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Predictive Capacity of the Integrated Care for Older People Screening Tool to Assess Fall Risk in Older Adults in Geriatric Care

ABSTRACT

Aim

To evaluate the predictive capacity of the Integrated Care for Older People screening tool for the risk of falls in older people receiving care at a healthcare service.

Design

A cross-sectional study.

Method

This study was conducted in a geriatric healthcare service in the southeast region of Brazil. The convenience sample included older people aged 60 and over living at home. The study used the Fall Risk Score to assess the risk of falls and the Integrated Care for Older People screening tool to track intrinsic capacity. The data was analysed using logistic regression to analyse the association between the six Intrinsic Capacity domains, for the early detection of impairment and risk of falls.

Results

A total of 253 older adults participated in the study, most of whom were identified as having a high risk of falls. Logistic regression analysis across six association models revealed that the models including the Intrinsic Capacity domains of locomotion and hearing had a significant association with having a higher risk of falls. Care plans should prioritise the domains most strongly associated with fall risk, guiding targeted strategies to enhance older adults' safety.

Conclusion

The Integrated Care for Older People screening tool, in the locomotion and hearing domains, is associated with the risk of falls in older people from the community receiving care in a geriatric healthcare service. Future longitudinal studies could show whether other domains of intrinsic capacity can predict the occurrence of falls.

Relevance to Clinical Practice

This study highlights the Integrated Care for Older People screening tool as essential in nursing practice, especially for assessing the locomotion and hearing domains of intrinsic capacity. Early detection of impairments helps identify increased fall risk in older adults, enabling nurses to implement targeted, person-centred interventions that enhance safety, autonomy and overall quality of life.

Patient or Public Contribution

No patient or public contribution.

Reporting Method

This study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.

Work ability during the COVID-19 pandemic: A cross-sectional study in a low-income urban setting in Brazil

by Ana Paula Cândido Oliveira, Daniela Alencar Vieira, Cristiane Wanderley Cardoso, Tereza Magalhães, Rosangela Oliveira Anjos, Eduardo José Farias Borges Reis, Kionna Oliveira Bernardes Santos, Guilherme Sousa Ribeiro

Work ability is a subjective concept that reflects the balance between an individual’s perception of the physical, mental, and social demands of work and their competence and resources to meet those demands. The COVID-19 crisis significantly impacted health, work, and socioeconomic conditions worldwide. However, few studies have examined work ability in disadvantaged urban communities during this period. To analyze factors associated with work ability within the context of social vulnerability during the COVID-19 pandemic, we conducted a cross-sectional study in a low-income neighborhood in Salvador, Brazil, between February and June 2022. Sociodemographic, health, and labor data were collected, and work ability was assessed using the Work Ability Index (WAI), a widely used tool for evaluating work ability. Multivariable analyses based on a hierarchical model were run to investigate factors associated with low WAI scores. The study included 292 workers aged ≥16 years (59.6% women; median age 41 years). Most workers (84.6%) were classified as having adequate work ability based on their WAI scores. Multivariable analyses found that inadequate work ability was more frequent among women (prevalence ratio [PR]: 1.89, 95% confidence interval [CI]: 1.02-3.48), individuals who self-rated their health as moderate/good (PR: 5.91; 95% CI: 1.45-24.05) or poor/very poor (PR: 21.62; 95% CI: 5.14-90.91) compared to those with excellent/very good health, and those reporting diabetes (PR: 2.1; 95% CI: 1.13-3.9). Working >40 hours per week (PR: 0.47; 95% CI: 0.28-0.96) was negatively associated with inadequate work ability, suggesting that individuals with adequate work ability may be selected for longer working hours. A history of COVID-19 was not associated with inadequate work ability. These findings suggest that targeted interventions to improve work ability in low-income communities should prioritize women and workers with chronic health conditions, such as diabetes.

People's Experiences of Their Involvement in Nursing Care: A Qualitative Systematic Review With Meta‐Aggregation Synthesis

ABSTRACT

Introduction

Global organizations have pronounced about the importance of involving people in health care, however, this process is challenging. Given the availability of evidence that addresses people's experiences of involvement in nursing care, it is important to produce recommendations at this point by synthesizing the evidence. So, this review aims to synthesize the available qualitative evidence about people's experiences of their involvement in nursing care in a hospital setting.

Design

Systematic review of qualitative evidence.

Methods

This systematic review was conducted according to the JBI methodology for systematic reviews of qualitative evidence. A comprehensive search strategy was conducted in nine databases/resources. The selection process, methodological quality assessment, and data extraction were conducted independently by two reviewers. The data were synthesized using the meta-aggregation approach, and the results were graded according to ConQual.

Results

A total of 75 findings and 141 illustrations were extracted from the 15 included studies. These findings were aggregated into 12 categories and generated into three synthesized findings: (1) People who are hospitalized conceptualize and attribute importance to involvement in nursing care as an active process of participation and monitoring of care, decision-making, opinion, and partnership; (2) The establishment of a relationship between hospitalized people and nurses, trust, communication, and information are essential for participation in care; (3) People's participation in care is affected by the person's own constraints and preference for assuming a passive role, by barriers associated with a lack of information, the organization of care, the relationship established between nurses, and paternalistic attitudes.

Conclusion

People who were admitted to hospital conceptualized and attached importance to this phenomenon, perceived the conditions necessary to promote it, and the barriers they experienced.

Clinical Relevance

This systematic review provides recommendations for nurses' clinical practice (with grade B). It recommends that nurses should establish a partnership relationship with hospitalized people, through trust, communication and information; give people the opportunity to monitor care, participate in decision-making and give their opinion; assess the person's preferences for involvement and other factors; and that the barriers to this process identified here should be assessed and addressed in each context. As such, this review provides very valuable information for nurses' clinical practice and should also be incorporated into health policy.

Protocol Registration: PROSPERO CRD42024506501.

Self-blaming as a barrier to lung cancer screening and smoking cessation programs in Italy. A qualitative study

by Luca Ghirotto, Eugenio Paci, Claudia Bricci, Silvia Marini, Valentina Bessi, Matías Eduardo Díaz Crescitelli, Ermanno Rondini, Francesco Pistelli, Giuseppe Gorini, Sandra Bosi, Paolo Giorgi Rossi, the Working Group

Background

Lung cancer screening (LCS) combined with smoking cessation programs is a critical strategy for reducing lung cancer mortality. Understanding the perspectives of cigarette users and former ones on these interventions is essential for enhancing their acceptability and effectiveness. This study aimed to explore, in Italy, the perceptions and experiences of individuals eligible for LCS within the context of a smoking cessation program.

Methods and findings

This multicenter qualitative study was conducted in two Italian regions as part of a larger project the Italian League against Cancer promoted. Using purposive sampling, we included (a) cigarette users and former ones who participated in an Italian trial, ITALUNG study, and (b) cigarette users who had been offered individual or group smoking cessation interventions and were theoretically eligible for screening in the following years (aged 50–70, ≥15 pack-years). Data were collected through open-ended semi-structured interviews and focus group meetings and analyzed using reflexive thematic analysis. The data analysis yielded six themes covering participants’ views on the interactions between the two types of interventions (screening and smoking cessation program). Across their data, we generated the following themes: (i) depreciation and fatalism toward the risk of smoking, (ii) self-blaming and ethicality, (iii) ambivalent impact of the screening on smoking, (iv) LCS-related information and concerns, (v) teachable and motivating moments, and (vi) non-stigmatizing communication and testimony by professionals.

Conclusions

Our study underscores the importance of avoiding stigma and respecting the dignity of cigarette users in implementing LCS and smoking cessation programs. Clear communication and supportive interactions with healthcare providers are crucial for enhancing the acceptability and effectiveness of these interventions. Future research should focus on quantifying these findings and exploring additional factors influencing the acceptability and effectiveness of combined LCS and smoking cessation programs.

Dimensiones del cuidado de las familias migrantes venezolanas residentes en Colombia

El presente artículo describe las dimensiones del cuidado que se estructuran alrededor de la creación y consolidación de las redes tanto sociales como familiares de los ciudadanos migrantes venezolanas residentes en Colombia. Se desarrolló una investigación cualitativa con un enfoque hermenéutico interpretativo, se empleó como técnica de investigación la entrevista en profundidad. En total se entrevistaron 48 migrantes venezolanos. El 48 % se encontraban de manera irregular en Colombia y un 52% de manera regular. Se identificaron cuatro dimensiones que posibilitan el cuidado en la familia migrante, la dimensión del cuidado residencial; la dimensión del cuidado de la salud familiar; la dimensión del cuidado reproductivo y la dimensión del cuidado emocional que se estructuran alrededor de la creación y consolidación de las redes tanto sociales como familiares.  

Efectos de la reforma universitaria en la Escuela de Enfermería de Ribeirão Preto de la Universidad de São Paulo: 1978-1982

Objetivo: El estudio tiene como objetivo identificar los efectos de la Reforma Universitaria durante la gestión 1978-1982 de la Escuela de Enfermería de Ribeirão Preto (EERPUSP). Metodología: Estudio en el campo de la Historia, en el ámbito de la Historia de la Enfermería, con enfoque de Micro-Historia. Para alcanzar su objetivo, el estudio utilizó la Historia Oral Temática. Resultados: Los avances identificados en la gestión estuvieron relacionados con los recursos humanos, infraestructura física, consolidación de posgrados, normativa y formación de profesionales de la salud. Como efectos de la Reforma Universitária, se observó la exigencia, en la Universidad de São Paulo, de la categoría de profesor titular para el ejercicio de director, hecho que condujo a dieciséis años de dirección por parte de profesores no enfermeros, la adhesión a la unificación del vestibular, consolidación de los estudios de posgrado y cambios curriculares. Consideraciones finales: El estudio se centró en la labor de los dos directores en su momento, pero se infiere que otros personajes pudieron haber ejercido protagonismo en la concreción de los avances registrados en las actas de congregación de la Escuela.

Perceived quality of life and associated factors in long COVID syndrome among older Brazilians: A cross‐sectional study

Abstract

Aims and objectives

This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID; (b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables; and (c) assess significant predictors of high perceived QoL.

Background

Given the inherent vulnerabilities of the ageing process, the older people are an at-risk group for both contagion of SARS-CoV-2 and the perpetuation of residual symptoms after infection, the so-called long COVID or post-COVID syndrome.

Design

A cross-sectional survey design using the STROBE checklist.

Methods

Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021–March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL.

Results

The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID-19 survivors.

Conclusions

Knowledge about the persistence of physical, emotional, and social symptoms of COVID-19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society.

Relevance to clinical practice

Given the novelty of long-COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns.

Patient or Public Contribution

No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection.

El juicio clínico de las enfermeras sobre el empoderamiento del cuidador

Objetivo principal: Identificar los factores que subyacen al juicio clínico de las enfermeras sobre el empoderamiento del cuidador. Metodología: Estudio cualitativo y exploratorio. Los participantes fueron 10 enfermeras expertas que pertenecían a un grupo que apoya a sus colegas en el diseño de los cuidados apoyados en modelos teóricos y enfermeras expertas en el empoderamiento de los cuidadores, en un hospital universitario. Se realizaron entrevistas semiestructuradas con grabación de audio. Los datos se analizaron mediante la técnica de análisis de contenido. Resultados principales: Emergieron tres temas, las enfermeras, los cuidadores y las dificultades y limitaciones, que se subdividieron en ocho subtemas. Se identificaron factores facilitadores, así como limitaciones y dificultades asociadas a la asunción y gestión del rol de cuidador. Conclusión principal: El empoderamiento del cuidador es un proceso complejo, en el que los cuidados de enfermería se centran más en la persona dependiente y menos en el cuidador, lo que demuestra que es un área que requiere mayor atención y conceptualización por parte de las enfermeras.

Percepción del proceso de trabajo de los técnicos de enfermería titulados

Objetive: analizar las percepciones, motivaciones y dificultades de los técnicos de enfermería titulados en enfermería. Metodología: Me-todología: Se trata de una investigación cualitativa, exploratoria descriptiva, la recolección de datos se realizó en un Hospital Municipal del Noroeste de Paraná, durante el primer semestre de 2020, mediante la aplicación de un guión semiestructurado con preguntas orien-tadoras y un cuestionario sociodemográfico. Resultados: El conocimiento adquirido en la graduación de enfermería fue uno de los facto-res facilitadores que contribuyó a una mejor ejecución de la atención brindada, y la mayor dificultad está relacionada con la aceptación de los colegas y supervisores, en relación a las opiniones y sugerencias sobre los procedimientos u organización de la Servicio. Las razones que llevaron a los técnicos de enfermería a cursar una carrera en el área en la que trabajan se deben a la necesidad de cono-cimientos y la búsqueda de un mejor futuro financiero. Conclusión: cuando el profesional tiene un título, se desarrolla con mayor destreza y eficacia en la asistencia proporcionada.

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