scholarly journals ‘We tend to get pad happy’: a qualitative study of health practitioners’ perspectives on the quality of continence care for older people in hospital

2021 ◽  
Vol 10 (2) ◽  
pp. e001380
Author(s):  
John Percival ◽  
Katharine Abbott ◽  
Theresa Allain ◽  
Rachel Bradley ◽  
Fiona Cramp ◽  
...  
Keyword(s):  
Quality Care ◽  
Age Groups ◽  
Well Being ◽  
Residential Home ◽  
Care Planning ◽  
Open Communication ◽  
Predisposing Factor ◽  
Health Practitioners ◽  
Care Training

BackgroundBladder and bowel control difficulties affect 20% and 10% of the UK population, respectively, touch all age groups and are particularly prevalent in the older (65+ years) population. However, the quality of continence care is often poor, compromising patient health and well-being, increasing the risk of infection, and is a predisposing factor to nursing and residential home placement.ObjectiveTo identify factors that help or hinder good continence care for patients aged 65 years and over in hospital medical ward settings. Medical care, not surgical, was our exclusive focus.MethodsWe conducted 27 qualitative interviews with nursing, medical and allied health practitioners in three hospitals. We used a purposive sample and analysed data thematically, both manually and with the aid of NVivo software.ResultsInterviews revealed perspectives on practice promoting or inhibiting good quality continence care, as well as suggestions for improvements. Good continence care was said to be advanced through person-centred care, robust assessment and monitoring, and a proactive approach to encouraging patient independence. Barriers to quality care centred on lack of oversight, automatic use of incontinence products and staffing pressures. Suggested improvements centred on participatory care, open communication and care planning with a higher bladder and bowel health profile. In order to drive such improvements, hospital-based practitioners indicate a need and desire for regular continence care training.ConclusionsFindings help explain the persistence of barriers to providing good quality care for patients aged 65 years and over with incontinence. Resolute continence promotion, in hospitals and throughout the National Health Service, would reduce reliance on products and the accompanying risks of patient dependency and catheter-associated gram-negative bacteraemia. Robust assessment and care planning, open communication and regular continence care training would assist such promotion and also help mitigate resource limitations by developing safer, time-efficient continence care.

scholarly journals “We tend to get pad happy”: a qualitative study of health practitioners’ perspectives on continence care for older people in hospital

2020 ◽  
Author(s):  
John Percival ◽  
Katharine Abbott ◽  
Theresa Allain ◽  
Rachel Bradley ◽  
Fiona Cramp ◽  
...  
Keyword(s):  
Quality Care ◽  
Qualitative Interviews ◽  
Age Groups ◽  
Residential Home ◽  
Care Planning ◽  
Open Communication ◽  
Predisposing Factor ◽  
Patient Dependency ◽  
Health Practitioners ◽  
Care Training

AbstractBackgroundBladder and bowel control difficulties affect twenty and ten per cent of the UK population respectively, touch all age groups and are particularly prevalent in the older (65+) population. However, the quality of continence care is often poor, compromising patient health and wellbeing, increasing the risk of infection and is a predisposing factor to nursing and residential home placement.ObjectiveTo identify factors that help or hinder good continence care in hospital.MethodsWe conducted 27 qualitative interviews with nursing, medical and allied health practitioners in three hospitals. We used a purposive sample and analysed data thematically, both manually and with the aid of NVivo software.ResultsInterviews revealed perspectives on practice promoting or inhibiting good quality continence care, as well as suggestions for improvements. Good continence care was said to be advanced through person-centred care, robust assessment and monitoring, and a proactive approach to encouraging patient independence. Barriers to quality care centred on lack of oversight, automatic use of incontinence products and staffing pressures. Suggested improvements centred on participatory care, open communication and care planning with a higher bladder and bowel health profile. In order to drive such improvements, hospital-based practitioners indicate a need and desire for regular continence care training.ConclusionsFindings help explain the persistence of barriers to providing good quality care for patients with incontinence. Resolute continence promotion, in hospitals and throughout the NHS, would reduce reliance on products and the accompanying risks of patient dependency and catheter associated gram negative bacteraemia. Robust assessment and care planning, open communication and regular continence care training would assist such promotion and also help mitigate resource limitations by developing safer, time-efficient continence care.

scholarly journals Down Syndrome and Quality of Life: A Case Report

2015 ◽  
Vol 3 (2) ◽  
pp. 112-114
Author(s):  
Hilary L. Schroeder ◽  
Marianinha Joanes ◽  
Andre Small ◽  
Raghu Maramraj,
Keyword(s):  
Quality Of Life ◽  
Down Syndrome ◽  
Early Onset ◽  
Quality Care ◽  
Well Being ◽  
Cardiac Complications ◽  
African American Female ◽  
Crucial Component ◽  
Patient’S History

  Background: Quality of life is considered a crucial component to the well-being of patients with Down syndrome. The strength of quality care through stable social and psychological interactions has built a framework for a positive well-being for patients with Down syndrome, improving their quality of life. Case: A 55-year-old African American female with a history of Down syndrome, congenital heart disease, and newly-diagnosed early onset Alzheimer’s disease presented with an arm contusion resulting from regular caretaking. The patient’s history was reviewed, and the complexity of her condition was discovered. While a subset of Down syndrome patients have cardiac complications and others have early-onset Alzheimer’s, our patient had both. We believe this complicated her condition. After the diagnosis of Alzheimer’s was made, the caregivers noticed a significant decline in her ability to communicate and continue day-to-day activities. Despite the decline in functions, a positive mood was apparent. Conclusion: Multiple medical interventions, along with strong family support, positively contributed to the patient’s quality of life. Therapies targeting cognition could result in the maintenance of quality of life and, ultimately, lower health care costs.

Long-term quality of life outcomes of women treated for early-stage endometrial cancer

2020 ◽  
pp. ijgc-2020-002145
Author(s):  
Saira Sanjida ◽  
Andreas Obermair ◽  
Val Gebski ◽  
Nigel Armfield ◽  
Monika Janda
Keyword(s):  
Quality Of Life ◽  
Endometrial Cancer ◽  
Early Stage ◽  
Age Groups ◽  
Laparoscopic Hysterectomy ◽  
Well Being ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy

ObjectiveTo compare long-term quality of life in women treated for early-stage endometrial cancer with population norms, and to compare quality of life outcomes of patients who had total laparoscopic or total abdominal hysterectomy.MethodsOnce the last enrolled patient had completed 4.5 years of follow-up after surgery, participants in the Laparoscopic Approach to Cancer of the Endometrium (LACE) clinical trial were asked to complete a self-administered questionnaire. Two instruments—EuroQol 5 Dimension 3-level (EQ-5D-3L) and the Functional Assessment of Cancer Treatment-General Population (FACT-GP)—were used to determine quality of life. The mean computed EQ-5D-3L index scores for LACE participants at different age categories were compared with Australian normative scores; and the FACT-GP scores were compared between patients treated with surgical treatments.ResultsOf 760 women originally enrolled in the LACE trial, 259 (50.2%) of 516 women consented to provide long-term follow-up data at a median of 9 years (range 6—12) after surgery. On the EQ-5D-3L, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression than normative levels across all age groups (55–64 years, 30% vs 14.9%; 65–74 years, 30.1% vs 15.8%; ≥75 years, 25.9% vs 10.7%). For women ≥75 years of age, the prevalence of impairment in mobility (57.6% vs 43.3%) and usual activities (58.8% vs 37.9%) was also higher than for population norms. For the FACT-GP, the physical (effect size: −0.28, p<0.028) and functional (effect size: −0.30, p<0.015) well-being sub-scale favored the total laparoscopic hysterectomy compared with total abdominal hysterectomy recipients.ConclusionCompared with population-based norms, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression across all age groups, and deficits in mobility and usual activities for women aged ≥75 years. Physical and functional well-being were better among women who were treated with total laparoscopic hysterectomy than among those receiving total abdominal hysterectomy.

Radiofrequency exposure in young and old: different sensitivities in light of age-relevant natural differences

2015 ◽  
Vol 30 (4) ◽  
Author(s):  
Mary Redmayne ◽  
Olle Johansson
Keyword(s):  
Age Groups ◽  
Well Being ◽  
The Elderly ◽  
Ageing Population ◽  
Economic Implications ◽  
Population Means ◽  
Increased Risk ◽  
Study Results ◽  
Comparative Risk

AbstractOur environment is now permeated by anthropogenic radiofrequency electromagnetic radiation, and individuals of all ages are exposed for most of each 24 h period from transmitting devices. Despite claims that children are more likely to be vulnerable than healthy adults to unwanted effects of this exposure, there has been no recent examination of this, nor of comparative risk to the elderly or ill. We sought to clarify whether research supports the claim of increased risk in specific age-groups. First, we identified the literature which has explored age-specific pathophysiological impacts of RF-EMR. Natural life-span changes relevant to these different impacts provides context for our review of the selected literature, followed by discussion of health and well-being implications. We conclude that age-dependent RF-EMR study results, when considered in the context of developmental stage, indicate increased specific vulnerabilities in the young (fetus to adolescent), the elderly, and those with cancer. There appears to be at least one mechanism other than the known thermal mechanism causing different responses to RF-EMR depending upon the exposure parameters, the cell/physiological process involved, and according to age and health status. As well as personal health and quality-of-life impacts, an ageing population means there are economic implications for public health and policy.

scholarly journals Psychological and spiritual well-being aspects of the quality of life in colostomy patients

2018 ◽  
Vol 75 (6) ◽  
pp. 611-617
Author(s):  
Gordana Repic ◽  
Suncica Ivanovic ◽  
Cedomirka Stanojevic ◽  
Sanja Trgovcevic
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Age Groups ◽  
Well Being ◽  
Life Questionnaire ◽  
Cross Sectional ◽  
Psychological Well Being ◽  
Spiritual Well Being ◽  
The Mean

Background/Aim. Colorectal cancer and its treatment can have a negative impact on the quality of life which has become an important outcome measure for cancer patients. The aim of this work was assessment of psychological and spiritual dimension of the quality of life in colostomy patients, regarding the gender and age. Methods. This is a cross-sectional study conducted at the Abdominal Surgery Polyclinic in the Clinical Canter of Vojvodina among colostomy patients operated between January 2010 and June 2011. The instrument used in this study was Quality of Life Questionnaire for a Patient with an Ostomy (QOL-O). Results. Majority of respondents were male (M:F = 50.7% : 49.3%). The age ranged between 36?86 years. Respondents did not report difficulties in adjustment to stoma, but their great difficulty was to look at it and the sense of depression and anxiety. The care of stoma was worse perceived by younger respondents (p = 0.014). Respondents were mostly satisfied with their memorizing ability and having the sense of control. The lowest score was found in sensing satisfaction or enjoyment in life. The age had a significant impact on positive aspects of psychological well-being (p < 0.05). Higher scores were found among younger age groups. The mean score of spiritual well-being (6.47 ? 3.01) was lower than the mean score of psychological well-being (7.76 ? 2.35). There were no statistically significant differences regarding gender (t = -0.738, df = 65, p = 0.463) or age (F = 1.307, p = 0.280). Conclusion. Psychological and spiritual well-being in colostomy patients appeared to be at satisfactory level, but it is necessary to provide tailor made support in order to prevent and resolve negative responses to stoma.

scholarly journals Sex and Age Differences in Levels of Anomia of Latvian Inhabitants

2015 ◽  
Vol 3 ◽  
pp. 567 ◽  
Author(s):  
Jeļena Ļevina ◽  
Kristīne Mārtinsone ◽  
Daiga Kamerāde
Keyword(s):  
Quality Of Life ◽  
Age Differences ◽  
Age Groups ◽  
Secondary Data ◽  
Well Being ◽  
Demographic Groups ◽  
The Third ◽  
Significant Difference ◽  
Sex And Age Differences

<p><em>Anomia is one of the important factors, which can influence the psychological well-being of individuals. It is especially valuable to determine those socio-demographic groups which can demonstrate the highest levels of anomia. The purpose of the research was to determine whether there are sex and age differences in levels of anomia of Latvian inhabitants. The secondary data from the third European Quality of Life Survey (EQLS) were used. The sample consisted of Latvian inhabitants (n = 1009), aged from 18 to 92 years (male – 34.9%, female – 65.1%). 3 indices and 3 subscales of anomia (Social Distrust, Social Isolation and Meaninglessness) were constructed (</em><em>Ļevina, Mārtinsone &amp; </em><em>Kamerāde, 2015a, 2015b). </em><em>A multivariate analysis of variance was conducted. It was found that there was a significant difference in multidimensional anomia between Latvian inhabitants of different age groups.</em></p><p> </p>

scholarly journals What Matters Most: ACP Evolving in Practice

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 497-497
Author(s):  
Kevin Valadares
Keyword(s):  
Advance Care Planning ◽  
Quality Care ◽  
Health Interventions ◽  
Care Planning ◽  
Primary Care Settings ◽  
Care Coordinators ◽  
Advance Care ◽  
The University ◽  
What Matters

Abstract The University of Southern Indiana (USI) GWEP uniquely embeds Area Agencies on Aging (AAA) care coordinators within primary care settings to invite the participation of aging patients in advance care planning (ACP), among other health interventions. Two subsequently developed features of the USI GWEP’s ACP initiative emerged to address the What Matters metric of the 4Ms: 1) Patients are invited to engage in What Matters Most conversations through multiple touchpoints that frame Medicare Wellness Visits with a Deaconess provider and introduce a free, online ACP platform, Prepare for Your Care. 2) Provider, patients and families are supported in having ACP conversations with the dedication of a new Advance Care Planning facilitator position. Certified in Respecting Choices and jointly funded by the GWEP and Deaconess, the ACP facilitator supports individuals in navigating these essential healthcare conversations about balancing quality care with quality of life.

Comprehensive Assessment of the Elderly Cancer Patient: The Feasibility of Self-Report Methodology

2002 ◽  
Vol 20 (3) ◽  
pp. 770-775 ◽  
Author(s):  
Sally S. Ingram ◽  
Pearl H. Seo ◽  
Robert E. Martell ◽  
Elizabeth C. Clipp ◽  
Martha E. Doyle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Cancer Patients ◽  
Daily Living ◽  
Older Patients ◽  
Age Groups ◽  
Well Being ◽  
Self Report ◽  
Younger Patients

PURPOSE: Comprehensive geriatric assessment (CGA) has aided the medical community greatly in understanding the quality-of-life issues and functional needs of older patients. With its professional team assessment approach, however, CGA may be time consuming and costly. The goal of the present study was to assess the ability of cancer patients to complete a self-administered CGA and then to characterize cancer patients across multiple domains and age groups. PATIENTS AND METHODS: Two hundred sixty-six male outpatient oncology patients at the Durham Veterans Affairs Medical Center were asked to fill out a survey assessing 10 domains (demographics, comorbid conditions, activities of daily living, functional status, pain, financial well being, social support, emotional state, spiritual well-being, and quality of life). RESULTS: Seventy-six percent of the patients who received their surveys and kept their appointments returned the assessment tool. Older oncology patients had significantly less education (P < .0001), income (P = .05), frequent exercise (P = .01), and chance of being disease free (P = .003) than younger patients. Other findings in older patients were a higher rate of marriage (P = .02), more difficulty in taking medications (P = .05), and less cigarette (P = .03) and alcohol (P = .03) use. Members of all age cohorts reported a sense of social support, with younger patients deriving this more from family and friends than older patients, and older patients deriving social support more from membership in religious communities than younger patients. No differences were found across age groups for number and impact of comorbid illnesses, number of medications, basic and instrumental activities of daily living, pain, overall health rating, financial adequacy, anxiety, depression, and quality of life. CONCLUSION: CGA can be conducted in an outpatient cancer community using a self-report format. Despite the fact that this population varied demographically across age groups and is limited to veterans, this study demonstrated remarkable similarities between younger and older cancer patients in terms of functional status, health states, and quality of life.

Documentation and Record Keeping Are Burdens to Be Completed as Quickly as Possible

2019 ◽  
pp. 117-122
Author(s):  
Jeffrey E. Barnett ◽  
Jeffrey Zimmerman
Keyword(s):  
Mental Health ◽  
Quality Care ◽  
Mental Health Practitioners ◽  
Record Keeping ◽  
Legal Obligations ◽  
Health Practitioners ◽  
Care Information ◽  
Clinical Records

Documentation and record keeping are not known as the most enjoyable aspects of being a mental health clinician. Yet, as this chapter explains, they play a vital and important role in meeting one’s ethical and legal obligations. Further, it is explained how timely, thorough, effective documentation can help mental health practitioners to fulfill their obligation to provide the highest possible quality of care. Information is also provided on how clinical records may be needed in the future, and the risks associated with minimal or absent documentation. The role of documentation as a risk management strategy, to meet legal requirements, and to assist in providing high-quality care are each addressed. Specific guidance is provided on the needed components of effective documentation.

scholarly journals Health Inequality Among the Elderly in Rural China and Influencing Factors: Evidence from the Chinese Longitudinal Healthy Longevity Survey

2019 ◽  
Vol 16 (20) ◽  
pp. 4018 ◽  
Author(s):  
Pan ◽  
Fan ◽  
Yang ◽  
Deng
Keyword(s):  
Health Inequality ◽  
Rural China ◽  
Age Groups ◽  
Well Being ◽  
The Elderly ◽  
Ordinary Least Squares ◽  
Age Group ◽  
Inequality Index ◽  
Healthy Longevity

Based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this paper calculates the health distribution of the elderly using the Quality of Well-Being Scale (QWB) score, and then estimates health inequality among the elderly in rural China using the Wagstaff index (WI) and Erreygers index (EI). Following this, it compares health inequalities among the elderly in different age groups, and finally, uses the Shapley and recentered influence function-index-ordinary least squares (RIF-I-OLS) model to decompose the effect of four factors on health inequality among the elderly in rural China. The QWB score distribution shows that the health of the elderly in rural China improved with social economic development and medical reform from 2002 to 2014. However, at the same time, we were surprised to find that the health level of the 65–74 years old group has been declining steadily since 2008. This phenomenon implies that the incidence of chronic diseases is moving towards the younger elderly. The WI and EI show that there is indeed pro-rich health inequality among the rural elderly, the health inequality of the younger age groups is more serious than that of the older age groups, and the former incidence of health inequality is higher. Health inequality in the age group of 65–74 years old is higher than that in other groups, and the trend of change fluctuated downward from 2002 to 2014. Health inequality in the age group of 75–84 years old is lower than that in the group of 65–74 years old, but higher than that in the other age groups. The results of Shapley decomposition show that demographic characteristics, socioeconomic status (SES), health care access, and quality of later life contributed 0.0054, 0.0130, 0.0442, and 0.0218 to the health inequality index of the elderly, which accounted for 6.40%, 15.39%, 52.41%, and 25.80% of health inequality index. From the results of RIF-I-OLS decomposition, this paper has analyzed detailed factors’ marginal effects on health inequality from four dimensions, which indicates that the health inequality among the elderly in rural China was mainly caused by the disparity of income, medical expenses, and living arrangement.

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