care homes

疗养院
  • 文章类型: Journal Article
    居住在养老院的人中,高达26%的人受到癌症的影响。这强调了了解患有癌症的养老院居民的整体需求以提高其护理质量的重要性。这篇综合文献综述的主要目的是巩固现有的关于疗养院癌症患者综合需求的证据。为满足他们多样化的需求提供有价值的见解。采用系统的方法进行了综合文献综述。在三个数据库中进行了广泛的搜索,辅以对灰色文献和相关论文的参考列表的全面审查。该评论的重点是2012年至2022年之间发表的文献。筛选过程涉及两名独立的审查员,由第三位审稿人解决任何差异。审查确定了20篇符合资格标准的研究论文。这些论文揭示了与癌症疗养院居民整体需求相关的三个主要主题:身体,心理,和报废的需求。身体需求包括疼痛管理,症状控制,和营养,虽然心理需求涉及社会支持,情感幸福,和精神保健。临终需求解决了临终护理和提前护理计划。这些主题突出了疗养院癌症护理的多面性,并强调了以全面和综合的方式满足居民整体需求的重要性。改善有关癌症的养老院教育,并在这种环境中整合姑息治疗和临终关怀服务对于满足癌症患者的多样化需求至关重要。
    Up to 26% of individuals residing in care homes are impacted by cancer. This underscores the importance of understanding the holistic needs of care home residents living with cancer to enhance the quality of their care. The primary objective of this integrative literature review was to consolidate the available evidence concerning the comprehensive needs of people living with cancer in care home settings, providing valuable insights into addressing their diverse needs. An integrative literature review was conducted using a systematic approach. Extensive searches were conducted in three databases, complemented by a thorough examination of grey literature and reference lists of relevant papers. The review focused on literature published between 2012 and 2022. The screening process involved two independent reviewers, with a third reviewer resolving any discrepancies. The review identified twenty research papers that met the eligibility criteria. These papers shed light on three primary themes related to the holistic needs of care home residents with cancer: physical, psychological, and end-of-life needs. Physical needs encompassed pain management, symptom control, and nutrition, while psychological needs involved social support, emotional well-being, and mental health care. End-of-life needs addressed end-of-life care and advance care planning. These themes highlight the multifaceted nature of cancer care in care homes and underscore the importance of addressing residents\' holistic needs in a comprehensive and integrated manner. Improving care home education about cancer and integrating palliative and hospice services within this setting are vital for addressing the diverse needs of residents with cancer.
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  • 文章类型: Systematic Review
    社会距离措施(SDM)是社区一级的干预措施,旨在减少社区中的人与人之间的接触。SDM是首先包含的回应的主要部分,然后缓解,SARS-CoV-2在社区中的传播。常见的SDM包括限制聚会的规模,关闭学校和/或工作场所,实施在家工作安排,或更严格的限制,如锁定。这篇系统综述总结了9项SDM有效性的证据。几乎所有纳入的研究都是观察性的,这意味着在随机分配给研究参与者的条件下,存在本可以避免的固有偏倚风险.在研究期间,没有在特定环境中只有一种形式的SDM存在的情况。这使得很难估计每种干预措施的单独效果。更严格的SDM,如留在家里的订单,估计对大规模集会和关闭的限制对减少SARS-CoV-2传播最有效。这篇综述中包含的大多数研究表明,SDM的组合成功地减缓甚至阻止了SARS-CoV-2在社区中的传播。然而,个体效应和干预措施的最佳组合,以及特定措施的最佳时机,需要进一步调查。本文是“非药物干预对COVID-19大流行的有效性:证据”主题的一部分。
    Social distancing measures (SDMs) are community-level interventions that aim to reduce person-to-person contacts in the community. SDMs were a major part of the responses first to contain, then to mitigate, the spread of SARS-CoV-2 in the community. Common SDMs included limiting the size of gatherings, closing schools and/or workplaces, implementing work-from-home arrangements, or more stringent restrictions such as lockdowns. This systematic review summarized the evidence for the effectiveness of nine SDMs. Almost all of the studies included were observational in nature, which meant that there were intrinsic risks of bias that could have been avoided were conditions randomly assigned to study participants. There were no instances where only one form of SDM had been in place in a particular setting during the study period, making it challenging to estimate the separate effect of each intervention. The more stringent SDMs such as stay-at-home orders, restrictions on mass gatherings and closures were estimated to be most effective at reducing SARS-CoV-2 transmission. Most studies included in this review suggested that combinations of SDMs successfully slowed or even stopped SARS-CoV-2 transmission in the community. However, individual effects and optimal combinations of interventions, as well as the optimal timing for particular measures, require further investigation. This article is part of the theme issue \'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence\'.
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  • 文章类型: Journal Article
    背景:在COVID-19大流行期间,养老院受到的影响不成比例。在养老院环境中制定感染控制措施的实际挑战已被广泛报道,但是在实施此类措施期间,对养老院工作人员的道德问题知之甚少。.
    目的:了解在COVID-19大流行的最初几个月,养老院工作人员所感受到的道德挑战。
    方法:探索性定性研究。
    方法:在2020年6月至8月期间,招募了15名香港不同角色和职级的养老院工作人员,参加半结构化访谈。
    方法:本研究获得了伦理批准。参与是自愿和匿名的。参与者有权在任何时候退出研究,没有报复。
    结果:确定了三个主题:感染控制措施的合法性不明确,在选择感染控制措施方面的自主权有限,不可避免地对居民的福祉造成伤害。虽然与会者期望他们将实施感染控制措施的权力合法化,当他们的测试和疫苗接种自决权受到侵犯时,他们就会产生抗药性。他们还感到被困在保护养老院居民免受感染风险的道德义务与感染控制措施的预期有害影响之间。
    结论:这项研究的结果揭示了养老院工作人员在应对突发公共卫生事件时的道德义务之间的紧张关系。他们强调了在确定和解决大流行应对挑战方面加强道德敏感性和道德领导力的重要性。
    BACKGROUND: Care homes have been disproportionately affected during the COVID-19 pandemic. Practical challenges of enacting infection control measures in care home settings have been widely reported, but little is known about the ethical concerns of care home staff during the implementation of such measures. .
    OBJECTIVE: To understand the ethical challenges perceived by care home staff during the early months of the COVID-19 pandemic.
    METHODS: An exploratory qualitative study.
    METHODS: A purposive sample of 15 care home staff in different roles and ranks in Hong Kong was recruited to take part in semi-structured interviews between June and August 2020.
    METHODS: Ethical approval for this study was obtained. Participation was voluntary and anonymous. Participants had the right to withdraw from the study at any time without reprisal.
    RESULTS: Three themes were identified: unclear legitimacy regarding infection control measures, limited autonomy in choices over infection control measures and inevitable harms to residents\' well-being. While the participants expected that they would have legitimated power to implement infection control measures, they were resistant when their right to self-determination of testing and vaccination was infringed. They also felt trapped between ethical duties to protect care home residents from infection risk and the anticipated detrimental effects of infection control measures.
    CONCLUSIONS: The findings of this study reveal tensions among the ethical obligations of care home staff in response to a public health emergency. They highlight the importance of strengthening ethical sensitivity and ethical leadership in identifying and resolving the challenges of pandemic responses.
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  • 文章类型: Journal Article
    OBJECTIVE: Despite the large number of older adults living in care homes in China, the reported prevalence of depression in such settings has varied greatly, while its pooled overall prevalence has remained unknown. In response, our systematic review and meta-analysis were designed to provide accurate, comprehensive evidence of the prevalence of geriatric depression in care homes in China.
    METHODS: Literature searches were conducted independently by two investigators in English- and Chinese-language databases from database inception through January 2020. The prevalence of depressive symptoms in late life was analyzed with a random effects model.
    RESULTS: In 69 studies addressing older adults living in care homes in China, the pooled overall prevalence of depressive symptoms was 36.8% (95% CI, 32.7%-41.1%). Respective estimates for mild and moderate-to-severe depressive symptoms were 29.1% (95% CI, 25.2%-32.7%) and 9.1% (95% CI, 7.5%-11.0%). Subgroup analyses revealed significant differences in the prevalence of late-life depression in care homes according to the type of care home, the individual\'s socioeconomic status, and the measurement instrument(s) used. Meta-regression analysis indicated that the prevalence of late-life depression among older adults living in care homes generally rose from 1991 to 2019.
    CONCLUSIONS: Given the high prevalence of geriatric depression in China\'s care homes, future studies should examine its risk and protective factors in those settings.
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  • 文章类型: Journal Article
    了解久坐的模式可以指导设计使老年人参与体育锻炼的策略。这项范围审查旨在综合有关护理机构久坐行为的现有证据。我们搜索了PubMed/MEDLINE和WebofScience从开始到2020年10月发表的研究。根据系统评价和荟萃分析(PRISMA)指南的首选报告项目纳入并审查了18项研究。根据所提供的护理水平分析获得的数据。总的来说,高级护理设施中的居民每天久坐时间较高(例如,疗养院)(11.6小时/天)比中级/混合水平护理设施(例如,辅助生活)(9.5小时/天)。在中级/混合级护理设施中,电视(TV)观看是最常见的久坐活动(每天2.5-2.9小时;每天久坐时间的26%),而午睡是高级护理机构中最喜欢的久坐活动(4.7小时/天;清醒时间的36%)。久坐行为的日常模式的性别差异(久坐时间,不间断的比赛,和回合持续时间)通常在中级/混合级别护理设施中观察到,例如,男性久坐不动0.7-1.1小时/天。总之,这项研究强调了居住在不同级别护理设施中的老年人的独特久坐模式,满足定制干预措施的迫切需要,使护理机构居民参与体育活动。
    Understanding the sedentary patterns can guide the design of strategies to engage older adults in physical activity. This scoping review aimed to synthesize available evidence on sedentary behaviors in care facilities. We searched PubMed/MEDLINE and Web of Science for studies published from inception through October 2020. Eighteen studies were included and reviewed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Data obtained were analyzed based on levels of care provided. Overall, daily sedentary time was higher among residents in high level care facilities (e.g., nursing homes) (11.6 h/day) than intermediate/mixed level care facilities (e.g., assisted living) (9.5 h/day). In intermediate/mixed level care facilities, television (TV) viewing was the most common sedentary activity (2.5-2.9 h/day; 26% of daily sedentary time), while napping was the most favorite sedentary activity (4.7 h/day; 36% of waking hours) in high level care facilities. Sex differences in daily patterns of sedentary behavior (sedentary time, uninterrupted bouts, and bout durations) were commonly observed in intermediate/mixed level care facilities, as exemplified by men being more sedentary by 0.7-1.1 h/day. In summary, this study highlights distinctive sedentary patterns among older adults residing in different levels of care facilities, addressing a pressing need for customized interventions to engage care facility residents in physical activity.
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