Comparison of the caregivers’ and community health professionals’ views on home health care services for disabled older adults: a cross-sectional study in Beijing, China

Abstract Background In an era of an increasingly ageing society, part of healthcare for older adults can be provided in patients’ homes, and the need for home health care services (HHCSs) is increasing. This study sought to determine whether a gap exists between the views of community health professionals and the caregivers of disabled older adults towards HHCSs in Beijing, China. Methods A cross-sectional study with two comparative questionnaire surveys was conducted in Beijing, China. One survey was administered to the caregivers of disabled older adults, and the other was administered to health professionals in community health service institutions (CHSIs). T-tests and Wilcoxon signed-rank tests were used to explore potential differences between the views of caregivers and community health professionals towards HHCSs. Results We received 370 valid questionnaires from caregivers and 224 questionnaires from health professionals. Of the 370 caregivers, 314 (84.9%) were willing to apply for HHCSs for the older adults, but only 20.5% (N = 76) received HHCSs. Over 80% of the caregivers accepted out-of-pocket costs less than 100 yuan per visit. Caregivers’ demands on home nursing services were significantly higher than those of health guidance services (Z = − 7.725, P < 0.001). Most of the 224 health professionals chose “health professionals’ personal safety cannot be guaranteed” as a problem limiting the provision of HHCSs (N = 151, 40.8%). The health professionals’ attitudes towards home nursing services were significantly less positive than those towards health guidance services (Z = − 10.081, P < 0.001). For home nursing services, health professionals’ attitude scores were lower than the caregivers’ demand scores (Z = − 4.960, P < 0.001), while for health guidance services, health professionals’ attitude scores were higher than the caregivers’ demand scores (Z = − 8.373, P < 0.001). Conclusions Gaps exist between the views of caregivers and health professionals on HHCSs. Compared to health professionals with a higher willingness to provide health guidance services, caregivers need home nursing services. Feasible policies should be implemented to safeguard the rights and interests of health professionals, and qualified health professionals should be trained for HHCSs.

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Predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2020-041578 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041578

Author(s):

Linglin Kong ◽

Huimin Zhao ◽

Junyao Fan ◽

Quan Wang ◽

Jie Li ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Depressive Symptoms ◽

Community Health ◽

Community Dwelling ◽

Central China ◽

Chinese Community ◽

Cross Sectional ◽

Community Dwelling Older Adults

ObjectivesTo assess the prevalence of frailty and identify predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes.DesignA cross-sectional design.SettingTwo community health centres in central China.Participants291 community-dwelling older adults aged ≥65 years with type 2 diabetes.Main outcome measuresData were collected via face-to-face interviews, anthropometric measurements, laboratory tests and community health files. The main outcome measure was frailty, as assessed by the frailty phenotype criteria. The multivariate logistic regression model was used to identify the predictors of frailty.ResultsThe prevalence of prefrailty and frailty were 51.5% and 19.2%, respectively. The significant predictors of frailty included alcohol drinking (ex-drinker) (OR 4.461, 95% CI 1.079 to 18.438), glycated haemoglobin (OR 1.434, 95% CI 1.045 to 1.968), nutritional status (malnutrition risk/malnutrition) (OR 8.062, 95% CI 2.470 to 26.317), depressive symptoms (OR 1.438, 95% CI 1.166 to 1.773) and exercise behaviour (OR 0.796, 95% CI 0.716 to 0.884).ConclusionsA high prevalence of frailty was found among older adults with type 2 diabetes in the Chinese community. Frailty identification and multifaceted interventions should be developed for this population, taking into consideration proper glycaemic control, nutritional instruction, depressive symptoms improvement and enhancement of self-care behaviours.

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Depression and empathy in health professionals who work in the long-term care institutions for older adults

Dementia & Neuropsychologia ◽

10.1590/1980-57642021dn15-030011 ◽

2021 ◽

Vol 15 (3) ◽

pp. 381-386

Author(s):

Marina Miranda Borges ◽

Ana Julia de Lima Bomfim ◽

Marcos Hortes Nisihara Chagas

Keyword(s):

Older Adults ◽

Health Professionals ◽

Long Term Care ◽

Cross Sectional Study ◽

Reactivity Index ◽

Cross Sectional ◽

Term Care ◽

Patient Health ◽

The Relationship

ABSTRACT Empathy is an important factor to guarantee the quality of care provided in the long-term care institutions (LTCIs) for older adults, and depression is a factor that affects the health of the professional and, consequently, the care. Thus, it is important that studies are conducted on the relationship of these variables in this context. Objective: The aim of this study is to verify the relationship between empathy and depressive symptoms among health professionals working in the LTCIs. Methods: A cross-sectional study was carried out at LTCIs in the state of São Paulo, Brazil. The final sample was constituted by 101 health professionals (i.e., caregivers and nursing technicians) with direct participation in the care of institutionalized older adults. The instruments were used as follows: the Interpersonal Reactivity Index (IRI) to assess empathy and the Patient Health Questionnaire-9 (PHQ-9) for the diagnosis of depression. For the analyses, the patients were divided into groups with and without depression, according to the score of the PHQ-9. Results: The prevalence of depression among health professionals was 19.8%. Significant statistical differences were found between the groups for the total score of the IRI (p=0.029), for the emotional domain (p=0.023), and for the personal distress (p=0.009). Conclusions: The findings indicate that the presence of depression among health professionals at LTCIs is related to the higher levels of empathy, especially in the emotional domain. Thus, future studies that contribute to understanding how care must be provided with empathy, but without harming the health of the professional, should be carried out.

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Biopsychopharmacosocial approach to assess impact of social distancing and isolation on mental health in older adults

British Journal of Community Nursing ◽

10.12968/bjcn.2020.25.5.231 ◽

2020 ◽

Vol 25 (5) ◽

pp. 231-238 ◽

Cited By ~ 5

Author(s):

Edward Baker ◽

Louise L Clark

Keyword(s):

Mental Health ◽

Older Adults ◽

Community Health ◽

Health Professionals ◽

Assessment Model ◽

Vulnerable Groups ◽

Severe Illness ◽

Social Distancing ◽

Health And Social Care ◽

The Impact

It is impossible to predict or comprehend the impact of the ongoing COVID-19 pandemic. The UK Government's advice for vulnerable people, including older adults, to move towards self-isolation and social distancing is likely to reduce rates of transmission, the risk of severe illness and the impact on the acute health services. Although justified and necessary, this process of isolation is likely to have a negative impact on the mental health of these vulnerable groups, especially older people. It will become increasingly important for community health professionals to assess subtle changes in older persons' mental health, as the duration of this period of isolation remains unclear. The biopsychopharmacosocial model provides one method of assessing mental health and planning health and social care needs. This article hopes to guide community health professionals through the specifics of this assessment model in relation to the growing COVID-19 pandemic.

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Nutritional Care for older adults in Primary Health Care, from the perspective of health professionals

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562020023.200168 ◽

2020 ◽

Vol 23 (6) ◽

Author(s):

Carolina Lou de Melo ◽

Maria Angélica Tavares de Medeiros

Keyword(s):

Older Adults ◽

Health Care ◽

Primary Health Care ◽

Health Professionals ◽

Healthy Aging ◽

Structured Interview ◽

Cross Sectional ◽

Nutritional Care ◽

Primary Health ◽

Theoretical Saturation

Abstract Objective: to characterize and analyze Nutritional Care (NC) for older adults in Primary Health Care (PHC), identifying how food and nutrition actions (F&N) were performed and the conceptions that guided them. Methods: a cross-sectional, quantitative and qualitative study was performed in PHC in Santos, São Paulo, Brazil, in two phases: i) a census study was carried out of health units, N=28 (100%), with managers who answered a structured interview to assess NC; followed by descriptive analysis. ii) a deeper investigation of this diagnosis was performed, using semi-structured interviews with key informants (interviewees) of care for older adults; being a nutritionist was not a criteria, as there were only three such professionals throughout the entire PHC, and one of the health regions studied was not served by a nutrition professional. The concept of theoretical saturation was used for the sampling plan; content analysis was carried out and the inferences were supported by references of integrality and aging. Results: NC for older adults was highlighted by individual care, predominant in all the services studied (28) (100%); nutritionists participated in this activity in just nine units (32.1%). Theoretical saturation was achieved with nine interviews. According to the discourse analysis, F&N actions were generic, focused on the treatment of diseases, influenced by negative aspects attributed to aging, there was no planning based on the needs of the territory, and health professionals identified themselves as information transmitters, leaving the responsibility of acting on such information to the older adults themselves. Conclusion: F&N actions were guided by the biomedical paradigm, fragmented, restricted to disease management, imputing the responsibility for health to the individual themselves. Thus, NC distanced itself from the promotion of healthy aging, weakening its strategic role in the quest for integrated care.

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Attitudes towards Advance Care Planning and Healthcare Autonomy among Community-Dwelling Older Adults in Beijing, China

BioMed Research International ◽

10.1155/2015/453932 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 9

Author(s):

Ning Zhang ◽

Xiao-hong Ning ◽

Ming-lei Zhu ◽

Xiao-hong Liu ◽

Jing-bing Li ◽

...

Keyword(s):

Older Adults ◽

Cross Sectional Study ◽

Influential Factors ◽

Community Dwelling ◽

Chinese Adults ◽

Cross Sectional ◽

Advance Care ◽

Older Chinese ◽

Older Chinese Adults ◽

Beijing China

Objectives. To investigate the preferences of ACP and healthcare autonomy in community-dwelling older Chinese adults.Methods. A community-based cross-sectional study was conducted with older adults living in the residential estate of Chaoyang District, Beijing.Results. 900 residents were enrolled. 80.9% of them wanted to hear the truth regarding their own condition from the physician; 52.4% preferred to make their own healthcare decisions. Only 8.9% of them preferred to endure life-prolonging interventions when faced with irreversible conditions. 78.3% of the respondents had not heard of an ACP; only 39.4% preferred to document in an ACP. Respondents with higher education had significantly higher proportion of having heard of an ACP, as well as preferring to document in an ACP, compared to those with lower education. Those aged <70 years had higher proportion of having heard of an ACP, as well as refusing life-prolonging interventions when faced with irreversible conditions, compared to those aged ≥70 years.Conclusions. Although the majority of community-dwelling older Chinese adults appeared to have healthcare autonomy and refuse life-prolonging interventions in terms of end-of-life care, a low level of “Planning ahead” awareness and preference was apparent. Age and education level may be the influential factors.

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Community health professionals’ dementia knowledge, attitudes and care approach: a cross-sectional survey in Changsha, China

BMC Geriatrics ◽

10.1186/s12877-018-0821-4 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 22

Author(s):

Yao Wang ◽

Lily Dongxia Xiao ◽

Yang Luo ◽

Shui-Yuan Xiao ◽

Craig Whitehead ◽

...

Keyword(s):

Community Health ◽

Health Professionals ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Approach

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Is Self-Reported Physical Activity Participation Associated with Lower Health Services Utilization among Older Adults? Cross-Sectional Evidence from the Canadian Community Health Survey

Journal of Aging Research ◽

10.1155/2015/425354 ◽

2015 ◽

Vol 2015 ◽

pp. 1-14 ◽

Cited By ~ 2

Author(s):

Koren L. Fisher ◽

Elizabeth L. Harrison ◽

Bruce A. Reeder ◽

Nazmi Sari ◽

Karen E. Chad

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Services ◽

Community Health ◽

Health Survey ◽

Age Groups ◽

Canadian Community Health Survey ◽

Cross Sectional ◽

Services Utilization ◽

Community Health Survey

Purpose. To examine relationships between leisure time physical activity (LTPA) and health services utilization (H) in a nationally representative sample of community-dwelling older adults.Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years) were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA) was categorized into four levels ranging from mostly sitting to mostly lifting objects.Results. Active 50–65-year-old individuals were 27% less likely to report any GP consultationsORadj=0.73; P<0.001and had 8% fewer GP consultations annually(IRRadj=0.92; P<0.01)than their inactive peers. Active persons aged 65–79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year(ORadj=0.82, P<0.05). Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups.Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services.

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