scholarly journals Impact of the chronic disease self-management program (CDSMP) on self-perceived frailty condition: the EU-EFFICHRONIC project

2021 ◽  
Vol 12 ◽  
pp. 204062232110567
Author(s):  
Sabrina Zora ◽  
Carlo Custodero ◽  
Yves-Marie Pers ◽  
Verushka Valsecchi ◽  
Alberto Cella ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Cognitive Performance ◽  
Nutritional Assessment ◽  
Short Form ◽  
Prognostic Index ◽  
Mini Nutritional Assessment ◽  
Management Program ◽  
The Self ◽  
Self Management

Introduction: The Chronic Disease Self-Management Program (CDSMP) improves self-efficacy and health outcomes in people with chronic diseases. In the context of the EFFICHRONIC project, we evaluated the efficacy of CDSMP in relieving frailty, as assessed by the self-administered version of Multidimensional Prognostic Index (SELFY-MPI), identifying also potential predictors of better response over 6-month follow-up. Methods: The SELFY-MPI explores mobility, basal and instrumental activities of daily living (Barthel mobility, ADL, IADL), cognition (Test Your Memory-TYM Test), nutrition (Mini Nutritional Assessment-Short Form-MNA-SF), comorbidities, medications, and socio-economic conditions (social-familiar evaluation scale-SFES). Participants were stratified in three groups according to the 6-month change of SELFY-MPI: those who improved after CDSMP (Δ SELFY-MPI < 0), those who remained unchanged (Δ SELFY-MPI = 0), and those who worsened (Δ SELFY-MPI > 0). Multivariable logistic regression was modeled to identify predictors of SELFY-MPI improvement. Results: Among 270 participants (mean age = 61.45 years, range = 26–93 years; females = 78.1%) a benefit from CDSMP intervention, in terms of decrease in the SELFY-MPI score, was observed in 32.6% of subjects. SELFY-MPI improvement was found in participants with higher number of comorbidities (1–2 chronic diseases: adjusted odd ratio (aOR)=2.38, 95% confidence interval (CI) =1.01, 5.58; ⩾ 3 chronic diseases: aOR = 3.34, 95% CI = 1.25, 8.90 vs no chronic disease), poorer cognitive performance (TYM ⩽ 42: aOR = 2.41, 95% CI = 1.12, 5.19 vs TYM > 42) or higher risk of malnutrition (MNA-SF ⩽ 11: aOR = 6.11, 95% CI = 3.15, 11.83 vs MNA-SF > 11). Conclusion: These findings suggest that the CDSMP intervention contributes to decreasing the self-perceived severity of frailty (SELFY-MPI score) in more vulnerable participants with several chronic diseases and lower cognitive performance and nutritional status.

scholarly journals Relationship between chronic diseases and diet in older persons in nursing homes

2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Melahat Kizil ◽  
Kamile Nazan Turhan ◽  
Ramazan Kizil ◽  
Nursun Ustunkarli
Keyword(s):  
Nursing Home ◽  
Chronic Disease ◽  
Older People ◽  
Chronic Diseases ◽  
Old Age ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Balanced Diet ◽  
The Relationship

This study aimed to determine the relationship between chronic diseases and nutrition in the older adults in a nursing home. In 2014 and 2019, we investigated older people aged 60 years and over living in a nursing home in Izmir and who agreed to participate and could perform self-care. A 26-item questionnaire that focuses on sociodemographic, socioeconomic and chronic disease characteristics, and the Turkish version of Mini Nutritional Assessment Test-Short Form were applied using the face-to-face method. In 2014, 68.9% of the older had no malnutrition risk, 23% had malnutrition risk, and 8.1% had malnutrition. The women had a higher malnutrition risk and actual malnutrition than men (P<0.05). Malnutrition was most common in 75-84 years of age. In 2019, 41.6% of the older had malnutrition risk, whereas 7.8% had actual malnutrition. No difference was found between malnutrition and malnutrition risk, between women and men and between age and sex (P>0.05). At both times, malnutrition risk increased in those with chronic disease (P<0.05). At least one chronic disease (high blood pressure, heart disease, diabetes, etc.) was found in 67.6% of the older. Meanwhile, 70.1% had been previously hospitalized for some reason. Malnutrition risk increases with old age. An adequate and well-balanced diet is important for protecting health and increasing longevity and quality of life in old age. Older people and nursing home employees need to be trained on the relationship and risks of chronic disease and malnutrition.

scholarly journals Standardising the Lay: Logics of Change in Programs of Disease Self-management

2012 ◽  
Vol 4 (3) ◽  
pp. 425-442 ◽  
Author(s):  
Annegrete Juul Nielsen ◽  
Lone Grøn
Keyword(s):  
Chronic Disease ◽  
Role Models ◽  
Chronic Condition ◽  
Expert Knowledge ◽  
Management Program ◽  
The Self ◽  
Self Management ◽  
Social Settings ◽  
Patient Centric ◽  
Forms Of Knowledge

The health political discourse on self-care is dominated by the view that the selfmanaging patient represents a more democratic and patient-centric perspective, as he or she is believed to renegotiate the terms on which patient participation in health care has hitherto taken place. The self-managing patient is intended as a challenge to traditional medical authority by introducing lay methods of knowing disease. Rather than a meeting between authoritative professionals and vulnerable patients, the self-managing patient seeks to open up new spaces for a meeting between experts. The present paper questions these assumptions through an ethnographic exploration of a patient-led self-management program called the Chronic Disease Self-Management Program. The program is concerned with what its developers call the social and mental aspects of living with a chronic disease and uses trained patients as role models and program leaders. Drawing inspiration from Annemarie Mol’s term ’logic’, we explore the rationale of ’situations of selfmanagement’ and identify what we call a ’logic of change’, which involves very specific ideas on how life with a chronic condition should be dealt with and directs attention towards particular manageable aspects of life with a chronic condition. This logic of change entails, we argue, a clash not between ’medical’ and ’lay’ forms of knowledge but between different logics or perceptions of how transformation can be achieved: through open-ended and ongoing reflection and experimentation in social settings or through standardised trajectories of change. Returning to the literature on lay forms of knowledge and illness perspectives, we question whether programs such as the Chronic Disease Self-Management Program – despite its apparent patient-centric perspective – reproduces classical hierarchical relations between lay and expert knowledge, albeit in new forms.

scholarly journals Self-Management as an Integral Method of Attention in the Treatment of the Patient with Chronic Kidney Disease

2018 ◽  
Vol 6 (12) ◽  
Author(s):  
María José Vázquez-Atanacio
Keyword(s):  
Health Care ◽  
Chronic Kidney Disease ◽  
Chronic Disease ◽  
Kidney Disease ◽  
Chronic Diseases ◽  
Care Provider ◽  
Integral Method ◽  
The Self ◽  
Self Management ◽  
Patient Relationship

Currently, the health care methods for chronic diseases are leaving behind the paternalism and the doctor-patient relationship, giving way to a new model, in which people with any chronic disease play an important role in their own health care with the support of the health care provider, this is called self-management. An important aspect of the self-management of diseases is the determination and elaboration of specific strategies in the patient´s empowerment through knowledge, in order to face all the challenges and demands of living with this disease.

scholarly journals The Impact of the Chronic Disease Self-Management Program on Health Literacy: A Pre-Post Study Using a Multi-Dimensional Health Literacy Instrument

2019 ◽  
Vol 17 (1) ◽  
pp. 58 ◽  
Author(s):  
Danielle Marie Muscat ◽  
Wenbo Song ◽  
Erin Cvejic ◽  
Jie Hua Cecilia Ting ◽  
Joanne Medlin ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Health Literacy ◽  
Chronic Diseases ◽  
Management Program ◽  
Self Management ◽  
Post Intervention ◽  
South Wales ◽  
Diverse Area ◽  
Potential Impact ◽  
The Impact

This study assessed the impact of the Chronic Disease Self-Management Program (CDSMP) on different domains of health literacy using a pre-post study design. Participants aged over 16 years and with one or more self-reported chronic diseases were recruited for the CDSMP in western Sydney (a highly diverse area of New South Wales, Australia) between October 2014 and September 2018. Health literacy was assessed pre- and immediately post-intervention using the Health Literacy Questionnaire (HLQ), with differences in mean scores for each HLQ domain analysed using paired sample t-tests. A total of 486 participants were recruited into the CDSMP. Of those, 316 (65.0%) completed both pre- and post-intervention surveys and were included in the analysis. The median age of the participants was 68 years, the majority were female (62.5%), and most were born in a country other than Australia (80.6%). There were statistically significant (P < 0.001) improvements across all nine domains of the HLQ. This is the first study evaluating the potential impact of the CDSMP on improving different domains of health literacy amongst a diverse sample of participants with chronic diseases using a multi-dimensional instrument. The absence of a control population in this study warrants caution when interpreting the results.

scholarly journals Evaluation of Malnutrition and Depression in Elderly People: An Epidemiological Study in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Aydoğan ◽  
A Ünsal ◽  
D Arslantaş
Keyword(s):  
Health Care Providers ◽  
Nutritional Assessment ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Cluster Sampling ◽  
Care Providers ◽  
Cross Sectional

Abstract Background Malnutrition is an important cause of morbidity and mortality. Malnutrition increases the number of hospitalizations and prolongs the length of hospitalization by disrupting organ functions, increasing the number and severity of infections and delaying wound healing. The aim of this study was to determine the frequency of suspected malnutrition in the elderly, to examine some related variables and to evaluate the depression. Methods The study is a cross-sectional study conducted between March-April 2019 in individuals aged 60 years and older living in Sivrihisar. Sample size was calculated as 579. Cluster sampling method used. Data was collected by door to door in 4 neighborhoods determined by randomly. Mini Nutritional Assessment Test-Short Form (for malnutrition), Katz Daily Living Activities Scale (for dependency) and Geriatric Depression Scale-Short Form (for depression) were used. Chi-square test, Mann Whitney U test and logistic regression analysis were used for the analyzes. Results The study group consisted of 220 (38%) women and 359 (62%) men. The mean age was 68.9±6.4 (ranged 60-93). Frequency of suspected malnutrition was 25% (n = 145). Being 80 years of age or older (OR:3.24, CI:1.53-6.85), having a primary and lower education level (OR:2.54, CI:1.32-4.90), history of chronic illness (OR:2.34, CI:1.33-4.03), using dentures (OR:1.62, CI:1.03-2.55) and suspected depression (OR:4.97, CI:3.17-7.78) are important risk factors for malnutrition. Those with suspicion of malnutrition had lower scores on DLA (z = 8.982;p=0.001). Conclusions Malnutrition was found to be an important health problem for the elderly. The frequency of suspected malnutrition is higher in individuals with depression. Those with suspected malnutrition have higher level of dependency. In order to reduce the frequency of malnutrition, it may be beneficial to increase the awareness of the elderly and caregivers and to give importance to the elderly nutrition of primary health care providers. Key messages Depression is an important risk factor for malnutrition. Malnutrition increases the dependence of the individual on daily activities.

scholarly journals Diagnostic Performance and Accuracy of the MNA-SF against GLIM Criteria in Community-Dwelling Older Adults from Poland

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2183
Author(s):  
Aleksandra Kaluźniak-Szymanowska ◽  
Roma Krzymińska-Siemaszko ◽  
Marta Lewandowicz ◽  
Ewa Deskur-Śmielecka ◽  
Katarzyna Stachnik ◽  
...  
Keyword(s):  
At Risk ◽  
Diagnostic Performance ◽  
Nutritional Assessment ◽  
Short Form ◽  
Area Under The Curve ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Study Results ◽  
Community Dwelling Older Adults ◽  
Test Result

Up to 28% of elderly residents in Europe are at risk of malnutrition. As uniform diagnostic criteria for malnutrition have not been formulated, in autumn 2018, the Global Leadership Initiative on Malnutrition (GLIM) presented a consensus on its diagnosis. According to the consensus, the diagnosis of malnutrition requires a positive screening test result for the risk of malnutrition, and the presence of at least one etiologic and one phenotypic criterion. This study aimed to assess the diagnostic performance and accuracy of the Mini Nutritional Assessment—Short Form (MNA-SF) against GLIM criteria. The analysis involved 273 community-dwelling volunteers aged ≥ 60 years. All participants were screened for malnutrition with the MNA-SF questionnaire. Next, the GLIM phenotypic and etiologic criteria were assessed in all subjects. Based on the presence of at least one phenotypic and one etiologic criterion, malnutrition was diagnosed in more than one-third of participants (n = 103, 37.7%). According to the MNA-SF, only 7.3% of subjects had malnutrition, and 28.2% were at risk of malnutrition. The agreement between the MNA-SF score and the GLIM criteria were observed in only 22.3% of the population. The sensitivity and specificity of MNA-SF against the GLIM criteria were fair (59.2% and 78.8%, respectively). The area under the curve (AUC) was 0.77, indicating the fair ability of MNA-SF to diagnose malnutrition. Based on the present study results, the best solution may be an optional replacement of the screening tool in the first step of the GLIM algorithm with clinical suspicion of malnutrition.

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