Strategies Used by Older Patients to Prevent Functional Decline During Hospitalization

2016 ◽  
Vol 26 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Sylvie Lafrenière ◽  
Nathalie Folch ◽  
Sylvie Dubois ◽  
Lucie Bédard ◽  
Francine Ducharme
Keyword(s):  
Older Patients ◽  
Functional Decline ◽  
Point Of View ◽  
Nursing Interventions ◽  
Preventive Strategies ◽  
Prevention Strategies ◽  
Relational Approach ◽  
Basic Care ◽  
Physical Abilities ◽  
Hospitalized Older Adults

Almost one third of older patients hospitalized for acute care suffer functional decline. Few studies have investigated the point of view of older patients on prevention of this decline. Within the framework of a descriptive qualitative study, the perceptions of 30 hospitalized older adults were collected regarding their personal prevention strategies, the barriers to implementing these, and nursing staff interventions deemed useful. Results show that participants are sensitive to the risk of functional decline and utilize various preventive strategies particularly to maintain their physical abilities, maintain good spirits, keep a clear mind, and foster nutrition and sleep. Their strategies are difficult to implement on account of internal and external barriers. Nursing interventions deemed useful are good relational approach, strong basic care, appropriate assessment, and respect for level of autonomy. The study underscores that older hospitalized patients are applying strategies to prevent functional decline, but some nursing interventions may thwart their efforts.

scholarly journals PENANGGULANGAN KORUPSI MELALUI PENDEKATAN TEOLOGIS BERBASIS AL-QURAN

2020 ◽  
Vol 20 (2) ◽  
pp. 216-249
Author(s):  
Muhammad Suaib Tahir ◽  
Ali Fikri Noor
Keyword(s):  
Qualitative Method ◽  
Social Situation ◽  
Point Of View ◽  
Preventive Strategies ◽  
Prevention Strategies ◽  
Research Results ◽  
Library Research ◽  
Moral Crisis ◽  
Corruption Prevention ◽  
Interpretation Method

This study concludes that overcoming corruption with a non-theological conventional approach is deadlocked, which is caused by a moral crisis, identity, and social situation, and group propaganda that prioritizes corruption prevention strategies with an approach to improving legislation rather than theological approach. The conventional, non-theological approach has so far turned out to be ineffective, because it is only superficial (saṭḥiyyun wa ẓāhiriyyun), not a deep solution, that is, a solution that reaches deep into the substance of the problem, namely theological or religious approach. The perspective of the Qur'an in dealing with corruption is found through three strategies, namely: detective, preventive, and repressive. Detective and preventive strategies are pursued in three ways: strengthening faith, strengthening the heart, and strengthening morality. Meanwhile, the repressive strategy is pursued in four ways: strengthening supervisory institutions (al-ḥisbah), strengthening juridical law and the judiciary, strengthening communities, and strengthening aspects of religiosity. Meanwhile, the detective, preventive, and repressive strategies as a whole are taken through strengthening theological values. The method used in this study is a qualitative method, based on library research, verses of the Qur'an, publications in the form of research results, journals, seminars, and articles. While the interpretation method used is the thematic interpretation method (tafsīr mawḍū’ī), both when analyzing problems from a theological point of view and when using verses of the Qur'an.

Human Papillomavirus Selected Properties and Related Cervical Cancer Prevention Issues

2020 ◽  
Vol 26 (18) ◽  
pp. 2073-2086
Author(s):  
Saule Balmagambetova ◽  
Andrea Tinelli ◽  
Ospan A. Mynbaev ◽  
Arip Koyshybaev ◽  
Olzhas Urazayev ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Screening Program ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Point Of View ◽  
Prevention Strategies ◽  
Middle Income ◽  
Screening Programs

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.

scholarly journals Focus on Function in Hospitalized Persons With Dementia: The Impact of Hospital-Acquired Complications

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 762-762
Author(s):  
Marie Boltz ◽  
Lorraine Mion
Keyword(s):  
Acute Care ◽  
Goal Attainment ◽  
Functional Decline ◽  
Policy And Practice ◽  
Increased Risk ◽  
Research Findings ◽  
Pharmacologic Management ◽  
Hospitalized Older Adults ◽  
Hospital Acquired ◽  
The Impact

Abstract Persons with dementia (PWD) are two-three times more likely to be hospitalized as persons without dementia and comprise one fourth of hospitalized older adults. Hospitalization often has a dramatic impact upon the health and disposition of the older PWD. They are at increased risk for hospital acquired complications (HAC) such as functional decline, behavioral symptoms of distress, and delirium, all of which contribute to increased disability, mortality, and long-term nursing home stays. Despite the unprecedented number of PWD admitted to acute care, little attention has focused on their specialized needs and HAC, and how they impact functional recovery. The purpose of this symposium is to describe the incidence of common HACs, and factors that influence their occurrence and presentation in PWD. Utilizing baseline findings from the Family-centered Function-focused Care (Fam-FFC) trial, the presentations will address this objective and discuss the ramifications for functional and cognitive post-acute recovery in PWD. The first presentation will describe the incidence and pharmacologic management of pain in PWD, and its association with common HACs. The second presentation will describe physical activity in PWD on medical units and the validity of the Motionwatch8 actigraphy. The third session will describe differences in common HACs between white and black PWD. The final presentation will examine function-focused goals developed in collaboration with family caregivers and patients, and the functional outcomes associated with goal attainment. Our discussant, Dr. Lorraine Mion, will synthesize the research findings and lead a discussion of future directions for policy and practice in dementia-capable acute care.

Adherence, Persistence, and Effectiveness in Real Life. Multicenter Long-Term Study on the Use of Pirfenidone and Nintedanib in the Treatment of Idiopathic Pulmonary Fibrosis

2021 ◽  
pp. 089719002110086
Author(s):  
Fiorenzo Santoleri ◽  
Luigia Auriemma ◽  
Antonella Spacone ◽  
Stefano Marinari ◽  
Fabio Esposito ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Pharmacological Study ◽  
Functional Decline ◽  
Real Life ◽  
Point Of View ◽  
Response To Treatment ◽  
First Year ◽  
Long Term Study ◽  
Second Year

Background: In the treatment of idiopathic pulmonary fibrosis (IPF), nintedanib and pirfenidone, with their different mechanisms of action, lead to a reduction in the rate of progression of the fibrosis process measured by the reduction of functional decline, and, in particular, the decrease in forced vital capacity (FVC) and of the diffusion capacity of the lungs for carbon monoxide (DLCO). The objective of this study was to analyze real-life adherence, persistence and efficacy in the use of pirfenidone and nintedanib in the treatment of IPF. Methods: A non-interventional multicenter retrospective observational pharmacological study in real-life treat-ment at 1 and 2 years was conducted. Furthermore, we analyzed the levels of FVC and DLCO at 6 and 12 months, respectively, from the start of treatment. Results: We identified 144 patients in the period between January 2013 and April 2019. From the point of view of adherence, there is no difference between the two drugs, even though patients who used pirfenidone had increasingly higher values: 0.90 vs 0.89, in the first year, and 0.91 vs 0.84, in the second year. In the first year of treatment, the percentage of persistent patients was 67% and 76%, while in the second year, it dropped to 47% and 53% for pirfenidone and nintedanib, respectively. Conclusion: The stratification of the adherence values as a function of the response to treatment in terms of FVC at 12 months for both study drugs showed that patients with optimal response scored adherence of more than 90%.

Fall prevention education for older people being discharged from hospital: Educators’ perspectives

2021 ◽  
pp. 001789692110327
Author(s):  
Jacqueline Francis-Coad ◽  
Den-Ching A Lee ◽  
Terry P Haines ◽  
Meg E Morris ◽  
Steven M McPhail ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Fall Prevention ◽  
Older Patients ◽  
Education Programme ◽  
Prevention Strategies ◽  
Post Intervention ◽  
Prevention Education ◽  
Barriers And Enablers ◽  
Education Delivery ◽  
Fall Prevention Education

Objective: Falls are a significant problem for many older patients after hospital discharge. The purpose of this study was to evaluate the fidelity and impact of a tailored patient fall prevention education programme from the perspective of the educators who delivered the programme. Design: Qualitative sequential design. Setting: Three rehabilitation hospitals in Western Australia. Method: Three experienced physiotherapists trained as ‘educators’ to deliver a tailored fall prevention education programme to 195 older patients prior to hospital discharge, together with monthly telephone follow-up for 3 months after discharge. Educator–patient interactions were recorded in a standardised educator diary. Post-intervention, educators participated in a mini-focus group, providing their perspectives regarding education delivery and its impact on patient abilities to engage in fall prevention strategies. Data were analysed using deductive content analysis. Results: Educators followed up 184 (94%) patients, identifying multiple barriers and enablers affecting patient engagement in planned fall prevention strategies. Key barriers included unresolved medical conditions, reluctance to accept assistance on discharge, delays in assistive service provision, patient beliefs and perceptions about falls and, in some cases, patients’ absolving responsibility for recovery. Enablers were related to programme design, the completion of hospital discharge processes and support networks following discharge. Conclusion: Educators identified several barriers and enablers to programme delivery, receipt and enactment by older patients that contributed to the fidelity of the education programme. The consistent need for more patient support to enable improved enactment of plans and assist with safe recovery long after discharge warrants further attention at policy and health system levels.

scholarly journals COVID-19 Prevention Measures Implemented by Tennis Coaches: The Role of Continent, Experience, and Type of Facility

2021 ◽  
Vol 18 (23) ◽  
pp. 12679
Author(s):  
Rafael Martínez-Gallego ◽  
Juan Pedro Fuentes-García ◽  
Miguel Crespo
Keyword(s):  
Latin America ◽  
Hand Hygiene ◽  
Latin American ◽  
Ad Hoc ◽  
Preventive Strategies ◽  
Prevention Measures ◽  
Prevention Strategies ◽  
Public Facilities ◽  
National Organizations

The prevention strategies used by tennis coaches when delivering tennis lessons during the COVID-19 pandemic were analyzed in this study. An ad hoc questionnaire collected data from 655 Spanish and Portuguese speaking tennis coaches working in Latin America and Europe. Differences in the prevention measures were analyzed according to the continent, the coaches’ experience, and the type of facility they worked in. Results showed that coaches used information provided from local and national organizations more than from international ones. Hand hygiene, communication of preventive strategies, and changes in the coaching methodology were the most used prevention measures. Latin American coaches and those working in public facilities implemented the measures more often than their European colleagues or those working in private venues. Finally, more experienced coaches showed a greater awareness of the adoption of the measures than their less experienced counterparts. The data provided by this research may assist in developing new specific guidelines, protocols, and interventions to help better understand the daily delivery of tennis coaching in this challenging context.

scholarly journals Health-Related Quality of Life, Functional Decline, and Long-Term Mortality in Older Patients Following Hospitalisation Due to COVID-19

2021 ◽  
Author(s):  
Marte Walle-Hansen ◽  
Anette Ranhoff ◽  
Marte Mellingsæter ◽  
Marte Wang-Hansen ◽  
Marius Myrstad
Keyword(s):  
Quality Of Life ◽  
Older Patients ◽  
Functional Decline ◽  
Health Related Quality ◽  
Negative Change ◽  
Related Quality ◽  
Health Related

Abstract Background Older people are particularly vulnerable to severe COVID-19. Little is known about long-term consequences of COVID-19 on health-related quality of life and functional status in older people, and the impact of age in this context. We aimed to study age-related change in health-related quality of life (HR-QoL), functional decline and mortality among older patients six months following hospitalisation due to COVID-19. Methods This was a cohort study including patients aged 60 years and older admitted to four general hospitals in South-Eastern Norway due to COVID-19, from March 1 up until July 1, 2020. Patients who were still alive were invited to attend a six-month follow-up. Change in HR-QoL and functional status compared to before the COVID-19 hospitalisation were assessed using the EuroQol 5-dimensional-5 levels questionnaire (EQ 5D-5L). A change in visual analogue scale (VAS) score of 7 or more was considered clinically relevant. Results Out of 216 patients aged 60 years and older that were admitted to hospital due to COVID-19 during the study period, 171 were still alive 180 days after hospital admission, and 106 patients (62%) attended the six-month follow-up. Mean age was 74.3 years, 27 patients (26%) had experienced severe COVID-19. 57 participants (54%) reported a decrease in the EQ5D-5L VAS score after six months, with no significant difference between persons aged 75 years and older compared to younger. 70 participants (66%) reported a negative change in any of the dimensions of the EQ-5D-5L, with impaired ability to perform activities of daily life (35%), reduced mobility (33%) and having more pain or discomfort (33%) being the most commonly reported changes. 46 participants (43%) reported a negative change in cognitive function compared to before the COVID-19 hospitalisation. Six-month mortality was 21%, and increased with increasing age. Conclusions More than half of the patients reported a negative change in HR-QoL six months following hospitalisation due to COVID-19, and one out of three experienced a persistently impaired mobility and ability to carry out activities of daily living. The results suggest awareness of long-term functional decline in older COVID-19 patients.

scholarly journals Hvad er religion i Danmark 2014?

2015 ◽  
pp. 139
Author(s):  
Niels Reeh
Keyword(s):  
Point Of View ◽  
Relational Approach ◽  
Analytical Point

By an analysis of the Danish Humanist Society and the Danish Atheist Society, the aim of this contribution is to consider one aspect of the borderland of the Danish model of religion. On the basis of a relational approach to the study of religion, I conclude that the Humanist Society from an analytical point of view is a religion while the Atheist Society is not. In this manner, the Humanist Society should be regarded as part of the Danish model of religion while the Atheist Society should not. Therefore, it may be argued that the borderland of the Danish model of religion is located between these two organisations.Dette bidrag undersøger en del af den danske religionsmodels grænseflade gennem en analyse af foreningerne Dansk Humanistisk Samfund og Ateistisk Selskab. På baggrund af et relationelt religionsbegreb konkluderes det, at Humanistisk Samfund analytisk set er en religion og dermed en del af den danske religionsmodel. Med hensyn til Ateistisk Selskab konkluderer analysen, at denne forening analytisk set ikke er en religion men snarere en religionspolitisk forening. Ateistisk Selskab er dermed ikke en del af den danske religionsmodel. Den danske religionsmodels grænseflade kan dermed siges at befinde sig imellem disse to organisationer

Maintaining independence in older people

2010 ◽  
Vol 20 (2) ◽  
pp. 128-153 ◽  
Author(s):  
AD Beswick ◽  
R Gooberman-Hill ◽  
A Smith ◽  
V Wylde ◽  
S Ebrahim
Keyword(s):  
Older People ◽  
Social Engagement ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Functional Decline ◽  
Complex Interventions ◽  
Preventive Strategies ◽  
Health And Social Care ◽  
Quality Trial ◽  
High Quality Trial

SummaryAppropriate social and medical interventions may help maintain independence in older people. Determinants of functional decline, disability and reduced independence are recognized and specific interventions target the treatment of clinical conditions, multiple health problems and geriatric conditions, prevention of falls and fractures, and maintenance of physical and cognitive function and social engagement.Preventive strategies to identify and treat diverse unmet needs of older people have been researched extensively. We reviewed systematically recent randomized controlled trials evaluating these ‘complex’ interventions and incorporated the findings of 21 studies into an established meta-analysis that included 108,838 people in 110 trials. There was an overall benefit of complex interventions in helping older people to live at home, explained by reduced nursing home admissions rather than death rates. Hospital admissions and falls were also reduced in intervention groups. Benefits were largely restricted to earlier studies, perhaps reflecting general improvements in health and social care for older people. The wealth of high-quality trial evidence endorses the value of preventive strategies to help maintain independence in older people.

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