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Factors associated with the intrinsic capacity in older adults: A scoping review

Abstract

Introduction

In 2015, the term ‘intrinsic capacity’ (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain.

Aim

We aim to synthesise the factors connected with IC.

Methods

This scoping review followed the five-stage framework of Arksey and O'Malley and was reported using PRISMA-ScR guidelines.

Results

In all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults.

Conclusions

This review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults.

Relevance to Clinical Practice

The influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well-being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline.

No Patient or Public Contribution

As this is a scoping review, no patient or public contributions are required.

Effects of different dressings in the prevention of facial skin pressure injury related to non‐invasive ventilation: Systematic review and network meta‐analysis

Abstract

To investigate the preventive effect of different dressings on pressure injuries related to non-invasive ventilation equipment and to screen the efficacy of dressings. Systematic review and network meta-analysis. PubMed, the Cochrane Library, Web of Science, EMBASE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM) and Weipu Database (VIP) were used for the search from the date of inception of each database to 15 October 2023. The quality of the data was assessed using the Cochrane Risk of Bias tool. Stata 16.0 Software was used to analysis and ranking of different types of dressings. A total of 23 randomized controlled trials on 7 interventions were included in the final analysis. The effectiveness of these in preventing the overall incidence of pressure injuries is ranked from best to worst as follows: hydrogel dressing > foam dressing > petroleum jelly gauze dressing > hydrocolloid dressing > film dressing > clean gauze dressing > sterile gauze. Sixteen studies reported the incidence of Stage I pressure injuries, the effectiveness in preventing the incidence of Stage I pressure injuries was ranked from best to least effective: foam dressing > hydrogel dressing > petroleum jelly gauze dressing > hydrocolloid dressing > film dressing > clean gauze dressing > sterile gauze dressing. Fourteen studies reported the incidence of Stages I/II pressure injuries, the effective in preventing the incidence of Stages I and II pressure injuries was ranked from best to least effective: foam dressing > hydrogel dressing > petroleum jelly gauze dressing > hydrocolloid dressing > clean gauze dressing > sterile gauze dressing. Considering the advantages and disadvantages of different dressings, both hydrogel and foam dressings are effective in preventing pressure injuries related to non-invasive ventilation equipment.

Validity and reliability of the Waterlow scale for assessing pressure injury risk in critical adult patients: A multi‐centre cohort study

Abstract

Aim

To evaluate the predictive validity and reliability of the Waterlow scale in critically adult hospitalised patients.

Design

A multi-centre cohort study.

Methods

This study was conducted in 72 intensive care units (ICUs) in 38 tertiary hospitals in Gansu Province, China. All adults admitted to the ICU for greater than or equal to 24 h without pressure injury (PI) on admission were screened by the Waterlow scale on admission, during ICU stay and ICU discharge from April 2021 to February 2023. Receiver operating characteristic (ROC) curves were used to determine a potential cut-off value for critical adult hospitalised patients. Cut-off values were then determined using Youden's index, and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated based on these cut-off values. Test–retest reliability was used to evaluate inter-rater reliability.

Results

A total of 5874 critical patients on admission were included, and 5125 of them were assessed regularly. The area under curve (AUC) was 0.623 (95% CI, 0.574–0.690), with a cut-off score of 19 showing the best balance among sensitivity of 62.7%, specificity of 57.4%, positive predictive value of 2.07% and negative predictive value of 99.08%. The test–retest reliability between the first assessment and the regular assessment was 0.447.

Conclusions

The Waterlow scale shows insufficient predictive validity and reliability in discriminating critical adults at risk of PI development. To further modify the items of the Waterlow scale, exploring specific risk factors for PI in the ICU and clarifying their impact degree was necessary. Risk predictive models or better tools are inevitable in the future.

Patient or Public Contribution

Patients or family members supported nurses with PI risk assessment, skin examination and other activities during the inquiry.

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