Person-Centred Care: A Support Strategy for Managing Non-Communicable Diseases.

BACKGROUND: Over the last decade, the inadequacy and unsustainability of current healthcare services for managing long-term co-morbid and multi-morbid diseases have become evident. METHODS: This study, involving 426 adults with at least one non-communicable disease in Slovenia, aimed to explore the link between quality of life, life satisfaction, person-centred care, and non-communicable disease management. RESULTS: Results indicated generally positive perceptions of quality of life, general health, and life satisfaction of individuals with non-communicable diseases. Participants assessed their physical health as the highest of the four quality of life domains, followed by the environment, social relations, and psychological health. Significant differences occurred in life satisfaction, general health, quality of life, and person-centred care for managing non-communicable diseases. But, there were no significant differences in person-centred care according to the living environment. The study revealed a positive association between person-centred care and effective non-communicable disease management, which is also positively associated with quality of life, general health, and life satisfaction. CONCLUSIONS: Person-centred care is currently the most compassionate and scientific practice conceived, representing a high ethical standard. However, implementing this approach in healthcare systems requires a cohesive national strategy led by capable individuals to foster stakeholder collaboration. Such an approach is crucial to address the deficiencies of existing healthcare services and ensure person-centred care sustainability in non-communicable disease management.

Frailty in community-dwelling older people and nursing home residents: An adaptation and validation study.

AIM: The aim of this was to psychometrically adapt and evaluate the Tilburg Frailty Indicator to assess frailty among older people living in Slovenia's community and nursing home settings. DESIGN: A cross-cultural adaptation and validation of instruments throughout the cross-sectional study. METHODS: Older people living in the community and nursing homes throughout Slovenia were recruited between March and August 2021. Among 831 participants were 330 people living in nursing homes and 501 people living in the community, and all were older than 65 years. RESULTS: All items were translated into the Slovene language, and a slight cultural adjustment was made to improve the clarity of the meaning of all items. The average scale validity index of the scale was rated as good, which indicates satisfactory content validity. Cronbach's α was acceptable for the total items and subitems. CONCLUSIONS: The Slovenian questionnaire version demonstrated adequate internal consistency, reliability, and construct and criterion validity. The questionnaire is suitable for investigating frailty in nursing homes, community dwelling and other settings where older people live. IMPACT: The Slovenian questionnaire version can be used to measure and evaluate frailty among older adults. We have found that careful translation and adaptation processes have maintained the instrument's strong reliability and validity for use in a new cultural context. The instrument can foster international collaboration to identify and manage frailty among older people in nursing homes and community-dwelling homes. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology checklist for reporting cross-sectional studies was used. NO PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement in the design or conduct of the study. Head nurses from nursing homes and community nurses helped recruit older adults. Older adults only contributed to the data collection and were collected from nursing homes and community dwelling.

The Multi-Strain Probiotic OMNi-BiOTiC® Active Reduces the Duration of Acute Upper Respiratory Disease in Older People: A Double-Blind, Randomised, Controlled Clinical Trial.

Immunosenescence is the adverse change in the human immune function during aging, leaving older people more prone to an increased risk of infections and morbidity. Acute upper respiratory tract infections (URTIs) are very common among older people, often resulting in continued morbidity and mortality. Therefore, approaches, such as consuming probiotics, that shorten the duration or even reduce the incidence of URTIs in older people are being studied. The aim of this study was to determine the effects of a multi-strain probiotic OMNi-BiOTiC® Active, which contains 11 live probiotic strains, on the incidence, duration, and severity of URTIs in older people. In this randomized double-blinded placebo-controlled study, 95 participants, with an average age of 70.9 years in the probiotic group and 69.6 years in the placebo group, were randomly allocated to two groups: 1010 cfu per day of the multi-strain probiotic intervention OMNi-BiOTiC® Active (49) or placebo (46). The incidence of URTIs in older people after 12 weeks supplementation with OMNi-BiOTiC® showed no statistically significant difference between the two groups (p = 0.5244). However, the duration of the URTI infections was statistically significantly different between the groups (p = 0.011). The participants that consumed the probiotic had an average duration of illness of 3.1 ± 1.6 days, whilst participants that received the placebo had symptoms for an average of 6.0 ± 3.8 days (p = 0.011). Statistically significant differences in lymphocyte counts in both groups after supplementation (p = 0.035 for the probiotic group and p = 0.029 for the placebo group) and between both groups were found (p = 0.009). Statistically significant differences in eosinophil (p = 0.002) and basophil counts (p = 0.001) in the probiotic groups before and after supplementation with probiotics were also found. Supplementation with the multi-strain probiotic OMNi-BiOTiC® Active may benefit older people with URTIs. Larger randomised controlled clinical trials are warranted. Clinical Trial Registration; identifier NCT05879393.

Associations between Sleep Quality, Frailty, and Quality of Life among Older Adults in Community and Nursing Home Settings.

Poor sleep quality is prevalent among older adults, but limited data document associations between frailty and quality of life comparing individuals living in the community with those in nursing homes. This cross-sectional study (conducted between August and November 2019) included 831 older adults (mean age 76.5 years) from Slovenia's community and nursing home settings. The results showed comorbidity in 38% of community-dwelling older adults and 31% of older adults in nursing homes. The prevalence of frailty among community-dwelling older adults was 36.5%, and among older adults in a nursing home was 58.5%. A total of 76% of community-dwelling older adults and 95.8% of nursing home residents reported poor sleep quality. Sleep quality and frailty predict 42.3% of the total variability of quality of life for older adults in nursing homes and 34.8% for community-dwelling older adults. The study's results indicate that the quality of life can be affected by factors (e.g., worse sleep quality and frailty) among older adults, regardless of being a resident or from the community. Understanding how sleep quality is affected by social, environmental, and biological factors can help improve sleep quality and potentially the quality of life of older adults.

Artificial intelligence based prediction models for individuals at risk of multiple diabetic complications: A systematic review of the literature.

AIM: The aim of this review is to examine the effectiveness of artificial intelligence in predicting multimorbid diabetes-related complications. BACKGROUND: In diabetic patients, several complications are often present, which have a significant impact on the quality of life; therefore, it is crucial to predict the level of risk for diabetes and its complications. EVALUATION: International databases PubMed, CINAHL, MEDLINE and Scopus were searched using the terms artificial intelligence, diabetes mellitus and prediction of complications to identify studies on the effectiveness of artificial intelligence for predicting multimorbid diabetes-related complications. The results were organized by outcomes to allow more efficient comparison. KEY ISSUES: Based on the inclusion/exclusion criteria, 11 articles were included in the final analysis. The most frequently predicted complications were diabetic neuropathy (n = 7). Authors included from two to a maximum of 14 complications. The most commonly used prediction models were penalized regression, random forest and Naïve Bayes model neural network. CONCLUSION: The use of artificial intelligence can predict the risks of diabetes complications with greater precision based on available multidimensional datasets and provides an important tool for nurses working in preventive health care. IMPLICATIONS FOR NURSING MANAGEMENT: Using artificial intelligence contributes to a better quality of care, better autonomy of patients in diabetes management and reduction of complications, costs of medical care and mortality.

Experiences with dignity among older people confined to beds living in a nursing home: A qualitative descriptive study.

AIM: The aim of this study is to explore the concept of dignity from the experience of older people with limited mobility and confined to beds while living in a nursing home. BACKGROUND: Nursing staff have an important impact on the dignity of those older people confined to beds in nursing homes. Individuals' uniqueness with respecting dignity should be ensured. METHODS: A qualitative descriptive study was conducted. The study was carried out with 19 older people who were immobile and confined to bed and living in nursing homes. The individual in-depth interviews were conducted between July and October 2021. Inductive thematic analysis was used to synthesize data. RESULTS: The main theme 'Dignity of older people confined to bed' emerged from subthemes 'Emotions', 'Lived experience' and 'Failure to maintain care'. The participants expressed their dissatisfaction towards the nursing staff's disrespectful care, which evoked feelings of insignificance and inferiority. CONCLUSION: Undignified and disrespectful nursing care can cause feelings of suffering, sadness and anger in older people confined to their beds. Nurses must listen to this group of older people and learn from their experiences. Compassionate, person-centred care with kindness and empathy should be provided by all those providing and receiving care in nursing homes. IMPLICATIONS FOR NURSING MANAGEMENT: To provide dignified care, nursing staff must understand the importance of person-centred, individually oriented nursing care for older people living with immobility in nursing homes.

Music Therapy as an Intervention to Reduce Blood Pressure and Anxiety Levels in Older Adults With Hypertension: A Randomized Controlled Trial.

Hypertension is a serious medical condition, the frequency of which increases significantly with age; has a negative impact on certain health complications; and increases the rate of mortality. Music therapy as a nonpharmacological treatment has many positive effects on an individual's body and mind. A randomized controlled trial was used to evaluate the effects of music therapy on blood pressure, heart rate, and anxiety levels in older adults with hypertension living in a nursing home. Sixty older adults were randomly divided into experimental and control groups (n = 30 each). Significant reductions in systolic blood pressure, heart rate, and anxiety levels were found in older adults with hypertension receiving music therapy compared with the control group. The current study confirms music therapy as a safe, noninvasive, nonpharmacological, and cost-effective intervention for reducing blood pressure, heart rate, and anxiety levels in older adults with hypertension. [Research in Gerontological Nursing, 15(2), 85-92.].

Development of a slovenian version of the pittsburgh sleep quality index (PSQI-SLO) for use with older adults.

BACKGROUND: Poor sleep quality predicts poor quality of life, poor self-rated health, and chronic diseases and mental disorders among older adults. The Pittsburgh Sleep Quality Index (PSQI) is the most widely used self-report measure of sleep quality in older adults. OBJECTIVES: This study aimed to assess internal reliability, face validity, content validity and internal consistency of the Slovenian version of the PSQI (PSQI-SLO) for sleep quality in older adults. METHODS: A cross-sectional study was used to evaluate content and face validity as well as reliability (ɑ, ω and item-total correlations). Residents of 13 nursing homes and community-dwelling older adults from all regions of Slovenia were sampled. A total of 831 participants aged 65 years and older participated in the study between March and August 2019. RESULTS: All items were successfully translated to Slovenian. A minor cultural adaptation was made to improve the clarity of the meaning of all items. None of the items had an item content validity index (I-CVI) score lower than 0.50. Kappa indices were excellent for half of the items and good for the remainder. Internal consistency agreed with prior research (ɑ = 0.74). Intraclass correlation coefficient for global PSQI-SLO was 0.62 (p < 0.001). The total score of PSQI-SLO (8.09 ± 3.64 (95%, CI = 7.85-8.34)) was expected and comparable. Fifty-eight and four tenths' per cent (95%, CI = 55%-62%) had at least one chronic disease and 40% (95%, CI = 37%-42%) lived in a nursing home. CONCLUSIONS: PSQI-SLO showed adequate internal consistency and test-retest reliability, and adequate construct and criterion validity. The instrument can be important in assessing older adults' subjective sleep quality in nursing homes, home environment and clinical settings.

Components for providing person-centred palliative healthcare: An umbrella review.

BACKGROUND: Person-centred palliative healthcare is an important approach to maintaining and improving patients' quality of life living with a chronic non-communicable disease and their partners. Such an approach can reduce unnecessary hospitalisation, holistically address the patient and their partners' needs, and help develop an advance care plan. OBJECTIVES: Assess, analyse, and synthesise the currently existing international guidelines for providing person-centred palliative care and identify the key components for providing a high-quality approach. METHODS: An umbrella review methodology of systematic reviews with the method of examination, analysis and synthesis of literature and the compilation method. Relevant systematic reviews of guidelines for providing person-centred palliative care in English, German and/or Slovenian language in PubMed, CINAHL, Web of Science and Cochrane Library databases, until November 2020. RESULTS: Out of 3,910 records, we included seven reviews for thematic synthesis. We identified four key elements of flourishing in person-centred palliative healthcare: (i) Healthcare staff prerequisites and traits; (ii) Palliative healthcare environment; (iii) Palliative healthcare processes; and (iv) Palliative healthcare outcomes. CONCLUSIONS: We concluded that person-centred palliative healthcare plays an important role in the comprehensive treatment of patients living with a non-communicable disease accompanied by disturbing symptoms. Therefore, it is necessary to raise awareness amongst healthcare professionals and especially general practitioners about the possibilities of including patients with a non-communicable disease in early person-centred palliative healthcare. Tweetable Abstract: #UmbrellaReview of components for providing #personcentredpalliative #healthcare. Components provide healthcare professionals and interdisciplinary #palliative teams with the steps on how to give #personcentredpalliative #healthcare to #patient and #support to #carepartners.

Diabetes management of older adults in nursing homes: A retrospective study.

AIM: To examine the diabetes management of older adults in nursing homes. BACKGROUND: Diabetes is an increasing problem in nursing homes, and diabetes care is defined as a neglected clinical area. METHODS: A retrospective collected data review of 166 older adults with known diabetes from four nursing homes. RESULTS: 65% older than 75 years had HbA1c levels lower than 7.5% (58 mmol/mol), 74% older than 85 years had HbA1c levels lower than 8% (64 mmol/mol). The HbA1c levels were 7.3% (56 mmol/mol) for those who had three and more chronic disorders and 6.8% (51 mmol/mol) for those who had less than three chronic disorders. Individuals treated with insulin had higher HbA1c levels (p < .001) and glycaemia (p = .002). Age was associated with a number of chronic disorders (p = .031), a number of regularly prescribed medications (p = .038) and a number of medications as needed (p = .009). CONCLUSIONS: More than half to three quarters have diabetes well-managed. Nevertheless, there is still some potential for improving diabetes care, and these findings warrant further research for improving diabetes management of older adults in nursing homes. IMPLICATIONS FOR NURSING MANAGEMENT: Interventions designed to promote a healthy lifestyle, documenting individuals' target level and regular monitoring of glycaemia and HbA1c levels may help to improve diabetes management, which may result in better well-being and quality of life for older adults with diabetes in nursing homes.

Digital Tools in Behavior Change Support Education in Health and Other Students: A Systematic Review.

Due to the increased prevalence of chronic diseases, behavior changes are integral to self-management. Healthcare and other professionals are expected to support these behavior changes, and therefore, undergraduate students should receive up-to-date and evidence-based training in this respect. Our work aims to review the outcomes of digital tools in behavior change support education. A secondary aim was to examine existing instruments to assess the effectiveness of these tools. A PIO (population/problem, intervention, outcome) research question led our literature search. The population was limited to students in nursing, sports sciences, and pharmacy; the interventions were limited to digital teaching tools; and the outcomes consisted of knowledge, motivation, and competencies. A systematic literature review was performed in the PubMed, CINAHL, MEDLINE, Web of Science, SAGE, Scopus, and Cochrane Library databases and by backward citation searching. We used PRISMA guidelines 2020 to depict the search process for relevant literature. Two authors evaluated included studies using the Mixed Methods Appraisal Tool (MMAT) independently. Using inclusion and exclusion criteria, we included 15 studies in the final analysis: six quantitative descriptive studies, two randomized studies, six mixed methods studies, and one qualitative study. According to the MMAT, all studies were suitable for further analysis in terms of quality. The studies resorted to various digital tools to improve students' knowledge of behavior change techniques in individuals with chronic disease, leading to greater self-confidence, better cooperation, and practical experience and skills. The most common limitations that have been perceived for using these tools are time and space constraints.

Well-Being and Satisfaction of Nurses in Slovenian Hospitals: A Cross-Sectional Study.

INTRODUCTION: Well-being is one of the most important factors in whether nurses decide to remain in the nursing profession. This study aims to examine well-being and satisfaction among nurses working in Slovenian hospitals and to identify the related demographic factors. METHODS: This descriptive cross-sectional study uses standardised instruments. The sample included 640 nurses working in Slovenian hospitals. The difference between individual variables were analysed using the Mann-Whitney and Kruskal-Wallis tests. RESULTS: Nurses self-assessed their satisfaction and well-being as moderate. Forty-seven per cent of nurses were satisfied with their job, 49% assessed their psychological well-being as good, 52% were often exposed to stress at the workplace and 30% were always exposed to stress at the workplace. Levels of job satisfaction (p=0.031), psychological well-being (p=0.029) and subjective well-being (p=0.014) were found to differ significantly according to level of education, while levels of job satisfaction (p=0.005), life satisfaction (p<0.001), psychological well-being (p<0.001) and subjective well-being (p<0.001) were also found to differ according to years of nursing service and from hospital to hospital (p<0.001). CONCLUSIONS: The key finding of the study is that nurses are moderately satisfied with their work and life and that they display moderate levels of psychological and subjective well-being. Hospitals can be successful and achieve the goals of the organisation if their employees are satisfied with work and enjoy good levels of well-being. Hospital management have to recognise the importance of ensuring that nurses and other employees are satisfied and healthy.

Nurses' perceptions of early person-centred palliative care: a cross-sectional descriptive study.

BACKGROUND: Palliative care is aimed at improving the quality of life of an individual with chronic noncommunicable disease and their care partners. Limitations in the provision of palliative care are mainly lack of knowledge and experience by nurses, fear of treating palliative persons, loss of control over treatment and fear of providing poor-quality palliative care to persons and care partners. AIM: The aim of this study was to investigate the perception, knowledge and attitudes of palliative care by nurses who use palliative care approaches in practice, as well as the difference in perception, knowledge and attitudes of palliative care between nurses in Slovenia and Finland. METHODS: We conducted a cross-sectional descriptive study. The survey included 440 nurses in clinical environments in Slovenia and Finland with a completed bachelor, master or doctoral level of education. RESULTS: We found statistically significant differences between both countries in the perception of palliative care. Differences between the two countries in the knowledge of palliative care were not confirmed. We confirmed statistically significant differences between both countries in the attitudes of palliative nursing care. CONCLUSION: Early person-centred palliative care is an important part of the holistic and integrative treatment of a person who has a disease with disturbing symptoms. For such an approach, it is important to educate nurses about knowledge, expectations, values and beliefs in developing a concept of person-centred palliative care to improve quality of life. The better perception, knowledge and attitudes of palliative care by nurses may help persons to improve and raise their quality of life, as well as diminish stress in their care partners and improve quality of life.

Health Professionals' Knowledge of Probiotics: An International Survey.

The objective of this study was to survey health professionals to investigate their knowledge of probiotics. An online survey was conducted to gather data on the knowledge of health professionals. The online survey was distributed via email and social media platforms using snowball sampling. A total of 1066 health professionals (859; 80.6% female) from 30 countries responded to the survey. Most of the respondents evaluated their knowledge of probiotics as medium (36.4%) or good (36.2%). Only 8.9% of the respondents rated it as excellent. No statistical difference in knowledge was found between male and female health professionals. Over 80% of pharmacists, allied health professionals, medical doctors and dentists, and other health professionals knew the correct definition of probiotics as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host", whereas three quarters of registered nurses and midwives and less than two thirds of psychologists identified the correct definition. Statistically, more female than male health professionals knew the correct definition of probiotics. The most frequently recognized species of bacteria containing probiotic strains were Lactobacillus acidophilus (92%), Bifidobacterium bifidum (82%), and Lactobacillus rhamnosus (62%). The opinions on when it is best to take probiotics were different (χ2 = 28.375; p < 0.001), with 90.2% of respondents identifying that probiotics have beneficial effects if taken during antibiotic therapy, 83.5% for diarrhea, 70.6% for constipation, 63.3% before traveling abroad, and 60.4% for treating allergies. Almost 79% of health professionals involved in this study have advised their patients to use probiotics and 57.5% of the respondents wanted to learn more about probiotics. All things considered, health professionals have a medium level of knowledge of probiotics, which could be improved by the implementation of targeted learning programs. As probiotics have many beneficial effects in a wide range of health areas, health professionals need to adopt the use of probiotics in clinical practice.

Job satisfaction of nurses and identifying factors of job satisfaction in Slovenian Hospitals.

AIM: To determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing. METHODS: The study included 4 hospitals selected from the hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the leaders and the other to employees, both consisting 154 items evaluated on a 5 point Likert-type scale. We examined the correlation between independent variables (age, number of years of employment, behavior of leaders, personal characteristics of leaders, and managerial competencies of leaders) and the dependent variable (job satisfaction - satisfaction with the work, coworkers, management, pay, etc) by applying correlation analysis and multivariate regression analysis. In addition, factor analysis was used to establish characteristic components of the variables measured. RESULTS: We found a medium level of job satisfaction in both leaders (3.49±0.5) and employees (3.19±0.6), however, there was a significant difference between their estimates (t=3.237; P=lt;0.001). Job satisfaction was explained by age (Plt;0.05; ß=0.091), years of employment (Plt;0.05; ß=0.193), personal characteristics of leaders (Plt;0.001; ß=0.158), and managerial competencies of leaders (Plt;0.000; ß=0.634) in 46% of cases. The factor analysis yielded four factors explaining 64% of the total job satisfaction variance. CONCLUSION: Satisfied employees play a crucial role in an organization's success, so health care organizations must be aware of the importance of employees' job satisfaction. It is recommended to monitor employees' job satisfaction levels on an annual basis.

Perceptions of managerial competencies, style, and characteristics among professionals in nursing.

AIM: To compare nursing leaders' and employees' perception of leaders' leadership style, personality characteristics, and managerial competencies and to determine the associations between these factors. METHODS: The study included 4 out of 5 Slovenian major hospitals selected from the hospital list; 1 hospital refused to participate. The employees of these hospitals represent 30% of all employees in nursing in Slovenian hospitals and the 509 employees included in the study represent 6%. One structured survey questionnaires was administered the leaders and the other to employees, both consisting of 134 statements evaluated on a 5-point Likert-type scale. The relationship between demographic data, leadership style, leaders' personality characteristics, and leaders' training and managerial competencies was analyzed by correlation and multivariate regression analysis. The study took place in April 2009. RESULTS: Leaders and employees significantly differently evaluated 13 out of 14 managerial competencies of the leaders, where leaders rated themselves higher for vision and goals, communication, conflict resolution--agreement, compromise, adjustment, motivation, interpersonal relationships, problem solving, delegation, teamwork, decision making, emotional intelligence, and human resources development. Employees rated the leaders higher for managing changes and conflict resolution--dominance and avoidance. Multivariate regression analysis showed that managerial competencies were explained by leadership style, leaders' training, leaders' characteristics, and type of employment in 86.1% of cases. CONCLUSION: Leaders in nursing too frequently used inappropriate leadership style. Forming a unique model for all health care institutions in the country would facilitate the evaluation of competencies and constant monitoring of leaders' work results.