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The proceedings contain 53 papers. The topics discussed include: clinical study of lurasidone combined with nutritional intervention strategy in the treatment of chronic schizophrenia;analysis of clinical medication scheme and nursing measures of acute stress disorder complicated with delirium under the COVID-19;a study on the mental state of prisoners near the end of their sentence caused by a psychological anxiety case;a clinical study on the effect of peperidone combined with cognitive behavioral therapy on symptoms of schizophrenia;the clinical effect of feedforward control nursing combined with methylphenidate sustained-release tablets on children with attention deficit hyperactivity disorder;study on the effect of community legal consciousness health management on cognitive function of senile patients;effects of special sports training on autonomic nervous regulation;a study of positive intervention of music therapy and neurofeedback on negative emotions and attention in college students;and alleviating effect of the geriatric care system integrating physical and psychological on the common mental problems of the elderly.
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PurposeThis study explored the students' perception of their adoption and acceptance of virtual learning (VL), the factors affecting the adoption of educational technologies and the correlation between their intention, perceived behavioral control and care competence in caring for older adults.Design/methodology/approachA cross-sectional survey was conducted. Surveys were administered to evaluate the participants who were involved in VL on geriatric care during coronavirus disease 2019 (COVID-19) pandemic. A total of 315 nursing students participated in the survey, and 287 valid questionnaires were collected (response rate: 91.11%).FindingsA total of 287 participants (mean age 21.09, SD 1.44 years;242/287, 84.3% female) were included in the study. The variables of intention to use technologies were positively correlated with care competence (r = 0.59, p < 0.001). The results revealed that the major predictors were perceived ease-of-use (PEOU) (β = 0.28, 95% confidence interval (CI) 0.16–0.40) and perceived usefulness (PU) (β = 0.22, CI 0.09–0.35) which were significantly positive predictors of competence in geriatric care.Research limitations/implicationsNursing students lack in clinical knowledge and situational experience in geriatric care;therefore, their perceptiveness, expressions and reflection on the process of providing care to hospitalized older patients should be increased. These results indicated that students improved in geriatric healthcare after/during the VL program during COVID-19 pandemic.Originality/valueIt is hoped that the present study would make an invaluable contribution to existing research on education in general and on the quality of care in geriatric nursing as limited studies have been published so far.
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Within a context where New Public Management [NPM] has become increasingly influential in shaping everyday working practices, social workers often handle risks in their everyday work using formalised bureaucratic procedures, among other strategies. As the COVID-19 pandemic progressed, rapid changes occurred in Swedish elder care that social workers were required to address in their everyday work. Intra-professional case conferences amongst social workers provide one opportunity to discuss individual viewpoints and obtain suggestions from colleagues on how to proceed with a case. These discussions have so far received little scholarly attention. In this study we used a data set consisting of 39 audio-recorded case conferences to analyse social workers' intra-professional discussions about risks during the COVID-19 pandemic. In the case conferences, social workers discussed the risks that were accentuated by the pandemic, such as the risk of spreading COVID-19 to clients, the risk of unmet care needs amongst clients, risks related to accountability, and the risks pertaining to blurred boundaries between different organisations. The collegial discussions in case conferences included opportunities for social workers to use their collective professional experience and competency to establish creative solutions 'on the go' and to discuss various ways of handling and balancing different risks while continuing to carry out their work in the changing and unknown situation. Our findings highlight the importance of collegial support in social work in dealing with accentuated risks during the pandemic.Copyright © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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INTRODUCTION: In June 2020, after the first wave of the COVID-19 pandemic, Hospital-Based Liaison Geriatrics units and Primary Care nursing care units were created in the Community of Madrid to improve health care for residents in a coordinated manner. OBJECTIVE: To analyze the situation and the activity of the Hospital-Based Liaison Geriatrics units. MATERIAL AND METHODS: A cross-sectional study was conducted using an electronic survey prepared and sent to the liaison geriatricians in March 2022, including the following sections: available resources, areas of health care, reasons for consultation, care interventions, research and teaching activity, profiles of residents attended and coordination with other health professionals at that time. A descriptive analysis of the data was performed. RESULTS: 100% of the existing Liaison Geriatrics units responded, describing essential differences in human resources, hours of care and volume of patients attended. Regarding the care activity of these units, they highlighted the telematic consultation, and the face-to-face assessment during hospitalization and in the emergency department. The main reasons for assessment were decision-making, acute pathology and geriatric syndromes; and the in-hospital drug management or orthoprosthetic aids among the interventions. CONCLUSIONS: Despite the heterogeneity in the resources of the different Liaison Geriatric units, there is a similarity in their care activity and the use of telemedicine. It is common to request an assessment for decision-making, acute pathology or geriatric syndromes and interventions for managing in-hospital drugs and tests, orthoprosthetic aids and coordination with other specialists. Liaison Geriatrics units must continue leading quality health care coordinated with nursing homes, as well as continuity of care for residents.
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Introduction: The use of digital health interventions has expanded, particularly in home-based primary care (HBPC), following the increase in the older adult population and the need to respond to the higher demand of chronic conditions, weakness and loss of autonomy of this population. There was an even greater demand with COVID-19 and subsequent isolation/social distancing measures for this risk group. The objective of this study is to map and identify the uses and types of digital health interventions and their reported impacts on the quality of HBPC for older adults worldwide. Methods and analysis: This is a scoping review protocol which will enable a rigorous, transparent and reliable synthesis of knowledge. The review will be developed from the theoretical perspective of Arksey and O'malley, with updates by Levac and Peters and respective collaborators based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Data from white literature will be extracted from multidisciplinary health databases such as: the Virtual Health Library, LILACS, MEDLINE/PubMed, Scopus, Web of Science, Cinahl and Embase; while Google Scholar will be used for gray literature. No date limit or language restrictions will be determined. The quantitative data will be analyzed through descriptive statistics and qualitative data through thematic analysis. The results will be submitted to stakeholder consultation for preliminary sharing of the study and will later be disseminated through publication in open access scientific journals, scientific events and academic and community journals. The full scoping review report will present the main impacts, challenges, opportunities and gaps found in publications related to the use of digital technologies in primary home care. Discussion: The organization of this protocol will increase the methodological rigor, quality, transparency and accuracy of scoping reviews, reducing the risk of bias.
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COVID-19 , Humans , Aged , COVID-19/epidemiology , Data Accuracy , Databases, Factual , Digital Technology , Primary Health Care , Systematic Reviews as Topic , Review Literature as TopicABSTRACT
ABSTRACTWith early and effective antiretroviral therapy leading to improved life expectancy in people with HIV (PWH), PWH aged 50 or older face concerns and issues related to aging. Providers at the University of Colorado identified a need to assess the healthcare needs of PWH aged 50 and older at the UCHealth Infectious Diseases/Travel (TEAM) Clinic in Aurora, Colorado. A survey was developed to illuminate participants' general rating of their health, factors that made it challenging to get the healthcare needed prior to COVID-19 and during COVID-19, and types of healthcare appointments and providers that would make a difference in healthcare experience. Descriptive statistics and brief thematic analysis of open-ended questions found that most participants rated their current health as very good or good. Participants noted that connecting to resources and appointment scheduling were the top challenges prior to the COVID-19 pandemic, and during the COVID-19 pandemic, participants described challenges with resource connection, communication with providers, and wait times. To reduce these barriers, telehealth video appointments, healthcare visits with a provider who specializes in aging, and healthcare visits with providers who specialize in aging if co-located in the HIV clinic were recognized as beneficial resources from the perspectives of participants.
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COVID-19 , HIV Infections , Telemedicine , Humans , Middle Aged , Aged , Pandemics , HIV Infections/drug therapy , Delivery of Health CareABSTRACT
Advances in medicine and technology have resulted in an increase in human life expectancy and aging population across the globe. The growing geriatric population and its medical needs, has a significant impact on the healthcare ecosystem, including higher medical and human costs to manage the upsurge of chronic diseases such as Alzheimer's Dementia, Parkinson's, Diabetes Mellitus, frailty, stroke, cardiovascular disease and with the recent COVID-19 pandemic. IoT wearables and devices offer a promising solution to reliably assess, monitor, and support healthy ageing in a remote manner. Objective and holistic patient information made available by IoT technology is very valuable for physicians to manage the chronic ailments and slow down the disease progression in their geriatric patient base. In this study we present a broad overview of ailments pertinent to elders and review of the case studies with IoT applications and its interconnected sensing solutions to manage those ailments. © 2022 American Institute of Physics Inc.. All rights reserved.
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Background: Older or geriatric patients were among the people most at risk from COVID-19. Their mortality rate increased alarmingly during the pandemic, and this undoubtedly presented an emotionally challenging situation for their caregivers. Methods: The aim of our research was to analyse the professional's current attitudes towards death among the professional caregivers of older people in the health and social care settings and to identify specific aspects of their coping strategies in the context of the COVID-19 pandemic. The standardized Death Attitude Profile-Revised (DAP-R) questionnaire was used to collect data. The research respondents consisted of direct care workers in social service institutions, nursing homes, and non-medical health care workers in facilities providing health care primarily to geriatric patients (n=180). Results and conclusion: A statistically significant difference was found between the attitudes of health and social workers. Social workers declare more reconciliation and less fear of death. They avoid death less, perceive it less as an escape and are more neutral than health workers. This result was influenced by the factor of faith.
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OBJECTIVES: Among patients over 75 years, little is known about functional decline due to COVID-19. The aim of this study was to explore this functional decline, compare to other infectious pneumonia. DESIGN AND SETTING: This case-control study included all COVID-19 patients hospitalized from March to December 2020 in Acute Geriatric Ward in Nantes University Hospital matched 1/1 with patients with pneumonia hospitalized in geriatric department between March 2017 and March 2019 (controls) on sex, age. Functional decline was assessed at 3 month follow up as it is routinely done after hospitalization in geriatric ward. We performed multivariable analyses to compare clinical outcomes between patients with COVID-19 vs controls. RESULTS: 132 pairs were matched on age (mean: 87 y-o), and sex (61% of women). In multivariable logistic regression analysis, there were no statistical significant association between COVID-19 infection and functional decline (OR=0.89 p=0.72). A statistical significant association was found between functional decline and Charlson comorbidity index (OR=1.17, p=0.039); prior fall (OR=2.08, p=0.012); malnutrition (OR=1.97, p=0.018); length of hospital stay (OR=1.05, p=0.002) and preadmission ADL(OR=1.25, p=0.049). CONCLUSION: COVID-19 does not seem to be responsible for a more frequent or severe functional decline than other infectious pneumonia in older and comorbid population after 3 month follow up. In this population, pneumonia is associated with functional decline in almost 1 in 2 cases. The individual preadmission frailty seems to be a more important predictor of functional decline, encouraging multidimensional care management for this population.
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COVID-19 , Pneumonia , Aged , COVID-19/epidemiology , Case-Control Studies , Female , Geriatric Assessment/methods , Hospitalization , Humans , Pneumonia/complications , Pneumonia/epidemiology , SurvivorsABSTRACT
Especially at the beginning of a pandemic, the risks of infection for health professionals but also for other professions are increased. As a result, more than 220,000 insurance claims due to COVID19 have been reported to the statutory accident insurance institutions (DGUV) since the end of December 2021. COVID19 can be recognized as either an accident at work or an occupational disease. To do this, certain conditions relating to diagnosis and occupational exposure must be met. The recognition rate for occupational diseases is approximately twice as high as for accidents at work (60.0 vs. 30.2%). The most commonly affected by occupational SARSCoV2 infections are nurses in the hospital and in inpatient geriatric care. In 2021, educators were also frequently affected. The assessment of the causal relationship usually does not cause any major problems, as the occupations with an increased risk of infection are already well described in epidemiological studies. So far, there is little experience with the assessment of longterm consequences of COVID19. There are two reasons for this. „Rehabilitation before retirement“also applies to the DGUV. Several specific rehabilitation services have been developed for patients with postCOVID symptoms, the effectiveness of which needs to be evaluated. As a further reason for the lack of experience in the assessment, it must be taken into account that naturally the spontaneous course of the longterm consequences of COVID19 cannot yet be known. An assessment is probably best carried out by the discipline in whose area the most pronounced symptoms fall, i.e. in the case of shortness of breath by pulmonologists, in the case of cardiac arrhythmias by cardiologists or in fatigue and concentration disorders by neurologists. If necessary, the assessment should be carried out with the support of the other disciplines. The good news, the likelihood of severe, longterm courses of COVID19 has been significantly reduced by vaccination.
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Background: Our study evaluates the efficacy of an outpatient personalized multidisciplinary intervention model guided by comprehensive geriatric assessment (CGA), for pre-frail and frail elderly. Methods: A single-arm self-controlled study was conducted at the outpatient departments (OPD) of a medical center in Taiwan. Subjects received personalized multidisciplinary intervention, including physical therapy, psychotherapy, a nutritional consultation, precise medicine, and social resource linkage, as determined by the results of their CGAs. After 3 months of interventions, change in the proportions of the frail status (frail, pre-frail and robust), functional scores, depressive status, cognition, nutritional status, percentage of inappropriate medication used and social resource usage were analyzed. A logistic regression model was applied to determine the predictive factors associated with an improvement in frail severity. Results: A significant improvement in frail status was found (proportion of frail: 44.5% versus 23.1%, p < 0.001). Physical function, depressive and nutritional status were also significantly improved. 18.5% of participants used inappropriate medications, with benzodiazepine hypnotics the most common (40.9%). 24.2% of subjects were successfully linked to social resources. The presence of the frail phenotypes exhaustion was significantly associated with an improvement in frail severity (odds ratio (OR) = 2.77, 95% confidence interval (CI) = 1.15–6.66, p = 0.023). There was a significant dose response relationship between the improvement of frail status and physical training times (proportion of improved frail status: 23.7%, 40.5% and 47.9% for 0, 1–3, and 4–6 times of physical training, p = 0.03). Conclusion: The reported CGA-based, personalized multidisciplinary intervention model was effective at improving frail severity among pre-frail and frail elderly in OPDs.
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BACKGROUND: Geriatric care professionals were forced to rapidly adopt the use of telemedicine technologies to ensure the continuity of care for their older patients in response to the COVID-19 pandemic. However, there is little current literature that describes how telemedicine technologies can best be used to meet the needs of geriatric care professionals in providing care to frail older patients, their caregivers, and their families. OBJECTIVE: This study aims to identify the benefits and challenges geriatric care professionals face when using telemedicine technologies with frail older patients, their caregivers, and their families and how to maximize the benefits of this method of providing care. METHODS: This was a mixed methods study that recruited geriatric care professionals to complete an online survey regarding their personal demographics and experiences with using telemedicine technologies and participate in a semistructured interview. Interview responses were analyzed using the Consolidated Framework for Implementation Research (CFIR). RESULTS: Quantitative and qualitative data were obtained from 30 practicing geriatric care professionals (22, 73%, geriatricians, 5, 17%, geriatric psychiatrists, and 3, 10%, geriatric nurse practitioners) recruited from across the Greater Toronto Area. Analysis of interview data identified 5 CFIR contextual barriers (complexity, design quality and packaging, patient needs and resources, readiness for implementation, and culture) and 13 CFIR contextual facilitators (relative advantage, adaptability, tension for change, available resources, access to knowledge, networks and communications, compatibility, knowledge and beliefs, self-efficacy, champions, external agents, executing, and reflecting and evaluating). The CFIR concept of external policy and incentives was found to be a neutral construct. CONCLUSIONS: This is the first known study to use the CFIR to develop a comprehensive narrative to characterize the experiences of Ontario geriatric care professionals using telemedicine technologies in providing care. Overall, telemedicine can significantly enable most of the geriatric care that is traditionally provided in person but is less useful in providing specific aspects of geriatric care to frail older patients, their caregivers, and their families.
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BACKGROUND: Aging is one of the most important prognostic factors increasing the risk of clinical severity and mortality of COVID-19 infection. However, among patients over 75 years, little is known about post-acute functional decline. OBJECTIVE: The aim of this study was to identify factors associated with functional decline 3 months after COVID-19 onset, to identify long term COVID-19 symptoms and transitions between frailty statesafter COVID-19 onset in older hospitalized patients. METHODS: This prospective observational study included COVID-19 patients consecutively hospitalized from March to December 2020 in Acute Geriatric Ward in Nantes University Hospital. Functional decline, frailty status and long term symptoms were assessed at 3 month follow up. Functional status was assessed using the Activities of Daily Living simplified scale (ADL). Frailty status was evaluated using Clinical Frailty Scale (CFS). We performed multivariable analyses to identify factors associated with functional decline. RESULTS: Among the 318 patients hospitalized for COVID-19 infection, 198 were alive 3 months after discharge. At 3 months, functional decline occurred in 69 (36%) patients. In multivariable analysis, a significant association was found between functional decline and stroke (OR = 4,57, p = 0,003), history of depressive disorder (OR = 3,05, p = 0,016), complications (OR = 2,24, p = 0,039), length of stay (OR = 1,05, p = 0,025) and age (OR = 1,08, p = 0,028). At 3 months, 75 patients described long-term symptoms (49.0%). Of those with frailty (CFS scores ≥5) at 3-months follow-up, 30% were not frail at baseline. Increasing frailty defined by a worse CFS state between baseline and 3 months occurred in 41 patients (26.8%). CONCLUSIONS: This study provides evidence that both the severity of the COVID-19 infection and preexisting medical conditions correlates with a functional decline at distance of the infection. This encourages practitioners to establish discharge personalized care plan based on a multidimensional geriatric assessment and in parallel on clinical severity evaluation.
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COVID-19 , Fatigue Syndrome, Chronic , Frailty , Activities of Daily Living , Aged , COVID-19/complications , COVID-19/therapy , Fatigue Syndrome, Chronic/complications , Follow-Up Studies , Frail Elderly , Frailty/complications , Frailty/diagnosis , Frailty/epidemiology , Geriatric Assessment/methods , Humans , Prospective Studies , SurvivorsABSTRACT
To protect nursing home residents from getting infected with COVID-19, several measures have been imposed. The aim of this study was to describe the impact of these measures on activities for Dutch nursing home residents, the conditions under which the activities could take place, and the considerations when making decisions about the (dis)continuation of activities. The study consisted of the data of the qualitative MINUTES-study. Textual units derived from documentation of an outbreak team (OT) meetings on activities, well-being, informal caregivers, and volunteers from 39 long-term care organizations were re-analyzed using a content analysis. The results shows that OTs more often discussed restarting and continuing activities than stopping activities during the COVID-19 pandemic. There were differences between time periods, but activities never completely stopped according to the minutes. Activities were offered in an adapted way, often under certain conditions, such as organizing activities at other locations (e.g., outside), with limited group size, and following specific guidelines. The main focus of the considerations made were the ability to adhere to the guidelines, the well-being of residents, ensuring safety, and balancing benefits versus risks given vaccination availability and coverage. Overall, the study showed that organizing activities for nursing home residents despite COVID-19 measures is possible.
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COVID-19 , COVID-19/epidemiology , Disease Outbreaks , Humans , Nursing Homes , Pandemics , SARS-CoV-2ABSTRACT
Purpose: This study explored the students' perception of their adoption and acceptance of virtual learning (VL), the factors affecting the adoption of educational technologies and the correlation between their intention, perceived behavioral control and care competence in caring for older adults. Design/methodology/approach: A cross-sectional survey was conducted. Surveys were administered to evaluate the participants who were involved in VL on geriatric care during coronavirus disease 2019 (COVID-19) pandemic. A total of 315 nursing students participated in the survey, and 287 valid questionnaires were collected (response rate: 91.11%). Findings: A total of 287 participants (mean age 21.09, SD 1.44 years;242/287, 84.3% female) were included in the study. The variables of intention to use technologies were positively correlated with care competence (r = 0.59, p < 0.001). The results revealed that the major predictors were perceived ease-of-use (PEOU) (β = 0.28, 95% confidence interval (CI) 0.16–0.40) and perceived usefulness (PU) (β = 0.22, CI 0.09–0.35) which were significantly positive predictors of competence in geriatric care. Research limitations/implications: Nursing students lack in clinical knowledge and situational experience in geriatric care;therefore, their perceptiveness, expressions and reflection on the process of providing care to hospitalized older patients should be increased. These results indicated that students improved in geriatric healthcare after/during the VL program during COVID-19 pandemic. Originality/value: It is hoped that the present study would make an invaluable contribution to existing research on education in general and on the quality of care in geriatric nursing as limited studies have been published so far. © 2022, Pei-Lun Hsieh, Shang-Yu Yang, Wen-Yen Lin and Tien-Chi Huang.
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The objective of this study was to analyze changes in access to health interventions during the pandemic among Brazilian older adults and to investigate the factors associated with social and health inequalities. We conducted an online survey with Brazilian adults aged 60 + years between May and June 2020. A multidimensional questionnaire was used to investigate access to health interventions during the pandemic and associated factors. Of 1482 participants, 56.5% reported health care before the pandemic, and 36.4% discontinued it during the pandemic. The discontinuation rate was 64.4% (95% CI 61.1-67.6). Participants with higher educational level (nine or more years of education: OR 0.34; 95% CI 0.17-0.70) and higher income (eight or more times the minimum wage: OR 0.54; 95% CI 0.36-0.81) were associated with less probability of discontinuation. Presenting multimorbidity (OR: 1.42; 95% CI 1.06-1.90) and polypharmacy (OR: 0.61; 95% CI 0.46-0.81) were associated with discontinuity in health interventions. Our study showed that structural health inequities in access to health care shaped the rates of discontinuation in health care interventions during the COVID-19 pandemic. Strategic actions should be set up to actively monitor socially vulnerable older adults and strengthen community-based services to mitigate the discontinuation of health care interventions.