geriatric health services

  • 文章类型: Journal Article
    目标:养老院(NH)居民的生活质量(QoL)至关重要,然而研究不足,特别是在COVID-19大流行期间。我们的目标是检查COVID-19是否爆发,缺乏老年专业人员,护理助理倦怠与NH居民的生活质量有关。
    方法:横断面研究(2021年7月至12月)。
    方法:我们有目的地在艾伯塔省选择了9个NHs,加拿大,基于他们的COVID-19暴露(没有或轻微/短暂爆发与重复或广泛爆发)。我们纳入了来自18个护理单位的689名居民的数据。
    方法:我们使用DEMQOL-CH通过基于视频的护理助手访谈评估居民QoL。独立变量包括过去两周在NH爆发的COVID-19(卫生当局记录),护理单位-护理助理倦怠水平(9项简短的Maslach倦怠量表),和居民接触老年专业人员(经过验证的设施调查)。我们运行了混合效应回归模型,针对设施和护理单位进行调整(经过验证的调查),和居民协变量(居民评估工具-最低数据集2.0)。
    结果:最近的COVID-19爆发(β=0.189;95%CI:0.058-0.320),护理单元中情绪疲惫的护理助手比例更高(β=0.681;95%CI:0.246-1.115),缺乏老年专业人员(β=0.216;95%CI:0.003-0.428)与居民生活质量较差显著相关。
    结论:旨在减少感染爆发的政策,更好的支持员工,增加对专业提供者的访问可能有助于减轻COVID-19对NH居民生活质量的负面影响。
    Quality of life (QoL) of nursing home (NH) residents is critical, yet understudied, particularly during the COVID-19 pandemic. Our objective was to examine whether COVID-19 outbreaks, lack of access to geriatric professionals, and care aide burnout were associated with NH residents\' QoL.
    Cross-sectional study (July to December 2021).
    We purposefully selected 9 NHs in Alberta, Canada, based on their COVID-19 exposure (no or minor/short outbreaks vs repeated or extensive outbreaks). We included data for 689 residents from 18 care units.
    We used the DEMQOL-CH to assess resident QoL through video-based care aide interviews. Independent variables included a COVID-19 outbreak in the NH in the past 2 weeks (health authority records), care unit-levels of care aide burnout (9-item short-form Maslach Burnout Inventory), and resident access to geriatric professionals (validated facility survey). We ran mixed-effects regression models, adjusted for facility and care unit (validated surveys), and resident covariates (Resident Assessment Instrument-Minimum Data Set 2.0).
    Recent COVID-19 outbreaks (β = 0.189; 95% CI: 0.058-0.320), higher proportions of emotionally exhausted care aides on a care unit (β = 0.681; 95% CI: 0.246-1.115), and lack of access to geriatric professionals (β = 0.216; 95% CI: 0.003-0.428) were significantly associated with poorer resident QoL.
    Policies aimed at reducing infection outbreaks, better supporting staff, and increasing access to specialist providers may help to mitigate how COVID-19 has negatively affected NH resident QoL.
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  • 文章类型: Journal Article
    背景:住院对老年人来说可能是危险的,但是欧洲大多数医院都没有准备好满足老年成人住院患者的独特需求。物理环境的适应,护理过程,工作人员在老年护理方面的知识和技能对于提高老年人的护理质量至关重要。评估老年人护理的基线组织方法是认识到组织在向老年人提供急性护理服务并试图改善它们时所面临的挑战的重要的第一步。老年机构评估概况可能是这项工作的有希望的工具。
    目的:描述在七个国家和语言中实施的系统过程,该过程旨在开发有效且适合文化的老年机构评估概况的翻译。
    方法:跨文化工具翻译和内容验证研究。
    方法:专家评审小组由来自七个欧洲或欧盟相关国家的68名执业护士组成(奥地利(德语),比利时(荷兰语),丹麦(丹麦语),以色列(希伯来语),波兰(波兰语),瑞士(德语,法语),和土耳其(土耳其语))评估了跨文化相关性,包括翻译,老年机构评估概况。
    方法:翻译和验证跨文化调查工具的系统方法,包括背靠背的翻译,适应,并使用每个国家和语言的内容有效性索引(CVI)技术评估内容有效性,分别评估翻译和相关内容的有效性。该项目,针对老年机构评估概况的所有部分的评估者之间的机会协议,计算并调整了子量表和领域内容有效性指数分数:老年护理环境的四个子量表,关于老年人分量表的一般知识,和临床老年知识量表。评估者之间的共识讨论随后最终确定了翻译。
    结果:相关性和翻译的CVI得分均在“良好”到“优秀”范围内。老年护理环境量表的CVI评分相关性为0.84~0.94,翻译为0.82~0.98。临床老年知识量表的CVI评分相关性为0.83至0.97,翻译为0.94至0.98。关于老年人的一般知识分量表获得了较高的翻译一致性(0.93至0.99),但相关性得分略低,范围从0.46到0.94。
    结论:研究结果提供了初步证据,证明了在不同的医疗保健系统中,年龄友好型护理的多因素措施的适用性和有效性。在德语中,荷兰人,丹麦语,希伯来语,波兰语,法语,土耳其语。
    BACKGROUND: Hospitalization can be hazardous for older people, but most hospitals in Europe are not prepared to meet the unique needs of older adult inpatients. Adaptations of the physical environment, care processes, and staff knowledge and skills in geriatric care are essential to improve the quality of care for older people. An assessment of baseline organizational approaches to older adult care is an important first step toward recognizing the challenges organizations face when delivering acute care services to older adults and attempting to improve them. The Geriatric Institutional Assessment Profile could be a promising tool for this endeavor.
    OBJECTIVE: To describe a systematic process implemented across seven countries and languages that sought to develop valid and culturally-appropriate translations of the Geriatric Institutional Assessment Profile.
    METHODS: Cross-cultural instrument translation and content validation study.
    METHODS: Expert review panels comprised of 68 practicing nurses from seven European or EU associated countries (Austria (German), Belgium (Dutch), Denmark (Danish), Israel (Hebrew), Poland (Polish), Switzerland (German, French), and Turkey (Turkish)) evaluated cross-cultural relevance, including translation, of the Geriatric Institutional Assessment Profile.
    METHODS: A systematic approach to translating and validating a cross-cultural survey instrument, including back-to-back translation, adaptation, and evaluation of content validity using content validity indexing (CVI) techniques for each country and language, assessing translation and relevance content validity separately. The item, subscale and domain content validity index scores were calculated and adjusted for chance agreement among raters for all parts of the Geriatric Institutional Assessment Profile: the four subscales of geriatric care environment, the general knowledge about older adults subscale, and the clinical geriatric knowledge subscale. Consensus discussions among the raters then finalized translations.
    RESULTS: CVI scores for relevance and translation were all in the \"good\" to \"excellent\" range. The geriatric care environment scale\'s CVI scores were 0.84 to 0.94 for relevance and 0.82 to 0.98 for translation. The clinical geriatric knowledge subscale\'s CVI scores were 0.83 to 0.97 for relevance and 0.94 to 0.98 for translation. The general knowledge about older adults subscale received high translation agreement (0.93 to 0.99) but slightly lower scores for relevance, ranging from 0.46 to 0.94.
    CONCLUSIONS: Study results provided preliminary evidence of the applicability and validity of a multi-factor measure of age-friendly care in diverse health care systems, in German, Dutch, Danish, Hebrew, Polish, French, and Turkish languages.
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  • 文章类型: Journal Article
    While the importance of primary care becomes more imminent for older adults to manage multi-morbidities, the perception of primary care among this group is not well examined.
    To evaluate the primary care experience among older adults in the United States (US).
    We conducted a retrospective cross-sectional study examining four domains of primary care: first contact, longitudinality, comprehensiveness, and coordination. Using survey responses from Medical Expenditure Panel Survey (MEPS), we used propensity score matching method to compare the percentage of geriatric (≥65 years old) and non-geriatric (< 65 years old) who answered favorably to questions that supported each domain from 2014 to 2016. Using multivariate regression, we also assessed the impact of each domain on various demographic and perceived need for care features of older adults.
    A total of 12,982 surveys were analyzed for geriatric, compared to 62,694 surveys for non-geriatric. Overall, older adults answered more favorably than younger adults for all four domains. However, uninsured older adults, Black older adults and older adults with limitation in activities, cognitive impairments, and multiple comorbidities were more likely to have difficulties in accessing their usual source of care (USC). Additionally, Black, Hispanic, and Asian older adults and cognitively impaired adults perceived less contribution in their own treatment management.
    Older adults in the US generally experience good quality of primary care, compared to younger adults. However, establishing and maintaining access (first contact) and being involved in disease management (coordination) were perceived as poor by several cohorts of older adults.
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  • 文章类型: Journal Article
    OBJECTIVE: This study was done to study, using Andersen\'s Behavioral Model, factors affecting health service utilisation among older Filipinos.
    METHODS: A total of 237 older people from Marikina City, Philippines, were randomly selected and surveyed face-to-face on factors affecting health service utilisation, specifically age, civil status, educational level, employment status, sex, health insurance coverage, household income, chronic disease status and perceived health status.
    RESULTS: Seventy-nine per cent had used health services in the past year (mean: 5.7 visits per year). Female sex and having a chronic disease were significantly associated with health service utilisation. The odds of using health services was 3.1 times higher for those who had a chronic disease and 2.2 times higher for female sex, assuming all other variables are held constant.
    CONCLUSIONS: Findings of this study support targeting men in health promotion campaigns and implementing population-based, chronic disease screening programs to improve the reach of health services among Filipino older people.
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  • 文章类型: Journal Article
    Elder abuse and neglect is a problem that occurs across all settings and all populations. Elder abuse has many forms, such as abandonment, emotional or psychological abuse, financial or material exploitation, neglect, physical abuse, and sexual abuse. We conducted this research to determine the prevalence of various types of abuse and neglect and their associated factors among elderly patients attending the urban and rural geriatric clinics at a medical college hospital in Bangalore, India. A total of 200 elderly patients participated in the study. The overall prevalence of elder abuse or neglect was 32 (16%), comprised of: verbal abuse in 25 (12.5%); neglect in 22 (11%); financial abuse in 17 (8.5%); and physical abuse in 3 (1.5%). Hence, many elderly patients had experienced multiple forms of abuse. There was statistically significant association between elder abuse and total financial dependence, lack of social support, and depression among the elderly patients.
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  • 文章类型: Journal Article
    背景:在老年人群中,益生菌对上呼吸道感染(URTIs)的预防作用的证据不足。
    方法:我们进行了多中心,双盲,随机化,安慰剂对照平行组研究。老年人参加了在东京的4个设施中使用日托的活动。我们使用含有干酪乳杆菌菌株Shirota(LcS)和安慰剂饮料的发酵奶作为测试饮料。
    结果:共分析了154名受试者。两组诊断为急性URTI的人数几乎相同(LcS:31,安慰剂:32),而LcS组的急性URTIs事件(LcS:68,安慰剂:51)和症状评分(LcS:425,安慰剂:396)均较高.使用急性URTI感染事件总数/观察总天数和症状总评分/观察总天数进行的排列测试分别没有统计学上的显着差异(P值分别为.89和.64)。比较每个感染事件的平均感染持续时间,发现LcS组的平均持续时间较短(LcS:3.71天,安慰剂:5.40天),差异有统计学意义。
    结论:结果表明,含有LcS的发酵乳可能会减少急性URTIs的持续时间。
    BACKGROUND: There is insufficient evidence of preventive effect of probiotics on upper respiratory tract infections (URTIs) in an elderly population.
    METHODS: We conducted a multicenter, double-blinded, randomized, placebo-controlled parallel group study. Elderly persons had participated who used day care at 4 facilities in Tokyo. We used fermented milks containing Lactobacillus casei strain Shirota (LcS) and placebo drinks as test drinks.
    RESULTS: A total of 154 subjects was analyzed. The number of persons diagnosed with an acute URTIs was almost identical in both groups (LcS: 31, placebo: 32), whereas the number of acute URTIs events (LcS: 68, placebo: 51) and the symptom score (LcS: 425, placebo: 396) were both higher in the LcS group. Permutation tests performed using the total number of acute URTIs infection events/total days of observation and the total symptom score/total days of observation found no statistically significant difference respectively (P values of .89 and .64, respectively). Comparing the mean duration of infection per infection event found a shorter mean duration in the LcS group (LcS: 3.71 days, placebo: 5.40 days), and the difference was statistically significant.
    CONCLUSIONS: The results suggest that fermented milk containing LcS probably reduces the duration of acute URTIs.
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