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1.
Int J Environ Res Public Health ; 19(22)2022 Nov 17.
Article in English | MEDLINE | ID: covidwho-2115954

ABSTRACT

This study investigated whether strength, balance, body mass index, falls self-efficacy, activity levels, self-rated health, and participation in a multicomponent exercise intervention could predict physical activity levels after 5 months of self-quarantine due to the COVID-19 pandemic. This study included baseline data of 200 community-dwelling older adults (79% women, 21% men) with a mean age of 72 years who participated in a randomized controlled trial investigating a multicomponent exercise program, with 7-month follow-up survey data of their physical activity levels. The results showed significant associations with the activity levels at the 7-month follow-up. The activity levels (odds ratio (OR): 2.83, 95% CI: 1.20-6.71), the self-rated health score (2.80, 1.42-5.53), and being allocated to a specific multicomponent group-based exercise program (2.04, 1.04-4.00) showed a significant association with the activity habits at the 7-month follow-up. As this study suggests, besides the physical activity levels and the self-rated health score, participation in a high challenge multicomponent exercise program was significantly associated with physical activity levels at the 7-month follow-up. This study indicates that a relatively short multicomponent group exercise program (6-9 weeks) can motivate individuals to sustain their own training and activity levels even several months after the program has been paused or terminated. Identifying older adults' physical activity levels and self-rated health scores and prescribing multicomponent group-based exercise programs to promote sustained physical activity habits may be a successful alternative to provide for older adults in the future.


Subject(s)
COVID-19 , Independent Living , Male , Humans , Female , Aged , COVID-19/epidemiology , Cohort Studies , Pandemics , Accidental Falls , Exercise Therapy/methods , Exercise , Habits
2.
Nurs Manage ; 53(11): 24-33, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2112966
3.
Clin Med (Lond) ; 22(Suppl 4): 7, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2094043
4.
Clin Interv Aging ; 17: 1393-1404, 2022.
Article in English | MEDLINE | ID: covidwho-2043233

ABSTRACT

Purpose: We aimed to investigate the prevalence and factors associated with falls in older adult outpatients during the coronavirus disease (COVID-19) pandemic in Vietnam. Patients and Methods: From February 2022 to June 2022, this cross-sectional study included 814 patients (aged ≥60 years; mean age 71.8 ± 7.3 years; women, 65.2%) attending three geriatric clinics for a comprehensive geriatric assessment. Self-reported fall events in the past 12 months and post-COVID-19 falls were assessed. Factors associated with falls were determined using logistic regression analysis. Results: In total, 188 patients (23.1%) had falls (single fall, 75.5%; recurrent falls, 24.5%). The most frequent location, time, and circumstance of falls were the bedroom (43.1%), morning (54.3%), and dizziness (34.6%), respectively. Most patients experienced health issues after falls (bruise/grazes, 53.7%; fracture, 12.8%; immobility, 9.6%; hospital admission, 14.9%). In the adjusted model, factors associated with falls were being underweight (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.37-4.56, P = 0.003), limitations in instrumental activities of daily living (OR 2.03, 95% CI 1.05-3.95, P = 0.036), poor sleep quality (OR 1.83, 95% CI 1.10-3.05, P = 0.020), and fear of falling (OR 3.45, 95% CI 2.23-5.33, P <0.001). Among 357 COVID-19 infected patients, post-COVID-19 falls occurred in 35 patients (9.8%) and were associated with fear of falling (OR 3.14, 95% CI 1.18-8.40, P = 0.023) and post-COVID-19 lower limb weakness (OR 2.55, 95% CI 1.07-6.10, P = 0.035). Conclusion: Our study found a substantial prevalence of falls among older outpatients during the COVID-19 pandemic in Vietnam. Management of factors associated with falls may be needed to reduce the burden of falls in the older population.


Subject(s)
Accidental Falls , COVID-19 , Accidental Falls/prevention & control , Activities of Daily Living , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Fear , Female , Humans , Pandemics , Risk Factors , Vietnam/epidemiology
5.
J Craniofac Surg ; 33(8): e853-e858, 2022.
Article in English | MEDLINE | ID: covidwho-1961267

ABSTRACT

The main purpose of this retrospective study is to analyze the main causes and the main anatomical structures involved in maxillofacial traumas in the province of Terni, Umbria. From January 2009 to July 2021, 603 patients were admitted with a maxillofacial trauma diagnosis and underwent surgery at "Santa Maria Hospital" in Terni, Italy. The collected data included sex, age, nationality, cause of trauma, type of fractures, comorbidities, clinical signs, symptoms, date of admission, and date of discharge from the hospital. Causes were divided into 5 categories: road traffic accidents, accidental falls, physical assault, sport accidents, and occupational injuries. Men were more involved than women, with a male:female ratio of 325:1. The mean age of the population was 41.7 years. The main cause of trauma were road traffic accidents (36%), followed by accidental falls (27%), an increasing phenomenon during the current SARS-CoV-2 global pandemic. The orbital floor was the most fractured anatomical site, followed by zygoma and nasal bones.


Subject(s)
COVID-19 , Fractures, Bone , Maxillofacial Injuries , Skull Fractures , Female , Humans , Male , Adult , Pandemics , Retrospective Studies , COVID-19/epidemiology , Accidents, Traffic , SARS-CoV-2 , Maxillofacial Injuries/epidemiology , Maxillofacial Injuries/surgery , Maxillofacial Injuries/etiology , Fractures, Bone/epidemiology , Accidental Falls , Italy/epidemiology , Skull Fractures/epidemiology , Skull Fractures/etiology , Skull Fractures/surgery
6.
Med Sci Monit ; 28: e936547, 2022 May 27.
Article in English | MEDLINE | ID: covidwho-1876159

ABSTRACT

BACKGROUND During the current Coronavirus Disease 2019 (COVID-19) pandemic, falls have been identified as a potential presenting symptom in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, data on factors increasing fall risk in this patient population are limited. This study aimed to examine the factors that may predispose hospitalized COVID-19 disease patients to falls. MATERIAL AND METHODS In this retrospective observational study, hospitalized COVID-19 disease patients were examined for fall incidence, as well as demographics, comorbidities, and clinical and laboratory data. Patients were stratified according to their fall status and their characteristics were compared using Fisher's exact test or Mann-Whitney U test. A total of 312 hospitalized COVID-19 disease patients were enrolled (median age, 75 years; males, 51.3%), of whom 11 (3.5%) fell. RESULTS There was a greater prevalence of falls among patients who experienced arrhythmias than those that did not (28.6% vs 1.7%; P<0.001). Additionally, a significantly greater proportion of those that were discharged to the internal ward and to the intensive care unit fell (10.3% and 10.0%, respectively) compared to those that were discharged home (1.6%, P=0.008). Thyroid-stimulating hormone (TSH) was significantly elevated in patients who fell (5.3 vs 0.97 µIU/mL, P=0.013), while alanine aminotransferase (ALT) was significantly lower in those who fell (17.1 vs 33.5 IU/L, P=0.041). CONCLUSIONS Arrhythmias may be an important predisposing factor for falls in COVID-19 disease patients and fall prevention programs should prioritize interventions directed at this vulnerable patient population.


Subject(s)
Accidental Falls , COVID-19 , Accidental Falls/prevention & control , Aged , Hospitalization , Humans , Male , Retrospective Studies , SARS-CoV-2
7.
Eur Geriatr Med ; 13(4): 893-906, 2022 08.
Article in English | MEDLINE | ID: covidwho-1859204

ABSTRACT

BACKGROUND: The pandemic has led to the isolation and social exclusion of older adults and cut them off from any exercise activity. Thus, it is more than ever necessary to implement organized interventions to prevent falls in older people as they remain a global health problem associated with serious injuries, chronic disability, and high costs for the healthcare system. Otago exercise program (OEP) can effectively reduce the number of falls. AIM: To study the effect of a 6 months modified video supported OEP in balance, functional ability, fear of falls and number of falls in Greek older people who have fallen. METHOD: 150 fallers aged 65-80 years [Median age 70 (67-74), 88.7% women] were divided into two groups (intervention and control). Primary outcomes included changes in Short FES-I, CONFbal scale, 4-Stage Balance test, BBS, TUG test and number of falls, while the secondary outcome consists of the monthly adherence to exercise after the intervention. Analysis of variance with repeated measures was applied. RESULTS: There were statistically significant between groups differences after 6 months with the OEP group to shows improved values in TUG time score (17.8 vs 3.9%, p < 0.001, 95% CI), 4-Stage Balance Test (6.85 vs 1.09%, p < 0.05 95% CI), 30-Second Chair Stand Test 7.35 vs 2.93%, p < 0.001), BBS score (13.27 vs 3.89%, p < 0.001, 95% CI), Short FES-I (35.78 vs 13.01%, p < 0.001, 95% CI) and number of falls (69.12 vs 18.70%, p < 0.001, 95% CI). All the above differences remained statistically significant in the 12 months follow-up (p < 0.05), when differences in the CONFbal score were also observed (p < 0.001, 95% CI). No differences were found in adherence to OEP (p > 0.05). CONCLUSIONS: A modified OEP decreases the number of falls, improves the balance and functional ability of older adults and reduces the fear of falling. However, it did not contribute to satisfactory adherence to exercise. TRIAL REGISTRATION NUMBER/DATE OF REGISTRATION: NCT04330053/April 1, 2020.


Subject(s)
COVID-19 , Independent Living , Accidental Falls/prevention & control , Aged , COVID-19/epidemiology , Exercise Therapy , Fear , Female , Greece/epidemiology , Humans , Male , Outpatients , Pandemics , Physical Therapy Modalities , Postural Balance
8.
Am J Phys Med Rehabil ; 101(9): 809-815, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-1816353

ABSTRACT

OBJECTIVE: We examined changes in physical activity from pre-COVID-19 to during the COVID-19 pandemic and the factors associated with reduced physical activity levels among adults 50 yrs and older. DESIGN: Participants of a validation study were stratified into being "less active than before" or "equally or more active than before" COVID-19. Multivariable manual backward analyses were used to identify self-reported barriers associated with the reduction in physical activity. RESULTS: Reduced physical activity levels during COVID-19 were reported among 244 of 503 participants (43%). After adjusting for demographics and health conditions, factors that increased the odds of reduced physical activity levels during COVID-19 were lacking access to workout places, feeling too anxious, and difficulty committing to physical activity. Factors that decreased the odds of reduced physical activity levels during COVID-19 were self-identifying a heart- or lung-associated diagnosis that impacts physical activity and having a 12-mo retrospective history of falling. CONCLUSIONS: The physical activity participation barriers identified to be associated with a reduction in physical activity can be used as a starting point for a conversation regarding physical activity participation during COVID-19. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Describe the changes in physical activity levels among adults 50 yrs and older from pre-COVID-19 to during the COVID-19 pandemic; (2) Differentiate between the COVID-19 related factors associated with reduced physical activity levels among adults 50 yrs and older and younger adults; and (3) Identify the physical activity-related factor that decreased the odds of reduced physical activity levels during COVID-19 among adults 50 yrs and older. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


Subject(s)
COVID-19 , Accidental Falls , Adult , COVID-19/epidemiology , Exercise , Humans , Pandemics , Retrospective Studies
9.
Front Public Health ; 10: 850533, 2022.
Article in English | MEDLINE | ID: covidwho-1776068

ABSTRACT

Background: Although fatigue has been shown to be strongly associated with falls risk, very few studies have focused on its mechanism involved in community-dwelling older subjects. The purpose of this study was to explore the relationship between fatigue and falls risk and its internal mechanism by constructing a chain mediation model. Methods: A cross-sectional study design was adopted. A convenience sample of 270 older adults was recruited from July to October 2021 in an urban community, in Beijing, China. The participants completed the 14-item Fatigue Scale (FS-14), Falls Efficacy Scale International (FES-I), the Short Physical Performance Battery (SPPB) and Fall-Risk Self-Assessment Questionnaire (FRQ) to measure fatigue, falls efficacy, lower limb function and falls risk. The theory of unpleasant symptoms was used as a conceptual framework. Structural equation modeling (SEM) was utilized to test the hypothetical model. Results: The overall fit of final model was found to be satisfactory: χ2/df = 1.61, CFI = 0.971, TLI = 0.962, RMSEA = 0.049 (95% CI 0.030/0.066) and SRMR = 0.023. Fatigue had a direct effect on falls risk (ß = 0.559, S.E. = 0.089, 95% CI 0.380/0.731), and it also had indirect effects on falls risk (ß = 0.303, S.E. = 0.072, 95% CI 0.173/0.460) through mediating factors. Falls efficacy and lower limb function were the main mediating variables, and there was a chain mediating effect (ß = 0.015, S.E. = 0.010, 95% CI 0.003/0.046). Conclusions: Our study suggests that fatigue can influence falls risk among the elderly in China. There are many mediating paths between fatigue and falls risk. These results may help healthcare professionals to better understand the inherent relationship between fatigue and fall risk that may benefit older adults.


Subject(s)
Accidental Falls , Fatigue , Aged , China/epidemiology , Cross-Sectional Studies , Fatigue/epidemiology , Humans , Lower Extremity , Postural Balance
10.
Front Public Health ; 10: 848122, 2022.
Article in English | MEDLINE | ID: covidwho-1776063

ABSTRACT

Background: Early childhood fall is a pressing global public health problem and one of the leading causes of child injury. China has a high proportion of children and a high burden of illness from falls. Therefore, educational interventions to prevent childhood fall would be beneficial. Methods: We used the outcome of knowledge, attitude and practice questionnaire, which was conducted by Pudong New District of Shanghai Municipal Government, to summarize demographic and baseline characteristics grouped by intervention or not, and analyzed descriptive statistics of continuous and categorical variables. A logistic stepwise function model was established to study the influence of different covariables on the degree of injury, and AIC/BIC/AICC was used to select the optimal model. Finally, we carried out single-factor analysis and established a multifactor model by the stepwise function method. Results: Attitude and actual behavior scores had significant differences. The intervention and control groups had 20.79 ± 3.20 and 20.39 ± 2.89 attitude scores, respectively. Compared to the control group (5.97 ± 1.32), the intervention group had higher actual behavior scores (5.75 ± 1.50). In the univariate analysis results, fathers' education level, mothers' education level, actual behavior and what cares for children had a significant influence on whether children got injured. In multivariate analysis, attitude had a positive influence on whether injured [odds ratio: 1.13 (1.05-1.21), P < 0.001]. Conclusion: Educational intervention for children and their guardians can effectively reduce the risk of childhood falls, and changes in behavior and attitude are the result of educational influence. Education of childhood fall prevention can be used as a public health intervention to improve children's health.


Subject(s)
Accidental Falls , Health Knowledge, Attitudes, Practice , Accidental Falls/prevention & control , Child , Child, Preschool , China , Humans , Surveys and Questionnaires
11.
Front Public Health ; 9: 749295, 2021.
Article in English | MEDLINE | ID: covidwho-1775927

ABSTRACT

Background: Unintentional falls seriously threaten the life and health of people in China. This study aimed to assess the long-term trends of mortality from unintentional falls in China and to examine the age-, period-, and cohort-specific effects behind them. Methods: This population-based multiyear cross-sectional study of Chinese people aged 0-84 years was a secondary analysis of the mortality data of fall injuries from 1990 to 2019, derived from the Global Burden of Disease Study 2019. Age-standardized mortality rates of unintentional falls by year, sex, and age group were used as the main outcomes and were analyzed within the age-period-cohort framework. Results: Although the crude mortality rates of unintentional falls for men and women showed a significant upward trend, the age-standardized mortality rates for both sexes only increased slightly. The net drift of unintentional fall mortality was 0.13% (95% CI, -0.04 to 0.3%) per year for men and -0.71% (95% CI, -0.96 to -0.46%) per year for women. The local drift values for both sexes increased with age group. Significant age, cohort, and period effects were found behind the mortality trends of the unintentional falls for both sexes in China. Conclusions: Unintentional falls are still a major public health problem that disproportionately threatens the lives of men and women in China. Efforts should be put in place urgently to prevent the growing number of fall-related mortality for men over 40 years old and women over 70 years old. Gains observed in the recent period, relative risks (RRs), and cohort RRs may be related to improved healthcare and better education.


Subject(s)
Accidental Falls , Accidental Falls/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , China/epidemiology , Cohort Studies , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult
12.
Front Public Health ; 9: 713202, 2021.
Article in English | MEDLINE | ID: covidwho-1775829

ABSTRACT

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL-Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults. Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL-Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC > 0.70 as adequate. To test the correlations, the Spearman test was used. Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL-Self-reported version was ICC 0.83 (IC95%, 0.70-0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74-0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls. Conclusions: The HOME FAST BRAZIL-Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.


Subject(s)
Independent Living , Accidental Falls , Aged , Brazil , Cross-Sectional Studies , Humans , Reproducibility of Results , Self Report
13.
Aust N Z J Public Health ; 46(2): 142-148, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1774711

ABSTRACT

OBJECTIVE: To identify leading injury risk factors and jurisdictional differences in Australian and US child-related product safety regulatory responses to inform the development of Australian policy and reform priorities. METHODS: The study established and evaluated a knowledge base of child-related product safety regulatory responses (recalls, bans, standards and warnings) made in Australia and the US over the period 2011-17 to identify risk factors and potential regulatory gaps. RESULTS: The research identified 1,540 Australian and US child-related product safety regulatory responses with the most common response type being product safety recall, and the leading product hazards in responses being choking, fire, fall, strangulation and chemical hazards. Jurisdictional differences identified potential regulatory gaps in Australia related to chemical hazards and high-risk durable infant and toddler products, and some data deficiencies in Australian responses. CONCLUSIONS: Priorities include the need to improve the prevention orientation of the Australian product safety framework, to create an intelligence platform to assess injury risks more precisely and to address regulatory gaps related to the use of toxic chemicals in children's products and high-risk durable infant and toddler products. IMPLICATIONS FOR PUBLIC HEALTH: The study demonstrates the identification of policy and reform priorities for child product safety using a public health lens.


Subject(s)
Accidental Falls , Public Health , Australia , Family , Humans , Infant , Risk Factors
14.
Front Public Health ; 9: 665985, 2021.
Article in English | MEDLINE | ID: covidwho-1771100

ABSTRACT

Purpose: This study examined the association between storey of building and fall risk in older adults' residences and residents' level of fear of falling. Methods: The National Health and Ageing Trends Study (NHATS) collected information that would provide an understanding of basic trends people aged 65 years and older. Using a longitudinal survey, the present study employed the first round of NHATS data that was collected in 2011. In the first round, 12,411 participants were enrolled, and 8,077 interviews were completed. The study sample sizes for falling and worry about falling are 6,153 and 6,142, respectively. Results: Unadjusted analysis revealed that storey of building was a risk factor for fall and worry about falling. There was a higher prevalence for fall and worry about falling when subjects lived in single storey of building compared with the subjects live in multi-storey. Logistic regression analysis showed no highly significant between storey of building and the fall/fear of falling. Conclusion: Several clinical factors independently were indicated pertaining to the fall and worry about falling in older adult's residences.


Subject(s)
Accidental Falls , Aged , Aging , Fear , Humans , Risk Factors
15.
Front Public Health ; 9: 610504, 2021.
Article in English | MEDLINE | ID: covidwho-1760273

ABSTRACT

Objective: Study aimed to identify the prevalence of falls and associated contributory factors among older Malaysians. Methods: A cross sectional study among community dwelling older adults aged 50 years and above. Self-administered questionnaires on history of falls in the previous 12 months, physical assessment and computerized and clinical measures of balance were assessed on a single occasion. Results: Forty nine (31.0%) participants fell, with 4.4% reported having multiple falls within the previous 12 months. Slips were the most prevalent cause of falls, accounting for 49% of falls. More than half (54.5%) of falls occurred in the afternoon while participants walked inside the home (32.7%), outside home (30.6%), and 36.7% were in community areas. More than half of respondents were identified as having turning instability. Step Test, turn sway, depression, physical activity level and edge contrast sensitivity were significantly worse for fallers (p < 0.05). Multiple logistic regression analysis showed that turning performance, visual acuity and back pain were significantly associated with falls risk, accounting for 72% of the variance of risk factors for falls among studied population. Conclusion: Falls are common among community dwelling older Malaysians. The findings provide information of falls and falls risk factors among community dwelling older adults in Malaysia. Future intervention studies should target locally identified falls risk factors. This study has highlighted the importance of instability during turning as an important fall risk factor.


Subject(s)
Accidental Falls , Independent Living , Accidental Falls/statistics & numerical data , Aged , Cross-Sectional Studies , Humans , Middle Aged , Prevalence , Risk Factors
16.
BMJ Open Qual ; 11(1)2022 03.
Article in English | MEDLINE | ID: covidwho-1759372

ABSTRACT

Inpatient falls are frequently reported incidents in hospitals around the world. The recent COVID-19 pandemic has further exacerbated the risk. With the rising importance of human factors and ergonomics (HF&E), a fall prevention programme was introduced by applying HF&E principles to reduce inpatient falls from a systems engineering perspective. The programme was conducted in an acute public hospital with around 750 inpatient beds in Hong Kong. A hospital falls review team (the team) was formed in June 2020 to plan and implement the programme. The 'Define, Measure, Analyse, Improve and Control' (DMAIC) method was adopted. Improvement actions following each fall review were implemented. Fall rates in the 'pre-COVID-19' period (January-December 2019), 'COVID-19' period (January-June 2020) and 'programme' period (July 2020-August 2021) were used for evaluation of the programme effectiveness. A total of 120, 85 and 142 inpatient falls in the 'pre-COVID-19', 'COVID-19' and 'programme' periods were reviewed, respectively. Thirteen areas with fall risks were identified by the team where improvement actions applying HF&E principles were implemented accordingly. The average fall rates were 0.476, 0.773 and 0.547 per 1000 patient bed days in these periods, respectively. The average fall rates were found to be significantly increased from the pre-COVID-19 to COVID-19 periods (mean difference=0.297 (95% CI 0.068 to 0.526), p=0.009), which demonstrated that the COVID-19 pandemic might have affected the hospitals fall rates, while a significant decrease was noted between the COVID-19 and programme periods (mean difference=-0.226 (95% CI -0.449 to -0.003), p=0.047), which proved that the programme in apply HF&E principles to prevent falls was effective. Since HF&E principles are universal, the programme can be generalised to other healthcare institutes, which the participation of staff trained in HF&E in the quality improvement team is vital to its success.


Subject(s)
Accidental Falls , COVID-19 , Accidental Falls/prevention & control , COVID-19/prevention & control , Ergonomics , Humans , Inpatients , Pandemics/prevention & control
17.
J Nurs Manag ; 30(4): 1061-1068, 2022 May.
Article in English | MEDLINE | ID: covidwho-1735960

ABSTRACT

AIM: To evaluate the completion of nursing records through scheduled audits to analyse risk outcome indicators. BACKGROUND: Nursing records support clinical decision-making and encourage continuity of care, hence the importance of auditing their completion in order to take corrective action where necessary. METHOD: This was an observational descriptive study carried out from February to November 2020 with a sample of 1131 electronic health records belonging to patients admitted to COVID-19 hospital units during three observation periods: pre-pandemic, first wave, and second wave. RESULTS: A significant reduction in nursing record completion rates was observed between pre-pandemic period and first and second waves: Braden scale 40.97%, 28.02%, and 30.99%; Downton scale: 43.74%, 22.34%, and 33.91%; Gijón scale: 40.12%, 26.23%, and 33.64% (p < 0.001). There was an increase in the number of records completed between the first and second waves following the measures adopted after the quality audit. CONCLUSIONS: The use of scheduled audits of nursing records as quality indicators facilitated the detection of areas for improvement, allowing timely corrective actions. IMPLICATIONS FOR NURSING MANAGEMENT: Support from nursing managers at health care facilities to implement quality assessment programmes encompassing audits of clinical record completion will encourage the adoption of measures for corrective action.


Subject(s)
COVID-19 , Pressure Ulcer , Accidental Falls , COVID-19/epidemiology , Humans , Nursing Records , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Pressure Ulcer/prevention & control , 34658
18.
BMC Public Health ; 22(1): 463, 2022 03 08.
Article in English | MEDLINE | ID: covidwho-1731525

ABSTRACT

BACKGROUND: Falls among older people are a major global health concern. This process evaluation investigates the experience of participants aged 60+ in a yoga program aimed at preventing falls which transitioned from studio-based classes to online classes in response to COVID-19 restrictions. We sought to understand how the Successful AGEing (SAGE) yoga program functioned in both settings and as a hybrid program, and to explain why it worked well for most participants. METHODS: Realist process evaluation was used to explore the factors that facilitated a successful transition for most participants, and to consider why it did not work for a minority. This approach develops program theories that describe which mechanisms an intervention is (or is not) activating, and how this is mediated by context to generate process outcomes. Data included interviews with participants (n = 21) and yoga instructors (n = 3), self-report feedback forms (n = 46), observation of classes and routine process measures. RESULTS: Factors that facilitated a successful transition for most participants included the quality of yoga instruction, the program format and inherent characteristics of yoga. Gains in transitioning online included continuity and greater convenience. Losses included perceived reduction in the effectiveness of yoga instruction. There were greater challenges for people struggling with pain and in disadvantageous home environments. We identified six program theories configured around 16 mechanisms: 1. It's worth the effort and 2. In expert hands (these had the same mechanisms: value expectancy, therapeutic alliance and achievement/mastery), 3. A communal experience (these mechanisms were shared experience, social connection, social comparison and peer checking), 4. Putting yoga within reach (accessibility, convenience, gratitude), 5. Building yoga habits (purposeful structure, momentum, accountability and continuity), and 6. Yoga's special properties (embodiment and mindfulness). CONCLUSIONS: This study showed that online delivery of a yoga program for people aged 60+ retained much of the value of a face-to-face program for the majority of participants, and increased the value for some. The structured, communal nature of an organised group program delivered by a skilled instructor, together with yoga's intrinsic focus on mindfulness, facilitated continued engagement and perceived health benefits, despite the change in delivery mode.


Subject(s)
COVID-19 , Meditation , Yoga , Accidental Falls/prevention & control , Aged , Humans , Middle Aged , SARS-CoV-2
19.
Int J Environ Res Public Health ; 19(3)2022 02 07.
Article in English | MEDLINE | ID: covidwho-1686760

ABSTRACT

In this study, a design science research methodology was used aiming at designing, implementing and evaluating a digital health service to complement the provision of healthcare for elderly people with balance disorders and risk of falling. An explanatory sequential mixed methods study allowed to identify and explore the dissatisfaction with electronic medical records and the opportunity for using digital health solutions. The suggested recommendations helped to elaborate and develop "BALANCE", a digital service implemented on the METHIS platform, which was recently validated for remote monitoring of chronic patients in primary healthcare. "BALANCE" provides clinical and interactive data, questionnaire pre and post-balance rehabilitation, tutorial videos with balance exercises and patient-recorded videos of the exercises. This digital service was demonstrated, including five elderly patients with clinical recommendations for balance rehabilitation at home. Finally, the authors conducted two focus groups with the participants and their caregivers as well as with physicians. The focus groups aimed at exploring their satisfaction level, needs of adjustment in the "BALANCE" service and strategies for applicability. The digital healthcare service evaluation revealed a significant potential for clinical applicability of this digital solution for elderly people with balance disorders and risk of falling.


Subject(s)
Accidental Falls , Exercise , Accidental Falls/prevention & control , Aged , Delivery of Health Care , Exercise Therapy , Health Services , Humans
20.
J Appl Gerontol ; 41(5): 1473-1479, 2022 05.
Article in English | MEDLINE | ID: covidwho-1673731

ABSTRACT

AIM: To examine the relationship between falls among high-risk older adults at one Program of All-Inclusive Care for the Elderly (PACE) and the COVID-19 closure of its Day Health Center (DHC), which provides participants with social and rehabilitative services and contributes to their weekly physical activity. METHODS: Self-reported falls during the 3 months before the DHC's closure ("pre-COVID-19") were compared in number and in character to falls during its closure ("COVID-19"). RESULTS: One thirty five participants were enrolled during the entire 6-month period; 37% (n = 50) fell during this time. These participants experienced fewer falls during COVID-19 (mean = 0.64) than they did pre-COVID-19 (mean=1.24, p = .0003). CONCLUSIONS: In this population of high-risk, community-dwelling older adults, an abrupt reduction in activity levels may have reduced falls. Physical activity has been shown to both increase and protect against falls in older adults. The long-term consequences of a comparably prolonged period of inactivity merit further study.


Subject(s)
Accidental Falls , COVID-19 , Accidental Falls/prevention & control , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Exercise , Humans , Independent Living
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