gerontology

老年学
  • 文章类型: Journal Article
    由于全球人口老龄化及其对卫生系统的影响,老年学和公共卫生的交叉越来越重要。这项范围审查旨在绘制公共卫生中关于老年学的现有文献,确定当前的观点,并评估适合老年人需求的干预措施。在多个数据库中使用预定义的关键字进行了系统的搜索,包括PubMed,谷歌学者,Scopus,和WebofScience。审查包括42项采用各种设计的研究,所有这些都侧重于针对老龄人口的公共卫生干预措施。主要研究结果表明,迫切需要将老年学原则纳入公共卫生实践,认识到老年人的异质性和健康的社会决定因素的重要性。干预措施包括预防性健康措施和慢性病管理计划,健康促进活动和护理人员支持,包括应用技术来改善健康结果。然而,明显缺乏对不同人群和心理健康干预措施的研究.这篇评论还发现了文献中的关键差距,如获得护理的经济障碍和应对老龄化人口多样化需求的全面政策的必要性。总之,这篇综述强调了多维度方法对有效满足老年人健康需求的重要性.虽然存在一些有效的干预措施,迫切需要解决已确定的差距,特别是关于不同的人群和心理健康,加强老龄化人口的整体健康战略。
    The intersection of gerontology and public health is increasingly vital due to the global aging population and its implications for health systems. This scoping review aims to map existing literature on gerontology within public health, identify current perspectives, and evaluate interventions tailored to the needs of older adults. A systematic search was performed using predefined keywords across multiple databases, including PubMed, Google Scholar, Scopus, and Web of Science. The review included 42 studies that employed various designs, all focusing on public health interventions targeting the aging population.  Key findings indicate a pressing need to integrate gerontological principles into public health practice, recognizing the heterogeneous nature of older adults and the significance of social determinants of health. Interventions ranged from preventive health measures and chronic disease management programs to health promotion activities and caregiver support, including the application of technology to improve health outcomes. However, there was a notable lack of research on diverse populations and mental health interventions. The review also uncovered critical gaps in the literature, such as economic barriers to care access and the necessity for comprehensive policies addressing the aging population\'s diverse needs. In conclusion, this review emphasizes the importance of a multidimensional approach to effectively addressing older adults\' health needs. While several effective interventions exist, there is an urgent need to tackle identified gaps, particularly concerning diverse populations and mental health, to enhance overall health strategies for the aging demographic.
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  • 文章类型: Journal Article
    背景:远程医疗的使用迅速增加,然而,一些人群可能被不成比例地排除在获得和使用这种护理方式之外。远程医疗中的培训服务用户可以增加某些群体的可访问性。这些培训活动的范围和性质尚未探讨。
    目的:本范围审查的目的是确定和描述培训服务用户使用远程医疗的活动。
    方法:五个数据库(MEDLINE[通过PubMed],Embase,CINAHL,PsycINFO,和WebofScience)于2023年6月进行了搜索。描述培训服务用户使用同步远程健康咨询的活动的研究有资格被纳入。专注于医疗保健专业教育的研究被排除在外。论文仅限于以英语发表的论文。该审查遵循了JoannaBriggs研究所的范围审查指南,并根据PRISMA-ScR(系统审查的首选报告项目和范围审查的Meta分析扩展)指南进行了报告。标题和摘要由1名审阅者(EG)筛选。全文由2名审稿人(EG和JH或SC)筛选。数据提取以研究问题为指导。
    结果:搜索确定了8087种独特的出版物。总的来说,13项研究符合纳入标准。远程健康培训通常被描述为在远程健康访问之前向服务用户提供一次性准备电话,主要由学生志愿者提供帮助,并附有书面指示。培训内容包括如何下载和安装软件的指导,解决技术问题,并调整设备设置。老年人是培训的最常见目标人群。除1项研究外,所有研究都是在COVID-19大流行期间进行的。总的来说,培训是可行的,受到服务用户的欢迎,研究大多报告了培训后视频访问率的增加。有限且混合的证据表明,培训提高了参与者的远程医疗能力。
    结论:这篇综述绘制了有关远程医疗服务用户培训活动的文献。服务用户的远程医疗培训的共同特点包括对远程医疗技术要素的一次性预备电话,针对老年人。需要考虑的关键问题包括需要共同设计培训和提高服务用户更广泛的数字技能。有必要进行进一步的研究,以评估地理上不同地区的远程保健培训活动的成果。
    BACKGROUND: The use of telehealth has rapidly increased, yet some populations may be disproportionally excluded from accessing and using this modality of care. Training service users in telehealth may increase accessibility for certain groups. The extent and nature of these training activities have not been explored.
    OBJECTIVE: The objective of this scoping review is to identify and describe activities for training service users in the use of telehealth.
    METHODS: Five databases (MEDLINE [via PubMed], Embase, CINAHL, PsycINFO, and Web of Science) were searched in June 2023. Studies that described activities to train service users in the use of synchronous telehealth consultations were eligible for inclusion. Studies that focused on health care professional education were excluded. Papers were limited to those published in the English language. The review followed the Joanna Briggs Institute guidelines for scoping reviews and was reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Titles and abstracts were screened by 1 reviewer (EG). Full texts were screened by 2 reviewers (EG and JH or SC). Data extraction was guided by the research question.
    RESULTS: The search identified 8087 unique publications. In total, 13 studies met the inclusion criteria. Telehealth training was commonly described as once-off preparatory phone calls to service users before a telehealth visit, facilitated primarily by student volunteers, and accompanied by written instructions. The training content included guidance on how to download and install software, troubleshoot technical issues, and adjust device settings. Older adults were the most common target population for the training. All but 1 of the studies were conducted during the COVID-19 pandemic. Overall, training was feasible and well-received by service users, and studies mostly reported increased rates of video visits following training. There was limited and mixed evidence that training improved participants\' competency with telehealth.
    CONCLUSIONS: The review mapped the literature on training activities for service users in telehealth. The common features of telehealth training for service users included once-off preparatory phone calls on the technical elements of telehealth, targeted at older adults. Key issues for consideration include the need for co-designed training and improving the broader digital skills of service users. There is a need for further studies to evaluate the outcomes of telehealth training activities in geographically diverse areas.
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  • 文章类型: Journal Article
    目标:综合老年护理提供者,居民和居民“家庭成员”在老年护理设施中药物管理的观点和经验;确定药物管理错误的发生率,以及药物管理对老年护理机构护理质量和居民中心的影响。
    方法:混合方法系统综述。
    CRD42023426990。
    方法:AMED,CINAHL,MEDLINE,EMBASE,EMCARE,PsycINFO,在2023年6月搜索了Scopus和WebofScience核心数据库。
    方法:纳入的研究进行独立筛选,由两名研究人员选择和评估。遵循系统审查和荟萃分析(PRISMA)清单的首选报告项目,使用混合方法评估工具进行批判性评估。数据的聚合合成,进行了主题综合和荟萃分析.
    结果:纳入了128项研究(33项定性,85种定量方法和10种混合方法)。制定了五个主题,包括1)人员配置问题,2)居民角色的不确定性,3)与药物相关的决策,4)使用电子给药记录和5)给药错误。对老年护理人员的教育干预显着减少了药物管理错误,在五项研究中进行了检查(OR=0.37,95CI0.28-0.50,p<.001)。
    结论:老年护理机构的药物管理在临床和人际关系层面上具有挑战性和复杂性。临床过程,用药错误和安全性仍然是实践的重点。然而,需要更积极地考虑居民的自主性和老年护理工作者和提供者的投入,以解决药物管理的人际和社会心理方面的问题。未来研究的新方向应该检查剂型修改背后的决策,老年护理人员“药物遗漏的定义和支持居民及其家庭成员在药物管理期间参与的实用方法”。
    重要的是,老年护理机构中的药物管理应被更明确地视为临床和人际任务。老年护理人员的临床决策需要更多的关注,特别是关于剂型修改,秘密管理和药物遗漏。以居民为中心的护理方法支持居民和家庭参与药物管理可能会提高依从性。满意度和护理质量。
    结论:研究解决了什么问题?老年护理机构的药物管理是一项复杂的临床和人际交往活动。尽管如此,到目前为止,尚未尝试围绕这种做法综合定性和定量证据。有必要确定围绕老年护理人员的观点和经验存在哪些证据,居民和居民的家庭成员了解挑战,用药期间的人际机会和风险。主要发现是什么?缺乏以居民为中心的药物管理护理方法的经验证据,以及如何使居民和他们的家人有更多的投入。作为药物施用的一部分,剂量形式的修改公开和秘密地发生。不仅仅是作为吞咽困难的老年人的一种方法,而是强制遵守处方药。药物管理错误通常包括药物遗漏作为一类错误,尽管一些遗漏源于药物遗漏和居民输入的明确理由。这项研究将在哪里和对谁产生影响?:本系统评价的结果有助于老年护理政策和有关药物管理和与老年人接触的实践。这篇综述提出了一些发现,为老年护理人员在专业发展和实践反思方面提供了一个起点,特别是关于剂型修改的临床决策,药物管理错误和使居民输入药物管理的张力。对于研究人员来说,这项审查强调了开发以居民为中心的护理方法和干预措施的必要性,并评估这些是否会对药物管理产生积极影响,居民参与,坚持处方药物和护理质量。
    此系统评价是根据系统评价和荟萃分析的首选报告项目进行报告的(Page等。,2021)。
    本系统评价无患者或公众贡献。
    OBJECTIVE: To synthesize aged care provider, resident and residents\' family members\' perspectives and experiences of medication administration in aged care facilities; to determine the incidence of medication administration errors, and the impact of medication administration on quality of care and resident-centredness in aged care facilities.
    METHODS: A mixed-methods systematic review.
    UNASSIGNED: CRD42023426990.
    METHODS: The AMED, CINAHL, MEDLINE, EMBASE, EMCARE, PsycINFO, Scopus and Web of Science core collection databases were searched in June 2023.
    METHODS: Included studies were independently screened, selected and appraised by two researchers. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was followed, with the Mixed Methods Appraisal Tool was used for critical appraisal. Convergent synthesis of data, thematic synthesis and meta-analysis were performed.
    RESULTS: One hundred and twenty-eight studies were included (33 qualitative, 85 quantitative and 10 mixed-methods). Five themes were formulated, including 1) Staffing concerns, 2) The uncertain role of residents, 3) Medication-related decision-making, 4) Use of electronic medication administration records and 5) Medication administration errors. Educational interventions for aged care workers significantly reduced medication administration errors, examined across five studies (OR = 0.37, 95%CI 0.28-0.50, p < .001).
    CONCLUSIONS: Medication administration in aged care facilities is challenging and complex on clinical and interpersonal levels. Clinical processes, medication errors and safety remain focal points for practice. However, more active consideration of residents\' autonomy and input by aged care workers and providers is needed to address medication administration\'s interpersonal and psychosocial aspects. New directions for future research should examine the decision-making behind dose form modification, aged care workers\' definitions of medication omission and practical methods to support residents\' and their family members\' engagement during medication administration.
    UNASSIGNED: It is important that medication administration in aged care facilities be more clearly acknowledged as both a clinical and interpersonal task. More attention is warranted regarding aged care workers clinical decision-making, particularly concerning dose form modification, covert administration and medication omissions. Resident-centred care approaches that support resident and family engagement around medication administration may improve adherence, satisfaction and quality of care.
    CONCLUSIONS: What Problem Did the Study Address? Medication administration in aged care facilities is a complex clinical and interpersonal activity. Still, to date, no attempts have been made to synthesize qualitative and quantitative evidence around this practice. There is a need to establish what evidence exists around the perspectives and experiences of aged care workers, residents and resident\'s family members to understand the challenges, interpersonal opportunities and risks during medication administration. What Were the Main Findings? There is a lack of empirical evidence around resident-centred care approaches to medication administration, and how residents and their families could be enabled to have more input. Dose form modification occurred overtly and covertly as part of medication administration, not just as a method for older adults with swallowing difficulties, but to enforce adherence with prescribed medications. Medication administration errors typically included medication omission as a category of error, despite some omissions stemming from a clear rationale for medication omission and resident input. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: The findings of this systematic review contribute to aged care policy and practice regarding medication administration and engagement with older adults. This review presents findings that provide a starting point for aged care workers in regards to professional development and reflection on practice, particularly around clinical decision-making on dose form modification, medication administration errors and the tension on enabling resident input into medication administration. For researchers, this review highlights the need to develop resident-centred care approaches and interventions, and to assess whether these can positively impact medication administration, resident engagement, adherence with prescribed medications and quality of care.
    UNASSIGNED: This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Page et al., 2021).
    UNASSIGNED: No patient or public contribution to this systematic review.
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  • 文章类型: Journal Article
    目标:目前尚不清楚实施最佳实践脆弱指南,在这些环境中,关于多方面的脆弱治疗的证据特别缺乏,包括药物优化,尽管多重用药和虚弱之间存在双向关系。这篇综述旨在检索所有相关文献,并评估与运动和/或营养干预相结合的药物优化在老年护理虚弱的最佳实践管理中的效果。
    方法:定性综合的系统综述。
    方法:居住在老年护理(也称为疗养院或长期护理)中的老年人。
    方法:该方案在PROSPERO上进行了前瞻性注册(Reg。不。:CRD42022372036)使用系统审查和荟萃分析(PRISMA)指南的首选报告项目。从开始到2023年11月23日,搜索了五个电子数据库,并对警报进行了监控,直到2024年3月28日。使用ROB2和ROBIN-1工具评估研究质量。
    结果:共检索到10955篇文章;综述了62篇全文,纳入3项研究(2项随机对照试验和1项非随机对照试验),涉及1030名参与者.纳入的研究未使用特定的虚弱评分,但报告了虚弱的各个组成部分,例如体重减轻或处方药物数量。没有结合药物审查的试验,锻炼,并确定了营养。药物审查减少了处方药物的数量,而营养支持的使用减少了胃肠道药物和维持体重。
    结论:目前还没有发表的研究调查最佳实践指南的药物优化与运动和营养相结合的老年护理,以解决虚弱问题。这篇综述证实了在这个脆弱队列中实施弱点治疗共识指南的研究的必要性。
    OBJECTIVE: Implementation of best practice frailty guidelines in residential aged care is currently unclear, and there is a particular scarcity of evidence regarding multifaceted frailty treatments inclusive of medication optimization in these settings, despite the bidirectional relationship between polypharmacy and frailty. This review aimed to retrieve all relevant literature and evaluate the effect of medication optimization delivered in conjunction with exercise and/or nutritional interventions in the best-practice management of frailty in residential aged care.
    METHODS: Systematic review with a qualitative synthesis.
    METHODS: Older adults residing within residential aged care (otherwise referred to as nursing homes or long-term care).
    METHODS: The protocol was prospectively registered on PROSPERO (Reg. No.: CRD42022372036) using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Five electronic databases were searched from inception to November 23, 2023, with alerts monitored until March 28, 2024. Quality of studies was assessed using the ROB 2 and ROBIN-1 tools.
    RESULTS: A total of 10,955 articles were retrieved; 62 full articles were reviewed, with 3 studies included (2 randomized controlled trials and 1 nonrandomized controlled trial) involving 1030 participants. Included studies did not use specific frailty scores but reported individual components of frailty such as weight loss or number of medications prescribed. No trial combining medication review, exercise, and nutrition was identified. Medication review reduced the number of medications prescribed, whereas the use of nutritional support reduced gastrointestinal medication and maintained weight.
    CONCLUSIONS: There is no published research investigating best-practice guidelines for medication optimization used in combination with both exercise and nutrition in aged care to address frailty. This review confirms the need for studies implementing Consensus Guidelines for frailty treatment in this vulnerable cohort.
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  • 文章类型: Journal Article
    背景:土耳其南部海岸的阿拉尼亚地区已成为德国退休移民的重要目的地。目标:确定有关德国退休移民到土耳其的研究研究,这些研究涉及生活状况,动机,在退休移民的背景下处理关键的生活情况,以及返回移民的原因。方法:研究人员于2021年1月至2021年5月在MEDLINE进行了定性系统文献综述,CINAHL完成,和APA心理信息。结果:在根据定义的纳入和排除标准进行严格评估后,纳入了11项有关德国和欧洲退休移民到土耳其的研究。退休移民的动机是气候因素,风景优美,土耳其的文化优势和较低的生活成本。结论:已经发现,大多数研究在主题上都是狭义的,详细的研究以更一般的方式处理和描述退休移民的发展。
    Background: The Alanya region on Turkey\'s southern coast has become an important destination for German retirement migration. Objective: Identify research studies on German retirement migration to Turkey which deal with the life situation, the motives, the handling of critical life situations in the context of retirement migration, and the reasons for return migration. Methods: The researcher conducted a qualitative systematic literature review from January 2021 to May 2021 in MEDLINE, CINAHL Complete, and APA PsychInfo. Results: Eleven studies on German and European retirement migration to Turkey were included after a critical assessment based on defined inclusion and exclusion criteria. Motives for retirement migration are climatic, scenic, cultural advantages and the lower cost of living in Turkey. Conclusion: It has been found that most of the studies are thematically narrowly defined, detailed studies deal with and describe the development of retirement migration in a more general way.
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  • 文章类型: Journal Article
    背景:研究表明,数字年龄歧视,也就是说,与年龄相关的偏见,存在于机器学习(ML)模型的开发和部署中。尽管人们认识到这个问题的重要性,缺乏专门研究ML模型中用于缓解年龄相关偏差的策略以及这些策略的有效性的研究.
    目标:为了弥补这一差距,我们对减少ML中年龄相关偏倚的缓解策略进行了范围审查.
    方法:我们遵循了Arksey和O\'Malley开发的范围审查方法框架。搜索是与信息专家共同开发的,并在6个电子数据库(IEEEXplore,Scopus,WebofScience,CINAHL,EMBASE,和ACM数字图书馆),以及2个额外的灰色文献数据库(OpenGrey和灰色文献报告)。
    结果:我们确定了8篇试图减轻ML方法中年龄相关偏差的出版物。引入与年龄相关的偏见主要是由于数据中缺乏老年人的代表性。减轻偏见的努力被分为三种方法之一:(1)创建一个更平衡的数据集,(2)增加和补充他们的数据,(3)直接修改算法以获得更均衡的结果。
    结论:识别和减轻ML模型中的相关偏差对于促进公平性至关重要,股本,inclusion,和社会效益。我们的分析强调了对严格研究和开发有效缓解方法以解决数字年龄歧视的持续需求。确保ML系统以维护所有个人利益的方式使用。
    背景:开放科学框架AMG5P;https://osf.io/amg5p。
    BACKGROUND: Research suggests that digital ageism, that is, age-related bias, is present in the development and deployment of machine learning (ML) models. Despite the recognition of the importance of this problem, there is a lack of research that specifically examines the strategies used to mitigate age-related bias in ML models and the effectiveness of these strategies.
    OBJECTIVE: To address this gap, we conducted a scoping review of mitigation strategies to reduce age-related bias in ML.
    METHODS: We followed a scoping review methodology framework developed by Arksey and O\'Malley. The search was developed in conjunction with an information specialist and conducted in 6 electronic databases (IEEE Xplore, Scopus, Web of Science, CINAHL, EMBASE, and the ACM digital library), as well as 2 additional gray literature databases (OpenGrey and Grey Literature Report).
    RESULTS: We identified 8 publications that attempted to mitigate age-related bias in ML approaches. Age-related bias was introduced primarily due to a lack of representation of older adults in the data. Efforts to mitigate bias were categorized into one of three approaches: (1) creating a more balanced data set, (2) augmenting and supplementing their data, and (3) modifying the algorithm directly to achieve a more balanced result.
    CONCLUSIONS: Identifying and mitigating related biases in ML models is critical to fostering fairness, equity, inclusion, and social benefits. Our analysis underscores the ongoing need for rigorous research and the development of effective mitigation approaches to address digital ageism, ensuring that ML systems are used in a way that upholds the interests of all individuals.
    BACKGROUND: Open Science Framework AMG5P; https://osf.io/amg5p.
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  • 文章类型: Systematic Review
    背景:家庭评估是成功进行家庭改造的关键组成部分,使具有功能限制的个人能够舒适地老化。高质量的家庭评估工具应有助于医疗保健和住房专业人员进行有效和可靠的评估,同时也吸引和赋予消费者和他们的照顾者,他们可能正在处理多种功能限制。与传统的纸笔评估不同,这需要广泛的培训和专业知识,可能会疏远消费者,移动健康(mHealth)应用程序有可能吸引所有相关方,授权和激活消费者采取行动。然而,很少有人知道哪些应用程序包含所有必要的功能,质量评估,和可访问性。
    目的:本研究旨在评估功能,整体质量,和mHealth家庭评估应用程序的可访问性。
    方法:通过对学术文章的全面搜索,确定了能够进行家庭老化评估的mHealth应用程序,在美国的苹果(iOS)和谷歌播放(Android)商店,和fnd.io.搜索是在2022年11月至2023年1月之间进行的,采用了PRISMA(系统审查和荟萃分析的首选报告项目)的方法。审阅者对移动应用程序功能进行了内容分析,以评估其功能,整体质量,和可访问性。功能评估使用了专门为此研究开发的家庭评估组件矩阵。对于整体质量,移动应用评分量表(MARS)用于确定应用程序在吸引和激活消费者及其护理人员方面的有效性。使用Web内容可访问性指南(WCAG)2.1(A和AA级别)评估可访问性。综合并可视化这3个评估以提供综合评估。
    结果:最初确定了总共698个应用程序。经过进一步筛选,仅剩下6个应用程序。我们的审查显示,没有一个应用程序使用经过彻底测试的评估工具,提供了可靠的家庭评估所需的所有功能,达到了由火星测量的“良好”质量阈值,或在根据WCAG2.1进行评估时符合可访问性标准。然而,DIYModify在整体质量和可访问性评估中得分最高。MapIt应用程序还显示出巨大的潜力,因为它们能够测量3D环境,并包含扩展应用程序功能的桌面版本。
    结论:我们的审查显示,在美国境内拥有必要功能的应用程序很少,引人入胜的品质,和可访问性,以有效地激活消费者及其照顾者,以成功进行房屋改造。未来的应用程序开发应优先考虑集成可靠且经过彻底测试的评估工具,作为开发过程的基础。此外,应该努力提高这些应用程序的整体质量和可访问性,以更好地吸引和授权消费者采取必要的行动来老化。
    BACKGROUND: Home assessment is a critical component of successful home modifications, enabling individuals with functional limitations to age in place comfortably. A high-quality home assessment tool should facilitate a valid and reliable assessment involving health care and housing professionals, while also engaging and empowering consumers and their caregivers who may be dealing with multiple functional limitations. Unlike traditional paper-and-pencil assessments, which require extensive training and expert knowledge and can be alienating to consumers, mobile health (mHealth) apps have the potential to engage all parties involved, empowering and activating consumers to take action. However, little is known about which apps contain all the necessary functionality, quality appraisal, and accessibility.
    OBJECTIVE: This study aimed to assess the functionality, overall quality, and accessibility of mHealth home assessment apps.
    METHODS: mHealth apps enabling home assessment for aging in place were identified through a comprehensive search of scholarly articles, the Apple (iOS) and Google Play (Android) stores in the United States, and fnd.io. The search was conducted between November 2022 and January 2023 following a method adapted from PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Reviewers performed a content analysis of the mobile app features to evaluate their functionality, overall quality, and accessibility. The functionality assessment used a home assessment component matrix specifically developed for this study. For overall quality, the Mobile Application Rating Scale (MARS) was used to determine the apps\' effectiveness in engaging and activating consumers and their caregivers. Accessibility was assessed using the Web Content Accessibility Guidelines (WCAG) 2.1 (A and AA levels). These 3 assessments were synthesized and visualized to provide a comprehensive evaluation.
    RESULTS: A total of 698 apps were initially identified. After further screening, only 6 apps remained. Our review revealed that none of the apps used thoroughly tested assessment tools, offered all the functionality required for reliable home assessment, achieved the \"good\" quality threshold as measured by the MARS, or met the accessibility criteria when evaluated against WCAG 2.1. However, DIYModify received the highest scores in both the overall quality and accessibility assessments. The MapIt apps also showed significant potential due to their ability to measure the 3D environment and the inclusion of a desktop version that extends the app\'s functionality.
    CONCLUSIONS: Our review revealed that there are very few apps available within the United States that possess the necessary functionality, engaging qualities, and accessibility to effectively activate consumers and their caregivers for successful home modification. Future app development should prioritize the integration of reliable and thoroughly tested assessment tools as the foundation of the development process. Furthermore, efforts should be made to enhance the overall quality and accessibility of these apps to better engage and empower consumers to take necessary actions to age in place.
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  • 文章类型: Systematic Review
    背景:需要护理的老年人数量将超过现有的护理人员,这是当代和全球性的挑战。需要解决方案来帮助老年人保持健康,防止残疾,延迟或避免依赖他人。技术可以使老年人在保持尊严和生活质量的同时变老。关于这一主题的文献综述已成为研究人员的重要工具,从业者,政策制定者,和决策者需要导航和访问广泛的可用证据。由于现有审查的数量众多,种类繁多,有必要审查审查,以概述现有的老龄化技术证据的范围和特征。
    目的:本研究旨在通过对综述进行范围审查,并提供证据图,说明研究人员,政策制定者,和从业人员可以用来识别差距和感兴趣的审查。
    方法:按照PRISMA-ScR(系统审查的首选报告项目和范围审查的Meta分析扩展)进行审查。文献检索在WebofScience中进行,PubMed,和Scopus使用由术语“老年人”和“老化技术”组成的搜索字符串,\"使用布尔运算符和截断的替代术语,适应每个数据库的规则。
    结果:共筛选了5447项研究,全文筛选后纳入344项研究。随着时间的推移,关于这个主题的评论数量急剧增加,文献分散在各种期刊上。用于描述技术的词汇和方法,人口,问题是高度异构的。我们已经确定了三种主要的方法来处理人口问题,审查利用5种战略来概念化技术,以及他们处理过的4种主要问题。这些可以被理解为可以为将来关于该主题的评论提供信息的方法。人口之间的关系,技术,审查中研究的问题在证据图中呈现,其中包括相关的差距。
    结论:关于老化技术的证据体系之间的冗余和未利用的协同作用极有可能。这些结果可用于降低这种风险,如果它们被用来为未来关于这一主题的评论的设计提供信息。有必要审查低收入和中等收入国家关于老龄化技术的最新知识,尤其是在非洲。
    BACKGROUND: It is a contemporary and global challenge that the increasing number of older people requiring care will surpass the available caregivers. Solutions are needed to help older people maintain their health, prevent disability, and delay or avoid dependency on others. Technology can enable older people to age in place while maintaining their dignity and quality of life. Literature reviews on this topic have become important tools for researchers, practitioners, policy makers, and decision makers who need to navigate and access the extensive available evidence. Due to the large number and diversity of existing reviews, there is a need for a review of reviews that provides an overview of the range and characteristics of the evidence on technology for aging in place.
    OBJECTIVE: This study aimed to explore the characteristics and the range of evidence on technologies for aging in place by conducting a scoping review of reviews and presenting an evidence map that researchers, policy makers, and practitioners may use to identify gaps and reviews of interest.
    METHODS: The review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Literature searches were conducted in Web of Science, PubMed, and Scopus using a search string that consisted of the terms \"older people\" and \"technology for ageing in place,\" with alternate terms using Boolean operators and truncation, adapted to the rules for each database.
    RESULTS: A total of 5447 studies were screened, with 344 studies included after full-text screening. The number of reviews on this topic has increased dramatically over time, and the literature is scattered across a variety of journals. Vocabularies and approaches used to describe technology, populations, and problems are highly heterogeneous. We have identified 3 principal ways that reviews have dealt with populations, 5 strategies that the reviews draw on to conceptualize technology, and 4 principal types of problems that they have dealt with. These may be understood as methods that can inform future reviews on this topic. The relationships among populations, technologies, and problems studied in the reviews are presented in an evidence map that includes pertinent gaps.
    CONCLUSIONS: Redundancies and unexploited synergies between bodies of evidence on technology for aging in place are highly likely. These results can be used to decrease this risk if they are used to inform the design of future reviews on this topic. There is a need for an examination of the current state of the art in knowledge on technology for aging in place in low- and middle-income countries, especially in Africa.
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  • 文章类型: Journal Article
    在老年人中,疗养院入院(NHA)被认为是一种显著的不良结局,并已被广泛研究.尽管电子数据源的数量和意义在不断扩大,目前尚不清楚文献中通过电子健康记录(EHRs)和管理数据系统地确定了NHA的预测因子.
    本研究综合了从管理数据或EHR中收集的有关识别NHA预测因子的最新文献的发现。
    PRISMA-ScR(系统审查的首选报告项目和范围审查的Meta分析扩展)指南用于研究选择。PubMed和CINAHL数据库用于检索研究。包括2012年1月1日至2023年3月31日之间发表的文章。
    共有34篇论文被选入本综述。除了NHA,全因死亡率,住院治疗,再次住院常被用作结局指标.最常用的预测NHA的模型是Cox比例风险模型(研究:n=12,35%),逻辑回归模型(研究:n=9,26%),和两者的组合(研究:n=6,18%)。NHA预测模型中使用了几种预测因子,被进一步归类为社会人口统计学,护理人员支持,健康状况,健康使用,和社会服务使用因素。只有5项(15%)研究在其NHA预测模型中使用了经过验证的脆弱措施。
    基于EHR或管理数据的NHA预测工具可以帮助临床医生,病人,和政策制定者做出明智的决定和分配公共卫生资源。需要更多的研究来评估各种预测因子和数据源在预测NHA和外部验证NHA预测模型方面的价值。
    UNASSIGNED: Among older adults, nursing home admissions (NHAs) are considered a significant adverse outcome and have been extensively studied. Although the volume and significance of electronic data sources are expanding, it is unclear what predictors of NHA have been systematically identified in the literature via electronic health records (EHRs) and administrative data.
    UNASSIGNED: This study synthesizes findings of recent literature on identifying predictors of NHA that are collected from administrative data or EHRs.
    UNASSIGNED: The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines were used for study selection. The PubMed and CINAHL databases were used to retrieve the studies. Articles published between January 1, 2012, and March 31, 2023, were included.
    UNASSIGNED: A total of 34 papers were selected for final inclusion in this review. In addition to NHA, all-cause mortality, hospitalization, and rehospitalization were frequently used as outcome measures. The most frequently used models for predicting NHAs were Cox proportional hazards models (studies: n=12, 35%), logistic regression models (studies: n=9, 26%), and a combination of both (studies: n=6, 18%). Several predictors were used in the NHA prediction models, which were further categorized into sociodemographic, caregiver support, health status, health use, and social service use factors. Only 5 (15%) studies used a validated frailty measure in their NHA prediction models.
    UNASSIGNED: NHA prediction tools based on EHRs or administrative data may assist clinicians, patients, and policy makers in making informed decisions and allocating public health resources. More research is needed to assess the value of various predictors and data sources in predicting NHAs and validating NHA prediction models externally.
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  • 文章类型: Systematic Review
    背景:尽管几十年来倡导者一直在努力提高本科护理计划中的老年学内容,护士毕业时仍然缺乏与老年人一起工作的知识和技能。学者们认为,纳入进入实践的老年学能力可能是提高毕业生护士对老年人知识的一种方法。
    目的:研究世界各地本科准备护士的老年学进入实践能力和标准的状况。
    方法:我们使用JoannaBriggs研究所(JBI)框架对文献进行了范围审查,并遵循PRISMA-ScR指南报告了研究结果。
    方法:我们从开始到2022年6月20日在Medline和EMBASE通过OVID进行了搜索,CINAHL通过EBSCOhost,Scopus,和科克伦图书馆通过威利。我们在GOOGLE上搜索了灰色文献。我们包括研究1)学士学位护理计划的文献,2)老年学能力/标准,3)老年人/成年人。
    结果:我们发现了8个文献来源,其中4篇是学术论文和4篇文件,描述了国家护理协会的老年学入门实践标准和能力。老年学能力强调在许多护理环境中为老年人及其家人提供以人为本的护理。这种关怀包括关系和文化能力,展示专业价值观和筛查潜在的虐待老人。两篇论文中的学者传达了他们将老年学能力纳入课程的经验,以及两名研究的学生护士的老年学能力。
    结论:各国在发展和纳入老年学能力方面有兴趣并取得了一些进展,但还不够。需要采取协调的方法在国家之间共享信息和专业知识,以发展国际老年学能力,以促进改善老年人的护理。
    BACKGROUND: Despite decades of advocates striving to enhance gerontological content in baccalaureate nursing programs, nurses are still graduating with inadequate knowledge and skills to work with older adults. Scholars suggest that incorporating entry-to-practice gerontological competencies could be one way to improve graduating nurses\' knowledge about older adults.
    OBJECTIVE: To examine the state of gerontological entry to practice competencies and standards for baccalaureate-prepared nurses around the world.
    METHODS: We conducted a scoping review of the literature using the Joanna Briggs Institute (JBI) framework and followed PRISMA-ScR guidelines to report findings.
    METHODS: We performed searches from inception to June 20th 2022 in Medline and EMBASE via OVID, CINAHL via EBSCOhost, Scopus, and Cochrane Library via Wiley. We conducted a search on GOOGLE for grey literature. We included literature that examined 1) baccalaureate nursing programs, 2) gerontological competencies/standards, and 3) older people/adults.
    RESULTS: We found 8 literature sources, 4 of which were academic papers and 4 documents describing gerontological entry-to-practice standards and competencies from national nursing associations. Gerontological competencies highlight providing person-centered care to older people and their families across many care contexts. This care includes relational and cultural competence, exhibiting professional values and screening for potential elder abuse. Scholars in two papers relayed their experiences incorporating gerontological competencies into their curricula and two studied student nurses\' gerontological competency.
    CONCLUSIONS: There is interest and some progress in developing and incorporating gerontological competencies in various countries but not enough. A coordinated approach to sharing information and expertise among nations is needed to develop international gerontological competencies to facilitate improved nursing care with older adults.
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