scholarly journals General and COVID-19-Related Mortality by Pre-Existing Chronic Conditions and Care Setting during 2020 in Emilia-Romagna Region, Italy

2021 ◽  
Vol 18 (24) ◽  
pp. 13224
Author(s):  
Nicola Caranci ◽  
Chiara Di Girolamo ◽  
Letizia Bartolini ◽  
Daniela Fortuna ◽  
Elena Berti ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Care Setting ◽  
Cross Sectional Study ◽  
Place Of Death ◽  
Cross Sectional ◽  
Term Care ◽  
Adjusted Risk ◽  
Neuropsychiatric Diseases ◽  
Emilia Romagna Region ◽  
The Impact

In 2020, the number of deaths increased in Italy, mainly because of the COVID-19 pandemic; mortality was among the highest in Europe, with a clear heterogeneity among regions and socio-demographic strata. The present work aims to describe trends in mortality and to quantify excess mortality variability over time and in relation to demographics, pre-existent chronic conditions and care setting of the Emilia-Romagna region (Northern Italy). This is a registry-based cross-sectional study comparing the 2020 observed mortality with figures of the previous five years by age, sex, month, place of death, and chronicity. It includes 300,094 deaths in those 18 years of age and above resident in the Emilia-Romagna region. Excess deaths were higher during the first pandemic wave, particularly among men and in March. Age-adjusted risk was similar among both men and women (Mortality Rate Ratio 1.15; IC95% 1.14–1.16). It was higher among females aged 75+ years and varied between sub-periods. Excluding COVID-19 related deaths, differences in the risk of dying estimates tended to disappear. Metabolic and neuropsychiatric diseases were more prevalent among those that deceased in 2020 compared to the deaths that occurred in 2015–2019 and therefore can be confirmed as elements of increased frailty, such as being in long-term care facilities or private homes as the place of death. Understanding the impact of the pandemic on mortality considering frailties is relevant in a changing scenario.

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

scholarly journals The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia

2021 ◽  
Vol 18 (23) ◽  
pp. 12361
Author(s):  
Suliman Alghnam ◽  
Saleh A. Alessy ◽  
Mohamed Bosaad ◽  
Sarah Alzahrani ◽  
Ibrahim I. Al Alwan ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Chronic Conditions ◽  
National Guard ◽  
Cross Sectional Study ◽  
Primary Diagnosis ◽  
Cross Sectional ◽  
Prevalence Of Obesity ◽  
Associated Conditions ◽  
Study Population ◽  
The Impact

This cross-sectional study aimed to estimate the prevalence of obesity and its association with diabetes and hypertension among beneficiaries in the National Guard Health Affairs system of Saudi Arabia. We included individuals aged 17 years and older, and patients were classified as diabetic or hypertensive if they had any visit during the 4 years where the primary diagnosis was one of those conditions or they were taking diabetes or hypertension medications. The association between obesity (body mass index ≥30) and diabetes and hypertension were evaluated using a multiple logistic regression model, adjusting for age, gender, nationality, and region. A total of 616,092 individuals were included. The majority were Saudi nationals (93.1%). Approximately 68% of the population were either obese (38.9%) or overweight (29.30%). Obesity was more prevalent among Saudi nationals (39.8% vs. 26.7%, p < 0.01) and females (45.3% vs. 31.2%, p < 0.01). Obesity was independently associated with diabetes mellitus (OR = 2.24, p < 0.01) and hypertension (OR = 2.15, p < 0.01). The prevalence of obesity in the study population was alarming and more pronounced among women. Our findings call for efforts to intensify preventive measures to reduce obesity and associated conditions. Using electronic records to examine the impact of interventions to reduce obesity and chronic conditions may help monitor and improve population health.

scholarly journals Characteristics of patients with cancer in European long-term care facilities

2021 ◽  
Author(s):  
Emanuele Rocco Villani ◽  
Domenico Fusco ◽  
Laura Franza ◽  
Graziano Onder ◽  
Roberto Bernabei ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Do Not Resuscitate ◽  
Cross Sectional ◽  
Term Care ◽  
Patients With Cancer ◽  
Care Approach ◽  
The Impact

Abstract Purpose Up to 26% of residents in nursing homes (NHs) are affected by cancer. Their care represents a challenge, because NHs are not usually considered a setting focused on oncologic management and care. The aim of this paper is to describe socio-demographic and clinical features of patients with cancer residing in European NHs. Methods Cross-sectional study based on data from the Services and Health for Elderly in Long TERm care (SHELTER) study. Participants were assessed through the interRAI-LTCF, which includes cancer assessment. Results Among 4140 participants (mean age 83.4 years; female 73%), 442 (10.7%) had cancer. Patients with cancer had a higher prevalence of do-not-resuscitate directives compared to those without cancer (21.1% vs 16.5%, p = 0.019). Variables directly associated with cancer were male sex (adj OR 1.67, 95% CI 1.36–2.05), pain (adj OR 1.43, 95% CI 1.16–1.77), fatigue (adj OR 1.25, 95% CI 1.01–1.55), polypharmacy (adj OR 1.59, 95% CI 1.21–2.08) and falls (adj OR. 1.30, 95% CI 1.01–1.67). Dementia was inversely associated with cancer (adj OR 0.74, 95% CI 0.58–0.94). Symptomatic drugs such as opioids (23.5% vs 12.2, p < .001), NSAIDS (7.2% vs 3.9%, p = 0.001), antidepressants (39.1% vs 33.8%, p = 0.026) and benzodiazepines (40.3% vs 34.3, p = 0.012) were all prescribed more in participants with cancer compared to those without cancer. Conclusions Cancer patients are prevalent in European NHs and they show peculiar characteristics. Studies are needed to evaluate the impact of a supportive care approach on the management of NHs residents with cancer throughout all its phases, until the end-of-life care

Older adults' views on their person-centred care needs in a long-term care setting in Ireland

2019 ◽  
Vol 28 (9) ◽  
pp. 552-557 ◽  
Author(s):  
Fiona Kelly ◽  
Mary Reidy ◽  
Suzanne Denieffe ◽  
Catherine Madden
Keyword(s):  
Older Adults ◽  
Care Setting ◽  
Long Term Care ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Cross Sectional Study ◽  
Care Needs ◽  
Cross Sectional ◽  
Term Care

Background: person-centred care should be responsive to the needs of older adults in long-term care. It is central to collaborative and high-quality healthcare delivery. Aim: to explore the perceptions of older Irish adults aged 65 years of age or more regarding the person-centred climate of the long-term care setting in which they live. Method: a cross-sectional study design using the Person-centered Climate Questionnaire–Patient (PCQ-P) was used to survey 56 older adults in a long-term care setting. Results: overall, residents considered the setting to be hospitable, welcoming, clean and safe; the mean (SD) scale score was 5.39 (0.520). Psychosocial concerns about adapting to living in long-term care environments need to be addressed, particularly among the younger male residents when compared with older male residents (53.8% v 86.7%, P=0.018). Conclusion: older people in long-term care may prioritise different facets of person-centredness to staff. Further research of approaches used in Irish older adult long-term person-centred care delivery is warranted.

scholarly journals A cross-sectional study of the relationship between delayed healthcare utilisation and chronic conditions among older adults during the COVID-19 pandemic in Ireland

2021 ◽  
Vol 4 ◽  
pp. 112
Author(s):  
Niamh Hennelly ◽  
Georgia Lalor ◽  
Sarah Gibney ◽  
Rose Anne Kenny ◽  
Mark Ward
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Healthcare Utilisation ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Policy And Practice ◽  
Cross Sectional ◽  
Healthcare Needs ◽  
The Impact ◽  
The Relationship

Background: Many healthcare services were cancelled or postponed during the coronavirus 2019 (COVID-19) pandemic, likely impacting the management of chronic conditions prevalent among older adults in Ireland. Methods: Data from the Irish Longitudinal Study on Ageing COVID-19 study and previous waves were used. Taking healthcare demand into account, the relationship between delayed healthcare utilisation among older adults (≥50) with chronic conditions was examined. Further analyses examined the reasons for delays in healthcare utilisation, and whether they were the result of the reduced availability of healthcare services or participant decisions. Results: In total, 31.6% of participants reported experiencing healthcare delay. The first analysis found that older adults with two or more chronic conditions were more likely to have experienced healthcare delay than those with no chronic conditions (odds ratio (OR): 1.46, 95% confidence interval (CI): 1.11, 1.90). The second analysis found that older adults with two or more chronic conditions were more likely to have healthcare delayed by the provider (OR: 1.73, 95% CI: 1.16, 2.56), and were also more likely to delay their own healthcare (OR: 1.62, 95% CI: 1.14, 2.29) than older adults with no chronic conditions. Additionally, people aged 70 years and over, females, those with problematic alcohol consumption, those with third-level education, those who had visited the GP and those who reported polypharmacy were all more likely to experience healthcare delay, while older adults living with others and those living outside Dublin were less likely to experience healthcare delay. Conclusion: COVID-19 has had a significant impact on the healthcare utilisation of older adults in Ireland, with some groups of older adults impacted more than others. Policy and practice must now focus on how the healthcare needs of these groups can be best served. Further research is required to understand the impact of healthcare delays on health outcomes.

scholarly journals Professional Pharmacy Services and Patient Complexity: An Observational Study

2015 ◽  
Vol 18 (5) ◽  
pp. 863 ◽  
Author(s):  
Teegan Aili Ignacy ◽  
Ximena Camacho ◽  
Muhammad Mamdani ◽  
David Juurlink ◽  
J. Michael Paterson ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Pharmacy Services ◽  
Cross Sectional ◽  
Term Care ◽  
Drug Benefits ◽  
The Past ◽  
Complex Patients ◽  
Patient Health ◽  
Patient Complexity ◽  
The Impact

PURPOSE: To examine the association between the provision of professional pharmacy services (PPS) and patient complexity as determined by the number of distinct medications dispensed in Ontario. METHODS: We conducted a cross-sectional study among all individuals dispensed one or more medications under the Ontario Public Drug Program (OPDP) between April 1st, 2012 and March 31st, 2013. We compared characteristics of patients receiving ­1 or more PPS to those receiving no PPS. To assess the relationship between patient complexity (as measured by the number of chronic medications dispensed) and receipt of PPS, we reported the number and proportion of patients eligible for Ontario Drug Benefits (ODB) who received a PPS within each patient complexity group, and compared these proportions using the Cochran-Armitage test. RESULTS: Over the 1-year study period, 27.1% (N = 799,674 of 2,946,183) of ODB beneficiaries received at least one professional pharmacy service. Among these services, more than two-thirds of the patients received a MedsCheck service (N=511,490; 64.0%). Overall, individuals who received a PPS tended to be older, more likely to reside in a long-term care (LTC) facility, have multiple comorbidities, and were more likely to have been prescribed 9 or more medications in the past year. As patient complexity increased, the proportion of ODB beneficiaries who received PPS also increased; 3.0% of individuals prescribed between 1 and 2 medications in the past year received PPS, while 53.6% of those treated with 13 or more medications received PPS (p<0.0001). CONCLUSIONS: Although the findings of our study suggest the use of PPS increases with patient complexity, many complex patients are not receiving these services. Further studies are required to better understand why patients do not access these services, the impact of professional pharmacy services on patient health outcomes, and their value for the health care system. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

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