This study investigated the diagnostic accuracy of different clusters of performance based outcome measures (PBOMs) recommended by two consensus-based guidelines: Stopping Elderly Accidents, Deaths, and Injuries (STEADI), and those recommended by a systematic review completed by the American Physical Therapy Association and Academy of Geriatric Physical Therapy (APTA-SR, APTA-SR3). 33 community-dwelling older adults (25 females, 8 males) aged mean 79.45 ± 7.64 years participated in this study. Participants completed a fall history questionnaire and were evaluated via a battery of PBOMs for comparative analysis. The diagnostic accuracy of each PBOM cluster was analyzed retrospectively (previous 1 year fall history) and prospectively (6 month follow up). Retrospective analysis revealed the APTA-SR3 had the highest clinical utility and diagnostic accuracy: Sp 88.24% (63.56-98.54), Sn 62.5% (35.43-84.8), LR+ 2.35 (1.22-4.53), LR- 0.19 (0.05-0.73), accuracy 70.22% (51.83-84.81). Prospective analysis revealed the cluster of the APTA-SR and APTA-SR3 had identical diagnostic accuracy: Sn 100% (39.76-100), Sp 43.75% (19.75-70.12), LR+ 1.78 (1.15-2.74), LR- 0 (0), accuracy 60.62% (36.63-81.36). The APTA-SR 3 cluster demonstrated the highest diagnostic accuracy and in this study was the most effective and efficient group of PBOMs to identify fall risk in community dwelling older adults.

This paper examines how older adults who participated in an online photovoice-based group intervention program reported their experience. In a qualitative-phenomenological study, in which 13 older-adult people participated, data were collected through semi-structured in-depth interviews and analyzed through content analysis. The findings point to three central themes: a) Challenges-technical difficulties, difficulties in finding a subject for photography, investing time in photography, and an emotional-intellectual effort to put their experience into photography; b) Growth: New knowledge and skills-acquiring new knowledge, acquiring skills, experiencing skills regardless of age, and empowerment; c) Meaning-reflexivity, the ability to project feelings onto images, connection to the outside world, mindfulness, ability to choose, creativity, and critical consciousness. The findings share the way in which the use of creative visual engagement with photography contributed to coping with various challenges and enabled various gains within the process among the older-adult participants.

Governing organisations for health services currently recommend a patient-centred (PC) approach to practice for all health professions, including dietetics. For the vulnerable older malnourished patient, this approach needs to be prioritised to improve outcomes. The paucity of patient experience data likely limits evidence-based, patient-centred care (PCC) from being implemented effectively. The present study aimed to identify quality indicators of dietetic services from the perspectives of older malnourished patients to inform evidence-based PC dietetic care.
Surveys were completed by a sample of 28 females and 28 males (mean age 81 years) who had been seen by a dietitian for malnutrition assessment. In-depth, face-to-face, semi-structured interviews were undertaken with a sub-sample of four females and six males (mean age 81 years). Interviews were transcribed verbatim. Thematic analysis of transcripts and open-ended survey responses was conducted to determine patient-identified quality indicators.
Three structure indicators (continuity of care through regular contact and post-discharge dietetic follow-up; interdisciplinary coordination and collaboration; and high-quality hospital food services), five process indicators (addressing a patient\'s primary medical concern; involving the patient\'s family; providing clear and simple dietetic information; providing expert dietary knowledge; utilising interpersonal communication skills) and three outcome indicators (improvement in health status; improvement or maintenance of independence; weight gain) were identified. The experiences of older malnourished patients with dietetic services, as described in the present study, reinforce the importance of ensuring high-quality and tailored dietetic care as a key element of PC dietetic services.
The quality indicators of dietetic services identified in the present study may facilitate dietitians to provide evidence-based PCC for older malnourished patients.