Geriatrics (Basel, Switzerland)最新文献

{"title":"Patient Interaction Involving Older Adults: Provider vs. Caregiver Expectations.","authors":"Pooja Shah,&nbsp;Kaitlin Donovan,&nbsp;Robert Hubal","doi":"10.3390/geriatrics7050101","DOIUrl":"https://doi.org/10.3390/geriatrics7050101","url":null,"abstract":"<p><p>This paper presents a study of the interaction between healthcare providers (HCPs) and older patients and their caregivers. The paper first presents results from a rapid review and narrative synthesis using PubMed and Google Scholar of HCP/patient/caregiver interactions involving older patients; these results then informed the design of a survey administered to HCPs and caregivers using a range of scenarios and their ratings of appropriateness of different responses, to explore where expectations align or differ between HCPs and caregivers. In analyzing ratings, the research found HCPs and caregivers generally approach the older adult encounter with similar expectations, but differences for specific situations are informative. HCPs appear to better recognize when there is a need to show empathy, as when a patient is frustrated or anxious. HCPs, overall, offer more calming responses, especially in embarrassing, upsetting, or worrying situations. For older patients of advanced age, HCPs value engagement with patients more than caregivers, but HCPs are more aligned with caregivers in their ratings of how to engage caregivers. Compared to caregivers, HCPs focus more on simplifying the description of treatment rather than using thorough explanations when a patient expresses hesitancy or avoidance. The results from this work suggest that having a fuller understanding of the different participants' expectations may improve communication and identify potential pitfalls. A better understanding may also lead to changes in how students in the healthcare fields are trained; having better insight into this relationship will prepare them for interacting with older patients while addressing the needs of caregivers.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33470033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of New Exercises to Promote Physical Activity in Nursing Home Settings.","authors":"Fanny Buckinx,&nbsp;Lucie Maton,&nbsp;Valentine Dalimier,&nbsp;Alexandre Mouton,&nbsp;Laetitia Lengelé,&nbsp;Jean-Yves Reginster,&nbsp;Olivier Bruyère","doi":"10.3390/geriatrics7050100","DOIUrl":"https://doi.org/10.3390/geriatrics7050100","url":null,"abstract":"<p><strong>Background: </strong>GAMotion is a giant physical activity board game intended to improve levels of physical activity and a broader array of physical and psychological outcomes among nursing home residents.</p><p><strong>Objective: </strong>The aim of the present study is to develop and validate new balance, flexibility, muscle strength, and walking exercises to be included in GAMotion.</p><p><strong>Methods: </strong>A two-step design combining the Focus group and Delphi method was conducted among healthcare professionals divided into two independent samples of experts. The first sample was asked to develop exercises during a focus group. The second sample participated in a two-round Ranking-type Delphi method. During the first round, the participants were asked to rate the exercises developed during the focus group on a four-point Likert scale (from 1: not adapted at all to 4: very adapted). The exercises that did not reach consensus were removed (consensus established: median ≥ 3 on the Likert scale and at least 75% of experts rating the exercises as « adapted » or « very adapted »). During the second round, it was asked to rank the exercises selected at the end of the first round from most suitable to least suitable.</p><p><strong>Results: </strong>The Focus group developed nine balance, twelve flexibility, twelve strength, and nine walking exercises. Following the first round of the Delphi method, two exercises in each category did not reach a consensus and were then removed. In the second round, the remaining seven balance, ten flexibility, ten strength, and seven walking exercises were ranked by the experts, and this classification allowed us to determine the four most suitable exercises from each category to be included in the GAMotion.</p><p><strong>Conclusion: </strong>A consensus-based approach among healthcare professionals allowed us to contribute to the development of new exercises to promote physical activity in nursing homes. These validated exercises can be included in the GAMotion board game.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33470032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Updates on Risk and Management Plans Associated with Polypharmacy in Older Population.","authors":"Asim Muhammed Alshanberi","doi":"10.3390/geriatrics7050097","DOIUrl":"https://doi.org/10.3390/geriatrics7050097","url":null,"abstract":"<p><p>The concept of polypharmacy encompasses adverse drug reactions and non-adherence factors in elderly individuals. It also leads to the increased use of healthcare services and negative health outcomes. The problem is further alleviated by the odds of potentially inappropriate medications (PIM), which lead to the development of drug-related problems. Since polypharmacy is more commonly observed in the elderly population, urgency is required to introduce operative protocols for preventing and managing this problem. The family medicine model of care can be associated with favorable illness outcomes regarding satisfaction with consultation, treatment adherence, self-management behaviors, adherence to medical advice, and healthcare utilization. Hence, interventions built on family medicine models can provide significant support in improving the outcomes of the older population and their quality of life. In this regard, the authors have taken up the task of explaining the accessible resources which can be availed to improve the application of health care services in the field of geriatric medicine.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life in Community-Dwelling Older People with Functional and Nutritional Impairment and Depressive Symptoms: A Comparative Cross-Sectional Study in Brazil and Portugal.","authors":"Jéssica Maria Arouca de Miranda,&nbsp;Dalyanna Mildred de Oliveira Viana,&nbsp;Anderson Antônio Lima Dos Santos,&nbsp;Áquila Filêmon de Andrade Costa,&nbsp;Bruno Araújo da Silva Dantas,&nbsp;Francisco Arnoldo Nunes de Miranda,&nbsp;Felismina Rosa Parreira Mendes,&nbsp;Gilson de Vasconcelos Torres","doi":"10.3390/geriatrics7050096","DOIUrl":"https://doi.org/10.3390/geriatrics7050096","url":null,"abstract":"<p><strong>Background: </strong>The interaction of quality of life (QoL) with functionality, nutrition and depression has been studied, but few studies have compared different realities. Our objective was to compare the associations of QoL with impaired functionality, nutritional status and depressive symptoms among older people patients treated in primary health care (PHC) in Brazil and Portugal.</p><p><strong>Methods: </strong>Cross-sectional, comparative study was conducted with primary data from PHC services in Brazil and Portugal with users over 65 years old. Participants' scores were classified as \"impaired\" and \"preserved\" for QoL, functional decline, nutrition and depression. We used Pearson's chi-square test, Fisher's exact test and the Mann-Whitney U test.</p><p><strong>Results: </strong>Our sample had a total of 150 PHC users. We found lower QoL scores in Brazil, which were associated with the risk of functional decline for the domains Physical Functioning, General Health Perceptions, Mental Health dimensions and Physical Health. Nutritional impairment in the group from Portugal included the domains of Vitality and Social Role Functioning. For depressive impairment, Portugal showed an association with the domains Mental Health, Vitality and Social Role Functioning.</p><p><strong>Conclusions: </strong>QoL was associated with functional and nutritional impairment and depressive symptoms, highlighting physical, mental and social characteristics related to the perception of well-being.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mild Cognitive Impairment Is Associated with Poorer Nutritional Status on Hospital Admission and after Discharge in Acutely Hospitalized Older Patients.","authors":"Olivia Bornæs,&nbsp;Aino L Andersen,&nbsp;Morten B Houlind,&nbsp;Thomas Kallemose,&nbsp;Juliette Tavenier,&nbsp;Anissa Aharaz,&nbsp;Rikke L Nielsen,&nbsp;Lillian M Jørgensen,&nbsp;Anne M Beck,&nbsp;Ove Andersen,&nbsp;Janne Petersen,&nbsp;Mette M Pedersen","doi":"10.3390/geriatrics7050095","DOIUrl":"https://doi.org/10.3390/geriatrics7050095","url":null,"abstract":"<p><p>In acutely hospitalized older patients (≥65 years), the association between mild cognitive impairment (MCI) and malnutrition is poorly described. We hypothesized that (1) MCI is associated with nutritional status on admission and after discharge; (2) MCI is associated with a change in nutritional status; and (3) a potential association is partly explained by frailty, comorbidity, medication use, and age. We combined data from a randomized controlled trial (control group data) and a prospective cohort study (ClinicalTrials.gov: NCT01964482 and NCT03052192). Nutritional status was assessed on admission and follow-up using the Mini Nutritional Assessment-Short Form. MCI or intact cognition (noMCI) was classified by three cognitive performance tests at follow-up. Data on frailty, comorbidity, medication use, and age were drawn from patient journals. MCI (<i>n</i> = 42) compared to noMCI (<i>n</i> = 47) was associated with poorer nutritional status with an average difference of -1.29 points (CI: -2.30; -0.28) on admission and -1.64 points (CI: -2.57; -0.70) at 4-week follow-up. Only age influenced the estimates of -0.85 (CI: -1.86; 0.17) and -1.29 (CI: -2.25; -0.34), respectively. In acutely hospitalized older patients, there is an association between MCI and poorer nutritional status upon admission and four weeks after discharge. The association is partly explained by higher age.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Nurses in Nursing Homes during the COVID-19 Pandemic in Germany: A Qualitative Study.","authors":"Elisabeth Diehl,&nbsp;David Hiss,&nbsp;Aline Wege,&nbsp;Anna Hirschmüller,&nbsp;Albert Nienhaus,&nbsp;Stephan Letzel","doi":"10.3390/geriatrics7050094","DOIUrl":"https://doi.org/10.3390/geriatrics7050094","url":null,"abstract":"<p><p>(1) Background: The aim of this qualitative study was to examine pandemic-related changes in nursing work in nursing homes, the resulting work-related stresses and external as well as internal alleviating measures. (2) Methods: We conducted 10 interviews from March to June 2021 with nurses from eight facilities. Data were analysed according to qualitative content analysis. (3) Results: Nurses faced increased workloads due to regulations and guidelines paired with staffing shortages. Work became more difficult due to personal protective equipment (PPE), conflict with residents' relatives and, in the case of outbreaks, excess death and suffering. Nurse-to-resident care work became more emotionally demanding, with residents more distressed due to the lockdown, while families and social workers were not allowed into the facility. Residents with dementia posed an additional challenge, as they did not remember hygiene and distancing rules. Internal and external measures were not sufficient to alleviate the situation. However, some measures, such as training programmes or existing palliative care concepts, were considered helpful. (4) Conclusions: Facing other possible upcoming pandemics, ways to improve facility administration to prepare for future pandemics are highly needed, such as regular training programmes to prepare for possible lockdown scenarios, PPE use or potential hygiene measures.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culturally Competent Assessment of Neurocognitive Functioning in Latinos with Complex Multimorbidity: A Case Study.","authors":"Diomaris Safi,&nbsp;Jesús Barreto Abrams,&nbsp;Melissa Rios,&nbsp;Elisenda Rodés,&nbsp;Mirella Díaz-Santos,&nbsp;Paola Suárez","doi":"10.3390/geriatrics7050093","DOIUrl":"https://doi.org/10.3390/geriatrics7050093","url":null,"abstract":"<p><p>Multimorbidity-the coexistence of multiple chronic conditions within an individual-is the new normal in hospital settings. Individuals with higher levels of multimorbidity require a multidisciplinary and holistic approach to meet their needs, though the complexity of their neurocognitive profiles is still poorly researched. This study reported on the neurocognitive profile of a 69-year-old, left-handed, Latino cisgender male with 10 years of education. He was deemed to have a short-term mortality in 2018, yet is still enjoying a good quality of life in 2022. This case report illustrated (a) a rather common neurocognitive profile of a patient with complex multimorbidity, (b) the advantages of being served in a center of excellence with linguistically and culturally appropriate services that evaluate patients' cognitive functioning and inform and provide continuity of care, and (c) the benefits of a holistic and multidisciplinary approach to the care of the multimorbidity population.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric Oncology in Portugal: Where We Are and What Comes Next-A Survey of Healthcare Professionals.","authors":"Joana Marinho,&nbsp;Sandra Custódio","doi":"10.3390/geriatrics7050091","DOIUrl":"https://doi.org/10.3390/geriatrics7050091","url":null,"abstract":"<p><p>In keeping with the trend worldwide, in Portugal, more than 60% of newly diagnosed patients with cancer are aged 65 years or older, which makes older adults the most common population seen in an oncology practice. This study's objectives were to assess geriatric oncology practices in Portugal and investigate medical professionals' current needs and perceptions on the treatment of elderly cancer patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using a web-based survey of healthcare providers treating elderly patients.</p><p><strong>Results: </strong>There were 222 responses: 62.6% of physicians reported the absence of geriatric oncology and/or geriatrics consultations in their institutions, 14.9% had guidelines for the management of older patients with cancer and 4.5% had physicians dedicated to geriatric oncology. The reported use of geriatric assessment tools was 23.4%. Medical oncologists and physicians from medical specialties (<i>p</i> = 0.009) and those practicing in the south of Portugal (<i>p</i> = 0.054) were more likely to use geriatric assessment. Education and training in geriatric oncology was identified by 95.0% of respondents as an unmet need. The inquiries identified that geriatric assessment could be useful to define a therapeutic strategy (85.1%), detect frailty (77.5%), predict toxicity and improve quality of life (73.4%).</p><p><strong>Conclusions: </strong>There is a paucity of expertise and training in geriatric oncology in Portugal but an increasing perception of the value of geriatric assessment and the demand for education. In the next years, Portugal will progress in this area with the aid of the recently created Geriatric Oncology Working Group.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Parity in Geriatrics Editorial Boards.","authors":"Sana Shah,&nbsp;Nichole B Shumway,&nbsp;Emily W Sarvis,&nbsp;Joe A Sena,&nbsp;Alesia Voice,&nbsp;Aqsa Mumtaz,&nbsp;Abu Baker Sheikh","doi":"10.3390/geriatrics7050090","DOIUrl":"https://doi.org/10.3390/geriatrics7050090","url":null,"abstract":"<p><p>Gender equality, with an emphasis on female education, has been designated by the United Nations as one of the 17 Sustainable Development Goals (SDGs) to be completed by 2030, since gender disparity is a major impediment to scientific and economic progress. This study was carried out in an effort to address the gender gaps that can be seen in academic and scientific publications. The purpose of this study is to describe the gender distribution of editorial board members and editors-in-chief across geriatrics journals with high impact factors. Clarivate Journal Citation Reports (JCR) 2021 were used to guide the selection of geriatric and gerontology journals utilizing Scopus All Science Journal Classification Codes. The genders of the editors-in-chief and editorial board members were determined and analyzed using publicly accessible data. A total of 47 geriatric journals with an average impact factor of 4.27 were examined. Of the 65 editors-in-chief, 21 (32%) were women, whereas 876 female editorial members were found out of a total of 2414, which constitutes 36% in total. Despite making up 60% of the geriatric medical workforce, women are still underrepresented on editorial boards and as chief editors in well-known geriatric periodicals.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33470843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty as a Predictor of Hospitalization and Low Quality of Life in Geriatric Patients at an Internal Medicine Outpatient Clinic: A Cross-Sectional Study.","authors":"Panita Limpawattana,&nbsp;Chudapha Khammak,&nbsp;Manchumad Manjavong,&nbsp;Apichart So-Ngern","doi":"10.3390/geriatrics7050089","DOIUrl":"https://doi.org/10.3390/geriatrics7050089","url":null,"abstract":"<p><p>Frailty is an aging-associated state that increases patients' vulnerability to disease, and can lead to various adverse outcomes. It is classified as either physical frailty alone or physical frailty in combination with cognitive impairment (cognitive frailty). There are currently limited data available regarding the prevalence and adverse outcomes of frailty in Thailand. This was a cross-sectional study aimed at determining the prevalence of physical and cognitive frailty and their effects on hospitalization and quality of life. Participants were older patients who attended an internal medicine outpatient clinic. Frailty was diagnosed using the Thai Frailty Index. The Thai version of the MoCA was used to evaluate cognitive status. Univariate and multivariate analyses were performed to compare adverse outcomes in terms of poor quality of life and history of admission to hospital between patients with frailty and non-frail patients, and among patients with physical frailty, cognitive frailty, cognitive impairment, and robust (non-frail and non-cognitively impaired) patients. We enrolled 198 participants. The prevalence of physical and cognitive frailty was 28.78% and 20.70%, respectively. When compared with non-frail patients, frailty was associated with hospitalization (adjusted OR 3.01, <i>p =</i> 0.002) but was not significantly related to quality of life (adjusted OR = 1.98, <i>p</i> = 0.09). However, physical and cognitive frailty were associated with fair quality of life when compared with normal patients (adjusted OR = 4.34, <i>p</i> = 0.04 and adjusted OR = 4.28, <i>p</i> = 0.03, respectively). The prevalence of frailty-particularly cognitive frailty-was high. Frailty was associated with adverse outcomes in terms of hospitalization and quality of life.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33470842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}