRIAL REGISTRATION The study was registered in the International Database of Prospectively Registered Systematic Reviews (PROSPERO): CRD42022358031.
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Affiliation(s)
- Wanhong Xiong
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
- Department of Oncology, Zigong First People's Hospital, Zigong, Sichuan, China
| | - Dan Wang
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Wei Ren
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Xinyi Liu
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Renhui Wen
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Yu Luo
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China.
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Zhao Y, Chen Y, Xiao LD, Liu Q, Nan J, Li X, Feng H. Intrinsic capacity trajectories, predictors and associations with care dependence in community-dwelling older adults: A social determinant of health perspective. Geriatr Nurs 2024; 56:46-54. [PMID: 38237340 DOI: 10.1016/j.gerinurse.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 04/05/2024]
Abstract
AIMS To identify intrinsic capacity trajectories, predictors of intrinsic capacity trajectories and associations between intrinsic capacity trajectories and care dependence in community-dwelling older adults in China. METHODS A retrospective longitudinal study was conducted, and the data were obtained from a five-year national longitudinal cohort study of older adults in China between 2011 and 2015. The social determinants of health framework informed the data analysis and interpretation. RESULTS A total of 3893 older adults met the selection criteria and were included in the study. Three intrinsic capacity trajectories were identified: high trajectory (15.7 %), stable trajectory (52.7 %) and declining trajectory (31.6 %). Social determinants contribute to intrinsic capacity decline in older adults. Decreased cognitive function, psychological status, and locomotion at baseline were associated with care dependence. CONCLUSION Approximately thirty percent of the older adults in this cohort study experienced a decline in intrinsic capacity within a 5-year period. Social determinants contributed to this decline in older adults.
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Affiliation(s)
- Yinan Zhao
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Yifei Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, GPO Box 2100, Adelaide, SA 5001, Australia.
| | - Qingcai Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Jiahui Nan
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Xiaoyang Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China; Xiangya-Oceanwide Health Management Research Institute, Central South University, China.
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Chen B, Zhu H, Fu H, Han Q, Chen L. A qualitative study on the willingness and influencing factors of master of geriatric nursing specialist postgraduates to volunteer for home respite care for disabled elderly families. BMC Nurs 2024; 23:49. [PMID: 38233888 PMCID: PMC10792901 DOI: 10.1186/s12912-024-01710-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND As China's population ages, the demand for care for the disabled elderly is increasing, and family caregivers find it challenging to meet the comprehensive care needs of the disabled elderly. Through home respite services, families of the disabled elderly can receive help and support from specialized nursing professionals to ease the burden on family caregivers and provide high-quality services. This study explores the willingness and influencing factors of Master of Geriatric Nursing Specialist postgraduates in China to volunteer to provide home respite services for disabled elderly individuals. METHODS A qualitative study based on Grounded Theory used Strauss and Corbin's programmatic version. A purposive sampling method was employed to conduct semi-structured interviews with 12 Master of Geriatric Nursing Specialist postgraduates from a tertiary hospital in Changsha, Hunan Province, China. RESULTS The willingness of Master of Geriatric Nursing Specialist postgraduates to volunteer to provide home respite services for the disabled elderly was established as a core category, which was influenced by three main categories: personal factors, service object factors, and social factors, and nine categories formed from 39 initial concepts were included under the main category. CONCLUSIONS Influenced by China's traditional cultural background, Master of Geriatric Nursing Specialist postgraduates in China have shown high motivation in volunteering to provide home respite services for the families of the disabled elderly but have been challenged by several challenges from China's healthcare environment and education system. Relevant departments need to adopt a series of policies and measures to increase volunteers' willingness to participate in respite care and promote its development.
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Affiliation(s)
- Bihui Chen
- College of Nursing, Hunan University of Chinese Medicine, No.300, Xueshi Road, Hanpu Science and Education Park, Yuelu District, Changsha City, Hunan Province, China
| | - Haili Zhu
- Nursing Department of Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine, 58 Lushan Road, Changsha City, Hunan Province, China.
| | - Han Fu
- College of Nursing, Hunan University of Chinese Medicine, No.300, Xueshi Road, Hanpu Science and Education Park, Yuelu District, Changsha City, Hunan Province, China
| | - Qiannan Han
- Changsha Hospital of Traditional Chinese Medicine, No. 22, Xingsha Avenue, Changsha County, Changsha City, Hunan Province, China
| | - Lei Chen
- College of Nursing, Hunan University of Chinese Medicine, No.300, Xueshi Road, Hanpu Science and Education Park, Yuelu District, Changsha City, Hunan Province, China
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Nohl-Deryk P, Grund S. [Geriatrics and geriatric aspects in the German coalition agreement of 2021]. Z Gerontol Geriatr 2023; 56:567-572. [PMID: 37661204 PMCID: PMC10589129 DOI: 10.1007/s00391-023-02226-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/20/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND The proportion of older people in Germany is increasing. By the next federal election in 2025 the Federal Statistical Office of Germany expects that one third of the population will have reached retirement age. Older people are thus one of the largest voter groups and are particularly politically relevant. OBJECTIVE How does the federal government support the living conditions of this voter group? What are the plans of the federal government regarding medical care of older people? METHODS A content analysis of the coalition agreement was carried out with respect to aspects of demographic change, geriatric care and living conditions of older people. The coded text passages were categorized using a mixed inductive-deductive approach. Finally, the implementation progress of concrete projects after 1.5 years in office was evaluated. RESULTS This study identified and categorized 23 passages with just under 620 words (about 1% of the total text) in the coalition agreement. Of the passages nine were assigned to the topic older population, six passages to medical care and eight to nursing care. Of the 23 passages 14 contained concrete plans for action or target dates. In the first 1.5 years of the federal government, partial progress could be identified in 4 of these, while no projects were realized. CONCLUSION Overall, the coalition agreement shows an awareness for an ageing population. In view of the demographic development, however, few solutions are proposed for genuine geriatric aspects. The first year in office was strongly influenced by other topics, which resulted in unplanned laws and regulations and projects from the coalition agreement faded into the background.
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Affiliation(s)
- Pascal Nohl-Deryk
- Institut für Allgemeinmedizin, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland.
| | - Stefan Grund
- Agaplesion Bethanien Krankenhaus Heidelberg, Rohrbacher Straße 149, 69126, Heidelberg, Deutschland
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Tevik K, Helvik AS, Stensvik GT, Nordberg MS, Nakrem S. Nursing-sensitive quality indicators for quality improvement in Norwegian nursing homes - a modified Delphi study. BMC Health Serv Res 2023; 23:1068. [PMID: 37803376 PMCID: PMC10557356 DOI: 10.1186/s12913-023-10088-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Use of nursing-sensitive quality indicators (QIs) is one way to monitor the quality of care in nursing homes (NHs). The aim of this study was to develop a consensus list of nursing-sensitive QIs for Norwegian NHs. METHODS A narrative literature review followed by a non-in-person, two-round, six-step modified Delphi survey was conducted. A five-member project group was established to draw up a list of nursing-sensitive QIs from a preliminary list of 24 QIs selected from Minimum Data Set (2.0) (MDS) and the international Resident Assessment Instrument for Long-Term Care Facilities (interRAI LTCF). We included scientific experts (researchers), clinical experts (healthcare professionals in NHs), and experts of experience (next-of-kin of NH residents). The experts rated nursing-sensitive QIs in two rounds on a seven-point Likert scale. Consensus was based on median value and level of dispersion. Analyses were conducted for four groups: 1) all experts, 2) scientific experts, 3) clinical experts, and 4) experts of experience. RESULTS The project group drew up a list of 20 nursing-sensitive QIs. Nineteen QIs were selected from MDS/interRAI LTCF and one ('systematic medication review') from the Norwegian quality assessment system IPLOS ('Statistics linked to individual needs of care'). In the first and second Delphi round, 44 experts (13 researchers, 17 healthcare professionals, 14 next-of-kin) and 28 experts (8 researchers, 10 healthcare professionals, 10 next-of-kin) participated, respectively. The final consensus list consisted of 16 nursing-sensitive QIs, which were ranked in this order by the 'all expert group': 1) systematic medication review, 2) pressure ulcers, 3) behavioral symptoms, 4) pain, 5) dehydration, 6) oral/dental health problems, 7) urinary tract infection, 8) fecal impaction, 9) depression, 10) use of aids that inhibit freedom of movement, 11) participation in activities of interest, 12) participation in social activities, 13) decline in activities of daily living, 14) weight loss, 15) falls, and 16) hearing loss without the use of hearing aids. CONCLUSIONS Multidisciplinary experts were able to reach consensus on 16 nursing-sensitive QIs. The results from this study can be used to implement QIs in Norwegian NHs, which can improve the quality of care.
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Affiliation(s)
- Kjerstin Tevik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
| | - Anne-Sofie Helvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Geir-Tore Stensvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Marion S Nordberg
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Geriatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Sigrid Nakrem
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- National Ageing Research Institute, Royal Melbourne Hospital, 34-54 Poplar Road, Victoria, 3050, Australia
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Chen H, Pu L, He S, Hu X, Chen Q, Huang Z, Cheng L. Status and associated factors of gerontological nurse specialists' core competency: a national cross-sectional study. BMC Geriatr 2023; 23:450. [PMID: 37479983 PMCID: PMC10362742 DOI: 10.1186/s12877-023-04153-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/04/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Nurses' core competency directly affects patients' safety and health outcomes. Gerontological nurse specialists play an essential role in improving older adults' health status. However, little is known about their core competency level and the factors influencing core competency. Therefore, this study aimed to investigate the status of core competency and factors influencing the core competency of gerontological nurse specialists in China. METHODS A multicenter cross-sectional study was conducted on gerontological nurse specialists certified by province-level or above organizations across China between March 2019 and January 2020. The Revised Core Competency Evaluation Instrument for Gerontological Nurse Specialists was used to measure participants' core competency. The median, frequencies, and percentages were used to describe participants' characteristics and level of core competency. Multivariate stepwise regression analysis was applied to analyze the factors influencing core competency. RESULTS The median score of gerontological nurse specialists' core competency was 3.84, and professional development skills and research and analysis decision-making skills had the lowest scores among the dimensions. The multivariate stepwise regression analysis showed that individual-level factors (i.e., working experience length of geriatric nursing and attitudes toward caring for older adults), employer-level factors (i.e., departments, job responsibilities, the degree of satisfaction toward the attention and support and the promotion rules provided by the hospital or department), and training-associated factors (i.e., economic zone where training organizations are located and the degree to which the training content met clinical needs) are independently associated with gerontological nurse specialists' core competency level (P < 0.05). CONCLUSIONS This study showed that gerontological nurse specialists' core competency needs further improvements, especially regarding professional development skills and research and analysis decision-making skills. Additionally, individual-, training-, and employer-level factors could influence their core competency level, indicating that interventions targeting these factors could be applied to improve the core competency of gerontological nurse specialists.
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Affiliation(s)
- Hongxiu Chen
- West China School of Nursing, Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Lihui Pu
- Menzies Health Institute & School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Shengyuan He
- West China School of Nursing, Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Xiuying Hu
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
| | - Qian Chen
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaojing Huang
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Linan Cheng
- West China School of Nursing, Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
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Benko E, Peršolja M. Nursing students' views of the impact of geriatric role-play workshops on professional competencies: survey. BMC Nurs 2023; 22:203. [PMID: 37316872 DOI: 10.1186/s12912-023-01373-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/09/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Simulation and role-playing are the most commonly used experiential teaching methods in nursing education. The purpose of the study was to describe the impact of geriatric role-play workshops on the knowledge and skills of nursing students. We set one hypothesis: Students believe that learning through experiential role-play improves their professional competencies. METHODS We conducted a descriptive quantitative study, collecting the data with a questionnaire. The study included 266 first-year nursing students who underwent 10 h of role-playing workshops in geriatric nursing in 2021. The questionnaire was compiled for the purpose of the present study, and its' internal consistency was 0.844 (n = 27). We used descriptive and correlation statistical analysis. RESULTS Respondents were convinced that they gained and consolidated knowledge and connected theory with practice through role-playing. They especially emphasized the abilities they acquired to communicate in a group, engage in constructive reflection, be more sensitive to one's own emotions, and feel empathy. CONCLUSIONS Respondents understand the use of the role-play method as an effective form of learning in geriatric nursing. They are convinced that they will be able to use the experience when working with an elderly patient in a clinical setting.
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Affiliation(s)
- Ester Benko
- Faculty of Health Sciences, University of Primorska, Koper, Slovenia
| | - Melita Peršolja
- Faculty of Health Sciences, Unit Vipava, University of Primorska, Koper, Slovenia.
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Vikström-Dahl I, Bing-Jonsson PC, Rauhala A, Fagerström L. Revealing a gap in the clinical competence of nursing staff in nursing homes: a cross-sectional study with the Ms. Olsen test. BMC Nurs 2023; 22:130. [PMID: 37072846 PMCID: PMC10111312 DOI: 10.1186/s12912-023-01297-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 04/08/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Nursing staff, caring for frail older people in long-term care, needs to have a certain level of clinical competence to identify diseases at an early stage and to assess and provide good nursing care. In Finland, nursing care is based on evidence-based and high-quality nursing care. However, earlier inspections by the National Supervisory Authority for Welfare and Health showed many discrepancies between the nursing staff's clinical competence and adequate and continuous education. AIM This study aimed to explore nursing staff, i.e. the clinical competence and decision-making skills of registered and practical nurses in nursing homes for older people in Finland and to analyse the association between nurses' clinical competence and fundamental background factors. METHODS We conducted a cross-sectional study of 337 participants in 50 nursing homes in the western part of Finland, between December 2020 and January 2021. The instrument used was the validated Ms. Olsen test, an extraction of NOP-CET. Statistical analyses were conducted with descriptive statistics and correlations and a cut-off for clinical competence. RESULTS This study with the Ms. Olsen test revealed that only one-fourth of the RNs and a third of the PNs passed the clinical competence test. In the self-evaluation, almost all participants evaluated themselves with good clinical competence. The Finnish Current Care Guidelines were used on a daily basis by 7.4% and weekly by 30%. Significant correlation was found between Swedish as a working language and mother tongue and the score for clinical competence. CONCLUSION The clinical competence test, the Ms. Olsen test, was used in Finland for the first time to evaluate the nursing staffs´ clinical competence in nursing homes. We found gaps in the clinical competence in Finnish nursing homes, both for PNs and RNs. The result differed remarkably from their self-assessments and the staff did not use the national nursing guidelines as required to develop their nursing skills and knowledge. Gaps in the clinical competence have been identified and can be used to develop targeted continuous education.
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Affiliation(s)
- Irén Vikström-Dahl
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland.
- Faculty of Health and Welfare, Novia University of Applied Sciences, Vaasa, Finland.
| | - Pia Cecile Bing-Jonsson
- Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), Kongsberg, Norway
| | - Auvo Rauhala
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
- Finnish Centre for Client and Patient Safety, Wellbeing Services County of Ostrobothnia, Vaasa, Finland
| | - Lisbeth Fagerström
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
- Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), Kongsberg, Norway
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Eltaybani S, Kawase K, Kato R, Inagaki A, Li CC, Shinohara M, Igarashi A, Sakka M, Sumikawa Y, Fukui C, Yamamoto-Mitani N. Effectiveness of home visit nursing on improving mortality, hospitalization, institutionalization, satisfaction, and quality of life among older people: Umbrella review. Geriatr Nurs 2023; 51:330-345. [PMID: 37060618 DOI: 10.1016/j.gerinurse.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 04/17/2023]
Abstract
This umbrella review followed the JBI methodology and synthesized systematic reviews of the effectiveness of long-term home visit nursing for older people (≥ 60 years) on improving mortality, hospitalization, institutionalization, patient satisfaction, and quality of life. Eight bibliographic databases were searched, and 10 reviews with 22 distinct relevant trials (n = 10,765 participants) were included. Mortality was the most frequently examined outcome and satisfaction was the least examined (n = nine and one reviews, respectively). Home visit nursing had a favorable effect on reducing the number of admissions to hospital (n = 1,152 participants in two trials vs. 788 participants in three trials) and no effect on other outcomes. The evidence of the effectiveness of long-term home visit nursing for older people is minimal. Future research needs to be based on a theoretical foundation that explains how interventions are expected to work.
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Affiliation(s)
- Sameh Eltaybani
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Global Nursing Research center (GNRC), The University of Tokyo, Tokyo, Japan.
| | - Kiyomi Kawase
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Risako Kato
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Asa Inagaki
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chia-Chien Li
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Masumi Shinohara
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Ayumi Igarashi
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Mariko Sakka
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Yuka Sumikawa
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Chie Fukui
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Homecare and Long-Term Care Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Heijkants CH, de Wind A, van Hooff MLM, Geurts SAE, Boot CRL. Effectiveness of Team and Organisational Level Workplace Interventions Aimed at Improving Sustainable Employability of Aged Care Staff: A Systematic Review. J Occup Rehabil 2023; 33:37-60. [PMID: 36149548 PMCID: PMC10025231 DOI: 10.1007/s10926-022-10064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 06/16/2023]
Abstract
Purpose The sustainable employability of healthcare professionals in aged care is under pressure, but research into the effectiveness of interventions aimed at improving employees' sustainable employability is scarce. This review therefore aimed to investigate the effectiveness of workplace interventions on sustainable employability of healthcare professionals in aged care. Methods A systematic literature search was performed. Studies were included when reporting about the effect of an intervention at work in an aged care setting on outcomes related to one of the three components of sustainable employability (i.e. workability, vitality, employability). The methodological quality of each study was assessed and a rating system was used to determine the level of evidence. Additionally, a sensitivity analysis was performed, accounting for the match between the intervention's focus and the targeted component of sustainable employability. Results Current review includes 32 interventions published between 1996 and 2019. Interventions covered learning and improving skills, changing the workplace, and exercising or resting. The initial analysis showed a strong level of evidence for employability and insufficient evidence for workability and vitality. The sensitivity analysis revealed strong evidence for the effectiveness of interventions addressing either employability or workability, and insufficient evidence for vitality. Conclusions Evidence for workplace interventions on sustainable employability of healthcare professionals in aged care differed. We found strong evidence for effects of workplace interventions on employability and for those directly targeting workability. Evidence for effects of interventions on vitality was insufficient. The alignment of the interventions to the targeted component of sustainable employability is important for effectiveness.
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Affiliation(s)
- Ceciel H Heijkants
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
- , Thomas van Aquinostraat 4, room 04.362, 6525GD, Nijmegen, The Netherlands.
| | - Astrid de Wind
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Sabine A E Geurts
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Cécile R L Boot
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Amsterdam, The Netherlands
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Arrogante O, Velarde García JF, Blázquez-González P, Moro-Tejedor MN. Great geriatric syndromes: Acquisition of nursing competencies and undergraduate nursing students' perceptions through high-fidelity simulation training. Nurse Educ Today 2023; 121:105685. [PMID: 36563587 DOI: 10.1016/j.nedt.2022.105685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/16/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The constant increase in the aging population will lead to a greater demand for high-quality nursing care for this population over the coming years. Early detection and proper treatment of great geriatric syndromes are essential and, consequently, geriatric nurses must acquire the necessary competencies for their adequate management. OBJECTIVES To evaluate the acquisition of the necessary nursing competencies for adequate management of great geriatric syndromes through high-fidelity simulation training and to explore undergraduate nursing students' perceptions about this training. METHODS 80 undergraduate nursing students participated in a mixed methods study. The simulated scenarios recreated older patients with diagnoses of great geriatric syndromes using standardized patients. Nursing competencies were evaluated using a verification list. 10 focus groups were interviewed to explore their perceptions, conducting a qualitative study with an interpretative approach. RESULTS Most of the students (86.55 %) acquired the necessary nursing competencies for adequate management of great geriatric syndromes. The nursing students stated that they improved their communication skills (provide solutions to older patients; facilitate and redirect the clinical interview; contrast the information given to the patient), psychological resources (psychological support; physical contact and accompaniment; empathy and persuasion), and geriatric knowledge (identify their lack of knowledge; recognize their limits in terms of healthcare and refer to other health professionals; know the patient's conditions) to provide quality care for older people diagnosed with great geriatric syndromes. CONCLUSIONS The use of high-fidelity simulation training including standardized patients makes it easier for nursing students to acquire the necessary nursing competencies for adequate management of great geriatric syndromes and improve their clinical skills. Geriatric nursing education should focus on equipping nursing students with the necessary clinical skills, integrating high-fidelity simulation training in geriatric study plans to train students in the nursing care to be provided to older patients, and preparing them for real clinical practice.
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Affiliation(s)
- Oscar Arrogante
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podology, University Complutense of Madrid, Plaza Ramón y Cajal, s/n. 28040 Madrid, Spain; Research Nursing Group of Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Calle Dr. Esquerdo 46, 28007 Madrid, Spain.
| | - Juan Francisco Velarde García
- Research Nursing Group of Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Calle Dr. Esquerdo 46, 28007 Madrid, Spain; Red Cross University College of Nursing, Spanish Red Cross, Autonomous University of Madrid, Avenida Reina Victoria 28, 28003 Madrid, Spain; Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Avenida Atenas s/n, 28922 Alcorcón, Spain.
| | - Patricia Blázquez-González
- Red Cross University College of Nursing, Spanish Red Cross, Autonomous University of Madrid, Avenida Reina Victoria 28, 28003 Madrid, Spain.
| | - Ma Nieves Moro-Tejedor
- Research Nursing Group of Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Calle Dr. Esquerdo 46, 28007 Madrid, Spain; Red Cross University College of Nursing, Spanish Red Cross, Autonomous University of Madrid, Avenida Reina Victoria 28, 28003 Madrid, Spain; Nursing Research Support Unit, Hospital General Universitario Gregorio Marañon, Calle Dr. Esquerdo 46, 28007 Madrid, Spain.
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Vilela de Sousa T, Cavalcante AMRZ, Lima NX, Souza JS, Sousa ALL, Brasil VV, Vieira FVM, Guimarães JV, de Matos MA, Silveira EA, Pagotto V. Cardiovascular risk factors in the elderly: a 10-year follow-up survival analysis. Eur J Cardiovasc Nurs 2023; 22:43-52. [PMID: 35574942 DOI: 10.1093/eurjcn/zvac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 01/14/2023]
Abstract
AIMS Cardiovascular risk factors present a high prevalence and have an impact on the morbimortality of the elderly; however, studies evaluating the impact of cardiovascular risk factors in the elderly have had short follow-up times and have not allowed specific analyses of the effects of these factors in the aged population, including how they affect the survival of the elderly. This study aimed to analyse the survival of elderly individuals living in the community, considering the presence of cardiovascular risk factors. METHODS AND RESULTS A prospective 10-year follow-up was initiated in 2008 with a cohort of 418 elderly people living in a community in Central Brazil. The Kaplan-Meier method and the Cox proportional hazards model were used to examine the association between survival and cardiovascular risk factors. The mean age of the participants was 70.6 (±7.1) years; most participants were hypertensive (81.6%) and participated in irregular physical activity (44%), and 43.3% smoked. After a mean follow-up of 8.38 (±2.82) years, 59.3% had survived and 34.1% had died; among the deaths, 14.1% were due to cardiovascular causes. Age [hazard ratio (HR) 1.067, 95% confidence interval (CI) 1.027-1.109], hypertension (HR 3.178, 95% CI 1.144-8.826), and smoking (HR 2.235, 95% CI 1.253-3.987) were confirmed as risk factors for reduced survival, whereas physical activity was a protective factor (HR 0.456, 95% CI 0.206-1.007). CONCLUSION The results from this study highlight the need for educational policies towards hypertension and smoking prevention among elderly people, and participation in physical activity needs to be encouraged.
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Affiliation(s)
- Thaís Vilela de Sousa
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Agueda Maria Ruiz Zimmer Cavalcante
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Nathália Xavier Lima
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Jennifer Siqueira Souza
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Ana Luiza Lima Sousa
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Virginia Visconde Brasil
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Flaviana Vely Mendonça Vieira
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Janaína Valadares Guimarães
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Marcos André de Matos
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Erika Aparecida Silveira
- 2 College of Medicine, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
| | - Valéria Pagotto
- 1 College of Nursing, Universidade Federal de Goias, 227 Street, Viela Q. 68, S/N - Sector Leste Universitario, Goiania, GO 74605-080, Brazil
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Park GE, Lee NY. Knowledge, Experience, and Attitudes of Nurses at Long-Term Care Hospitals regarding Advance Directives. J Hosp Palliat Care 2022; 25:139-149. [PMID: 37674667 PMCID: PMC10179997 DOI: 10.14475/jhpc.2022.25.4.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 09/08/2023]
Abstract
Purpose The purpose of this study was to promote awareness of the need for advance directives (ADs) and to provide baseline data for the development of a nurse training program about ADs. Methods Nurses at eight long-term care hospitals in Busan and South Gyeongsang Province (N=143) were recruited using the random sampling method from December 2018 to January 2019. Data were obtained using a structured self-reported questionnaire to assess their knowledge, experience, and attitudes regarding ADs. Data were analyzed in SPSS 22.0 using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson's correlation coefficient, and stepwise multiple regression analysis. Results The mean scores were 7.79±1.39 points for knowledge, 1.92±2.00 points for experience, and 2.80±0.24 points for attitudes regarding ADs. Knowledge and experience (r=0.32, P<0.001) had a positive correlation with knowledge and attitudes (r=0.17, P=0.39). Conclusion According to the results, nurses generally had a high level of knowledge regarding ADs, which resulted in a positive attitude toward ADs. However, they had little experience with ADs. Therefore, nurses' must develop both direct and indirect experience with ADs using a practical training program to strengthen their clinical competency regarding ADs.
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Affiliation(s)
- Go Eun Park
- Department of Nursing, Gupo Sungshim Hospital, Busan, Korea
| | - Nae Young Lee
- Department of Nursing, Silla University, Busan, Korea
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Gisch UA, Ahlers E, Lee D, Heuser-Collier I, Somasundaram R. A program for volunteers accompanying older patients with cognitive dysfunction to improve the quality of emergency department care: A pilot study. Geriatr Nurs 2022; 48:94-102. [PMID: 36155315 DOI: 10.1016/j.gerinurse.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 12/14/2022]
Abstract
Admission to an emergency department (ED) is challenging for older patients with cognitive dysfunction (PWCD). Targeted patient-oriented approaches to improve the care for PWCD are needed. The aim of this pilot study was to design and evaluate a program for volunteers to support PWCD in the ED. Volunteers (N = 9) first received a training and during the following six months (N = 90 shifts), they accompanied PWCD (N = 112) during their stay. Results showed that the training increased volunteers' knowledge and expertise, but not shift-related self-efficacy. The most frequent strategies applied were conversations, holding hands and touching, and providing food and drinks. After six months, volunteers reported a great sense of meaningfulness and felt that they were highly appreciated by the patients. ED nurses' sceptical attitudes towards the program decreased. The program is beneficial for PWCD, appears to be meaningful for volunteers and is appreciated by ED nurses.
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Affiliation(s)
- Ulrike A Gisch
- Charité - Universitaetsmedizin Berlin, Department of Psychiatry and Neurosciences, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitaetsmedizin Berlin, Department of Emergency Medicine, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - Eike Ahlers
- Charité - Universitaetsmedizin Berlin, Department of Psychiatry and Neurosciences, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany; Johanniter-Krankenhaus Treuenbrietzen, Department of Psychiatry and Psychotherapy, Johanniterstraße 1, 14929 Treuenbrietzen, Germany.
| | - Denise Lee
- Charité - Universitaetsmedizin Berlin, Department of Emergency Medicine, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - Isabella Heuser-Collier
- Charité - Universitaetsmedizin Berlin, Department of Psychiatry and Neurosciences, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - Rajan Somasundaram
- Charité - Universitaetsmedizin Berlin, Department of Emergency Medicine, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
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Arrogante O, Velarde-García JF, Blázquez-González P, Nieves Moro-Tejedor M. The effects of high-fidelity simulation training on empathy and attitudes toward older people among undergraduate nursing students: A quasi-experimental study. Nurse Educ Pract 2022; 64:103441. [PMID: 36037720 DOI: 10.1016/j.nepr.2022.103441] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/22/2022]
Abstract
AIM To evaluate the effects of high-fidelity simulation training on attitudes towards older people and empathy among undergraduate nursing students. BACKGROUND People worldwide are living longer and, consequently, the number of older people is increasing globally. Geriatric syndromes are highly prevalent and associated with increased morbidity and mortality in this population. Positive attitudes towards older people and high levels of empathy are necessary for the provision of high-quality nursing care, which will contribute towards improving the quality of life of older patients affected by these syndromes. METHODS A quasi-experimental study was conducted using a longitudinal design with a single group and a pre- and post-intervention evaluation. The development of attitudes towards older people and empathy skills were evaluated using high-fidelity simulation-based training, comparing the levels obtained in these skills at baseline and after the simulation experience. The simulated scenarios recreated the great geriatric syndromes in older patients: instability, immobility, intellectual impairment and incontinence. RESULTS After the simulation sessions, nursing students significantly improved their total scores for both attitudes toward older people and empathy, moreover, improvements were found in the three subscales of empathy. The effect size was large for the total scores of both the attitudes towards older people and the empathy scales and the 'perspective taking' subscale. The obtained effect size was small for the 'compassionate care' subscale, whereas for the 'standing in the patient's shoes' subscale, the obtained effect size was medium. CONCLUSIONS Our high-fidelity simulation-based training allows undergraduate nursing students to improve their empathy levels and positive attitudes toward older people. The development of these skills may provide benefits directly related to high-quality care for older patients. Therefore, the inclusion of simulation training programs in geriatric nursing study plans is necessary to train nursing students in the care of older people and to prepare them for real clinical practice.
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Pagotto V, Rodrigues de Lima B, Amorim de Souza Feitosa IA, da Cunha Guimarães LC, Ruiz Zimmer Cavalcante AM, da Silva Oliveira MD, Pires Nunes D. Risk factors for pneumonia in hospitalized older people with femoral fractures: Results from a Brazilian prospective cohort. Heart Lung 2022; 54:80-84. [PMID: 35358906 DOI: 10.1016/j.hrtlng.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Pneumonia is a common complication in older people who are hospitalized to treat different fractures, which increases morbimortality in this population. OBJECTIVES Estimating the pneumonia incidence density in older people hospitalized to treat femoral fractures and identifying risk factors for this infection. METHODS Prospective cohort study whose data were collected from a population of older people who were being treated for femoral fractures at a hospital in the central region of Brazil between September 2016 and February 2017. The pneumonia diagnosis was based on radiography and clinical tests. Incidence density was estimated according to gender, age, Charlson comorbidity index, polypharmacy, chronic pulmonary disease, admission to the intensive care unit, surgical treatment, and nasoenteral tube feeding. Magnitude of the associations was estimated by multiple Poisson regression. RESULTS Among the 200 patients, the pneumonia incidence density was 13.04/1,000 person-days. For men and older people 80 years old or older, the pneumonia incidence density was 15.6/1,000 person-days and 18.3/1,000 person-days, respectively. After adjusting for age, gender, chronic pulmonary disease, and admission to the intensive care unit, use of nasoenteral tubes remained associated with occurrence of pneumonia in older people, and the risk of developing the infection was eight times higher in the population who received nasoenteral feeding than that calculated for the population that did not use the devices (p ≤ 0.001). CONCLUSION Using nasoenteral tubes during hospital stays increased the risk of developing pneumonia in hospitalized older people, which reinforces the need for continuous care monitoring regarding use of tubes to prevent complications.
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Affiliation(s)
- Valéria Pagotto
- Faculdade de Enfermagem, Programa de Pós-Gradução em Enfermagem, Universidade Federal de Goiás, Rua 227, Quadra 68, Setor Leste Universitário, Goiânia, Goiás 74605-080, Brazil
| | - Brunna Rodrigues de Lima
- Faculdade de Enfermagem, Programa de Pós-Gradução em Enfermagem, Universidade Federal de Goiás, Rua 227, Quadra 68, Setor Leste Universitário, Goiânia, Goiás 74605-080, Brazil
| | - Ione Almeida Amorim de Souza Feitosa
- Faculdade de Enfermagem, Programa de Pós-Gradução em Enfermagem, Universidade Federal de Goiás, Rua 227, Quadra 68, Setor Leste Universitário, Goiânia, Goiás 74605-080, Brazil
| | - Lara Cristina da Cunha Guimarães
- Faculdade de Enfermagem, Programa de Pós-Gradução em Enfermagem, Universidade Federal de Goiás, Rua 227, Quadra 68, Setor Leste Universitário, Goiânia, Goiás 74605-080, Brazil.
| | - Agueda Maria Ruiz Zimmer Cavalcante
- Faculdade de Enfermagem, Programa de Pós-Gradução em Enfermagem, Universidade Federal de Goiás, Rua 227, Quadra 68, Setor Leste Universitário, Goiânia, Goiás 74605-080, Brazil
| | - Michele Dias da Silva Oliveira
- Faculdade de Enfermagem, Programa de Pós-Gradução em Enfermagem, Universidade Federal de Goiás, Rua 227, Quadra 68, Setor Leste Universitário, Goiânia, Goiás 74605-080, Brazil
| | - Daniella Pires Nunes
- Faculdade de Enfermagem da Universidade Estadual de Campinas, Brazil. Pesquisadora do Estudo SABE - Saúde Bem-Estar e Envelhecimento
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Kretschmer R, Trögner J, Schindlbeck M, Schmitz P. [Postoperative multiprofessional comprehensive treatment]. Orthopade 2022; 51:98-105. [PMID: 35029699 DOI: 10.1007/s00132-021-04208-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In orthogeriatric centers, postoperative, multiprofessional comprehensive treatment has proven to be an effective component in the convalescence of geriatric patients. The aim of the treatment is to minimize the perioperative risk and safely achieve individual rehabilitation goals in the acute inpatient stay. To meet the needs of geriatric patients, in addition to changes in the spatial division and design, primarily adjustments to the team composition and the procedural processes are required. THERAPEUTIC STRATEGIES An interdisciplinary and multiprofessional team (orthopedics/traumatology, geriatrics, nursing, physiotherapy, occupational therapy, social services, psychology, speech therapy, …) uses geriatric assessments in regular team meetings to collect and analyze the current rehabilitation status of patients; ICF-based goals are formulated and the therapy is adapted to individual needs. Here, too, the focus is on recording the individual risk (comorbidities, mental status, polypharmacy, malnutrition, fragility) and avoiding preventable complications. Multiprofessional strategies for avoiding or treating postoperative delirium are particularly important. In addition, maintaining patients' autonomy is the top priority, so that they can be released from the acute inpatient stay strengthened for follow-up treatment or their home environment. The establishment of orthogeriatric comanagement in acute inpatient facilities is an important component in the process chain, from which many geriatric patients benefit in the context of postoperative recovery.
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Affiliation(s)
- Rainer Kretschmer
- HSD - Hochschule Döpfer, Prüfeninger Str. 20, 93049, Regensburg, Deutschland. .,Alterstraumazentrum CURA, Klinik für Unfallchirurgie, Caritas Krankenhaus St. Josef, Landshuter Str. 65, 93053, Regensburg, Deutschland.
| | - Jens Trögner
- Klinik für Innere Medizin III - Geriatrie und Frührehabilitation, Klinikum St. Marien Amberg, Amberg, Deutschland
| | | | - Paul Schmitz
- Alterstraumazentrum CURA, Klinik für Unfallchirurgie, Caritas Krankenhaus St. Josef, Landshuter Str. 65, 93053, Regensburg, Deutschland
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Yan Z, Chang HCR, Montayre J, Ho MH. How does geriatric nursing education program change the knowledge, attitude and working intention among undergraduate nursing students? A systematic literature review. Nurse Educ Today 2022; 108:105161. [PMID: 34649069 DOI: 10.1016/j.nedt.2021.105161] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/17/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This review aimed to examine the changes of knowledge, attitude and working intention in nursing students after an undergraduate geriatric nursing education. DESIGN A systematic review of the literature. DATA SOURCES Five databases which included CINAHL, MEDLINE, PubMed, Scopus and Web of Science were searched for this literature review from January 2010 to October 2020. REVIEW METHODS The review was registered in PROSPERO registry with registration number CRD42020215703. The review examined undergraduate nursing education programs in terms of knowledge, attitude and working intention towards geriatric care among undergraduate nursing students as outcomes. We used JBI critical appraisal tools and Mixed Methods Appraisal Tool to evaluate and assess the quality of the retrieved research papers. RESULTS The search yielded 19 studies included in the final review, 14 of which were quantitative studies and five were qualitative studies. Four types of education programs were identified. These were type 1, a four-year undergraduate gerontology program consisting of geriatric theory and geriatric care clinical placement; type 2, stand-alone geriatric subject and geriatric clinical placement program; type 3, integrated geriatric subject and geriatric clinical placement program; type 4, solely geriatric clinical placement program. The review found that the type 2 program demonstrated the best educational outcomes in undergraduate students. CONCLUSIONS This review provided the most recent literature evidence pertaining to undergraduate geriatric education program and its educational outcomes. Future research should focus on the evaluating the content of each type of geriatric education program to inform the development of undergraduate geriatric nursing education.
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Affiliation(s)
- Zhoumei Yan
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia; Illawarra Health and Medical Research Institute (IHMRI), Northfields Ave, Wollongong, NSW 2522, Australia.
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Campbelltown Campus, NSW 2751, Australia.
| | - Mu-Hsing Ho
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia; Illawarra Health and Medical Research Institute (IHMRI), Northfields Ave, Wollongong, NSW 2522, Australia.
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Sigurdardottir AS, Geirsdottir OG, Ramel A, Arnadottir IB. Cross-sectional study of oral health care service, oral health beliefs and oral health care education of caregivers in nursing homes. Geriatr Nurs 2021; 43:138-145. [PMID: 34890954 DOI: 10.1016/j.gerinurse.2021.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess oral care beliefs and oral hygiene procedures among nursing home personnel to identify strengths and weaknesses in managing oral care. METHODS A cross-sectional study in two nursing homes using an oral health care questionnaire including the Nursing Dental Coping Belief Scale. RESULTS A total of 109 health personnel participated. Oral care was seldomly achieved twice a day and dental supplies were not guaranteed. Registered nurses found the oral health of residents more acceptable than did allied health personnel with less oral care education, who mostly delivered daily care. Conversely, nursing staff with oral care education had lower dental coping beliefs, suggesting a lack of self-reliance in controlling oral health outcomes. CONCLUSION Dental supplies should be part of nursing care equipment. Educational programs could increase positive oral health beliefs and enhance the quality of care in these settings, particularly among those who are accountable for oral care.
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Affiliation(s)
| | - Olof Gudny Geirsdottir
- Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Aragata 14, 101 Reykjavik, Iceland
| | - Alfons Ramel
- Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Aragata 14, 101 Reykjavik, Iceland
| | - Inga Bergmann Arnadottir
- Faculty of Odontology, School of Health Sciences, University of Iceland, Vatnsmyravegur 16, 101 Reykjavík, Iceland
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Abstract
The purpose of this article is to report the literature review findings of our larger deprescribing initiative, with the goal of developing a competency framework about deprescribing to be incorporated into the future geriatric nursing education curriculum. A literature review was conducted to examine the facilitators and barriers faced by nurses with regard to the process of deprescribing for older adults, and the development of deprescribing competency in nursing education. We adopted the seven steps of the Comprehensive Literature Review Process Model, which is sub-divided into the following three phases (a) Exploration; (b) Interpretation; and (c) Communication. A total of 24 peer-reviewed documents revealed three major facilitating factors: (a) Effective education and training in deprescribing; (b) Need for continuing education and professional development in medication optimization; and (c) Benefits of multi-disciplinary involvement in medication management.
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Affiliation(s)
- Winnie Sun
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Magda Grabkowski
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Ping Zou
- School of Nursing, Nipissing University, Toronto, ON, Canada
| | - Bahar Ashtarieh
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
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Fonseca C, de Pinho LG, Lopes MJ, Marques MDC, Garcia-Alonso J. The Elderly Nursing Core Set and the cognition of Portuguese older adults: a cross-sectional study. BMC Nurs 2021; 20:108. [PMID: 34162387 PMCID: PMC8220736 DOI: 10.1186/s12912-021-00623-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The aging population and its associated health needs require specific nursing care. The aim of this study was to draw an epidemiological profile of Portuguese elderly adults attending in residential homes and day centers and to evaluate the association between the functioning and cognition of these older adults and their sociodemographic characteristics and presence of multimorbidity. METHODS This was a cross-sectional study of 613 older adults. Functioning was assessed using the Elderly Nursing Core Set, and cognition was assessed using the Mini Mental State Examination. Descriptive and inferential analyses were performed. RESULTS The mean age was 85.73 years; the majority of the participants were female (69.3 %), widowed (67.0 %) and over 85 years old (60.4 %). A total of 68.2 % of the sample presented multimorbidity. A total of 54.5 % had cognitive impairment, and the average functional profile was classified as "moderate difficulty". Institutionalized older adults had more diseases than those who attended the day center. Women, those who were illiterate, those who were institutionalized and older adults who had diseases of the nervous system had a worse functional profile and greater cognitive impairment. Those with multimorbidity had a worse functional profile, and those without a spouse had greater cognitive impairment. CONCLUSIONS Given the functional and cognitive profile of older adults, it is necessary to adopt care practices focused on the rehabilitation/maintenance of self-care and affective relationships. This care must be provided by highly qualified professionals. Therefore, it is necessary to increase the ratio of nurses per older adult in these institutions.
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Affiliation(s)
- César Fonseca
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Lara Guedes de Pinho
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal. .,Comprehensive Health Research Centre (CHRC), Évora, Portugal.
| | - Manuel José Lopes
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Maria do Céu Marques
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Évora, Portugal
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22
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Jadidi A, Sadeghian E, Khodaveisi M, Fallahi-Khoshknab M. Spiritual Needs of the Muslim Elderly Living in Nursing Homes: A Qualitative Study. J Relig Health 2021. [PMID: 33914235 DOI: 10.1007/s10943-021-01263-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 02/03/2023]
Abstract
Paying attention to and meeting the needs of people who are elderly helps to improve their health. Caring for the elderly includes addressing their spiritual needs which has been less investigated. This study aimed to examine the spiritual needs of the Muslim elderly living in nursing homes. A qualitative study was conducted using conventional content analysis. Seventeen elderly people (nine women and eight men) were selected from four nursing homes in Iran using purposive sampling. The subjects were asked to participate in semi-structured interviews. The interview transcripts were analyzed using content analysis. First, semantic units were identified and then related codes were extracted and classified into categories and subcategories based on their similarities. Finally, themes were extracted from the data. The elderly’s spiritual needs were classified into three main themes: religious needs, existential needs, and communication needs. Religious needs were divided into religious beliefs, individual religious practices, and collective religious practices. Existential needs were categorized as meaning of life, purpose of life, and need for peace. Communication needs were conceptualized to include relationship with God and relationship with others. It is argued that caregivers of the elderly should recognize the elderly’s spiritual needs, including religious, existential, and communication needs, and attempt to maintain and promote the elderly’s spiritual health.
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23
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Squires A, Murali KP, Greenberg SA, Herrmann LL, D'amico CO. A Scoping Review of the Evidence About the Nurses Improving Care for Healthsystem Elders (NICHE) Program. Gerontologist 2021; 61:e75-e84. [PMID: 31681955 DOI: 10.1093/geront/gnz150] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The Nurses Improving Care for Healthsystem Elders (NICHE) is a nurse-led education and consultation program designed to help health care organizations improve the quality of care for older adults. To conduct a scoping review of the evidence associated with the NICHE program to (a) understand how it influences patient outcomes through specialized care of the older adult and (b) provide an overview of implementation of the NICHE program across organizations as well as its impact on nursing professionals and the work environment. RESEARCH DESIGN AND METHODS Six databases were searched to identify NICHE-related articles between January 1992 and April 2019. After critical appraisal, 43 articles were included. RESULTS Four thematic categories were identified including specialized older adult care, geriatric resource nurse (GRN) model, work environment, and NICHE program adoption and refinement. Specialized older adult care, a key feature of NICHE programs, resulted in improved quality of care, patient safety, lower complications, and decreased length of stay. The GRN model emphasizes specialized geriatric care education and consultation. Improvements in the geriatric nurse work environment as measured by perceptions of the practice environment, quality of care, and aging-sensitive care delivery have been reported. NICHE program adoption and refinement focuses on the methods used to improve care, implementation and adoption of the NICHE program, and measuring its impact. DISCUSSION AND IMPLICATIONS The evidence about the NICHE program in caring for older adults is promising but more studies examining patient outcomes and the impact on health care professionals are needed.
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Affiliation(s)
- Allison Squires
- Rory Meyers College of Nursing, New York University, New York, New York.,Division of General Internal Medicine, Langone School of Medicine, New York University, New York, New York
| | | | | | - Linda L Herrmann
- Hartford Institute for Geriatric Nursing, New York University, New York, New York
| | - Catherine O D'amico
- Nurses Improving Care for Healthsystem Elders Program (NICHE), Rory Meyers College of Nursing, New York, New York
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24
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Simpson V, Edwards N, Kovich M. Conversations about wellness: A qualitative analysis of patient narratives post annual wellness visit. Geriatr Nurs 2021; 42:681-686. [PMID: 33831714 DOI: 10.1016/j.gerinurse.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 11/26/2022]
Abstract
Support for successful aging in place requires an understanding of the factors that impede or support health promotion behaviors. Nurse-led monthly follow-up calls between annual wellness visits (AWV) offer the opportunity to both provide support and collect data which can inform development of effective health promotion strategies. The aim of this research was to provide ongoing support for health promotion efforts and explore factors playing a role in meeting AWV recommendations. A total of 144 visit summaries for 47 Medicare beneficiaries (65+) who had completed an AWV within the last year were analyzed using a thematic approach. Themes were organized into 7 categories with findings indicating the complexity of factors which influence health promotion behaviors. The importance of ensuring personalization of health promotion recommendations using data collected during the AWV and provision of ongoing support between visits may enhance health outcomes.
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Affiliation(s)
- Vicki Simpson
- Purdue University School of Nursing, 502 N. University Street, West Lafayette, IN 47907, United States.
| | - Nancy Edwards
- Purdue University School of Nursing, 502 N. University Street, West Lafayette, IN 47907, United States
| | - Melissa Kovich
- Purdue University Department of Public Health, 812 W. State Street, West Lafayette, IN 47907, United States
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25
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Meng D, Xu G, He L, Zhang M, Padula WV, Davidson PM. Nursing students' perceived value of the work environment: A discrete choice experiment. Geriatr Nurs 2020; 42:94-98. [PMID: 33340916 DOI: 10.1016/j.gerinurse.2020.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to elicit graduating undergraduate nursing students' perceived value of the work environment in aged care. Applying a cross sectional design, an electronic questionnaire was sent to 625 graduating undergraduate nursing students from three schools of nursing in Jiangsu Province, China. A discrete choice experiment questionnaire with eight choice-set questions was performed. In total, 267 nursing students (42.7%) responded to the questionnaire. We found that nursing students valued excellent working conditions the highest (OR = 3.632 [2.846~4.635]), followed by adequate formal professional development activities (OR = 2.252 [1.907~2.660]), good/excellent safety management (OR = 2.214 [1.828~2.682])/ (OR = 2.202 [1.758~2.759]), and 10% higher earnings (OR = 1.615 [1.360~1.919]). Based on these findings, the study provided information to improve the recruitment of nursing students to work with older adults. Findings suggest that students may be 44.07~73.41% more likely to choose working with older people when valued job characteristics are present.
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Affiliation(s)
- Dijuan Meng
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Guihua Xu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Lin He
- Department of General Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of TCM, Nanjing, Jiangsu, China
| | - Min Zhang
- Department of Nursing, Jiangsu University School of Medicine, Zhenjiang, Jiangsu, China
| | - William V Padula
- Department of Pharmaceutical and Health Economics, University of Southern California School of Pharmacy, Los Angeles, California, USA
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26
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da Silva Schulz R, Santana RF, Dos Santos CTB, Faleiro TB, do Amaral Passarelles DM, Hercules ABS, do Carmo TG. Telephonic nursing intervention for laparoscopic cholecystectomy and hernia repair: A randomized controlled study. BMC Nurs 2020; 19:38. [PMID: 32425692 PMCID: PMC7212613 DOI: 10.1186/s12912-020-00432-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background Patient undergoing surgery may be afraid and concerned about the diagnosis, the treatment, the procedure, the postoperative care, and the surgical recovery. Good communication between staff and patients can minimize or prevent this situation. This study aimed to evaluate the effectiveness of a Telecare nursing intervention, “Telephone consultation”, in reducing the “Delayed surgical recovery” nursing diagnosis in patients undergoing laparoscopic cholecystectomy and hernia repair. Methods This study was performed in two different institutions located in Rio de Janeiro, Brazil. A total of 43 patients were enrolled. The experimental group consisted of 22 patients who had access to the telephone follow-up intervention, and the control group consisted of 21 patients who received conventional treatment without telephone follow-up. This was a randomized controlled study with patients who were 60 years or older and awaiting operative procedures of hernia repair and laparoscopic cholecystectomy who had a mobile or landline phone and were available for telephone contact. Results There was a reduction in “loss of appetite with nausea” (p = 0.013); “need help to complete self-care” (p = 0.041); “pain” (p = 0.041); and “postoperative sensation” (p = 0.023). The experimental group showed a significantly larger decrease in factors related to the “Delayed surgical recovery” diagnosis, suggesting a positive effect of the intervention compared to the effect in control group.\. Conclusion Telephone consultation identified factors that increased the risk of complications after surgery, recognized potential patients for delayed surgical recovery and helped perioperative nurses provide accurate interventions to prevent or mitigate delayed recovery. This study was registered in the platform Brazilian Registry of Clinical Trials (ReBEC) - link: http://www.ensaiosclinicos.gov.br under registration number RBR-4C249M, retrospectively registered on April 13, 2020.
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Affiliation(s)
| | - Rosimere Ferreira Santana
- 2Federal Fluminense University, CNPq researcher, Rio de Janeiro, Brazil.,Present Address: Rua Dr. Celestino, 74, 6° andar, Niterói, Rio de Janeiro, CEP: 24020-091 Brazil
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27
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Rosenfeld P, Glassman KS. Evaluating the NICHE program in an Academic Medical Center: Uncovering the missing link between training and effective practice change in the care of older adults. Appl Nurs Res 2019; 49:13-18. [PMID: 31495413 DOI: 10.1016/j.apnr.2019.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/25/2019] [Accepted: 07/07/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE This paper recounts the history and experiences of one academic medical center that sought to improve the care of elderly patients by adopting and adapting the Geriatric Resource Nurse (GRN) model recommended by the Nurses Improving the Care of Healthsystem Elderly (NICHE) program. A formal evaluation examined the perceptions, opinions and attitudes of non-GRN nursing peers, Nurse Managers (NMs) and members of the Inter-Professional Advisory Board (IAB) regarding GRN practices and the institution's NICHE program. DESIGN A qualitative research design with purposive sampling was utilized. METHODS Semi-structured interviews and focus groups conducted in the fall/winter 2017 were analyzed using standard content analysis methods of isolating and grouping contextual themes without a predefined framework. FINDINGS The institution's GRN training program, a hybrid of the national NICHE program and organization-developed components, has strong support among NMs, members of the IAB and other RNs. However, there exist many misconceptions, erroneous information and misunderstandings about the program and the roles and expectations of GRNs that have hindered the likelihood of producing desired outcomes. CONCLUSIONS Training GRNs was insufficient in disseminating and implementing evidenced-based geriatric practices in this hospital. Future work in this area would benefit from integrating concepts and methods from dissemination and implementation science when developing, launching, and sustaining NICHE programs. CLINICAL RELEVANCE Integrating principles and models of dissemination and implementation science can increase consistent use of evidence based practices and the likelihood of improved geriatric patient outcomes in NICHE hospitals.
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Affiliation(s)
- Peri Rosenfeld
- NYU Langone Health, Departments of Nursing, 550 First Avenue, New York, NY 10016, United States of America.
| | - Kimberly S Glassman
- NYU Langone Health, Departments of Nursing, 550 First Avenue, New York, NY 10016, United States of America.
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28
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Bahrami M, Purfarzad Z, Keshvari M, Rafiei M. The Components of Nursing Competence in Caring for Older People in Iranian Hospitals: A Qualitative Study. Iran J Nurs Midwifery Res 2019; 24:124-130. [PMID: 30820224 PMCID: PMC6390437 DOI: 10.4103/ijnmr.ijnmr_83_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: There is limited research on gerontological nursing competence in hospitals. However, there is no comprehensive and integrated description of the gerontological nursing competence requirements in hospitals. The purpose of this study was to explain the components of nursing competence in caring for older people in Iranian hospitals. Materials and Methods: This is a qualitative descriptive-exploratory study. The data were collected through a semi-structured interview with nurses, nurse managers, and clinical educators in teaching hospitals and nursing schools affiliated to Arak, Isfahan, and Tehran Universities of Medical Sciences in Iran from September 2015 to July 2016. Participants included 25 people who were selected by purposive and snowball sampling method. Sampling continued until data saturation. Data were analyzed using conventional content analysis method. Results: Data analysis generated three main categories including (1) Patient and family centered care; (2) Process-oriented care; and (3) Self-care and continuing professional development. Conclusions: Nurses should have competencies such as participation and empowerment of the patient and family; ease of comfort in the elderly; comprehensive geriatric assessment; development, implementation and evaluation of care plan; development of knowledge and clinical proficiency; and coaching so that they can work effectively during the care of the elderly. The results of this study can be used by nursing educators, nursing students, and nurses to develop their individual and professional skills in the field of gerontological nursing.
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Affiliation(s)
- Masoud Bahrami
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Purfarzad
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahrokh Keshvari
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Rafiei
- Department of Biostatistics and Epidemiology, Arak University of Medical Sciences, Arak, Markazi Province, Iran
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29
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Hsieh PL, Chen CM. Nursing Competence in Geriatric/Long Term Care Curriculum Development for Baccalaureate Nursing Programs: A Systematic Review. J Prof Nurs 2018; 34:400-411. [PMID: 30243697 DOI: 10.1016/j.profnurs.2018.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 05/10/2018] [Accepted: 05/30/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND As facing the rapid growth of the elderly population, the demands for geriatric and long-term care are drastically increasing. Since one of the important strategies in preparation for long-term care system is to focus on the engagement of health care professionals, this paper applies a systematic approach to review the current geriatric and long term care courses in Bachelor of Science in Nursing (BSN) programs. This review assessed the impact of Geriatric Nursing (GN) and/or Long Term Care (LTC) courses on nursing students' knowledge, care intention and competence of Geriatric Long Term Care (GLTC) care to enable their nursing competence before graduation. METHOD Data related to the purpose of the study, research design, sample, curriculum content, teaching strategies, evaluation measurements and results were extracted. The methodological quality of all publications was included in the review. RESULTS Eighteen articles were eligible for analysis, including 16 quantitative and 2 qualitative studies. The review revealed that including geriatric and long term care content in undergraduate nursing curriculum could effectively enhance students' nursing competence. CONCLUSION GN and LTC curriculum development should offer established content on geriatric and long term care as a foundation to implement early learning experiences in the curriculum. Both theory and clinical practice of GLTC course can be developed to increase the nursing students' knowing on the elders and the disabled through the clinical placement.
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Affiliation(s)
- Pei-Lun Hsieh
- Department of Long-Term Care Management, Chung Hwa University of Medical Technology
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30
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Abstract
The challenge of caring for patients with fragility fractures is particularly acute for nursing teams who are in short supply and work with patients following fracture on a 24 h basis, coordinating as well as providing complex care. This paper considers the role of nurses within the orthogeriatric team and highlights the value of effective nursing care in patient outcomes. It explores the nature of nursing for patients with fragility fracture with a focus on the provision of safe and effective care and the coordination of care across the interdisciplinary team. It also highlights the need for specific skills in orthopaedic and geriatric nursing as well as specialist education.
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Affiliation(s)
- Louise Brent
- National Office of Clinical Audit, Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland.
| | - Ami Hommel
- Malmö University, Malmo, Sweden; Skane University Hospital, Lund, Sweden
| | | | - Karen Hertz
- University Hospital of North Midlands, NHS Trust, United Kingdom
| | - Anita J Meehan
- Cleveland Clinic Akron General, Akron, Ohio, United States
| | - Julie Santy-Tomlinson
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom
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31
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Rawson H, Bennett PN, Ockerby C, Hutchinson AM, Considine J. Emergency nurses' knowledge and self-rated practice skills when caring for older patients in the Emergency Department. ACTA ACUST UNITED AC 2017; 20:174-180. [PMID: 28923236 DOI: 10.1016/j.aenj.2017.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 08/02/2017] [Accepted: 08/08/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Older adults are high users of emergency department services and their care requirements can present challenges for emergency nurses. Although clinical outcomes for older patients improve when they are cared for by nurses with specialist training, emergency nurses' knowledge and self-assessment of care for older patients is poorly understood. AIM To assess emergency nurses' knowledge and self-rating of practice when caring for older patients. METHODS A cross-sectional self-report survey of emergency nurses (n=101) in Melbourne, Australia. RESULTS Mean scores were 12.7 (SD 2.66) for the 25-item knowledge of older persons questionnaire, and 9.04 (SD 1.80) for the 15-item gerontic health related questions. Scores were unaffected by years of experience as a registered nurse or emergency nurse. More than 80% of nurses rated themselves as 'very good' or 'good' in assessing pain (94.9%), identifying delirium (87.8%), and identifying dementia (82.8%). Areas with a 'poor' ratings were identifying depression (46.5%), assessing polypharmacy (46.5%) and assessing nutrition (37.8%). CONCLUSIONS There was variation in knowledge and self-rating of practice related to care of older patients. The relationship between knowledge and self-ratings of practice in relation to actual emergency nursing care of older people and patient outcomes warrants further exploration.
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Affiliation(s)
- Helen Rawson
- Deakin University, Geelong, School of Nursing and Midwifery,75 Pigdons Road, Waurn Ponds, VIC 3126, Australia; Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, VIC 3125, Australia; Centre for Quality and Patient Safety Research, Monash Health Partnership, Clayton, VIC, Australia.
| | - Paul N Bennett
- Deakin University, Geelong, School of Nursing and Midwifery,75 Pigdons Road, Waurn Ponds, VIC 3126, Australia; Satellite Healthcare Inc, San Jose, CA, USA
| | - Cherene Ockerby
- Centre for Quality and Patient Safety Research, Monash Health Partnership, Clayton, VIC, Australia
| | - Alison M Hutchinson
- Deakin University, Geelong, School of Nursing and Midwifery,75 Pigdons Road, Waurn Ponds, VIC 3126, Australia; Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, VIC 3125, Australia; Centre for Quality and Patient Safety Research, Monash Health Partnership, Clayton, VIC, Australia
| | - Julie Considine
- Deakin University, Geelong, School of Nursing and Midwifery,75 Pigdons Road, Waurn Ponds, VIC 3126, Australia; Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, VIC 3125, Australia; Centre for Quality and Patient Safety Research, Eastern Health Partnership, Box Hill, VIC, Australia
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Mewshaw J, Bailey DE, Porter KA, Anderson AL, Anderson RA, Burd AL, Colón-Emeric C, Corazzini KN. A novel program for ABSN students to generate interest in geriatrics and geriatric nursing research. ACTA ACUST UNITED AC 2017; 7:95-99. [PMID: 28435479 DOI: 10.5430/jnep.v7n6p95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The current shortage of nurse researchers in geriatrics adversely affects the capacity of nurses to conduct research to advance the evidence-based care of older adults. In an effort to generate interest in geriatrics and geriatric nursing research, the Duke University School of Nursing designed a summer internship for four students enrolled in the accelerated baccalaureate nursing (ABSN) program. This paper describes the experience of these ABSN students and the staff and faculty who worked with them. The program design, staff and faculty experiences, benefits and challenges, as well as recommendations for future programs are discussed. The purpose of this article is to highlight the benefits and challenges of offering research experiences to nursing students in an ABSN program to stimulate interest in geriatrics and geriatric nursing research.
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Affiliation(s)
| | | | - Kristie A Porter
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | | | - Ruth A Anderson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Andrew L Burd
- School of Nursing, Duke University, Durham, United States
| | - Cathleen Colón-Emeric
- Center for the Study of Aging and Human Development, Department of Biometry and Bioinformatics, Duke University Medical Center, Durham, United States.,Geriatrics Research Education and Clinical Center, Durham VA Medical Center, Durham, United States
| | - Kirsten N Corazzini
- School of Nursing, Duke University, Durham, United States.,Center for the Study of Aging and Human Development, Department of Biometry and Bioinformatics, Duke University Medical Center, Durham, United States
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Krause O, Junius-Walker U, Wiese B, Hager K. Are even geriatric patients becoming older and older? : Changes in the age structure of geriatric inpatients in the course of two decades. Z Gerontol Geriatr 2018; 51:81-4. [PMID: 27986998 DOI: 10.1007/s00391-016-1162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 04/08/2016] [Accepted: 11/17/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The life expectancy of the German population has steadily risen in the course of the past decades. As especially the oldest members of the population are treated in geriatric clinics, it would be of interest to investigate whether the increase in population age can also be found among geriatric inpatients. PATIENTS AND METHODS The demographic data of inpatients of a geriatric clinic in Hannover in the years 1994, 2004 and 2014 were analyzed according to age, gender and classification as acute care or geriatric rehabilitation. RESULTS The mean patient age rose by 6 years in the past two decades. This was the case for both men and women but the age of men (+7.5 years) rose more than that of women (+4.9 years). Whereas the patient average age increased, especially in the first decade (+3.9 years), this increase slowed down in the following decade (+1.7 years). The 80 to 89-year-old patients remained the biggest and steadily increasing group (in 1994: 41.1%, 2004: 46.9% and 2014: 51.3%). The greatest increase, however, was found for those aged 90 years and older (1994: 4.8%, 2004: 12.2% and 2014: 17.7%). CONCLUSION The results confirm the professional experiences of many geriatricians in that they care for an increasingly aging clientele. Particularly very old male patients in geriatric clinics are increasing. All health professional groups involved will have to face this challenge.
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Bullich-Marín I, Miralles Basseda R, Torres Egea P, Planas-Campmany C, Juvé-Udina ME. [Evaluation of the nurse working environment in health and social care intermediate care units in Catalonia]. Rev Esp Geriatr Gerontol 2016; 51:342-348. [PMID: 26705825 DOI: 10.1016/j.regg.2015.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/19/2015] [Accepted: 10/25/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION A favourable work environment contributes to greater job satisfaction and improved working conditions for nurses, a fact that could influence the quality of patient outcomes. The aim of the study is two-fold: Identifying types of centres, according to the working environment assessment made by nurses in intermediate care units, and describing the individual characteristics of nurses related to this assessment. METHODS An observational, descriptive, prospective, cross-sectional, and multicentre study was conducted in the last quarter of 2014. Nurses in intermediate care units were given a questionnaire containing the Practice Environment Scale of the Nursing Work Index (PES-NWI) which assesses five factors of the work environment using 31 items. Sociodemographic, employment conditions, professional and educational variables were also collected. RESULTS From a sample of 501 nurses from 14 centres, 388 nurses participated (77% response). The mean score on the PES-NWI was 84.75. Nine centres scored a "favourable" working environment and five "mixed". The best valued factor was "work relations" and the worst was "resource provision/adaptation". Rotating shift work, working in several units at the same time, having management responsibilities, and having a master degree were the characteristics related to a better perception of the nursing work environment. CONCLUSIONS In most centres, the working environment was perceived as favourable. Some employment conditions, professional, and educational characteristics of nurses were related to the work environment assessment.
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Affiliation(s)
- Ingrid Bullich-Marín
- Plan Director Sociosanitario, Departamento de Salud de la Generalitat de Catalunya, Barcelona, España; Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España.
| | - Ramón Miralles Basseda
- Servicio de Geriatría, Parc Salut Mar, Barcelona, España; Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, España
| | - Pilar Torres Egea
- Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España
| | - Carme Planas-Campmany
- Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España; Dirección General de Planificación e Investigación en Salud, Departamento de Salud de la Generalitat de Catalunya, Barcelona, España
| | - María Eulalia Juvé-Udina
- Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España; Dirección assistencial, Instituto Catalán de la Salud, Barcelona, España; Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España
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Meléndez Frigola C, Arroyo Borrell E, Saez M. [Data Analysis of Subacute Patients with Registered Information in the Minimum Basic Data Set for Social-Healthcare (CMBD-RSS), Spain]. Rev Esp Salud Publica 2016; 90:e1-e7. [PMID: 27708254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/19/2016] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVE It is necessary to deepen in the knowledge of the Basic Minimum Set of Data (CMBD-RSS) of patients with chronic pathology associated and frequent hospitalisations (the subacute care). The aim of this study was to analyse the sanitary information of these patients, once initiated the subacute program. METHODS We used data of 660 patients hospitalised in the subacute care unit at the Santa Caterina Hospital, sanitary region of Girona, from October 2013 to December 2014. The CMBD data base was analysed using SPSS Statistics 15.0. We verified the relationship between variables i.e. length of stay and age; origin of the patient admission and length of stay (Mann-Whitney U Test); main diagnosis and length of stay (Kruskal-Wallis). We also studied the relationship between origin of the patient admission and main diagnosis (Chi-square test and Cramer's V). RESULTS The average age of patients was 83 years old, and mainly female profile (55%). Five illnesses concentrated 80% of all patients' diagnosed diseases (mental health problems, nervous system diseases, circulatory problems, respiratory system problems and genitourinary infections). Patients admitted from hospitals had a shorter length of stay (8 days) than patients admitted from home (9 days). 80% of cases patients come back home after the hospital discharge. CONCLUSIONS People with chronic pathology associated and frequent hospitalisations are an important group of risk. Elderly and clinical decompensations add complexity to these cases. The evaluation of these patients at the admission and discharge procedures optimise the use of the resources.
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Affiliation(s)
- Cristina Meléndez Frigola
- CatSalut. Girona. España
- Grup de Recerca en Estadística. Econometria i Salut (GRECS).Universidad de Girona. Girona. España
| | - Elena Arroyo Borrell
- Grup de Recerca en Estadística. Econometria i Salut (GRECS).Universidad de Girona. Girona. España
- CIBER de Epidemiología y Salud Pública (CIBERESP)
| | - Marc Saez
- Grup de Recerca en Estadística. Econometria i Salut (GRECS).Universidad de Girona. Girona. España
- CIBER de Epidemiología y Salud Pública (CIBERESP)
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Meyer-Kühling I, Eckardt R, Makrantonaki E. Professional caregivers' knowledge in dermatology : Improving knowledge and communication to dermatologists in geriatric facilities. Z Gerontol Geriatr 2016; 51:54-59. [PMID: 27637580 DOI: 10.1007/s00391-016-1132-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 08/18/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research regarding effective collaboration and communication between professional caregivers and dermatologists and the need for further education and training for caregivers in the field of geriatric dermatology still remains relatively scarce. OBJECTIVE To document the state of knowledge of professional caregivers in the field of geriatric dermatology and make recommendations for dermatological education and postgraduate training. METHODS A questionnaire with open and closed questions was used to evaluate the level of knowledge and current need for information in geriatric dermatology. A total of 58 professional caregivers from several hospital departments, including geriatric wards and nursing homes participated in this study. Quantitative and qualitative data were generated and responses to open questions were categorized according to the most quoted contents. The study was approved by the Charité University in Berlin ethics committee. RESULTS The study demonstrates that there is a lack of dermatological knowledge. Participants indicated a huge information need regarding skin tumors (77.2 %), prevention of skin diseases (50.0 %) and pruritus (41.4 %). According to the caregivers, communication problems with physicians arise in view of using standardized terms of skin diseases (22.9 %) and formulating unclear care records of skin diseases (20.8 %). CONCLUSION Difficulties in communication between professional caregivers and physicians can influence patients' punctual and well-founded treatment; therefore, further education must be mediated vividly and practically. Moreover, training should focus on learning standardized terms and descriptions for optimizing the flow of information with physicians and written communication, such as care records.
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Affiliation(s)
- Inga Meyer-Kühling
- Institute of Gerontology, Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Rahel Eckardt
- Research Group of Geriatrics, Charité Universitätsmedizin Berlin, Reinickendorferstr. 61, 13347, Berlin, Germany
- Geriatrics Clinic, St. Joseph-Krankenhaus, Wüsthoffstraße 15, 12101, Berlin, Germany
| | - Evgenia Makrantonaki
- Department of Dermatology and Allergic Diseases, Ulm University, Meyerhofstrasse 11c/Life Sciences Building N27, 89081, Ulm, Germany.
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Kaspar R, Hartig J. Emotional competencies in geriatric nursing: empirical evidence from a computer based large scale assessment calibration study. Adv Health Sci Educ Theory Pract 2016; 21:105-119. [PMID: 26108300 DOI: 10.1007/s10459-015-9616-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 06/11/2015] [Indexed: 06/04/2023]
Abstract
The care of older people was described as involving substantial emotion-related affordances. Scholars in vocational training and nursing disagree whether emotion-related skills could be conceptualized and assessed as a professional competence. Studies on emotion work and empathy regularly neglect the multidimensionality of these phenomena and their relation to the care process, and are rarely conclusive with respect to nursing behavior in practice. To test the status of emotion-related skills as a facet of client-directed geriatric nursing competence, 402 final-year nursing students from 24 German schools responded to a 62-item computer-based test. 14 items were developed to represent emotion-related affordances. Multi-dimensional IRT modeling was employed to assess a potential subdomain structure. Emotion-related test items did not form a separate subdomain, and were found to be discriminating across the whole competence continuum. Tasks concerning emotion work and empathy are reliable indicators for various levels of client-directed nursing competence. Claims for a distinct emotion-related competence in geriatric nursing, however, appear excessive with a process-oriented perspective.
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Affiliation(s)
- Roman Kaspar
- Department of Educational Quality and Assessment, German Institute for International Educational Research, Schloßstraße 29, 60486, Frankfurt am Main, Germany.
- Interdisciplinary Ageing Research, Goethe University, Frankfurt am Main, Germany.
| | - Johannes Hartig
- Department of Educational Quality and Assessment, German Institute for International Educational Research, Schloßstraße 29, 60486, Frankfurt am Main, Germany
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Abstract
BACKGROUND External fixation is a well-known procedure for the management of intertrochanteric fractures in very elderly high-risk patients. A new compression pin that can be adapted to all fixators was designed to provide inter fragmentary compression. In the present study, its effects on the fracture stability and healing were evaluated. MATERIALS AND METHODS Thirty-one patients treated using compression pin and thirty-six patients treated using standard pins were evaluated retrospectively between January 2009 and July 2014. Patients were evaluated according to age, gender, duration of preoperative period, duration of operation time, American Society of Anesthesiologists (ASA) scores, and immediate postoperative and final femoral neck angle measurements. The stability of the fixation was evaluated by calculating the secondary varus angulation after weight bearing. RESULTS Thirty one patients (82.1 ± 6.1 years old) comprised the compression pin group, and 36 patients (83.33 ± 6.24 years old) comprised the standard pin group. From the time of weight bearing to healing time, 1.0 ± 1.25° (0-4) and 2.5 ± 1.8° (0-9) of secondary varus angulation in the compression pin and standard pin groups were measured, respectively (P = 0.000). With weight bearing, 2 of 31 (6%) and 9 of 36 (25%) patients in the compression and standard pin groups, respectively, had >4° of secondary varus angulation. In the compression pin group, 13 fractures were unstable, but only 2 (15%) of them had >4° of secondary varus angulation. In the standard pin group, 19 fractures were unstable, and 7 (37%) of them had >4° of secondary varus angulation. CONCLUSIONS Treatment of very elderly, high risk patients' with intertrochanteric fractures with external fixation is effective. Compression pin maintained stability better than standard pins after weight bearing, especially for unstable intertrochanteric fractures.
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Affiliation(s)
- Aydın Arslan
- Department of Orthopaedics, State Hospital, Malatya, Turkey,Address for correspondence: Dr. Aydın Arslan, Department of Orthopaedics, Malatya State Hospital, Postal Code: 44080 Yesilyurt, Malatya, Turkey. E-mail:
| | - Ali Utkan
- Department of Orthopaedics, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Tuba Tulay Koca
- Department of Physical Therapy, State Hospital, Malatya, Turkey
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Morilla-Herrera JC, Garcia-Mayor S, Martín-Santos FJ, Kaknani Uttumchandani S, Leon Campos Á, Caro Bautista J, Morales-Asencio JM. A systematic review of the effectiveness and roles of advanced practice nursing in older people. Int J Nurs Stud 2015; 53:290-307. [PMID: 26542652 DOI: 10.1016/j.ijnurstu.2015.10.010] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To identify, assess and summarize available scientific evidence about the effect of interventions deployed by advanced practice nurses when providing care to older people in different care settings, and to describe the roles and components of the interventions developed by these professionals. BACKGROUND In older people, evidence of advanced practice roles remains dispersed along different contexts, approaches and settings; there is little synthesis of evidence, and it is not easy to visualize the different practice models, their components, and their impact. DESIGN Systematic review. DATA SOURCES Sixteen electronic databases were consulted (1990-2014). The research also included screening of original studies in reviews and reports from Centers of Health Services Research and Health Technology Agencies. REVIEW METHODS Studies were assessed by two reviewers with the Cochrane risk of bias tool. They were classified depending on the type of follow-up (long and short-term care) and the scope of the service (advanced practice nurses interventions focused on multimorbid patients, or focused on a specific disease). RESULTS Fifteen studies were included. In long-term settings, integrative, multi-component and continuous advanced practice nursing care, reduced readmissions, and increased patients' and caregivers' satisfaction. Advanced practice nurses were integrated within multidisciplinary teams and the main interventions deployed were patient education, multidimensional assessments and coordination of multiple providers. CONCLUSION Positive results have been found in older people in long-term care settings, although it is difficult to discern the specific effect attributable to them because they are inserted in multidisciplinary teams. Further investigations are needed to evaluate the cost-effectiveness of the two modalities detected and to compare internationally the interventions developed by advanced practice nurses.
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Affiliation(s)
- Juan Carlos Morilla-Herrera
- Primary Health Care District of Málaga, Spain; Department of Nursing, Faculty of Health Sciences, University of Málaga, Spain
| | - Silvia Garcia-Mayor
- Department of Nursing, Faculty of Health Sciences, University of Málaga, Spain
| | - Francisco Javier Martín-Santos
- Primary Health Care District of Málaga, Spain; Department of Nursing, Faculty of Health Sciences, University of Málaga, Spain
| | | | - Álvaro Leon Campos
- Department of Nursing, Faculty of Health Sciences, University of Málaga, Spain
| | - Jorge Caro Bautista
- Health Care Centre El Limonar, Primary Health Care District of Málaga, Spain
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Kaşıkçı M, Kılıç D, Avşar G, Şirin M. Prevalence of urinary incontinence in older Turkish women, risk factors, and effect on activities of daily living. Arch Gerontol Geriatr 2015; 61:217-23. [PMID: 26123541 DOI: 10.1016/j.archger.2015.06.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 06/10/2015] [Accepted: 06/11/2015] [Indexed: 11/21/2022]
Abstract
PURPOSE The study was conducted to determine the prevalence of urinary incontinence (UI) among older women, risk factors, and the effect on activities of daily living (ADLs). METHOD The study was conducted in family health centers located in a city in eastern Turkey. The study population consisted of 1094 women age 65 and older chosen with a simple random sampling method. The inclusion criteria were 65 years and older, female, and not diagnosed with mental or emotional diseases or conditions that obstruct communication. Data were collected in face-to-face interviews with the Questionnaire and Daily Life Activities Data Form created by the researchers based on the Roper, Logan, and Tierney model. RESULTS The prevalence of UI in women age 65 and older was 51.6%, and the most common type was urge incontinence. The number of births, number of abortions, age at last birth, and home births affected the development of UI (p<0.001). In addition, body mass index, constipation, urinary tract infection, cough, hormone replacement therapy, genital prolapse, cystocele, urogenital surgery, nocturia, and daily urine output were determined to be risk factors (p<0.001). Among the ADLs, 13.7% with UI reported that they had fallen when getting up from the toilet, 34.3% had experienced a sense of shame, 45.8% avoided coughing, and 46.5% restricted fluid intake. CONCLUSION Prevalence of UI in women age 65 and older was high, and the most common was urge incontinence. UI has many risk factors and affects many ADLs.
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Bakerjian D, Beverly C, Burger SG, Carter D, Dornberger S, Eliopoulos C, Remsburg R. Gerontological nursing leadership in the Advancing Excellence Campaign: moving interdisciplinary collaboration forward. Geriatr Nurs 2014; 35:417-22. [PMID: 24970338 DOI: 10.1016/j.gerinurse.2014.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 05/17/2014] [Accepted: 05/25/2014] [Indexed: 11/24/2022]
Abstract
Nursing was not a part of the coalition of multiple nursing home stakeholders at the roll out of the Advancing Excellence Campaign (AEC). In January 2007, several nurse organizations proactively approached the AEC leadership, were welcomed and immediately began to volunteer for leadership positions such as committee chairs and conference coordinators. This paper presents an exemplar of how a proactive stance, even when not initially included, allowed nurses to secure chairs at the decision making table of this quality campaign and contribute to improved resident outcomes.
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Affiliation(s)
- Debra Bakerjian
- Betty Irene Moore School of Nursing, University of California, Davis, 4610 X Street, Suite 2354, Sacramento, CA 95817, USA.
| | - Claudia Beverly
- Arkansas Aging Initiative, Donald W. Reynolds Institute on Aging, USA; John A. Hartford Center of Geriatric Nursing Excellence, USA; Colleges of Nursing, Medicine and Public Health, University of Arkansas for Medical Sciences, USA
| | - Sarah Greene Burger
- Coalition of Geriatric Nursing Organizations, Hartford Institute for Geriatric Nursing, New York University, College of Nursing, USA
| | - Diane Carter
- American Association of Nurse Assessment Coordination, USA
| | - Sherrie Dornberger
- National Association of Directors of Nursing Administration in Long Term Care, USA
| | | | - Robin Remsburg
- School of Nursing, College of Health and Human Services, George Mason University, USA
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Möhler R, Meyer G. Attitudes of nurses towards the use of physical restraints in geriatric care: a systematic review of qualitative and quantitative studies. Int J Nurs Stud 2013; 51:274-88. [PMID: 24176718 DOI: 10.1016/j.ijnurstu.2013.10.004] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 10/02/2013] [Accepted: 10/04/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To examine nurses' attitudes towards the use of physical restraints in geriatric care. DESIGN Systematic review and synthesis of qualitative and quantitative studies. DATA SOURCES The following databases were searched: Medline, CINAHL, EMBASE, Psyndex, PsychInfo, Social SciSearch, SciSearch, Forum Qualitative Social Research (1/1990 to 8/2013). We performed backward and forward citation tracking to all of the included studies. REVIEW METHODS We included in the present review all qualitative and quantitative studies in English and German that investigated nurses' attitudes towards the use of physical restraints in geriatric care. Two independent reviewers selected the studies for inclusion and assessed the study quality. We performed a thematic synthesis for the qualitative studies and a content analysis of the questionnaires' items as well as a narrative synthesis for the quantitative surveys. RESULTS We included 31 publications in the review: 20 quantitative surveys, 10 qualitative and 1 mixed-method study. In the qualitative studies, nurses' attitudes towards the use of physical restraints in geriatric care were predominately characterised by negative feelings towards the use of restraints; however, the nurses also described a perceived need for using restraints in clinical practice. This discrepancy led to moral conflicts, and nurses described several strategies for coping with these conflicts when restraints were used. When nurses were in doubt regarding the use of restraints, they decided predominantly in favour of using restraints. The results of the quantitative surveys were inconsistent regarding nurses' feelings towards the use of restraints in geriatric care. Prevention of falls was identified as a primary reason for using restraints. However, the items of the questionnaires focussed primarily on the reasons for the use of restraints rather than on the attitudes of nurses. CONCLUSIONS Despite the lack of evidence regarding the benefits of restraints and the evidence on the adverse effects, nurses often decided in favour of using restraints when in doubt and they used strategies to cope with negative feelings when they used restraints. A clear policy change in geriatric care institutions towards restraint-free care seems to be warranted to change clinical practice. The results of this review should also be considered in the development of interventions aimed at reducing the use of restraints.
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Affiliation(s)
- Ralph Möhler
- School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany.
| | - Gabriele Meyer
- School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany; Institute of Health and Nursing Science, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
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Menéndez MD, Alonso J, Miñana JC, Arche JM, Díaz JM, Vazquez F. Characteristics and associated factors in patient falls, and effectiveness of the lower height of beds for the prevention of bed falls in an acute geriatric hospital. Rev Calid Asist 2013; 28:277-84. [PMID: 23684046 DOI: 10.1016/j.cali.2013.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 12/17/2012] [Accepted: 01/22/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Whereas several studies about patient falls have provided data for long-term healthcare institutions, less information is available for acute care centres. The objective was to analyze the characteristics of the patient falls and associated factors, and the effectiveness of the lower beds' height to reduce the frequency and the harms of the patient falls in an acute geriatric hospital. METHODS A descriptive and retrospective study using a mandatory safety incident report, the IHI Global Trigger Tool, and the claims related to patient falls between 2007 and 2011 in a 200-bed university-associated geriatric hospital. RESULTS The falls rate was 5.4 falls per 1000 patient days (1.3% of falls led to fractures) and there was exitus in 6 patients (0.6%). Nearly half of the falls ocurred during the night shift (42.4%). By wards, falls were more frequent in acute geriatric wards (42.9%). A 7.5% of patients had a fall before admission. 3 (0.2%) claims due to possible clinical negligence were found. A reduction (28.3%) of bed falls with the lower height of the bed and a 1.88 times less falls with harm (RR 0.53; CI 95% 0.83-0.34) (p=0.006) was observed. CONCLUSION The prevention of patient falls is an important task in geriatric units with a potential reduction of harms and costs, some measures such as the lower height of the bed showed a significant reduction of the falls.
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Affiliation(s)
- M D Menéndez
- Servicio de Calidad del Área 4, Hospital Monte Naranco, Oviedo, Spain
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