Frailty–a clinical overview

2007 ◽  
Vol 17 (3) ◽  
pp. 171-175 ◽  
Author(s):  
Ahmed F Jaafar ◽  
Robert Heycock ◽  
James George

Frailty as a concept has been around in medical practice for many years but has only relatively recently been established as a medical syndrome. Although frailty is not synonymous with chronological age, it is recognized to be more common as people get older. Frailty is independently associated with increasing dependency, hospital admissions and morbidity and mortality. As populations age, frailty will become more of a challenge to health care systems. It is important that health care professionals, especially geriatricians, are aware of this emerging syndrome and its potential adverse outcomes, as well as measures to reverse and slow its progress. The aim of this review is to discuss the definition, identification and potential treatment options for frailty, most relevant to the practising clinician.

2018 ◽  
Author(s):  
Christina Østervang ◽  
Lene Vedel Vestergaard ◽  
Karin Brochstedt Dieperink ◽  
Dorthe Boe Danbjørg

BACKGROUND In cancer settings, relatives are often seen as a resource as they are able to support the patient and remember information during hospitalization. However, geographic distance to hospitals, work, and family obligations are reasons that may cause difficulties for relatives’ physical participation during hospitalization. This provided inspiration to uncover the possibility of telehealth care in connection with enabling participation by relatives during patient rounds. Telehealth is used advantageously in health care systems but is also at risk of failing during the implementation process because of, for instance, health care professionals’ resistance to change. Research on the implications for health care professionals in involving relatives’ participation through virtual presence during patient rounds is limited. OBJECTIVE This study aimed to investigate health care professionals’ experiences in using and implementing technology to involve relatives during video-consulted patient rounds. METHODS The design was a qualitative approach. Methods used were focus group interviews, short open interviews, and field observations of health care professionals working at a cancer department. The text material was analyzed using interpretative phenomenological analysis. RESULTS Field observational studies were conducted for 15 days, yielding 75 hours of observation. A total of 14 sessions of video-consulted patient rounds were observed and 15 pages of field notes written, along with 8 short open interviews with physicians, nurses, and staff from management. Moreover, 2 focus group interviews with 9 health care professionals were conducted. Health care professionals experienced the use of technology as a way to facilitate involvement of the patient’s relatives, without them being physically present. Moreover, it raised questions about whether this way of conducting patient rounds could address the needs of both the patients and the relatives. Time, culture, and change of work routines were found to be the major barriers when implementing new technology involving relatives. CONCLUSIONS This study identified a double change by introducing both new technology and virtual participation by relatives at the same time. The change had consequences on health care professionals’ work routines with regard to work load, culture, and organization because of the complexity in health care systems.


2008 ◽  
Vol 24 (5) ◽  
pp. 1159-1161 ◽  
Author(s):  
Claudia Travassos

The Introduction outlines this issue's special Forum on equity in access to health care, including three Articles and a Postscript. The Forum represents a continuation of the debates raised during a seminar organized by the Oswaldo Cruz Foundation in the city of Rio de Janeiro, Brazil, in 2006, in collaboration with UNICEF, UNDP, World Bank, the WHO Special Program for Research and Training in Tropical Diseases, and the United Nations Research Institute for Social Development. The authors approach health care access and equity from a comprehensive and contemporaneous perspective, introducing a new conceptual framework for access, in which information plays a central role. Trust is proposed as an important value for an equitable health care system. Unethical practices by health administrators and health care professionals are highlighted as hidden critical aspects of inequities in health care. As a whole, the articles represent a renewed contribution for understating inequalities in access, and for building socially just health care systems.


2020 ◽  
Vol 180 (10) ◽  
pp. 1328 ◽  
Author(s):  
Molly M. Jeffery ◽  
Gail D’Onofrio ◽  
Hyung Paek ◽  
Timothy F. Platts-Mills ◽  
William E. Soares ◽  
...  

2019 ◽  
Vol 38 (1) ◽  
pp. 147-155 ◽  
Author(s):  
Dawn M. Hawthorne ◽  
Shirley C. Gordon

Background and Purpose: Spirituality has been identified as the essence of being human and is recognized, by many health care professionals, as a central component in health and healing. Scholars have identified spiritual nursing care as essential to nursing practice and include caring for the human spirit through the development of relationships and interconnectedness between the nurse and the patient. However, despite the recognition of spiritual practices as important to health, little attention has been given to spirituality in nursing practice and education in the literature. The purpose of this article is to explore factors contributing to the invisibility of spiritual nursing care practices (SNCP), recognition and offer strategies to enhance the visibility of SNCP. Two major factors that reduce visibility of SNCP are conceptual confusion differentiating between spirituality and religion and limited education in the area of spirituality including nursing curricula and organizations. Strategies to enhance visibility of SNCP include educational approaches in nursing curricula and health care organizations. to influence nurses’ perceptions about spirituality and creation of a culture of spiritual care. Conclusion: Holistic nursing includes assessing and responding to the spiritual needs of patients. Changes in nursing education and health care systems are needed to increase the visibility of SNCP.


2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Patricia Lynn Dobkin

Amidst the commotion of constant changes in health care systems, budget cuts, burnout and compassion fatigue there are resilient clinicians who relieve suffering and promote healing in those who seek their care. This workshop will focus on how doctors, nurses, and allied health care professionals serve in this way while maintaining equanimity and sense of meaning in their work and personal lives.This 90-minute experiential-based workshop will be divided into three parts.First, Mindful Clinical Practice will be described using narratives from different health care professionals in various settings. Mindful Congruence will be defined, along with Satir’s four other communication stances.Second, how the Four Noble Truths stemming from Buddhist philosophy inform clinical practice will be discussed with an emphasis on the Eightfold Path to end suffering. Third, a model of Healing Relationships (Scott et al, 2008; 2009) will be used to help participants identify underlying processes contributing to the relational outcomes: hope, trust, and being known. An Appreciative Inquiry exercise will be used to enrich participants’ understanding of their own experiences of being healers in clinical encounters.If and how medicine may be a spiritual practice will be examined.At the end of the workshop participants will be able to: 1. Define Mindful Congruence.2. Understand how the Four Noble Truths from Buddhist philosophy inform clinical practice.3. See how meditation practice contributes to clinicians’ mindfulness and emotional regulation.4. Discern the competencies and processes underlying healing.


Author(s):  
Elham Navab ◽  
Mehraneh Shali

Background: The practical difficulties for patients with stroke include lack of information about their condition, poor knowledge of the services and benefits available. Specialist Stroke nurses provide education and support services for people with Stroke  in many health care systems. A key goal is helping and empowering unable people to self-manage their stroke and supporting caregivers of these valnurable population, too.Objective: The objective of this review was to assess the role of specialist nurse in care for patients following a stroke and their caregivers support.Search methods: The databases CINAHL, PubMed, Science Direct and Synergy were searched from 1988 to 2017 using the keywords Stroke, Specialist Nurse, Care, Caregivers and support. Bibliographies of relevant papers were searched, and hand searching of relevant publications was undertaken to identify additional Studies.Selection criteria: All studies of the effects of a specialist nurse practitioner on short and long term stroke outcomes were included in the review.Data collection and analysis: Three investigators performed data extraction and quality scoring independently; any discrepancies were resolved by consensus.Findings:  Stroke, Specialist Nurse, Care, Caregivers concepts and labels are defined and measured in different and often contradictory ways by using 31 founded study.Conclusions: The findings indicate a dissonance in the views of different stakeholders within the care system. The division of labour associated with nursing care and specialist nurse requires further exploration. The contrasting paradigms of health care professionals and people with stroke regarding models of disability were highlighted.  Stroke, like other chronic illnesses, requires substantial nursing care. There is a growing number of specialist nurses in the workforce, however, little is known how their role interfaces with other nurses.  


2016 ◽  
Vol 3 (1) ◽  
pp. 24
Author(s):  
Gerald Monk ◽  
Stacey Sinclair ◽  
Michael Nelson

Despite the overwhelming evidence that suggests that patients, families and health care systems benefit from offering appropriate disclosures and apologies to patients and families following the aftermath of medical errors, few health care organizations in the U.S. invest in providing systemic training in disclosure and apology. Using a narrative analysis this paper explores the cultural barriers in the United States healthcare environment that impede health care providers from engaging in restorative conversations with patients and families when things go wrong. The paper identifies a handful of programs and models that provide disclosure and apology training and argues for the unique contributions of narrative mediation to assist health care professionals to disclose adverse events to patients and families to restore trust.


Author(s):  
Domingo Palacios-Ceña ◽  
César Fernández-de-las-Peñas ◽  
María Palacios-Ceña ◽  
Ana I de-la-Llave-Rincón ◽  
Lidiane L Florencio

Abstract Objective Knowledge of the experiences of health care professionals who have actively worked on the first line of the COVID-19 pandemic could help in identifying specific professional duties focused on health assistance objectives. No qualitative study has yet been published describing the experience of physical therapists during the COVID-19 pandemic. The purpose of this study was to describe and explore the experiences and perspectives of physical therapists working in public hospitals in Madrid, Spain, during the COVID-19 pandemic. Methods A qualitative exploratory study was conducted based on an interpretive framework. Thirty physical therapists working at 11 national public hospitals during the COVID-19 outbreak were recruited by purposeful sampling and snowball techniques. In-depth interviews and researchers’ field notes were used to collect data. Interviews were transcribed verbatim. Inductive thematic analysis was used to identify emerging themes. Results After identifying 3912 codes and 13 categories, 3 themes emerged. First theme was “Call of Duty,” COVID-19 infection dramatically spread, the hospitals were contaminated and overwhelmed, and all floors were converted into COVID-19 wards. Second theme was “Working in War Time.” Every day, therapists were given “the war report,” receiving their orders, meeting protective personal equipment requirements, and doing a job with fear. Third theme was “When I Arrive at Home.” Working during the pandemic had an impact on the therapists’ families and the information shared with them. Conclusions Physical therapists described the COVID-19 outbreak as an apocalyptic and unexpected war. Comprehensive support is needed for all frontline health care professionals. The COVID-19 outbreak revealed that health care systems were not prepared for a pandemic. Impact This is the first qualitative study to be published describing the experience of physical therapists during the COVID-19 pandemic.


2020 ◽  
Author(s):  
Francesco Petracca ◽  
Oriana Ciani ◽  
Maria Cucciniello ◽  
Rosanna Tarricone

UNSTRUCTURED A common development observed during the COVID-19 pandemic is the renewed reliance on digital health technologies. Prior to the pandemic, the uptake of digital health technologies to directly strengthen public health systems had been unsatisfactory; however, a relentless acceleration took place within health care systems during the COVID-19 pandemic. Therefore, digital health technologies could not be prescinded from the organizational and institutional merits of the systems in which they were introduced. The Italian National Health Service is strongly decentralized, with the national government exercising general stewardship and regions responsible for the delivery of health care services. Together with the substantial lack of digital efforts previously, these institutional characteristics resulted in delays in the uptake of appropriate solutions, territorial differences, and issues in engaging the appropriate health care professionals during the pandemic. An in-depth analysis of the organizational context is instrumental in fully interpreting the contribution of digital health during the pandemic and providing the foundation for the digital reconstruction of what is to come after.


Author(s):  
Keerthi Chadam Venkatesulu ◽  
Shaik Habeeb Jan ◽  
Harika Sree Gaddam

With the increase, the spread of COVID-19 its effect can be seen on health care systems seek innovative treatment ways as the need of the hour. The suspected leading cause of COVID-19 is due to the response to inflammations and the cytokine storm, which majorly damages the lung tissue. The difference in response to the vaccine can be seen due to different sex. Moreover, age-related decrease in sex steroid hormones like Estrogen as well as testosterone can promote pro-inflammatory raise in older individuals which in turn increases the risk of COVID-19 related adverse outcomes. Such sex hormones have the capacity of mitigating inflammatory response and can also provide promising therapeutic benefits for patients suffering from COVID-19. Moreover, over above the effects of on any ERS, these drugs showed useful ancillary properties. Most showed to highlight broader roles in mitigating viral replication by the ER-independent mechanisms as mentioned. Data simplifies ER modulation an apt pharmacological approach for restricting storm and thus prevents the inflammation due to COVID-19. Mainly the application of or tissue-selective estrogen complex can provide a pharmacological response. Such treatment options can be fruitful for both sexes in the early phase of such disease condition to prevent further progression of the disease to severe forms.


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