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Vanlaer N, Dirven I, Neyns B, Rogiers A. Emotional Distress, Cognitive Complaints, and Care Needs among Advanced Cancer Survivors Treated with Immune Checkpoint Blockade: A Mixed-Method Study. Cancers (Basel) 2024; 16:1638. [PMID: 38730590 PMCID: PMC11083145 DOI: 10.3390/cancers16091638] [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: 03/20/2024] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND There is a need for a better understanding of survivorship-related issues in advanced cancer survivors treated with immune checkpoint blockade (ICB). The purpose of this study was to identify survivorship-related issues, with a focus on psychological distress, cognitive complaints, physical sequelae, impact on family dynamics, and care needs in unresectable, advanced cancer survivors treated with ICB. METHODS Semi-structured interviews and patient-reported outcome measures (PROMs) were conducted in survivors followed up at the University Hospital Brussels. We performed content analysis on the semi-structured interviews and analyzed the PROMs descriptively. RESULTS 70 cancer survivors (71.4%) consented to participate between July 2022 and November 2023. Clinical fear of cancer recurrence (FCR) was present in 54.3% of the cancer survivors, and 18.6% had elevated cognitive complaints. We identified triggers related to clinically important psychological distress, such as immune-related adverse events, the progression/recurrence of disease, difficulties in adjusting to life after treatment, and co-existing life stressors, alongside persistent physical issues and unmet psychological and nutritional care needs. CONCLUSION Our results indicate the existence of persistent psychological, physical, and cognitive issues, and support the need for routine screening for FCR. The identified triggers related to severe psychological distress can aid clinicians in timely referring the patient, thereby enhancing survivorship care.
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Affiliation(s)
- Nathalie Vanlaer
- Department of Medical Oncology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Iris Dirven
- Department of Medical Oncology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Bart Neyns
- Department of Medical Oncology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Anne Rogiers
- Department of Medical Oncology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- Department of Psychiatry, Centre Hospitalier Universitaire Brugmann, 1020 Brussels, Belgium
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Kimura H, Koga K, Nishio M. Care needs of caregivers of the elderly with early-stage dementia. J Rural Med 2024; 19:57-65. [PMID: 38655223 PMCID: PMC11033670 DOI: 10.2185/jrm.2023-023] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/13/2023] [Indexed: 04/26/2024] Open
Abstract
Objective This study aimed to identify the care needs of family caregivers of elderly patients with early-stage dementia and examine support measures. Materials and Methods We conducted a self-administered questionnaire survey with 115 primary caregivers of outpatients who visited A City Community General Support Center or B University Hospital Department of Neurology for memory loss consultation. The questionnaire content included demographic characteristics, the care needs scale for caregivers of the elderly with early-stage dementia (Care Needs Scale), and the Japanese short version of the Zarit Burden Interview. The Medical Ethics Committee of Fukuoka University approved this study (approval number: M047). Of the 115 participants, 104 were included in the analysis after excluding 11 respondents with missing data. We divided the participants into a young group (under 65 years of age) and an old group (65 years of age or older) and compared the variables and each scale score using the Mann-Whitney U test. We also compared the correlations between the total score and subscale scores of the Care Needs Scale and each variable, in addition, we performed multiple regression analyses using the total score of the Care Needs Scale as the dependent variable. Results The young caregivers wanted to know how to take care, prevent deterioration, and deal with symptoms of early-stage dementia. They were trying to balance caregiving with work and housekeeping and reduce the stress and burden of long-term care. Older caregivers were confused about caregiving and wanted someone to talk about their situations. Conclusion Both groups shared that the family's lack of understanding about caregiving and personal and role strains were associated with the care needs of caregivers of the elderly with early-stage dementia.
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Affiliation(s)
| | - Kayoko Koga
- Faculty of Medicine, Fukuoka University, Japan
| | - Midori Nishio
- Japanese Red Cross Kyushu International College of Nursing, Japan
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Nguyen AN, Nguyen BT, Nguyen BT, Nguyen BTT, Nguyen NTA, Dang NTK, Nguyen ATP, Nguyen AT, Pham T, Mantyh WG, Tran D, Le OTP, Ta M. Care needs assessment of older adults with dementia in a semi-rural district in Vietnam: A community-based cross-sectional study. Psychogeriatrics 2024; 24:249-258. [PMID: 38155441 PMCID: PMC11058465 DOI: 10.1111/psyg.13068] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND The increasing needs of people living with dementia (PLWD) in Vietnam present an enormous public health challenge. Vietnam is an understudied country, and little is known regarding the overall unmet needs of caregivers or the demographic risk factors associated with unmet caregiving needs. This study aimed to determine the burden of unmet care needs of community-dwelling PLWD and identify sociodemographic risks associated with unmet care needs. METHODS A cross-sectional study in a rural area facing urbanisation in Hanoi, Vietnam recruited PWLD-caregiver dyads with multistage sampling. We utilised the Camberwell Assessment of Need for the Elderly (CANE) instrument to evaluate care needs across four domains. Caregivers rated PLWD needs, with higher scores indicating greater unmet needs. The Mann-Whitney test was employed for comparing two groups, while the Kruskal-Wallis test was used for comparisons involving more than two groups in the analysis, and a P-value of less than 0.05 was considered statistically significant. RESULTS Among 90 PLWD participating in the study, the overall mean care needs score was 11.6 ± 4.3, with only 16.2% of PLWD having their care needs met. Environmental and physical needs were more frequently met than psychological or social needs. Only 48.0% and 43.9% of environmental and physical needs were met respectively, and a meagre 20.9% and 23.6% for psychological and social needs. Unmet care needs were more frequent for PWLD who were female, single or divorced, had lower monthly household income, or who were in more advanced stages of dementia, as indicated by Clinical Dementia Rating scores ≥1. CONCLUSIONS Unmet needs for PWLD are common. Increased caregiver education, resources, and services in Vietnam are urgently required to improve the quality of life for this population.
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Affiliation(s)
- Anh Ngoc Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Binh Thanh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
- Hanoi Medical University, Hanoi, Vietnam
| | - Binh Thanh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Binh Thi Thanh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Nguyet Thi Anh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Nhung Thi Kim Dang
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | | | - Anh Trung Nguyen
- Hanoi Medical University, Hanoi, Vietnam
- National Geriatric Hospital, Hanoi, Vietnam
| | - Thang Pham
- National Geriatric Hospital, Hanoi, Vietnam
| | | | - Duyen Tran
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Oanh Thi Phương Le
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - My Ta
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA
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Tan R, Gao R, Tan J, Zhu Q, Liu H, Lei W, Yan R, Yan L, Lei Y. The care needs of the elderly in China's elderly care institutions: a narrative synthesis. Int J Qual Health Care 2024; 36:mzad112. [PMID: 38156423 DOI: 10.1093/intqhc/mzad112] [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: 05/06/2023] [Revised: 12/03/2023] [Accepted: 12/26/2023] [Indexed: 12/30/2023] Open
Abstract
China's population is ageing, affecting trends in social development and basic national conditions. More attention must be paid to the lack of care needs assessments for the elderly in China's pension institutions. This paper discusses a systematic evaluation of the care needs of the elderly in China's elderly care institutions. Literature was collected and synthesized after a search of the Web of Science, PubMed, and other databases for works published up to August 2021. Relevant content is proposed, including the name of the first author, publication date, study area, and sample size. Exactly 18 articles were included in the literature, documents that reported on a total of 7277 elderly people. The results showed a combined demand rate of primary care needs ≥50%. The top five needs included mental/psychological (76%), tranquillity/care (73%), living/environmental (71%), medical treatment (64%), and preventive healthcare (64%). The combined demand rate of secondary care needs was ≥50%. The top five needs included 79% for room/laundry/cleaning, 77% for psychological comfort and nursing, 73% for end-of-life care, 70% for disease diagnosis and treatment, and 69% for physical examination. The health needs of older people are diverse and focus mainly on mental/psychological, tranquility/care, living/environmental (71%), pharmacotherapy, and preventive healthcare.
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Affiliation(s)
| | - Ruizhe Gao
- Department of Geriatric Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province 250100, China
| | - Jiping Tan
- The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, 178 Hangkong Dadao, Enshi City, Hubei Province 445000, China
- Department of Respiratory and Critical Care Medicine, Minda Hospital of Hubei Minzu University, Enshi City, Hubei province 445000, China
| | - Qunhui Zhu
- Hematology Department, The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, 178 Hangkong Dadao, Enshi City 445000, China
| | - Hua Liu
- The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, 178 Hangkong Dadao, Enshi City, Hubei Province 445000, China
| | - Wei Lei
- The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, 178 Hangkong Dadao, Enshi City, Hubei Province 445000, China
| | - Ruofen Yan
- The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, 178 Hangkong Dadao, Enshi City, Hubei Province 445000, China
| | - Lianmei Yan
- The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, 178 Hangkong Dadao, Enshi City, Hubei Province 445000, China
| | - Yunhong Lei
- Yichang Hubo Medical Research Institute, Yichang, Hubei Province 443000, China
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Pigott JS, Bloem BR, Lorenzl S, Meissner WG, Odin P, Ferreira JJ, Dodel R, Schrag A. The Care Needs of Patients With Cognitive Impairment in Late-Stage Parkinson's Disease. J Geriatr Psychiatry Neurol 2024:8919887231225484. [PMID: 38230692 DOI: 10.1177/08919887231225484] [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] [Indexed: 01/18/2024]
Abstract
BACKGROUND Cognitive impairment is common in Parkinson's disease (PD), but care needs and resource use for those with significant cognitive impairment are not well established. METHODS 675 participants with PD from the international Care of Late-Stage Parkinsonism (CLaSP) study were grouped into those without (n = 333, 49%) and with cognitive impairment (MMSE < 24/30 or diagnosis of dementia or Mild Cognitive Impairment; n = 342, 51%) and their clinical features, care needs and healthcare utilisation compared. The relationship between cognition and healthcare consultations was investigated through logistic regression. RESULTS Cognitive impairment was associated with more motor and non-motor symptoms, less antiparkinsonian but higher rates of dementia and antipsychotic medication, worse subjective health status and greater caregiver burden. A considerable proportion did not have a pre-established cognitive diagnosis. Care needs were high across the whole sample but higher in the cognitive impairment group. Home care and care home use was higher in the cognitive impairment group. However, use of healthcare consultations was similar between the groups and significantly fewer participants with cognitive impairment had had recent PD Nurse consultations. Worse cognitive impairment was associated with lower frequency of recent PD nurse and multidisciplinary therapy consultation (physiotherapy, massage, occupational therapy, speech training and general nursing). CONCLUSIONS Those with cognitive impairment have more severe PD, higher care needs and greater social care utilisation than those with normal cognition, yet use of health care services is similar or less. Cognitive impairment appears to be a barrier to PD nurse and multidisciplinary therapy consultations. This challenges current models of care: alternative models of care may be required to serve this population. PLAIN LANGUAGE SUMMARY Parkinson's disease is a long-term progressive health condition. Over time, many people with Parkinson's develop problems with thinking and memory, called cognitive impairment. This can negatively impact the daily lives of the person with Parkinson's and their caregiver. It is also thought to be a barrier to accessing healthcare. How people with Parkinson's who have cognitive impairment use healthcare and detail of their care needs is not well known.We analysed data from a large sample of people with advanced Parkinson's from six European countries to investigate their symptoms, care needs and healthcare use. We compared those with cognitive impairment to (342 people) to those without cognitive impairment (333 people).We found that those with cognitive impairment had more severe Parkinson's across a range of symptoms compared to those without cognitive impairment. They also had more care needs, reported their health status to be worse, and their caregivers experienced greater strain from caring. Whilst use of other healthcare services was similar between the two groups, those with cognitive impairment were less likely to have recently seen a Parkinson's nurse than those without cognitive impairment. Further analysis showed an association between cognitive impairment and not having seen a Parkinson's nurse or therapist recently, taking psychiatric symptoms, functional disability and care home residence into account. Therapists included were physiotherapy, massage, occupational therapy, speech training and general nursing. These findings highlight unmet need. We suggest that healthcare should be more targeted to help this group of people, given their higher care needs.
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Affiliation(s)
- Jennifer S Pigott
- Queen Square Institute of Neurology, University College London, London, UK
| | - Bastiaan R Bloem
- Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Stefan Lorenzl
- Institute for Palliative Care, Paracelsus Medical University, Salzburg, Austria
- Department of Neurology and Palliative Care, University Hospital Agatharied, Hausham, Germany
- Institute of Nursing Science and Practice, Salzburg, Austria
| | - Wassilios G Meissner
- CHU Bordeaux, Service de Neurologie des Maladies Neurodégénératives, IMNc, NS-Park/FCRIN Network, Bordeaux, France
- Univ. Bordeaux, CNRS, IMN, UMR5293, Bordeaux, France
- Deptartment of Medicine, University of Otago, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Per Odin
- Division of Neurology, Department of Clinical Sciences Lund, Skåne University Hospital, Lund University, Lund, Sweden
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Richard Dodel
- Department of Geriatric Medicine, University Duisburg Essen, Essen, Germany
| | - Anette Schrag
- Queen Square Institute of Neurology, University College London, London, UK
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Basile I, Consolo L, Rusconi D, Arba L, Rampichini F, Caraceni A, Lusignani M. The Perspective of Cancer Patients in Palliative Care on Unmet Needs: A Qualitative Synthesis Using Meta-Ethnography. Am J Hosp Palliat Care 2024:10499091231226429. [PMID: 38180378 DOI: 10.1177/10499091231226429] [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] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND As cancer patients approach the end of life, their needs become more complex, increasing the demand for palliative care. Advanced-stage cancer patients encounter increasing unmet psychological, physical, autonomy, and communication needs, reflecting the difference between patients' perceived requirements and the support from health care professionals. The objective of this study was to synthesize qualitative evidence on unmet needs in palliative cancer care among inpatient and outpatient adults. METHODS We conducted a meta-ethnographic review according to Noblit and Hare's framework and the operationalized guidelines developed by Sattar. The eMERGe Reporting Guidance was followed. A literature search was conducted in Cinahl, Embase, Medline, Scopus, Web of Science, PsycINFO and Google Scholar for gray literature. For all the studies, direct quotes from the participants and authors' results were identified, coded and analyzed in NVivo 1.7.1 and extracted as I and II order constructs from which higher third-order themes originated. RESULTS Eight studies were included. Four new themes emerged, representing areas where palliative cancer care patients expressed a need for help: the need for comprehensive, patient-centered care, the need for maintaining a sense of autonomy and dignity, the need for attentive support to patients' soul and the need for accessible and timely care. CONCLUSIONS Palliative care patients require a secure, suffering-free end-of-life journey with informed decision-making and team support. Ensuring continuity of care, validating their suffering, and allocating sufficient time are crucial aspects of care. This involves maintaining a consistent care plan, respecting patients' emotions and experiences, and providing services tailored to individual needs.
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Affiliation(s)
- Ilaria Basile
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, Foundation IRCCS, National Cancer Institute, Milan, Italy
| | - Letteria Consolo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- Bachelor School of Nursing, Foundation IRCCS, National Cancer Institute, Milan, Italy
| | - Daniele Rusconi
- Urology Unit, Foundation, IRCCS, National Cancer Institute, Milan, Italy
| | - Laura Arba
- Head and Neck Cancer and Rare Tumor Medical Oncology Unit, Foundation, IRCCS, National Cancer Institute, Milan, Italy
| | - Flavia Rampichini
- Library of the Central School of Medicine, University of Milan, Milan, Italy
| | - Augusto Caraceni
- High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, Foundation IRCCS, National Cancer Institute, Milan, Italy
- University of Milan, Milan, Italy
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Narsakka N, Suhonen R, Groot B, Stolt M. Promoting activity and mobility in long-term care environments: A photo-elicitation study with older adults and nurses. J Clin Nurs 2023; 32:8078-8094. [PMID: 37698144 DOI: 10.1111/jocn.16866] [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: 05/04/2023] [Revised: 08/03/2023] [Accepted: 08/21/2023] [Indexed: 09/13/2023]
Abstract
AIM(S) The aim of this research study is to collaboratively generate insights in the current institutional long-term care environment for activity and mobility of older adults, and of solutions that could be used to increase the activity and improve the mobility of the older adults. DESIGN This research constitutes a qualitative study with a critical approach. METHODS Data were collected using photo-elicitation in four long-term care units in Finland during the spring of 2022. Older adults participated in individual data collection sessions which combined photographing and discussion. Staff members individually took photographs and later participated in a group discussion based on the photographs. Reflexive thematic analysis was used to analyse all data together. RESULTS Ten older adults and 12 staff members participated in the research study. Four themes were identified: (1) facilities should be designed and equipped for their users, (2) moving in the institutional environment, (3) passivity as a norm, and (4) nurses should act differently and have the resources to do so. CONCLUSION To increase the activity and improve the mobility of older adults, improvements are needed in terms of the design of facilities, opportunities for freedom of movement, outdoor activity, daily life activities, exercise, nurses' role in activating older adults and resources. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Increased attention to the support of activity and mobility could benefit older adults in institutional long-term care. Physical activity promotion should be incorporated as an integral part of nursing practice. PATIENT OR PUBLIC CONTRIBUTION Directors of units were consulted when planning the study. Older adults and nurses contributed to the data collection and interpretation of data. IMPACT (ADDRESSING): What problem did the study address? ○Older adults have recurrently been reported as living inactive lives in institutional long-term care. ○There is evidence of the relationship between the environment and the activity and mobility of older adults, but there seems to be a research-practice gap in terms of implementing activity- and mobility-promoting environments. ○Older adults and staff members are important in developing practice and change-oriented knowledge that can be used to increase the activity and improve the mobility of older adults in institutional long-term care. What were the main findings? ○Various environmental improvements are recommended to increase the activity and improve the mobility of older adults in institutional long-term care settings. ○Improvements for the design of facilities, opportunities for freedom of movement, outdoor activity, daily life activities, exercise, nurses' role in activating older adults and resources for activity support would benefit older adults' activity and mobility. Where and on whom will the research have an impact? ○Increasing the activity of older adults requires better activity promotion and mobility support by nurses in institutional care. Sufficient education and resources should be organized for activity promotion, in addition to a care and organizational culture that values activity. ○Environmental aspects to promote activity and mobility need to be considered already at the planning, building and renovating phases of facilities. ○Policymakers and care organizers should consider evidence of the harms and benefits of different institutional living environments when making decisions on organizing care. REPORTING METHOD The study is reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ).
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Affiliation(s)
- Noora Narsakka
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
- Wellbeing Services County of Southwest Finland, Turku University Hospital, Turku, Finland
| | - Barbara Groot
- Department of Health Sciences, Vrije Universiteit and Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Engelmann P, Eilerskov N, Thilsing T, Bernardini F, Rasmussen S, Löwe B, Herrmann-Lingen C, Gostoli S, Andréasson F, Rafanelli C, Pedersen SS, Jaarsma T, Kohlmann S. Needs of multimorbid heart failure patients and their carers: a qualitative interview study and the creation of personas as a basis for a blended collaborative care intervention. Front Cardiovasc Med 2023; 10:1186390. [PMID: 38028443 PMCID: PMC10667702 DOI: 10.3389/fcvm.2023.1186390] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Involving patients and carers in the development of blended collaborative care (BCC) interventions for multimorbid heart failure (HF) patients is recommended but rarely practised, and research on the patient perspective is scarce. The aim of this study is to investigate patients' and carers' care-related needs and preferences to better customize a novel international BCC intervention. Methods A qualitative study design using framework analysis was employed. The study was performed in accordance with the EQUATOR standards for reporting qualitative research (SRQR). Patients aged at least 65 years with HF and at least two other physical diseases as well as their carers completed semistructured interviews in Germany, Italy, and Denmark. Based on these interviews, personas (prototype profiles of patients and carers) were created. Results Data from interviews with 25 patients and 17 carers were analysed. Initially, seven country-specific personas were identified, which were iteratively narrowed down to a final set of 3 personas: (a) the one who needs and wants support, (b) the one who has accepted their situation with HF and reaches out when necessary, and (c) the one who feels neglected by the health care system. Carers identifying with the last persona showed high levels of psychological stress and a high need for support. Discussion This is the first international qualitative study on patients' and carers' needs regarding a BCC intervention using the creation of personas. Across three European countries, data from interviews were used to develop three contrasting personas. Instead of providing "one size fits all" interventions, the results indicate that BCC interventions should offer different approaches based on the needs of individual patients and carers. The personas will serve as a basis for the development of a novel BCC intervention as part of the EU project ESCAPE (Evaluation of a patient-centred biopSychosocial blended collaborative CAre Pathway for the treatment of multimorbid Elderly patients).
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Affiliation(s)
- Petra Engelmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Natasja Eilerskov
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Trine Thilsing
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Francesco Bernardini
- Department of Psychology “Renzo Canestrari”, University of Bologna, Bologna, Italy
| | - Sanne Rasmussen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Sara Gostoli
- Department of Psychology “Renzo Canestrari”, University of Bologna, Bologna, Italy
| | - Frida Andréasson
- Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
| | - Chiara Rafanelli
- Department of Psychology “Renzo Canestrari”, University of Bologna, Bologna, Italy
| | - Susanne S. Pedersen
- Department of Psychology, University of Southern Denmark, Odense M, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Walker J. Patient and caregiver experiences of living with dementia in Tanzania. Dementia (London) 2023; 22:1900-1920. [PMID: 37879079 PMCID: PMC10644685 DOI: 10.1177/14713012231204784] [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] [Indexed: 10/27/2023]
Abstract
Introduction: Tanzania is a low-income country with an increasing prevalence of dementia, which provides challenges for the existing healthcare system. People with dementia often don't receive a formal diagnosis, and with a lack of formal healthcare, are often predominantly supported by family relatives. There are very few published data relating to lived experiences of people with dementia in Tanzania. This study aimed to understand people with dementia, and their caregivers' experiences of living with dementia in Tanzania and the perceived needs of people with dementia.Methods: Qualitative, semi-structured interviews were conducted with 14 people with dementia and 12 caregivers in Moshi, Tanzania. Interviews were audio-recorded, translated, transcribed and analysed using a Framework Analysis approach.Results: Three sub-themes were identified within data describing the experience of 'Living with Dementia in Tanzania': 'Deteriorations in Health', 'Challenges to living with Dementia in Tanzanian Culture', and 'Lack of Support': people with dementia faced challenges due to social isolation, stigmatisation, and lack of caregiver knowledge on how best to provide support. Collectively, these impacted on both the physical and mental health of people with dementia. Misconceptions about dementia aetiology related to age, stresses of daily life and other co-morbidities. People with dementia were motivated to access treatment, exhibiting pluralistic health-seeking behaviours. There was an overall preference for non-pharmacological interventions over medication, with high levels of trust in medical professional opinions.Conclusions: Living with dementia in Tanzania is influenced by both cultural and religious factors. More work is needed to target supplementary healthcare (with efforts to promote accessibility), support for caregivers and public health education about dementia to overcome existent misconceptions and stigma.
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Affiliation(s)
- Jessica Walker
- Population Health Sciences Institute, Newcastle University, UK
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10
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Lim D, Grady A, Liu KPY. Public Mixed Funding for Residential Aged Care Facilities Residents' Needs in the Asia-Pacific Region: A Scoping Review. Int J Environ Res Public Health 2023; 20:7007. [PMID: 37947564 PMCID: PMC10648075 DOI: 10.3390/ijerph20217007] [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: 09/28/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
Due to population aging and sociodemographic change, there is an increasing reliance on residential aged care facilities in the Asia-Pacific region. Most countries have adopted taxation as the primary means to levy capital for funding universal health services and means-testing of benefits may be further incorporated as a policy balance between horizontal equity and fiscal sustainability. It was hypothesized that residential care needs are evaluated by assessments relating to funding; this scoping review seeks to synthesize how such assessments relate to the care needs of residents. Searches were conducted in concordance with a priori protocol for English-language literature published since 2008 in Embase, CINAHL, PubMed, Scopus, JBI, TROVE, and four peak international organizations for studies and reports that describe the assessment of residents' needs in Asia-Pacific countries that used a mixture of taxation and means-testing to publicly fund residential aged care. One paper and 47 reports were included. Australia, New Zealand, and Singapore utilize a taxation and means-tested user charge approach to fund residential aged care needs. The common care needs assessed include health conditions, daily activities, cognition, psychiatric, and behavioral needs. While essential care needs are publicly funded, other holistic care needs, such as spirituality and autonomy-based needs, still need to be covered for meaningful occupation by the residents.
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Affiliation(s)
- David Lim
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Ashley Grady
- School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Karen P. Y. Liu
- School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong;
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11
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Cabote C, Salamonson Y, Trajkovski S, Maneze D, Montayre J. The needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care: An integrative review. J Clin Nurs 2023; 32:5430-5444. [PMID: 36681869 DOI: 10.1111/jocn.16617] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/06/2022] [Accepted: 01/04/2023] [Indexed: 01/23/2023]
Abstract
AIMS AND OBJECTIVES To synthesise information about the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care from the perspectives of the residents, families and care staff. BACKGROUND Older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care have care needs that are complex. Identifying these needs is critical to ensure quality care is delivered. DESIGN An integrative review of literature. METHODS Five databases were searched for relevant articles: APA PsychINFO, CINAHL, MEDLINE, Scopus and Google Scholar. The search and screening were guided by PRISMA guidelines and Whittemore and Knafl's five-step framework. RESULTS Fifteen papers were included in this review consisting of 4 quantitative, 9 qualitative and 2 mixed method studies. Two themes described the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care. The first was related to culture-specific needs, and the second was related to dementia-specific care needs. Culture-specific needs comprised of three subthemes: (a) common language, (b) traditional food, and (c) social and spiritual requirements. Dementia-specific needs comprised of (a) focusing on comfort in addition to clinical requirements and (b) individualised care that addresses behavioural symptoms of dementia. CONCLUSIONS Identifying and meeting the needs of older people with dementia from culturally and linguistically diverse backgrounds will improve quality care delivery in addition to increased caregiving satisfaction among residents, families and care staff, and the management of behaviours that characterise dementia. RELEVANCE TO CLINICAL PRACTICE Care needs of older people with dementia from culturally and linguistically diverse backgrounds living in the residential setting can be complex. Education and training of care staff including nurses must be considered so that provision of care is inclusive of the cultural and dementia needs for older people in residential aged care.
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Affiliation(s)
- Christy Cabote
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Yenna Salamonson
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Suza Trajkovski
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Della Maneze
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
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12
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Van Acker I, Dewaele A, Elaut E, Baetens K. Exploring Care Needs of Partners of Transgender and Gender Diverse Individuals in Co-Transition: A Qualitative Interview Study. Healthcare (Basel) 2023; 11:healthcare11111535. [PMID: 37297675 DOI: 10.3390/healthcare11111535] [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: 04/01/2023] [Revised: 05/03/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Scientific knowledge on the impact of a gender-affirming transition on intimate partners of transgender and gender diverse (TGD) individuals is limited. It is unclear which care needs partners have and which role health care professionals can play during this transition process. The aim of this study was to explore the unique experiences and care needs of people partnering with TGD people in the context of a gender-affirming transition. A qualitative research method was chosen, and a semi-structured interview was conducted with a sample of nine participants. After transcription, thematic analysis was used to analyse the data. Three main themes, with three subthemes each, were identified: (1) intrapersonal processes, with (1a) the process of acceptance, (1b) concerns surrounding the medical transition and (1c) impact on sexual orientation as subthemes; (2) dyadic processes, with (2a) the importance of mutual commitment, (2b) experiences regarding intimacy and (2c) relational growth as subthemes; and (3) perception of support, with (3a) need for support, (3b) the importance of support and (3c) evaluation of support as subthemes. The results suggest that health care providers can help partners to navigate the process of a gender-affirming transition; however, the care needs of partners are currently not satisfied with the available professional support.
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Affiliation(s)
- Isabeau Van Acker
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Alexis Dewaele
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Els Elaut
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
- Centre of Sexology and Gender, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Kariann Baetens
- Centre of Sexology and Gender, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
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13
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Yin Z, Ying Y, Li X, Jiang Y, He B, Zheng E, Huang L, Li H, Zhang C, Fu L. Post-discharge care needs of the older people with hospital-associated disability: A longitudinal study. J Clin Nurs 2023; 32:1303-1315. [PMID: 35332590 DOI: 10.1111/jocn.16293] [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: 09/20/2021] [Revised: 01/31/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
AIMS To investigate the change and associated factors of care needs within 6 months post-discharge in older people with hospital-associated disability, and the relationship between time-varying care needs and physical function. BACKGROUND Older people with hospital-associated disability will have various care needs post-discharge. Understanding their care needs will help to improve their health. However, studies on this population are still limited. DESIGN A longitudinal study. METHODS The older people who met the inclusion and exclusion criteria were selected in 2 tertiary hospitals in Zhejiang Province, China. The questionnaire survey method was used to collect data about socio-demographic characteristics, physical function and care needs. The data of 375 older people who completed follow-up were analysed using logistic regression analysis, generalised estimating equations and generalised additive mixed model. We followed STROBE checklist for reporting the study. RESULTS The care needs of the older people with hospital-associated disability declined unevenly, it decreased rapidly in the first three months, and then flattening out. The percentage of people with care needs in each dimension decreased over time, but daily care and rehabilitation needs were consistently more important. Socio-demographic factors and physical function had different effects on need at different time points, the physical function was the main factor among them. There were non-linear relationships between the physical function and different care needs with different inflection points. CONCLUSION This research revealed change patterns of the care needs of older people with hospital-associated disability post-discharge and the non-linear relationship between physical function and care needs. These findings may help healthcare professionals and caregivers to provide accurate care. RELEVANCE TO CLINICAL PRACTICE The findings can be used to identify effective approaches to address the care needs of older people with hospital-associated disability based on the time of discharge, in conjunction with age, education, and especially physical function, which will promote the justify allocation of nursing resources. What does this paper contribute to the wider global clinical community?
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Affiliation(s)
- Zhiqin Yin
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yisha Ying
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Xiuyue Li
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yuqi Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Buxin He
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Enjie Zheng
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Lili Huang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hui Li
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Chunmei Zhang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Liyan Fu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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14
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Marchini S, Reis J, Ben-Shaool E, Delhaye M, Kornreich C, Nicolis H, Slama H, Leys C, Delvenne V. Dimensional model on how familial vulnerability and environmental factors impact transitional age youth psychopathology: The Transition_psy study. Front Psychiatry 2023; 14:1103030. [PMID: 37032919 PMCID: PMC10076738 DOI: 10.3389/fpsyt.2023.1103030] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/20/2023] [Indexed: 04/11/2023] Open
Abstract
Background Understanding psychopathology in transitional age youth (TAY) requires a complex model, incorporating familial vulnerability and environmental factors. A trans-diagnostic and dimensional approach seems the most appropriate. Transition_psy study aims to assess factors playing a role in TAY psychopathology and to define predictors. Materials and methods This article presents part of the Transition_psy study results, a case-control observational study. Youth aged 17 years old were recruited between June 2020 and December 2021, from both clinical [clinical population (CP) group] and non-clinical settings [non-clinical population (NCP) group]. Participants completed self-report questionnaires. The primary outcome to assess TAY psychopathology was the Youth-Self Report (YSR). We evaluated care needs with the Health of The Nation Outcome Scales For Children And Adolescents (HoNOSCA-SR) and quality of life with the World Health Organization Quality of Life - BREF (WHOQoL-BREF). Exposure factors included familial vulnerability, childhood, and present environmental factors, such as first-degree family history of psychopathology, the Childhood Trauma Questionnaire (CTQ) and the Family Assessment Device (FAD). YSR scores were compared, between groups, according to exposure factors with ANOVA and linear regression. We performed best subsets selection of multivariable analyses based on the Akaike Information Criterion. This study was registered with ClinicalTrials.gov (Identifier: NCT04333797). Results A total of 220 TAY (CP = 106, NCP = 114) were included in the study. Participants were aged 17 years old. The majority were female (69.1%), single (96.8%), and born in Belgium (82.3%). Clinical data were all significantly different between CP and NCP groups. YSR scores were found statistically different according to group (p < 0.001), first-degree family history of psychopathology (p < 0.001), CTQ (p < 0.001), and FAD (p < 0.001). Predictive dimensional model suggested that TAY psychopathology can be predicted by group, CTQ and FAD. Significant positive correlation was found between YSR and HoNOSCA (rho = 0.81) and negative correlation between YSR and physical and psychological health (rho = -0.69 and -0.71, respectively). Conclusion This study findings allowed to present a predictive dimensional model on TAY psychopathology, including belonging to a clinical population at transitional age, childhood trauma, and family dysfunction. Further research is needed to replicate Transition_psy study results in other samples. The proposed model could be used in clinical practice to improve assessment of TAY psychopathology.
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Affiliation(s)
- Simone Marchini
- Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Department of Psychiatry for Infant, Child, Adolescent and Youth, University Hospital Brussels (HUB), Brussels, Belgium
| | - Joana Reis
- Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Department of Psychiatry for Infant, Child, Adolescent and Youth, University Hospital Brussels (HUB), Brussels, Belgium
| | - Ella Ben-Shaool
- Department of Psychiatry for Infant, Child, Adolescent and Youth, University Hospital Brussels (HUB), Brussels, Belgium
- Department of Neuropsychology and Speech Therapy, University Hospital Brussels (HUB), Brussels, Belgium
| | - Marie Delhaye
- Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Department of Psychiatry for Infant, Child, Adolescent and Youth, University Hospital Brussels (HUB), Brussels, Belgium
| | - Charles Kornreich
- Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Department of Psychiatry, Brugmann University Hospital, Brussels, Belgium
| | - Hélène Nicolis
- Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Mental Health Service, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Hichem Slama
- Department of Neuropsychology and Speech Therapy, University Hospital Brussels (HUB), Brussels, Belgium
- Faculty of Psychological Sciences and Education, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Christophe Leys
- Faculty of Psychological Sciences and Education, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Véronique Delvenne
- Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Department of Psychiatry for Infant, Child, Adolescent and Youth, University Hospital Brussels (HUB), Brussels, Belgium
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15
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Doheny M, Schön P, Orsini N, Fastbom J, Burström B, Agerholm J. Socio-demographic differences in polypharmacy and potentially inappropriate drug use among older people with different care needs and in care settings in Stockholm, Sweden. Scand J Public Health 2023; 51:11-20. [PMID: 34190622 PMCID: PMC9903244 DOI: 10.1177/14034948211018384] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIMS Polypharmacy and potentially inappropriate medications (PIM) are risk factors for negative health outcomes among older people. This study aimed to investigate socio-demographic differences in polypharmacy and PIM use among older people with different care needs in a standard versus an integrated care setting. METHODS Population-based register data on residents aged ⩾65 years in Stockholm County based on socio-demographic background and social care use in 2014 was linked to prescription drug use in 2015. A logistic regression analysis was used to estimate socio-demographic differences in polypharmacy and PIM, adjusting for education, age group, sex, country of birth, living alone, morbidity and dementia by care setting based on area and by care need (i.e. independent, home help or institutionalised). RESULTS The prevalence of polypharmacy and PIM was greater among home-help users (60.4% and 11.5% respectively) and institutional residents (74.4% and 11.9%, respectively). However, there were greater socio-demographic differences among the independent, with those with lower education, older age and females having higher odds of polypharmacy and PIM. Morbidity was a driver of polypharmacy (odds ratio (OR)=1.19, confidence interval (CI) 1.16-1.22) among home-help users. Dementia diagnosis was associated with reduced odds of polypharmacy and PIM among those in institutions (OR=0.78, CI 0.71-0.87 and OR 0.52, CI 0.45-0.59, respectively) and of PIM among home-help users (OR=0.53, 95% CI 0.42-0.67). CONCLUSIONS Polypharmacy and PIM were associated with care needs, most prevalent among home-help users and institutional residents, but socio-demographic differences were most prominent among those living independently, suggesting that municipal care might reduce differences between socio-demographic groups. Care setting had little effect on inappropriate drug use, indicating that national guidelines are followed.
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Affiliation(s)
- Megan Doheny
- Department of Global Public Health, Karolinska Institutet, Sweden,Megan Doheny, Department of Global Public Health, Karolinska Institutet, Widerströmska plan 3, Stockholm, 171 71, Sweden. E-mail:
| | - Pär Schön
- Aging Research Center, Karolinska Institutet – Stockholm University, Sweden
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Johan Fastbom
- Aging Research Center, Karolinska Institutet – Stockholm University, Sweden
| | - Bo Burström
- Department of Global Public Health, Karolinska Institutet, Sweden,Center for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Janne Agerholm
- Aging Research Center, Karolinska Institutet – Stockholm University, Sweden
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16
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Tang Q, Yuan M, Wu W, Wu H, Wang C, Chen G, Li C, Lu J. Health Status and Individual Care Needs of Disabled Elderly at Home in Different Types of Care. Int J Environ Res Public Health 2022; 19:ijerph191811371. [PMID: 36141656 PMCID: PMC9517395 DOI: 10.3390/ijerph191811371] [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: 08/15/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 05/13/2023]
Abstract
For the disabled, paying attention to their health status is the starting point to discovering their survival problems, while meeting their care needs is the end point to solving their survival problems. As the country with the largest number of disabled elderly in the world, how to ensure this group could obtain appropriate home care is a major public health issue facing China. Thus, we conducted a cross-sectional study from October to December 2020 to explore the basic characteristics and health status of disabled elderly in different types of care who are living at home in 37 streets in Shanghai, as well as the individual care needs and its relevance. We observed the significant differences in the number of diagnoses (p = 0.03), smoking (p = 0.009), drinking (p = 0.016), exercise (p = 0.001), activity of daily living (p < 0.0001), and the quality of life (p < 0.0001) across care types. The care needs of the disabled elderly are diversified, of which a vast majority of them have not been fully guaranteed. The urgent need for improving the identification accuracy of care needs of disabled elderly, as well as the development of elaborate and personalized care programs for them, is needed.
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Affiliation(s)
- Qi Tang
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
| | - Min Yuan
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
| | - Wenhui Wu
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
| | - Huanyun Wu
- Shanghai Jinshan District Health Service Management Center, Shanghai Jinshan District Municipal Health Commission, Shanghai 200540, China
| | - Cao Wang
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
| | - Gang Chen
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
| | - Chengyue Li
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
- Correspondence: (C.L.); (J.L.)
| | - Jun Lu
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
- Correspondence: (C.L.); (J.L.)
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17
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Park M, Kwon SY, Yun H, Lyu CJ, Han JW, Hahn SM, Jung M, Rha SY, Beom SH, Lee CK, Jang H. Care Needs of Adolescents and Young Adults with Cancer Undergoing Active Treatment in South Korea: A Mixed Methods Study. J Adolesc Young Adult Oncol 2022. [PMID: 35904961 DOI: 10.1089/jayao.2022.0030] [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] [Indexed: 11/12/2022] Open
Abstract
Purpose: Adolescents and young adults (AYAs) with cancer have special care needs that are different from those of children and older adults with cancer. This study assessed the perspective and experience of AYAs with cancer in South Korea to identify their care needs. Methods: This study used a convergent mixed-methods design. From July 2020 to November 2021, AYAs with cancer (N = 77; 15-39 years of age) participated in a quantitative cross-sectional study, using a tool developed by our study team. In May 2021, a qualitative focus group was conducted with 10 AYAs with cancer. Integrated analyses were conducted concurrently by reporting the quantitative and qualitative findings together. Results: Quantitative findings revealed that the highest care need domains were communication and information, whereas the highest care priority item was the management of pain and symptoms occurring during the treatment. Qualitative findings revealed 12 themes across 5 domains. Comparing and merging of the quantitative and qualitative data resulted in eight confirmed themes and four expanded findings, including knowing people who overcame similar illnesses, fear of death, dedicated space, and a program for AYAs with cancer. Conclusion: When developing and implementing programs and health care services, especially in countries with no established program or cancer specialty unit for AYAs with cancer, it is important to consider the special care needs and priorities of AYAs with cancer. This mixed methods study provided empirical evidence to help understand and prioritize the needs of AYAs with cancer undergoing active treatment in South Korea.
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Affiliation(s)
- Mina Park
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Seung Yeon Kwon
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Palliative Care Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - Hyeseon Yun
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Chuhl Joo Lyu
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Woo Han
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Min Hahn
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyu Jung
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea.,Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Sun Young Rha
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.,Department of Internal Medicine, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung-Hoon Beom
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Choong-Kun Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeju Jang
- Provider Partners Health Plan, Linthicum Heights, Maryland, USA
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18
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Yoon H, Kim J. Future expectations of receiving care and all-cause mortality among older adults in Korea. Health Soc Care Community 2022; 30:e933-e943. [PMID: 34245191 DOI: 10.1111/hsc.13495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 09/28/2020] [Revised: 05/26/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
While demand for care-giving is increasing rapidly among older adults in Korea, there are large unmet care needs. In the face of an elder care crisis, older adults feel uncertain about how and by whom they will be cared for. This study examines the relationship between expectations of receiving care in the future and all-cause mortality among Korean older adults. We explore whether mortality risk differs by sources of care (non-family vs. family caregivers), and further disaggregate different sources of care by family member type (spouse, sons and daughters). Using data from the Korean Longitudinal Study of Ageing (N = 3,111 participants aged 65 or older), we estimate Cox proportional hazards regression models predicting all-cause mortality. Expecting to receive care from either non-family or family members is significantly associated with lower mortality risk. Expecting care from a spouse and/or daughter was associated with lower mortality risk, but expecting care from sons was not. After adjusting for covariates, expecting future care from a spouse and/or daughter predicted lower mortality risk (HR = 0.83; 95% CI = 0.71-0.97 [spouse], HR = 0.79; 95% CI = 0.67-0.94 [daughter]), and the coefficient for expectations of formal care from non-family members became statistically insignificant. After controlling for family structure, only the association between expecting care from daughters and mortality remained statistically significant (HR = 0.78; 95% CI = 0.66-0.94). These effects are more pronounced among women than men. Initiatives to support and maintain high-quality family relationships across the life course and remove barriers that obstruct family members from providing care to their elders would improve older adults' longevity.
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Affiliation(s)
- Heesoo Yoon
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
| | - Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
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Kostyál LÁ, Széman Z, Almási VE, Fabbietti P, Quattrini S, Socci M, Gagliardi C. The Impact of COVID-19 on the Health and Experience of the Carers of Older Family Members Living with Dementia: An Italian-Hungarian Comparative Study. Int J Environ Res Public Health 2022; 19:5329. [PMID: 35564723 DOI: 10.3390/ijerph19095329] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 02/04/2023]
Abstract
This quantitative study (n = 370) compares the pandemic-related experiences of the family carers of older people living with dementia during the first wave of the pandemic, in two countries with different care regimes: Italy (Mediterranean) and Hungary (Eastern European). It aims at answering the following research questions: (1) How did the pandemic affect the subjective health of carers, and what were their experiences with care-related worries and workload? (2) What factors significantly predicted negative changes in these experiences? (3) What were carers' main difficulties during the first pandemic wave? Results have shown that carers in both samples reported a worsening in mental health (Italy/Hungary: M = 2.25/2.55, SD = 0.93/0.99), and Italian carers also in general health (M = 2.54, SD = 0.98) (on a scale of 1 to 5, with values under "3" representing deterioration). Carers in both samples experienced high worry levels (Italy/Hungary: M = 4.2/3.7, SD = 0.93/0.89) and feeling overwhelmed with care tasks (M = 3.2/3.7, SD = 1.3/1.3) (on a scale of 1 to 5, higher values representing higher worry/work overload). In regression models, all of the above negative experiences were predicted by a combination of factors. Two of these factors stood out in importance due to being a predictor of more than one type of negative experience: a decline in the carer-care receiver relationship, predicting work overload, as well as general and mental health deterioration and being the child of the care receiver, predicting both high worry and subjective work overload. The top five encountered problems were the unavailability of medical and social care, difficulties with shopping (medicine included), restricted freedom, isolation, and anxiety.
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20
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Tickner C, Holland L, Wark P, Hilton J, Morrison C, Kay-Lambkin F, Heinsch M. Mental health care needs in cystic fibrosis: A scoping review. Soc Work Health Care 2022; 61:1-15. [PMID: 35422201 DOI: 10.1080/00981389.2022.2060422] [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] [Received: 05/17/2021] [Revised: 02/14/2022] [Accepted: 03/22/2022] [Indexed: 06/14/2023]
Abstract
People with cystic fibrosis experience rates of anxiety and depression that are considerably higher than those of the general population. Research suggests low mental health functioning can lead to poor health outcomes and quality of life for this population. Consequently, recognition of the need for routine mental health screening and referral in cystic fibrosis care is increasing. Yet to date, less is known about the actual mental health care needs of people with cystic fibrosis. This scoping review sought to address this gap by examining the mental health care needs of adults and adolescents living with cystic fibrosis, and how are these needs are (or are not) being met. Findings suggest current efforts at mental health care provision do not adequately meet the needs of people with cystic fibrosis, highlighting the urgency of conducting high quality intervention research to support effective mental health care for this population.
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Affiliation(s)
- Campbell Tickner
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Lucy Holland
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Peter Wark
- Priority Research Centre for Healthy Lungs, University of Newcastle, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Jodi Hilton
- Paediatric Respiratory and Sleep Medicine Department, John Hunter Children's Hospital, New Lambton Heights, NSW, Australia
| | - Cathy Morrison
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Milena Heinsch
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, Australia
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21
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Ryszewska-Łabędzka D, Tobis S, Kropińska S, Wieczorowska-Tobis K, Talarska D. The Association of Self-Esteem with the Level of Independent Functioning and the Primary Demographic Factors in Persons over 60 Years of Age. Int J Environ Res Public Health 2022; 19:1996. [PMID: 35206185 DOI: 10.3390/ijerph19041996] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 01/25/2023]
Abstract
Self-esteem reflects the way we see ourselves. The aim of this study was to determine the relationship among self-esteem, bio-psycho-social functioning, and sociodemographic conditions in the elderly. The study included 300 individuals over 60 years of age living in their home environment. The employed research tools included the Abbreviated Mental Test Score, Rosenberg Self-Esteem Scale (RSES), and EASYCare Standard 2010 questionnaire involving the following scales: independence score, risk of breakdown in care, and risk of falls. Results: The average score achieved by the study group according to the RSES scale was 29.9 ± 5.6 points. In addition, the study group presented a low risk of independence loss (independence score 13.3 ± 18.1), risk of breakdown in care (4.4 ± 2.4), and risk of falls (1.8 ± 1.6). The conducted multivariate analysis demonstrated that a significant (p < 0.05) negative predictor of low self-esteem was education below the secondary level, a poor financial condition, and functional limitations in domain I (seeing, hearing, and communicating skills) of the EASYCare Standard 2010 questionnaire. A relationship was found between self-esteem and the level of bio-psycho-social functioning, as well as between education and the financial situation. The results demonstrate that even successfully ageing individuals require a regular assessment of their functional status and individually adapted support in order to maintain independence and to increase their self-esteem.
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22
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Venturas M, Prats J, Querol E, Zabalegui A, Fabrellas N, Rivera P, Casafont C, Cuzco C, Frías CE, Olivé MC, Pérez-Ortega S. Lived Experiences of Hospitalized COVID-19 Patients: A Qualitative Study. Int J Environ Res Public Health 2021; 18:ijerph182010958. [PMID: 34682704 PMCID: PMC8535666 DOI: 10.3390/ijerph182010958] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/21/2021] [Accepted: 10/12/2021] [Indexed: 01/05/2023]
Abstract
The COVID-19 pandemic has resulted in many hospitalized patients and deaths worldwide. Coronavirus patients were isolated from their relatives and visits were banned to prevent contagion. This has brought about a significant change in deeply rooted care habits in Mediterranean and Latin American countries where the family normally accompanies vulnerable hospitalized patients. The aim of this qualitative study was to examine the hospitalization experience of COVID-19 patients and their family members. A phenomenological qualitative approach was used. Data collection included inductive, in-depth interviews with 11 COVID-19 hospitalized patients. The mean age of patients was 55.4 years and 45% were female. Nearly 50% required Intensive Care Unit (ICU) admission. Ten meaningful statements were identified and grouped in three themes: Positive and negative aspects of the care provided, the patient’s perspective, and perception of the experience of the disease. In conclusion, COVID-19 patients, aware of the severity of the pandemic, were very adaptable to the situation and had full confidence in health professionals. Patient isolation was perceived as necessary. Technology has helped to maintain communication between patients and relatives.
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Affiliation(s)
- Montserrat Venturas
- Hospital Clinic Barcelona, 08036 Barcelona, Spain; (M.V.); (J.P.); (E.Q.); (A.Z.); (P.R.); (C.C.); (C.C.); (C.E.F.)
- School of Nursing, University of Barcelona, 08036 Barcelona, Spain; (N.F.); (M.C.O.)
| | - Judith Prats
- Hospital Clinic Barcelona, 08036 Barcelona, Spain; (M.V.); (J.P.); (E.Q.); (A.Z.); (P.R.); (C.C.); (C.C.); (C.E.F.)
| | - Elena Querol
- Hospital Clinic Barcelona, 08036 Barcelona, Spain; (M.V.); (J.P.); (E.Q.); (A.Z.); (P.R.); (C.C.); (C.C.); (C.E.F.)
| | - Adelaida Zabalegui
- Hospital Clinic Barcelona, 08036 Barcelona, Spain; (M.V.); (J.P.); (E.Q.); (A.Z.); (P.R.); (C.C.); (C.C.); (C.E.F.)
- School of Nursing, University of Barcelona, 08036 Barcelona, Spain; (N.F.); (M.C.O.)
| | - Núria Fabrellas
- School of Nursing, University of Barcelona, 08036 Barcelona, Spain; (N.F.); (M.C.O.)
| | - Paula Rivera
- Hospital Clinic Barcelona, 08036 Barcelona, Spain; (M.V.); (J.P.); (E.Q.); (A.Z.); (P.R.); (C.C.); (C.C.); (C.E.F.)
| | - Claudia Casafont
- Hospital Clinic Barcelona, 08036 Barcelona, Spain; (M.V.); (J.P.); (E.Q.); (A.Z.); (P.R.); (C.C.); (C.C.); (C.E.F.)
- School of Nursing, University of Barcelona, 08036 Barcelona, Spain; (N.F.); (M.C.O.)
| | - Cecilia Cuzco
- Hospital Clinic Barcelona, 08036 Barcelona, Spain; (M.V.); (J.P.); (E.Q.); (A.Z.); (P.R.); (C.C.); (C.C.); (C.E.F.)
- School of Nursing, University of Barcelona, 08036 Barcelona, Spain; (N.F.); (M.C.O.)
| | - Cindy E. Frías
- Hospital Clinic Barcelona, 08036 Barcelona, Spain; (M.V.); (J.P.); (E.Q.); (A.Z.); (P.R.); (C.C.); (C.C.); (C.E.F.)
- School of Nursing, University of Barcelona, 08036 Barcelona, Spain; (N.F.); (M.C.O.)
| | - Maria Carmen Olivé
- School of Nursing, University of Barcelona, 08036 Barcelona, Spain; (N.F.); (M.C.O.)
| | - Silvia Pérez-Ortega
- Hospital Clinic Barcelona, 08036 Barcelona, Spain; (M.V.); (J.P.); (E.Q.); (A.Z.); (P.R.); (C.C.); (C.C.); (C.E.F.)
- School of Nursing, University of Barcelona, 08036 Barcelona, Spain; (N.F.); (M.C.O.)
- Correspondence:
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23
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Fearn S, Bartolomeu Pires S, Agarwal V, Roberts HC, Spreadbury J, Kipps C. The Causes and Impact of Crisis for People with Parkinson's Disease: A Patient and Carer Perspective. J Parkinsons Dis 2021; 11:1935-1945. [PMID: 34250952 DOI: 10.3233/jpd-212641] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND The reasons for acute hospital admissions among people with Parkinson's disease are well documented. However, understanding of crises that are managed in the community is comparatively lacking. Most existing literature on the causes of crisis for people with Parkinson's disease (PwP) uses hospital data and excludes the individual's own perspective on the crisis trigger and the impact of the crisis on their care needs. OBJECTIVE To identify the causes and impact of crises in both community and hospital settings, from a patient and carer perspective. METHODS A total of 550 UK-based PwP and carers completed a survey on (a) their own personal experiences of crisis, and (b) their general awareness of potential crisis triggers for PwP. RESULTS In addition to well-recognised causes of crisis such as falls, events less widely associated with crisis were identified, including difficulties with activities of daily living and carer absence. The less-recognised crisis triggers tended to be managed more frequently in the community. Many of these community-based crises had a greater impact on care needs than the better-known causes of crisis that more frequently required hospital care. PwP and carer responses indicated a good general knowledge of potential crisis triggers. PwP were more aware of mental health issues and carers were more aware of cognitive impairment and issues with medications. CONCLUSION These findings could improve care of Parkinson's by increasing understanding of crisis events from the patient and carer perspective, identifying under-recognised crisis triggers, and informing strategies for best recording symptoms from PwP and carers.
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Affiliation(s)
- Sarah Fearn
- Human Development and Health, Faculty of Medicine, University of Southampton, UK.,NIHR Applied Research Collaboration Wessex, University of Southampton, UK
| | - Sandra Bartolomeu Pires
- NIHR Applied Research Collaboration Wessex, University of Southampton, UK.,Neurodegenerative Research, R&D, University Hospital Southampton NHS Trust, UK
| | - Veena Agarwal
- Neurodegenerative Research, R&D, University Hospital Southampton NHS Trust, UK.,School of Health Sciences, Faculty of Environmental & Life Sciences, University of Southampton, UK
| | - Helen C Roberts
- Human Development and Health, Faculty of Medicine, University of Southampton, UK.,NIHR Applied Research Collaboration Wessex, University of Southampton, UK.,Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, UK
| | - John Spreadbury
- Human Development and Health, Faculty of Medicine, University of Southampton, UK.,NIHR Applied Research Collaboration Wessex, University of Southampton, UK
| | - Christopher Kipps
- NIHR Applied Research Collaboration Wessex, University of Southampton, UK.,Wessex Neurological Centre, University Hospital Southampton, Southampton, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK
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24
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Van Nieuw Amerongen-Meeuse JC, Schaap-Jonker H, Anbeek C, Braam AW. Religious/spiritual care needs and treatment alliance among clinical mental health patients. J Psychiatr Ment Health Nurs 2021; 28:370-383. [PMID: 32890450 DOI: 10.1111/jpm.12685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 01/06/2020] [Revised: 07/08/2020] [Accepted: 08/03/2020] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The relationship between patient and professional is one of the cornerstones of successful treatment in mental health care. For part of the mental health patients, a similar outlook on life with their caregiver(s) is important. Attention to religion/spirituality (R/S) in mental health care is likely to influence the relationship between a patient and mental health professional, for patients preferring so. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Patients, who appreciate and experience personalized attention to R/S in conversations with practitioners and nurses, are likely to receive the highest therapeutic benefit from their relationship with their mental health professionals Patients who welcome personalized attention to R/S in conversations but find themselves unsupported in this regard experience significantly lower levels of treatment alliance than do those whose needs are met or those who do not express such needs For religious and nonreligious patients attaching importance to a similar outlook on life with practitioner or nurse, this experience was also related to a better relationship, compared with patients preferring so but experiencing a different outlook on life. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Personalized attention to R/S in conversations is recommended, both for practitioners and nurses. In case of a different outlook on life between a patient and mental health professional, addressing R/S with an open and respectful attitude may prevent negative effects on a patient's treatment experience. ABSTRACT: Introduction Attention to religion and spirituality (R/S) in mental health care has increased and may benefit treatment alliance. Aim To describe the association of (un)met R/S care needs with treatment alliance and compliance among mental health patients. Methods Patients in a Christian and a secular mental health clinic (n = 201) filled in a questionnaire. Scales of met and unmet R/S care needs (range 0-14) were regressed on the Working Alliance Inventory (WAI), Service Engagement Scale and Medication Adherence Report Scale. Ancova analyses were performed for the fourteen R/S care needs separately. Results In the Christian clinic, met R/S care needs were associated with a higher WAI score (p = .001) and unmet R/S care needs, with a lower WAI score (p = .000). For the Secular clinic, the same trends were observed, but insignificant. Items with the strongest associations were conversations about religious distress with a nurse (p = .000) and a similar outlook on life with practitioner (p = .001) or nurse (p = .005). (Un)met R/S care needs were not associated with treatment compliance. Discussion and implications for practice We recommend personalized attention to R/S in conversations. A (perceived) similar outlook on life with mental health professionals may be beneficial for religious and nonreligious patients.
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Affiliation(s)
- Joke C Van Nieuw Amerongen-Meeuse
- Department of Humanist Chaplaincy Studies for a Plural Society, University of Humanistic Studies, Utrecht, The Netherlands.,Center for Research and Innovation in Christian Mental Health Care, Amersfoort, The Netherlands
| | - Hanneke Schaap-Jonker
- Center for Research and Innovation in Christian Mental Health Care, Amersfoort, The Netherlands.,Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Christa Anbeek
- Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Arjan W Braam
- Department of Humanist Chaplaincy Studies for a Plural Society, University of Humanistic Studies, Utrecht, The Netherlands.,Department of Emergency Psychiatry and Residency Training, Altrecht Mental Health Care, Utrecht, The Netherlands
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25
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Yan T, Zheng W, Wang D, Zhang W. Cultural adaptation and validation of the Survivor Unmet Needs Survey Short-Form among cancer patients in China. Nurs Open 2021; 8:1098-1107. [PMID: 34482653 PMCID: PMC8046061 DOI: 10.1002/nop2.720] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/29/2020] [Accepted: 11/05/2020] [Indexed: 12/24/2022] Open
Abstract
AIM Cancer patients have long been found to have multiple types of unmet needs during their survivorship. Composite psychological instruments are essential for measuring the unmet needs of cancer patients. The objective of this study was to evaluate the psychometric properties of the Short-Form Survivor Unmet Needs Survey (SF-SUNS)-Chinese version. DESIGN A cross-sectional survey. METHODS The Chinese version was developed using the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology and 428 Chinese cancer patients participated in the survey between 2016-2017. Inter-rater reliability, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were calculated. RESULTS Confirmatory factor analysis supported the four-factor structure with good model fit. Cronbach's alpha of 0.894 for the overall scale and intra-class correlation coefficients (0.869-0.884) indicated that reliability was satisfactory. The EFA extracted four factors with eigenvalues greater than 1 and these factors explained 50.68% of the total variance. The Chinese version of SF-SUNS was confirmed to have the potential to become a useful and valid instrument. It could contribute to the assessment of unmet needs among Chinese cancer patients with accuracy and with respect to Chinese culture and context. This measurement of unmet needs may help promote cancer management and nursing quality. Clinical nurses and researchers could use the simple assessment tool to target the individual needs of Chinese cancer patients and then provide more personalized care efficiently.
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Affiliation(s)
- Tingting Yan
- The Nethersole School of NursingThe Chinese University of Hong KongHong KongChina
| | - Wei Zheng
- The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Dandan Wang
- The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Wei Zhang
- The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
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26
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Khan Z, Da Silva MV, Nunez K, Kalafatis C, Nowicki S, Walker Z, Testad I, Francis P, Ballard C. Investigating the effects of impairment in non-verbal communication on neuropsychiatric symptoms and quality of life of people living with dementia. Alzheimers Dement (N Y) 2021; 7:e12172. [PMID: 33969179 PMCID: PMC8088100 DOI: 10.1002/trc2.12172] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/19/2021] [Accepted: 04/23/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION People living with dementia in nursing homes have complex needs; impairments in cognition, communication, and daily function; neuropsychiatric symptoms (NPS); and poor quality of life (QoL). The current study examines impairments in non-verbal communication as a potential driver of NPS and QoL. METHODS One hundred nursing home residents with dementia were assessed using the Emory Dyssemia Index (EDI), Neuropsychiatric Inventory Nursing Home version (NPI-NH), Quality of Life in Alzheimer's Disease (QoL-AD) at baseline, 12-, and 24-week follow-up. RESULTS The quantile regression (0.5) model indicated that impairment of non-verbal communication was independently associated with the severity of NPS (P = .001) and proxy reported QoL (P < .05), levels of agitation (P < .05), and professional caregiver burden (P < .05). DISCUSSION These results highlight a novel potential approach to improve NPS and QoL using retained elements of non-verbal communication, particularly for people with severe dementia.
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Affiliation(s)
- Zunera Khan
- Institute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | | | | | - Chris Kalafatis
- Institute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | | | | | - Ingelin Testad
- Centre for Age‐related Medicine ‐ SESAMStavanger University HospitalStavangerNorway
| | - Paul Francis
- Exeter University Medical SchoolUniversity of ExeterExeterUK
| | - Clive Ballard
- Exeter University Medical SchoolUniversity of ExeterExeterUK
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27
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Chen L, Xiao LD, Chamberlain D, Newman P. Enablers and barriers in hospital-to-home transitional care for stroke survivors and caregivers: A systematic review. J Clin Nurs 2021; 30:2786-2807. [PMID: 33872424 DOI: 10.1111/jocn.15807] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [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: 09/22/2020] [Revised: 02/24/2021] [Accepted: 03/30/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To synthesise qualitative research evidence on the experience of stroke survivors and informal caregivers in hospital-to-home transitional care. BACKGROUND Due to a shortened hospital stay, stroke survivors/caregivers must take over complex care on discharge from hospital to home. Gaps in the literature warrant a meta-synthesis of qualitative studies on perceived enablers and barriers during this crucial period. DESIGN A systematic review and meta-synthesis. METHODS A review was guided by Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist where six databases were searched from April to June 2020 including CINAHL Plus, MEDLINE, PsycINFO, Scopus, Web of Science and ProQuest and ProQuest Dissertations and Theses. There was no date limit to the search. Selected studies were critically appraised. A thematic synthesis approach was applied. RESULTS The synthesis of 29 studies identified three major findings. First, partnerships with stroke survivors/caregivers empower discharge preparation, foster competence to navigate health and social care systems and activate self-management capabilities. Second, gaps in discharge planning and the lack of timely postdischarge support contribute to unmet care needs for stroke survivors/caregivers and affect their ability to cope with poststroke changes. Third, stroke survivors/caregivers expect integrated transitional care that promotes shared decision-making and enables long-term self-management at home. CONCLUSIONS Hospital-to-home transition is a challenging period in the trajectory of poststroke rehabilitation and recovery. Further research is required to deepen understandings of all stakeholders' views and address unmet needs during transitional care. RELEVANCE TO CLINICAL PRACTICE Protocols and clinical guidelines relating to discharge planning and transitional care need to be reviewed to ensure partnership approach with survivors/caregivers in the design and delivery of individualised transitional care. Stroke nurses are in a unique position to lead timely support for survivors/caregivers and to bridge service gaps in hospital-to-home transitional care.
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Affiliation(s)
- Langduo Chen
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Diane Chamberlain
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Peter Newman
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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28
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Curnow E, Rush R, Maciver D, Górska S, Forsyth K. Exploring the needs of people with dementia living at home reported by people with dementia and informal caregivers: a systematic review and Meta-analysis. Aging Ment Health 2021; 25:397-407. [PMID: 31791140 DOI: 10.1080/13607863.2019.1695741] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To provide prevalence estimates of needs of people with dementia living at home, and to determine sources of variation associated with needs for this population. METHOD A systematic review and meta-analysis was performed searching CINAHL, MEDLINE, PsycINFO and ASSIA databases. Following quality checks, random effects meta-analysis produced prevalence estimates for needs reported by people with dementia and by their informal caregivers. Fixed effects models were undertaken to compare caregiver and person with dementia reported needs. Heterogeneity was explored through sensitivity analysis. The study protocol was registered with Prospero #CRD42017074119. RESULTS Six retrieved studies published between 2005 and 2017 including 1011 people with dementia and 1188 caregivers were included in the analysis. All data were collected using Camberwell Assessment of Need for the Elderly. Prevalence estimates are provided for 24 needs reported by participants in The Netherlands, United Kingdom, Poland, Ireland, Germany, Norway, Portugal, Italy and Sweden. Most prevalent needs reported by people with dementia were Memory 0.713 [95% CI 0.627, 0.791]; Food 0.706 [95% CI 0.547, 0.842]; Household activities 0.677 [95% CI 0.613, 0.738]; and Money 0.566 [95% CI 0.416, 0.711]. Caregivers reported greater prevalence than people with dementia did for 22 of 24 needs, although the priority ranking of needs was similar. Exploration of heterogeneity revealed that people with young onset dementia were the major source of variation for 24 out of 48 analyses. CONCLUSION Increased understanding of prevalence of needs of people with dementia and associated heterogeneity can assist in planning services to meet those needs.
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Affiliation(s)
- Eleanor Curnow
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Robert Rush
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Sylwia Górska
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
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29
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Zhang M, Chen C, Du Y, Wang S, Rask M. Multidimensional factors affecting care needs in daily living among community-dwelling older adults: A structural equation modelling approach. J Nurs Manag 2021; 29:1207-1219. [PMID: 33480142 DOI: 10.1111/jonm.13259] [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: 05/11/2020] [Revised: 11/01/2020] [Accepted: 01/15/2021] [Indexed: 11/30/2022]
Abstract
AIMS To develop a model illustrating the factors that can influence care needs in daily living (CNDL) of older adults and the pathways between these. BACKGROUND The care needs in community-dwelling older adults have increased sharply. A better understanding of the elderly's CNDL would thus help policymakers define which types of support and services should be given. METHODS A multicentre study with structural equation modelling was conducted in this study. We recruited 3,448 community-dwelling older adults in China by using a stratified random cluster sampling technique. RESULTS Physical and mental health was the strongest predictor of CNDL. Both age and living situation had positive effects on CNDL, while economic factors, social support and family support were the major risk factors for CNDL. CONCLUSION The presented model provides a better understanding of how to address CNDL in the targeted population. The older adults who are the oldest, low-income, non-empty nesters, and with poor self-rated health or the signs of loneliness should be firstly targeted for daily assistance. IMPLICATIONS FOR NURSING MANAGEMENT Using this model could provide health authorities and managers with the information of distinguishing between the priority group and the strategies for easing the caregiving burden in older adults care, and thus improving resource utilization.
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Affiliation(s)
- Min Zhang
- College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, China
| | - Changxiang Chen
- College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, China
| | - Yanan Du
- North China University of Science and Technology Affiliated Hospital, Tangshan, China
| | - Shuoshuo Wang
- College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, China
| | - Mikael Rask
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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Rodríguez-González AM, Rodríguez-Míguez E, Claveria A. Determinants of caregiving burden among informal caregivers of adult care recipients with chronic illness. J Clin Nurs 2021; 30:1335-1346. [PMID: 33528913 DOI: 10.1111/jocn.15683] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 04/13/2020] [Revised: 12/26/2020] [Accepted: 01/22/2021] [Indexed: 01/05/2023]
Abstract
AIMS AND OBJECTIVES This study examined the predictors of caregiver burden based on patient and caregiver characteristics in a sample of Spanish caregivers looking after adult patients with chronic disease. The effect of task type and patient-caregiver interaction is also analysed. BACKGROUND Specific predictors of caregiver burden have been widely examined in the literature. Few studies, however, jointly analyse a wide range of factors, including the effect of task type and patient-caregiver interaction. DESIGN Correlational study. METHODS One hundred and thirty five informal caregivers for 148 care recipients were recruited from primary health care centres. The caregivers responded to the short version of the Zarit Burden Interview (ZBI), the DEPendency index-6 Dimensions (DEP-6D), and reported how long they spent on caregiving on a daily basis. Sociodemographic and health characteristics were also recorded. Linear and logistic regression models were used to evaluate factors associated with ZBI scores and the likelihood of being severely burdened, respectively. This research complies with STROBE guidelines for observational studies. RESULTS Severe burden was present in 62% of the caregivers. Regression analysis shows that burden severity increases significantly with the level of dependence when the latter is measured either by DEP-6D or by time spent on basic activities. Care related to incontinence and mobility has the greatest effect on burden, which is aggravated when the patient has behavioural problems. Poor caregiver health or not being retired also contributes to burden levels. CONCLUSIONS These results establish that caregiver burden is related to characteristics of both the caregiver and the care recipient as well as to their interaction. RELEVANCE TO CLINICAL PRACTICE The findings indicate that the socio-sanitary attention focused on reducing caregiver burden must address the caregiver and patient as a dyad. Identifying the dependence level and the patient's aggressive behaviour can be a good predictor of caregiver burden.
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Affiliation(s)
- Ana-María Rodríguez-González
- University of Vigo, Vigo, Spain.,Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Cantabrian Health Service, Primary Care, Puente San Miguel, Spain
| | - Eva Rodríguez-Míguez
- Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Department of Applied Economics, University of Vigo, Vigo, Spain.,Group of Research in Empirical Economics (GRiEE, ECOBAS), Vigo, Spain
| | - Ana Claveria
- Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Quality and Research Unit, EOXI Vigo, Galician Health Service, Vigo, Spain
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Rimmelzwaan LM, Bogerd MJL, Schumacher BMA, Slottje P, Van Hout HPJ, Reinders ME. Multimorbidity in General Practice: Unmet Care Needs From a Patient Perspective. Front Med (Lausanne) 2021; 7:530085. [PMID: 33415113 PMCID: PMC7783195 DOI: 10.3389/fmed.2020.530085] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: In the Netherlands, as in many other countries, current clinical guidelines are directed at single diseases. Patients with multiple chronic conditions may benefit from a more patient-tailored approach. Therefore, our objective is to explore the general practice care needs of patients with multimorbidity from a patient perspective. We also assessed their care experiences and the impact of chronic conditions on their daily functioning. Methods: We conducted a qualitative study, using semi-structured interviews complemented with self-report questionnaire assessments for triangulation, with consenting community-dwelling patients with three or more chronic conditions. Participants were identified through purposeful sampling in three general practices. Two researchers independently coded and thematically analyzed the audiotaped and anonymously transcribed interviews using the constant comparative method. The self-report questionnaire assessments were used to describe the patient characteristics and for triangulation of the data retrieved from the semi-structured interviews. Results: After 12 interviews, saturation was achieved. Overall, most participants were positive about their relationship with the general practitioner (GP) and practice nurse (PN) as well as the care they received in general practice. However, several unmet care need themes were observed: firstly, lack of a holistic approach (by the GP and PN), in particular, insufficient attention to the patient's state of functioning, their limitations in daily life, and their well-being; secondly, they mentioned that personal continuity of care was important to them and sometimes lacking; thirdly, lack of patient-tailored explanations about diseases and treatments. Conclusion: From a community-dwelling multimorbid patient perspective, general practice care could benefit from improving personal continuity of care, attention to personal circumstances and daily functioning, and patient-tailored communication.
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Affiliation(s)
- Lisanne M Rimmelzwaan
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Mieke J L Bogerd
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bregitta M A Schumacher
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pauline Slottje
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Hein P J Van Hout
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marcel E Reinders
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Pleh DN, Rosted E, Thomsen TG. Key competences of outpatient nurses, as perceived by patients attending nurse-led clinics - An integrative review. J Clin Nurs 2020; 30:311-322. [PMID: 33169469 DOI: 10.1111/jocn.15557] [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: 06/29/2020] [Revised: 10/20/2020] [Accepted: 10/31/2020] [Indexed: 11/28/2022]
Abstract
AIM The aim of this review was to identify key competences of outpatient nurses, as perceived by patients attending nurse-led clinics. BACKGROUND The increased demand for nurses to manage treatment and care in hospital outpatient clinics requires a better understanding of nurses' competences important to outpatients. DESIGN An integrative review using Whittemore and Knafl's five-stage model. METHODS Relevant studies were located by systematically searching PubMed, CINAHL and Scopus. A group of three researchers assessed the studies found and the quality of the included studies using the CASP tool. Data were extracted and analysed by thematic analyses. The current study was evaluated using PRISMA checklist. RESULTS Nine studies met the inclusion criteria. Three key competences emerged: providing access, sharing knowledge and establishing relationships. The key competences were supported by ten sub-themes that were characterised by nurses' actions and qualities, derived from the included studies. CONCLUSIONS The identified key competences reflected a holistic approach that encompasses knowledge, skills and attitudes, indicating outpatient nurses being able to manage different ways of involving patients, which may lead to the consideration of outpatient consultations as a kind of negotiation, based on a respectful dialogue. RELEVANCE TO CLINICAL PRACTICE The findings are usable when optimising the performance and quality of the health workforce, including outpatient nurses, as recommended by WHO (World Health Organization, Global strategy on human resources for health: Workforce 2030, 2016). Furthermore, the identified knowledge emphasises the need for clinical skills training and academic education, specially targeted outpatient nurses, in order to enable the nurses to become experts in specific practice settings.
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Affiliation(s)
- Denise Nana Pleh
- Department of Gynecology and Obstetrics, Zealand University Hospital, Roskilde, Denmark
| | - Elizabeth Rosted
- Department of Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Thora Grothe Thomsen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
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Groenvynck L, de Boer B, Hamers JPH, van Achterberg T, van Rossum E, Verbeek H. Toward a Partnership in the Transition from Home to a Nursing Home: The TRANSCIT Model. J Am Med Dir Assoc 2020; 22:351-356. [PMID: 33223451 DOI: 10.1016/j.jamda.2020.09.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 07/01/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 11/15/2022]
Abstract
The transition from home to a nursing home can be stressful and traumatic for both older persons and informal caregivers and is often associated with negative outcomes. Additionally, transitional care interventions often lack a comprehensive approach, possibly leading to fragmented care. To avoid this fragmentation and to optimize transitional care, a comprehensive and theory-based model is fundamental. It should include the needs of both older persons and informal caregivers. Therefore, this study, conducted within the European TRANS-SENIOR research consortium, proposes a model to optimize the transition from home to a nursing home, based on the experiences of older persons and informal caregivers. These experiences were captured by conducting a literature review with relevant literature retrieved from the databases CINAHL and PubMed. Studies were included if older persons and/or informal caregivers identified the experiences, needs, barriers, or facilitators during the transition from home to a nursing home. Subsequently, the data extracted from the included studies were mapped to the different stages of transition (pre-transition, mid-transition, and post-transition), creating the TRANSCIT-model. Finally, results were discussed with an expert panel, leading to a final proposed TRANSCIT model. The TRANSCIT model identified that older people and informal caregivers expressed an overall need for partnership during the transition from home to a nursing home. Moreover, it identified 4 key components throughout the transition trajectory (ie, pre-, mid-, and post-transition): (1) support, (2) communication, (3) information, and (4) time. The TRANSCIT model could advise policy makers, practitioners, and researchers on the development and evaluation of (future) transitional care interventions. It can be a guideline reckoning the needs of older people and their informal caregivers, emphasizing the need for a partnership, consequently reducing fragmentation in transitional care and optimizing the transition from home to a nursing home.
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Affiliation(s)
- Lindsay Groenvynck
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands; KU Leuven Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium.
| | - Bram de Boer
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands
| | - Jan P H Hamers
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands
| | - Theo van Achterberg
- KU Leuven Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Erik van Rossum
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands; Academy of Nursing, Research Centre on Community Care, Zuyd University of Applied Sciences, Heerlen, the Netherlands
| | - Hilde Verbeek
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands
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Shen J, Xiao LD, Liu Y, Zhang H, Wu L. A Phenomenological Study on New Care Needs of Maslow's Need-Hierarchy Among Disabled Residents at Nursing Homes in Modern Chinese Society. J Transcult Nurs 2020; 32:501-507. [PMID: 33103595 DOI: 10.1177/1043659620967426] [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] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Meeting the care needs of disabled residents of nursing homes is a vital element to providing high-quality care in modern society. Therefore, this study aimed to explore the disabled residents' new care needs in nursing homes based on Maslow's hierarchy of needs theory from their perspectives in modern society. METHOD This was a qualitative study. Semi-structured interviews were conducted with a purposeful sample of 23 disabled residents in a nursing home in China. All data were transcribed and coded for emerging themes. RESULTS A qualitative data analysis generated 4 dimensions and 12 aspects of needs: intelligent technology (including intelligent health management, intelligent life care, and intelligent psychological care), security (including air and food safety, network security, and protecting privacy), participation (including social relations, self-regulated learning, and volunteer service), and spirituality (including religious beliefs needs, maintaining dignity, and self-determination). DISCUSSION These findings can inform nursing home health care professionals about the new care needs of disabled residents to improve nursing home care protocols to accommodate residents' expressed needs, thus fostering better care.
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Affiliation(s)
- Jun Shen
- Chongqing Medical University, Chongqing, China
| | | | - Yue Liu
- Chongqing Medical University, Chongqing, China
| | - Hong Zhang
- Chongqing Medical University, Chongqing, China
| | - Lin Wu
- Columbia University, New York, NY, USA
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Wei Y, Zhang L. Analysis of the Influencing Factors on the Preferences of the Elderly for the Combination of Medical Care and Pension in Long-Term Care Facilities Based on the Andersen Model. Int J Environ Res Public Health 2020; 17:E5436. [PMID: 32731557 DOI: 10.3390/ijerph17155436] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/17/2020] [Accepted: 07/27/2020] [Indexed: 01/09/2023]
Abstract
Background: The purpose of this study is to evaluate the status quo and factors that influence the preferences of the elderly for the combination of medical care and pension (CMCP) in long-term care (LTC) facilities and to provide an evidence-based basis for building a multi-tiered, continuous LTC system with CMCP. Methods: Using a multi-stage sampling method, face-to-face questionnaire surveys were conducted on 3260 elderly people aged 60 years or over in 44 communities in 16 sub-districts in six districts in Xiamen. Based on the Andersen model, the chi-square test was used to analyze differences in population distribution, and binary logistic regression analysis was used to analyze the factors affecting the elderly’s preference for CMCP in LTC institutions in terms of the factors of predisposition, enablement, and personal needs. Results: Most elderly people choose traditional home care (82.01%), and only 12.89% choose LTC facilities with CMCP. This choice is influenced by a number of predisposing factors. The elderly who are at the upper end of the age range, have a higher education level, and live in rural areas are more likely to choose CMCP (odds ratio (OR) value greater than 1, p < 0.05). With regard to enabling factors, the elderly who were married, mainly taken care of by spouses, and had better economic status also tended to choose CMCP (OR > 1, p < 0.01). In terms of personal needs, the elderly with worse self-care status tended to choose CMCP (OR > 1, p < 0.01). Enabling factors have the largest contribution to the model, and they have the greatest impact on elder preference for CMCP services. In addition, the elderly with higher age and education level, non-remarried, with better economic status, and with poorer health status have a demand for a wider variety of CMCP services. Compared to those in urban areas, the elderly in rural areas have greater needs, mainly related to personal care, medical care, and psychological counseling. Conclusion: The preference of the elderly for CMCP are lower compared to their preference for home care in Xiamen, China. Preference for CMCP is affected by a range of factors such as age, education level, residence, income, and self-care ability, among which the enabling factors have the greatest impact.
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Wang TF, Huang RC, Yang SC, Chou C, Chen LC. Evaluating the Effects of a Mobile Health App on Reducing Patient Care Needs and Improving Quality of Life After Oral Cancer Surgery: Quasiexperimental Study. JMIR Mhealth Uhealth 2020; 8:e18132. [PMID: 32716303 PMCID: PMC7418017 DOI: 10.2196/18132] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/26/2020] [Accepted: 06/03/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Intervention with a mobile Health (mHealth) app can improve the efficacy of early detection of oral cancer and the outcomes for patients taking oral anticancer medications. The quality of life of oral cancer patients is significantly reduced within three months after surgery; also, their needs for nursing care and health information increase, mainly due to side effects and associated psychological problems. OBJECTIVE This study aimed to evaluate changes in the care needs and quality of life of patients with oral cancer after receiving the intervention of a newly developed mHealth app. METHODS After surgery, oral cancer patients were divided into an experimental group (n=50) who received the mHealth app intervention and a control group (n=50) who received routine health care and instruction. After 3 months of intervention, survey questionnaires were used to assess the patients' quality of life, nursing care needs, and acceptance of the mHealth app. RESULTS The physiological care needs were significantly decreased in the experimental group compared with the control group (P<.05). Although the differences were not statistically significant, the psychological needs, communication needs, and care support needs all improved after the mHealth app intervention. The overall improvement in quality of life was higher in the experimental group than in the control group (-7.24 vs -4.36). In terms of intention to use, perceived usefulness, and perceived ease of use, the acceptability scores of the mHealth app were significantly increased after 3 months of intervention (P<.05). CONCLUSIONS Compared with routine health care and instruction, for patients after surgery, the education/information intervention using the mHealth app significantly reduced their nursing care needs, improved their quality of life, and increased their acceptance of using an mHealth app on a mobile device. These findings can provide a theoretical basis for future health care app design and improvement. This study suggests that an mHealth app should be incorporated into the routine care of oral cancer patients to provide medical information quickly and improve their self-management abilities, thereby reducing the patients' need for physiological care and improving their quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT04049968; https://www.clinicaltrials.gov/ct2/show/NCT04049968.
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Affiliation(s)
- Tze-Fang Wang
- School of Nursing, National Yang-Ming University, Taipei City, Taiwan
| | - Rou-Chen Huang
- School of Nursing, National Yang-Ming University, Taipei City, Taiwan
| | - Su-Chen Yang
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chyuan Chou
- Excellent Dental Center, Taipei City, Taiwan
| | - Lee-Chen Chen
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
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Abstract
The aim of this study was to investigate service needs and health care utilization among people with type 2 diabetes, further to identify the relationship between service needs and health care utilization.We used a self-reported questionnaire to collect data regarding demographic and diabetes characteristics, service needs toward self-management and follow-up care, and 4 health care utilizations during past year. Multiple linear regression and binary logistic regression were used to test the impacts of demographic and diabetes characteristics on service needs and health care utilizations, respectively. Spearman rank correlations were used to explore correlation between service needs and health care utilization.We recruited 1796 participants with type 2 diabetes from 20 community health centers across 12 cities of Sichuan Province in China. Needs of self-management and follow-up had significant positive correlations with health care utilization. Participants rated that nutrition was the most needed aspects of self-management (78.5%), and out-patient visit was the most popular type of follow-up (66.8%). Educational level and treatment modality were predictors of self-management needs. Low educational level (elementary school or blow, β = 0.11, P = .008; middle school, β = 0.10, P = .015) and insulin treatment (β = 0.08, P = .007) were positive factors of self-management needs. Younger age (age < 45 years old, β = 0.07, P = .046), being employed (β = 0.14, P < .001), and underdeveloped region (β = 0.16, P < .001) were positive factors of follow-up care needs. Elementary educational level (OR: 0.53; CI: 0.30-0.96) and underdevelopment region (OR: 0.01; CI: 0.01-0.07) were protective factors of general practitioner visit, in contrast, those factors were risk factors of specialist visit (elementary educational level, OR: 1.69; CI: 1.13-2.5; underdevelopment region, OR: 2.93; CI: 2.06-4.16) and emergency room visit (elementary educational level, OR: 2.97; CI: 1.09, 8.08; underdevelopment region, OR: 6.83; CI: 2.37-14.65).The significant positive relationship between service needs and health care utilization demonstrated the role of service needs in influencing health care utilization. When self-management education is provided, age, educational level, employment status, treatment modality, and region should be considered to offer more appropriate education and to improve health care utilization.
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Doroszkiewicz H, Sierakowska M. Factors associated with risk of care dependency in disabled geriatric patients. Scand J Caring Sci 2020; 35:134-142. [PMID: 32091637 DOI: 10.1111/scs.12827] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 01/21/2020] [Indexed: 01/29/2023]
Abstract
INTRODUCTION The growing number of elderly people results in the intensification of disability, reduced level of independency and quality of life as well as augmented demand on medical and social services. The aim of the study was to identify factors associated with probability of care dependency in disabled geriatric patients. MATERIALS AND METHODS The study involved 200 patients aged 60 or over, consecutively admitted to the Geriatrics Unit. A cross-sectional quantitative study design. The study carried out using the questionnaire evaluating the patients' biopsychosocial needs and level of care dependency: the Polish version of the Care Dependency Scale (CDS). Data regarding the patients' self-care, locomotor function, emotional status, cognitive function, vision, hearing, the risk of pressure sores or falls, self-assessed health status and the sense of loneliness were obtained from medical documentation using selected elements of the CGA (Comprehensive Geriatric Assessment). RESULTS The mean CDS score (15-75) for all the evaluated patients was 55.3 ± 15.1-43.4 ± 11.9 in the category of dependent patients and 67.5 ± 4.6 in the category of independent of care, respectively (p < 0.001). The participants' mean age was 81.8 ± 6.6 (in the dependent category, 83.3, and in the independent category, 80.2). The final model produced statistically significant independent factors: cognitive ability, Instrumental-ADL performance, locomotive ability and age. CONCLUSIONS The progressing care dependency increased with the worsening of cognitive functions, difficulties performing I-ADL, locomotion impairment and advanced age. To support independent living of elderly people, healthcare professionals should recognise the situation in the community to carry out interventions aimed at preventing and minimising disability and delaying institutionalisation.
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Affiliation(s)
| | - Matylda Sierakowska
- Department of Integrated Medical Care Medical, University of Bialystok, Bialystok, Poland
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Holl M, van den Dries L, Stenberg SÅ, Wolf JRLM. Subgroups of tenants at risk of eviction due to rent arrears in five Dutch cities: A latent class approach. Health Soc Care Community 2020; 28:148-159. [PMID: 31490603 DOI: 10.1111/hsc.12849] [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: 09/24/2018] [Revised: 08/06/2019] [Accepted: 08/08/2019] [Indexed: 06/10/2023]
Abstract
This study identifies subgroups of tenants in a sample of 495 tenants at risk of eviction, due to rent arrears, by 16 housing associations in five Dutch municipalities, and examines the attuning of services to the needs of the tenants in these subgroups. Latent class analysis with eight known risk factors for eviction identified five subgroups of tenants, which can be characterised as young immigrants, native Dutch tenants with little support, highly educated native Dutch tenants with much support, depressed tenants with little support and highly educated mentally stable older single tenants. The young immigrants reported the highest number of unmet care needs; the highly educated native Dutch tenants with much support, on the other hand, mentioned the least unmet care needs. This study demonstrates the diversity of a population of tenants at risk of eviction. Together with the differences in care needs, this indicates the necessity to develop targeted and personalised interventions to prevent evictions.
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Affiliation(s)
- Marieke Holl
- Impuls - Netherlands Center for Social Care Research, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Linda van den Dries
- Impuls - Netherlands Center for Social Care Research, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sten-Åke Stenberg
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - Judith R L M Wolf
- Impuls - Netherlands Center for Social Care Research, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Abu Sharour L, Malak M, Subih M, Bani Salameh A. Quality of life, care needs, and information needs among patients diagnosed with cancer during their treatment phase. PSYCHOL HEALTH MED 2019; 25:252-258. [PMID: 31795738 DOI: 10.1080/13548506.2019.1699660] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Proper assessment of patients' needs might enhance patients' outcomes, ability to cope with new challenges, identify required resources, prioritize service needs, determine patients with higher need levels, and improve patients' quality of life. A cross-sectional descriptive design was used. Total of 113 patients from different settings completed the study surveys including demographic sheet, Short-form cancer needs questionnaire (CNQ-SF), Functional Assessment of Cancer Therapy-General (FACT-G), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-INFO 25). Regression analysis indicated that care needs and information needs were predictors of QOL (R2 = 0.688, adjusted R2 = 0.61, F (1.17, p < 0.001)). A significant correlation exists between QOL, care needs and information needs. Daily nursing practices should include assessing patients; care needs, information needs, and QOL through using valid and reliable scales.
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Affiliation(s)
- Loai Abu Sharour
- Faculty of nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Malakah Malak
- Faculty of nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Maha Subih
- School of Nursing, Al-Zaytoonah University of Jordan (ZUJ), Amman, Jordan
| | - Ayman Bani Salameh
- School of Nursing, Al-Zaytoonah University of Jordan (ZUJ), Amman, Jordan
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Mohammadhossini S, Ahmadi F, Gheibizadeh M, Saki Malehi A, Zarea K. Comprehensive physical domain care needs of burn patients: a qualitative study. Clin Cosmet Investig Dermatol 2019; 12:573-581. [PMID: 31686885 PMCID: PMC6709513 DOI: 10.2147/ccid.s215517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/29/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Burn patients have various physical needs. To provide full care for such patients, we need a broad range of services. The current study aims at showing the physical needs of burn patients. METHODS The current qualitative study has been done through content analysis. The data were collected from 20 in-depth, unstructured individual interviews with hospitalized patients with burns on more than 25% of their body, nurses, physiotherapists, and psychologists. The participants were selected by purposive sampling. The data were analyzed with a conventional content analysis approach using the Elo and Kyngas method. RESULTS By analyzing the data, 7 main categories were obtained from 932 primary codes: the necessity to provide optimal physiotherapy, the necessity of the patient's overall physical assessment, the necessity of monitoring and coordination in care, healthy nutrition for burn patients, the need for pharmacotherapy, the need for pain reliefs, and finally the theme for comprehensive physical care needs in burn patients. CONCLUSION According to the findings, by applying the extracted categories, it is possible to provide quality care based on the patient's individual needs. This can help speed up the treatment and shorten the length of hospitalization significantly.
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Affiliation(s)
- Sima Mohammadhossini
- Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mahin Gheibizadeh
- Nursing Care Research Center in Chronic Diseases, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amal Saki Malehi
- Biostatistics and Epidemiology Department, Public Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Cameron A, Johnson EK, Lloyd L, Evans S, Smith R, Porteus J, Darton R, Atkinson T. Using longitudinal qualitative research to explore extra care housing. Int J Qual Stud Health Well-being 2019; 14:1593038. [PMID: 30935291 PMCID: PMC6450491 DOI: 10.1080/17482631.2019.1593038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: The process of individual ageing in the context of a care environment is marked by continuity and change. It is shaped by individual, health-related factors as well as by diverse social and environmental factors, including characteristics of the places where older people live. The aim of this paper was to explore how longitudinal qualitative research, as a research method, could be used to explore older people’s changing care needs. Methods: The study used a longitudinal design to examine how the care and support needs of residents and their expectations of services developed over time and how these were influenced by changes in the organisation of their housing as well as in the make-up of the resident population. Residents were interviewed on four occasions over 20 months. Results: The study highlighted the complex ways in which some participants proactively managed the care and support they received, which we argue would have been difficult to discern through other methods. Conclusion: The study adds to the growing evidence base that supports the use of qualitative longitudinal research; the approach enables the researcher to capture the diverse and mutable nature of older people’s experiences at a time of profound change in their lives.
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Affiliation(s)
- Ailsa Cameron
- a School for Policy Studies , University of Bristol , Bristol , UK
| | | | - Liz Lloyd
- a School for Policy Studies , University of Bristol , Bristol , UK
| | - Simon Evans
- b Association for Dementia Studies , University of Worcester, Institute of Health and Society , Worcester , UK
| | - Randall Smith
- a School for Policy Studies , University of Bristol , Bristol , UK
| | - Jeremy Porteus
- c Housing Learning and Improvement Network , London , UK
| | - Robin Darton
- d Personal Social Services Research Unit , University of Kent , Kent , UK
| | - Teresa Atkinson
- b Association for Dementia Studies , University of Worcester, Institute of Health and Society , Worcester , UK
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van Dongen SI, van Straaten B, Wolf JRLM, Onwuteaka‐Philipsen BD, van der Heide A, Rietjens JAC, van de Mheen D. Self-reported health, healthcare service use and health-related needs: A comparison of older and younger homeless people. Health Soc Care Community 2019; 27:e379-e388. [PMID: 31020738 PMCID: PMC6850679 DOI: 10.1111/hsc.12739] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 01/09/2019] [Accepted: 02/27/2019] [Indexed: 05/13/2023]
Abstract
The number of older homeless people with a limited life expectancy is increasing. European studies on their health-related characteristics are lacking. This study compared self-reported health, healthcare service use and health-related needs of older and younger homeless people in the Netherlands. It is part of a cohort study that followed 513 homeless people in the four major Dutch cities for a period of 2.5 years, starting from the moment they registered at the social relief system in 2011. Using cross-sectional data from 378 participants who completed 2.5-year follow-up, we analysed differences in self-reported health, healthcare service use, and health-related needs between homeless adults aged ≥50 years (N = 97) and <50 years (N = 281) by means of logistic regression. Results show that statistically significantly more older than younger homeless people reported cardiovascular diseases (23.7% versus 10.3%), visual problems (26.8% versus 14.6%), limited social support from family (33.0% versus 19.6%) and friends or acquaintances (27.8% versus 14.6%), and medical hospital care use in the past year (50.5% versus 34.5%). Older homeless people statistically significantly less often reported cannabis (12.4% versus 45.2%) and excessive alcohol (16.5% versus 27.0%) use in the past month and dental (20.6% versus 46.6%) and mental (16.5% versus 25.6%) healthcare use in the past year. In both age groups, few people reported unmet health-related needs. In conclusion, compared to younger homeless adults, older homeless adults report fewer substance use problems, but a similar number of dental and mental problems, and more physical and social problems. The multiple health problems experienced by both age groups are not always expressed as needs or addressed by healthcare services. Older homeless people seem to use more medical hospital care and less non-acute, preventive healthcare than younger homeless people. This vulnerable group might benefit from shelter-based or community outreach programmes that proactively provide multidisciplinary healthcare services.
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Affiliation(s)
- Sophie I. van Dongen
- Department of Public HealthErasmus University Medical CentreRotterdamthe Netherlands
| | | | - Judith R. L. M. Wolf
- Radboud Institute for Health Sciences, Impuls ‐ Netherlands Centre for Social Care ResearchRadboud University Medical CentreNijmegenthe Netherlands
| | - Bregje D. Onwuteaka‐Philipsen
- Department of Public and Occupational Health, Expertise Centre for Palliative CareVU University Medical Centre, Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
| | - Agnes van der Heide
- Department of Public HealthErasmus University Medical CentreRotterdamthe Netherlands
| | - Judith A. C. Rietjens
- Department of Public HealthErasmus University Medical CentreRotterdamthe Netherlands
| | - Dike van de Mheen
- IVO Addiction Research InstituteThe Haguethe Netherlands
- School of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and WelfareTilburg UniversityTilburgthe Netherlands
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Towle RM, Tan CG, Saptu K, Ong LJ, Yap MM, Kheng JH, Low LL. What do caregivers value and is there agreement in perception of met needs between nurses and caregivers? Singapore Med J 2019; 60:575-582. [PMID: 31044258 DOI: 10.11622/smedj.2019040] [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] [Indexed: 11/18/2022]
Abstract
INTRODUCTION There is an increasing reliance on informal caregivers to continue the care of patients after discharge. This is a huge responsibility for caregivers and some may feel unprepared for the role. Without adequate support and understanding regarding their needs, patient care may be impeded. This study aimed to identify the needs valued by caregivers and if there was agreement between acute care nurses and caregivers in the perception of whether caregiver needs were being met. METHODS We conducted face-to-face interviews with 100 pairs of acute care nurses and caregivers. Participants were recruited from inpatient wards through convenience sampling. Questionnaires included demographic data of nurses and caregivers, patients' activities of daily living, and perception of caregiver needs being met in six domains of care. Independent t-test was used to compare mean values in each domain, and intraclass correlation coefficient was used to compare agreement in perception. RESULTS Caregivers valued reassurance the most. Three domains of care needs showed significant differences in perception of caregiver needs being met:reassurance (p = 0.002), honesty and timeliness (p = 0.008), and kindness and genuine care (p = 0.026). There was poor agreement in all six domains of caregiver needs being met between nurses and caregivers. CONCLUSION Although caregivers valued reassurance the most, there was poor agreement between acute care nurses and caregivers in the perception of caregiver needs being met. Hence, more attention should be paid to the caregiver's needs. Further studies can examine reasons for unmet caregiver needs and interventions to improve support for them.
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Affiliation(s)
- Rachel Marie Towle
- Nursing Division, Speciality Nursing, Singapore General Hospital, Singapore
| | - Cheng Gaik Tan
- Office of Integrated Care, Singapore General Hospital, Singapore
| | - Kalsom Saptu
- Office of Integrated Care, Singapore General Hospital, Singapore
| | - Li Jiao Ong
- Office of Integrated Care, Singapore General Hospital, Singapore
| | - Mei Mei Yap
- Office of Integrated Care, Singapore General Hospital, Singapore
| | - Jia Hui Kheng
- Office of Integrated Care, Singapore General Hospital, Singapore
| | - Lian Leng Low
- Family Medicine and Continuing Care, Singapore General Hospital, Singapore
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Rezaei F, Mardani A, Moradi AH, Nikkerdar N. Examining oral hygiene status and care needs of deaf and blind 6-12 years old exceptional school children in Kermanshah in 2015. J Family Med Prim Care 2019; 8:871-874. [PMID: 31041216 PMCID: PMC6482767 DOI: 10.4103/jfmpc.jfmpc_225_17] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Controlling and preventing oral diseases of patients with mental and physical disabilities had become one of the most important topics within the realm of dentistry researches. The main objective of this study was to examine oral hygiene and care needs of deaf and blind 6-12 years old exceptional school children in Kermanshah in 2015. Materials and Methods Oral hygiene of 51 deaf and blind 6-12 years old exceptional school children in Kermanshah in 2015 was examined in this study; indicators which underwent assessment included DMFT/decay, missing, falling, teeth (dmft), Gingival Index (GI), Plaque Index (PI), brushing, and flossing; the amount of used Unmet Treatment Need (UTN) was measured using DMFT/dmft index, and collected data were analyzed using SPSS, version 18. Findings The mean and standard deviation of GI and PI of the 51 deaf and blind students examined turned out to be 1.39 ± 0.30 and 0.86 ± 0.15, respectively; DMFT, dmft, and UTN of the blind students were 1.31 ± 1.20, 2.81 ± 2.81, and 0.76 ± 0.34, respectively; these values turned out to be 1.81 ± 2.16, 2.08 ± 3.48, and 0.85 ± 0.31, respectively, in case of deaf students. According to the results of this study, 18.7% of blind students and 27% of deaf students brushed their teeth once on a daily basis. Conclusion Based on the results of this study, the incidence and severity of dental caries, particularly in primary teeth, were high among these children (mean: 2.06) and a large number of their teeth needed treatment (UTN: 1.18). In comparison to their peers, these group of children had lower state of oral health; therefore, a systematic, long-term is definitely required for the improvement of oral hygiene of studied patients.
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Affiliation(s)
- Fatemeh Rezaei
- Department of Oral Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arkiya Mardani
- Department of Periodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Hossein Moradi
- Department of Periodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nafiseh Nikkerdar
- Department of Radiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Abstract
BACKGROUND Many people with Parkinson's disease (PD) (PwP) require care from either informal or formal carers, due to worsening symptoms. Carer strain is a recognised consequence of caring. However there are few data on the role and profile of informal carers and if this impacts on carer strain. METHOD People with moderate to advanced PD, with an informal carer were invited to participate. Data regarding motor and non-motor symptoms of the participant, along with demographics, tasks and duration of caring and health issues of the carer were collected. RESULTS One-hundred and fifteen participants and their carer were recruited. Mean carer age was 70.7 years, 66.1% were female caring for a median of 16 hours per day. Over 80% provided help in housework and companionship activities, 63.2% with dressing and 49.1% with feeding. There was a significant relationship between disease stage and level of strain. Participant age, physical and cognitive disability were significantly associated with greater care need. High care need was associated with poor carer quality of life. CONCLUSIONS The care needs of PwP are considerable. To reduce carer strain and improve quality of life, carers' needs must be considered to enable them to carry on with their vital role.
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Affiliation(s)
- Annette Hand
- a Northumbria Healthcare NHS Foundation Trust , North Shields , Tyne and Wear, United Kingdom.,b Department of Nursing Midwifery and Health , Northumbria University , Newcastle upon Tyne , United Kingdom
| | - Lloyd Louis Oates
- a Northumbria Healthcare NHS Foundation Trust , North Shields , Tyne and Wear, United Kingdom
| | - William Keith Gray
- a Northumbria Healthcare NHS Foundation Trust , North Shields , Tyne and Wear, United Kingdom
| | - Richard W Walker
- a Northumbria Healthcare NHS Foundation Trust , North Shields , Tyne and Wear, United Kingdom
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Hultstrand Ahlin C, Hörnsten Å, Coe AB, Lilja M, Hajdarevic S. Wishing to be perceived as a capable and resourceful person-A qualitative study of melanoma patients' experiences of the contact and interaction with healthcare professionals. J Clin Nurs 2019; 28:1223-1232. [PMID: 30549354 DOI: 10.1111/jocn.14730] [Citation(s) in RCA: 5] [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: 06/07/2018] [Revised: 10/03/2018] [Accepted: 12/05/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore patients' experiences of contact and interaction with healthcare professionals (HCPs) during the diagnostic process of melanoma. BACKGROUND In Sweden, most patients with suspected skin lesions seek care at the primary level of services in the first instance. Previous research describes the diagnostic process as a complex journey with uncertainty. Nonetheless, the importance of contact and interaction between patient and HCPs during the diagnostic process is rarely explored. DESIGN This study adopted a qualitative design in which semi-structured interviews were conducted and the COREQ-checklist for qualitative studies employed (EQUATOR guidelines). METHODS A sample of 30 patients (15 women, 15 men) diagnosed with melanoma was included. Secondary analysis of interviews was carried out using qualitative content analysis. RESULTS One theme emerged: Wishing to be perceived as a capable and resourceful person that consisted of three categories: (a) The need of being valued, (b) The need of being informed and (c) The need of taking actions. CONCLUSIONS Our results suggest that patients wish to be valued as capable and resourceful persons as well as to be provided with honest and sufficient information about the diagnosis and subsequent procedures. By fulfilling these wishes, HCPs can involve patients in the diagnostic process and reduce patients' uncertainty. A need of supportive and accessible health care to manage the diagnostic process and to reduce patients' struggle for care was also identified. RELEVANCE TO THE CLINICAL PRACTICE Patients are satisfied when health care is organised in a patient-/person-centred manner, that is, in accordance with patients' needs, avoiding gatekeeping, and when HCPs interact respectfully in encounters. Accessible HCPs during the diagnostic process of melanoma are required to inform, support and navigate patients within the healthcare system and through their diagnostic journey.
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Affiliation(s)
| | - Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Mikael Lilja
- Department of Public Health and Clinical Medicine, Unit of Research, Education, and Development, Östersund Hospital, Umeå University, Umeå, Sweden
| | - Senada Hajdarevic
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
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Hand A, Oates LL, Gray WK, Walker RW. Understanding the Care Needs and Profile of People Living at Home With Moderate to Advanced Stage Parkinson Disease. J Geriatr Psychiatry Neurol 2018; 31:237-247. [PMID: 30012028 DOI: 10.1177/0891988718788680] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND In the United Kingdom, people with Parkinson disease (PD) and atypical parkinsonism will require more support with their care needs as the condition progresses. There are few data on the nature of care input required and the amount of informal and formal care needed by people with PD to enable them to remain within their own home. METHOD All people with moderate to advanced stage (Hoehn and Yahr III-V) idiopathic PD and atypical parkinsonism under the care of the Northumbria Healthcare NHS Foundation Trust PD service and living in their own home were invited to take part in The Northumbria Care Needs Project, a 10-year prospective longitudinal study. At baseline, data regarding formal (paid) personal and domestic care input and use of respite care, sitting services, and day centers were collected. We also collected data on patient cognitive disability, functional disability, and disease severity and informal carer tasks. RESULTS Of 162 people with PD included in the study, only 25.2% accessed formal domestic care and the same proportion formal personal care. In contrast, 80.2% identified an informal carer who helped with these tasks. Despite greater level of functional disability in those with an informal carer, levels of formal personal care input were similar to those with and without a formal carer. Levels of formal domestic carer input were higher in those without an informal carer. CONCLUSIONS Use of formal care services was relatively uncommon in our cohort and much of the burden of caring appears to be being met by informal carers.
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Affiliation(s)
- Annette Hand
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, United Kingdom.,2 Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Lloyd L Oates
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, United Kingdom
| | - William K Gray
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, United Kingdom
| | - Richard W Walker
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, United Kingdom.,3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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Doroszkiewicz H, Sierakowska M, Muszalik M. Utility of the Care Dependency Scale in predicting care needs and health risks of elderly patients admitted to a geriatric unit: a cross-sectional study of 200 consecutive patients. Clin Interv Aging 2018; 13:887-894. [PMID: 29773946 PMCID: PMC5947105 DOI: 10.2147/cia.s159511] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective The aim of the study was to evaluate the usefulness of the Polish version of the Care Dependency Scale (CDS) in predicting care needs and health risks of elderly patients admitted to a geriatric unit. Methods This was a cross-sectional study of 200 geriatric patients aged ≥60 years, chronologically admitted to a geriatrics unit in Poland. The study was carried out using the Polish version of the CDS questionnaire to evaluate biopsychosocial needs and the level of care dependency. Results The mean age of the participating geriatric patients was 81.8±6.6. The mean result of the sum of the CDS index for all the participants was 55.3±15.1. Detailed analysis of the results of evaluation of the respondents’ functional condition showed statistically significant differences in the levels of care dependency. Evaluation of the patients’ physical performance in terms of the ability to do basic activities of daily living (ADL) and instrumental ADL (I-ADL) showed statistically significant differences between the levels of care dependency. Patients with high dependency were more often prone to pressure ulcers – 13.1±3.3, falls (87.2%), poorer emotional state – 6.9±3.6, mental function – 5.1±2.8, and more often problems with locomotion, vision, and hearing. The results showed that locomotive disability, depression, advanced age, and problem with vision and hearing are connected with increasing care dependency. Conclusion CDS evaluation of each admitted geriatric patient enables us to predict the care needs and health risks that need to be reduced and the disease states to be improved. CDS evaluation should be accompanied by the use of other instruments and assessments to evaluate pressure ulcer risk, fall risk, and actions toward the improvement of subjective well-being, as well as correction of vision and hearing problems where possible and assistive devices for locomotion.
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Affiliation(s)
| | - Matylda Sierakowska
- Department of Integrated Medical Care, Medical University of Bialystok, Bialystok, Poland
| | - Marta Muszalik
- Department and Clinic of Geriatrics, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
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Parr JM, Bell J, Koziol-McLain J. Evaluating fundamentals of care: The development of a unit-level quality measurement and improvement programme. J Clin Nurs 2018; 27:2360-2372. [PMID: 29292544 DOI: 10.1111/jocn.14250] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The project aimed to develop a unit-level quality measurement and improvement programme using evidence-based fundamentals of care. BACKGROUND Feedback from patients, families, whānau, staff and audit data in 2014 indicated variability in the delivery of fundamental aspects of care such as monitoring, nutrition, pain management and environmental cleanliness at a New Zealand District Health Board. DESIGN A general inductive approach was used to explore the fundamentals of care and design a measurement and improvement programme, the Patient and Whānau Centred Care Standards (PWCCS), focused on fundamental care. METHODS Five phases were used to explore the evidence, and design and test a measurement and improvement framework. RESULTS Nine identified fundamental elements of care were used to define expected standards of care and develop and test a measurement and improvement framework. Four six-monthly peer reviews have been undertaken since June 2015. Charge Nurse Managers used results to identify quality improvements. Significant improvement was demonstrated overall, in six of the 27 units, in seven of the nine standards and three of the four measures. In all, 89% (n = 24) of units improved their overall result. CONCLUSION The PWCCS measurement and improvement framework make visible nursing fundamentals of care in line with continuous quality improvement to increase quality of care. RELEVANCE TO CLINICAL PRACTICE Delivering fundamentals of care is described by nurses as getting ?back to basics'. Patient and family feedback supports the centrality of fundamentals of care to their hospital experience. Implementing a unit-level fundamentals of care quality measurement and improvement programme clarifies expected standards of care, highlights the contribution of fundamentals of care to quality and provides a mechanism for ongoing improvements.
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Affiliation(s)
- Jenny M Parr
- Counties Manukau Health District Health Board, Middlemore Hospital, Auckland, New Zealand
| | - Jeanette Bell
- Institute for Innovation and Improvement, Waitemata District Health Board, North Shore Hospital, Takapuna, Auckland, New Zealand
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