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Things That Matter: Special Objects in Our Stories as We AgeBy William L. Randall and Matte Robinson (eds.), Toronto: University of Toronto Press, 2024. 360 pp. ISBN: 9781487524470 Things That Matter:William L. Randall 和 Matte Robinson(编著),多伦多:多伦多大学出版社,2024 年。360 pp.ISBN: 9781487524470
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-24 DOI: 10.1111/opn.12659
Ellen Munsterman
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引用次数: 0
Best Evidence Summary for Management of Older People With Type 2 Diabetes Mellitus Using ‘Internet Plus Nursing Services’ 使用 "互联网+护理服务 "管理 2 型糖尿病老年人的最佳证据摘要》(Best Evidence Summary for Management of Older People With Type 2 Diabetes Mellitus Using 'Internet Plus Nursing Services')。
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-21 DOI: 10.1111/opn.12657
Litian Hu, Hua Chen, Wanying Mo, Yuebing Han, Hongyu Sun
<div> <section> <h3> Aim</h3> <p>To evaluate and summarise the evidence for the management of older people with Type 2 diabetes mellitus (T2DM) using ‘Internet Plus nursing services (IPNS)’.</p> </section> <section> <h3> Design</h3> <p>This study was conducted as an evidence summary, adhering strictly to the evidence summary reporting standards established by Fudan University Center for Evidence-based Nursing.</p> </section> <section> <h3> Methods</h3> <p>We systematically searched for the best available evidence pertaining to the management of older people with T2DM using the IPNS. The literature types encompassed clinical guidelines, expert consensuses, systematic reviews, evidence summaries and original research studies.</p> </section> <section> <h3> Data Sources</h3> <p>In order to gather pertinent information, we conducted a comprehensive search across various databases, including UpToDate, BMJ Best Practice, Joanna Briggs Institute, Guidelines International Network, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Scottish Intercollegiate Guidelines Network, the Cochrane Library, PubMed, Web of Science, Yi Maitong Guidelines Network, SinoMed, CNKI, WanFang database, Chinese Biomedical Literature Database and China Science and Technology Journal Database. The search spanned from the inception of each database up to July 2023, ensuring an extensive coverage of relevant resources.</p> </section> <section> <h3> Result</h3> <p>After rigorous screening and evaluation, our study ultimately identified 19 articles with high-quality research outcomes. These articles consisted of three guidelines, two expert consensus documents, three systematic reviews and eleven original research studies. Through collaborative and in-depth discussions, we extracted and synthesised 27 pieces of evidence related to the application of the IPNS to enhance the T2DM management for older people. We categorised the evidence into five primary themes: mobile terminal design, team building, health education design, interaction and social support, and information feedback.</p> </section> <section> <h3> Conclusion</h3> <p>In designing the IPNS for older people with T2DM, utmost attention should be paid to the intricacies of Internet module development preceded by comprehensive guidance. It is imperative to establish multidisciplinary teams to oversee the curation of patient educational content, ensuring its relevance and effectiveness. Leveraging Internet-based
目的:评估并总结利用 "互联网+护理服务(IPNS)"管理老年2型糖尿病(T2DM)患者的证据:本研究严格按照复旦大学循证护理研究中心制定的证据摘要报告标准,以证据摘要的形式进行:方法:我们利用 IPNS 系统地搜索了与 T2DM 老年患者管理相关的现有最佳证据。文献类型包括临床指南、专家共识、系统综述、证据摘要和原始研究:为了收集相关信息,我们对各种数据库进行了全面检索,包括 UpToDate、BMJ Best Practice、Joanna Briggs Institute、Guidelines International Network、National Institute for Health and Care Excellence、Registered Nurses Association of Ontario、Scottish Intercollegiate Guidelines Network、Cochrane Library、PubMed、Web of Science、易麦通指南网、SinoMed、CNKI、万方数据库、中国生物医学文献数据库和中国科技期刊数据库。检索时间跨度从各数据库建立之初至 2023 年 7 月,确保了相关资源的广泛覆盖:经过严格筛选和评估,我们的研究最终确定了 19 篇具有高质量研究成果的文章。这些文章包括三份指南、两份专家共识文件、三篇系统综述和十一项原创研究。通过合作和深入讨论,我们提取并综合了 27 项与应用 IPNS 加强老年人 T2DM 管理相关的证据。我们将证据分为五个主要主题:移动终端设计、团队建设、健康教育设计、互动和社会支持以及信息反馈:在为患有 T2DM 的老年人设计 IPNS 时,应高度重视互联网模块开发的复杂性,并提供全面指导。当务之急是建立多学科团队,监督患者教育内容的策划,确保其相关性和有效性。利用基于互联网的信息反馈机制对于促进同伴支持、协助控制血糖、提高自我管理能力以及最终改善整体生活质量至关重要。医疗保健专业人员应根据机构资源和当地实际情况,为这一弱势群体量身定制 IPNS:强烈建议世界各地的临床医务人员遵守循证建议,利用 IPNS 为患有 T2DM 的老年人提供更好的护理:患者或公众的贡献:本研究未纳入患者或公众的贡献:我们的研究为IPNS在T2DM管理中的应用提供了结构化思路,为IPNS改善T2DM老年人自我管理提供了切实可行的新方法,鼓励根据老年人的需求和特点提供基于互联网的护理服务,共同解决T2DM管理中的难题,以提高护理服务的有效性。
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引用次数: 0
Far More Than Burnout and Burden: Gerontological Nurses and Care Partners 远不止倦怠和负担:老年学护士和护理伙伴
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-16 DOI: 10.1111/opn.12661
Sarah H. Kagan
<p>Nurse burnout. Caregiver burden. The corrosive experiences of burnout and burden are everywhere today, threatening to blot out the very purposes of nursing and caregiving. Nurses and care partners support us all at various points in our lives and especially so in later life.</p><p>The terms burnout and burden have become shorthand characterisations of the contemporary state of our roles. Nurses are burned out; caregivers are overburdened. The words are draining, connoting a sense of hollow actions and brittle responses lacking both purpose and relationship. Yet, the work that nurses and care partners do separately and together is vital to any society.</p><p>Defining vital social roles like those held by nurses and care partners in the negative is detrimental. Our roles—many of us are both nurses in our professional lives and care partners in our personal lives—are fundamentally relational and reciprocal. Relationships within these roles and the rewards we find within them sustain nurses and care partners alike. Relationships central to the scope of these roles anchor our responsibilities with a sense of meaning and feelings of fulfilment. Examination of problems and dissatisfaction without consideration of other elements entailed in these roles quickly erodes the understanding of purposes, key features and benefits. We all know that feeling dissatisfied in any role rapidly dissolves into feelings of being trapped or wanting to simply leave. Departure from nursing and caregiving roles, where possible, may offer some relief to that person but can provide no substantive means to redress the causes. Gestures offered by institutions that espouse self-care and resilience skirt the underlying causes of burnout and burden, risking a sense of tokenism among their nursing workforces as well as care partners who receive healthcare there. Thus, these reactions are not solutions and instead further damage both the identities and purposiveness of nursing and caregiving.</p><p>In every context, the language we use represents our beliefs and perceptions. For example, the term caregiving and its companion label of caregiver specifically underscore a naïve impression that roles like ours are about giving to others without reward. The use of these words misrepresents relationships where one person needs specific care from another and reciprocates to them in other ways. Indeed, the word caregiver sufficiently frustrates people in that role that there is now a movement to replace the word caregiver with the more accurate and inclusive phrase care partner. While care partners are working towards a better understanding of their role, I am concerned that we in nursing are not doing the same.</p><p>With abundant references to burnout and burden, those looking on from outside our world of gerontological nursing or at nursing more broadly might be forgiven for thinking that our role is ultimately thankless. Around the world, nurses are researching burnout and, when we c
如今,对护士和护理人员的身份、范围和权力的理解和解释普遍缺乏实质内容。展望未来,我们必须纠正这一趋势。增强我们的研究实力需要明确的转变。过分强调职业倦怠和负担的现象会掩盖护理和照顾工作存在的目的,从而使基本护理面临风险。我们需要更好地解决 "是什么"、"为什么"、"如何 "以及 "何时 "的问题,通过这些问题,老年护理和照护为我们整个社会的个人、家庭和社区的健康、功能和福祉带来积极的变化。只有这样,我们才能倡导从教育和实践发展到机构和卫生政策的结构性和系统性变革。没有关系,这些角色就不存在。没有病人就没有护士,没有护理对象就没有护理伙伴。但这些角色在其他方面也是互惠的。护理是许多人生活的一部分。许多前一天还是病人的人,第二天就成了护理伙伴。同样,我们这些护士在某些时候也总是病人,在个人生活中也经常是护理伙伴。尽管护士与护理伙伴之间有着天然的联系,但医疗保健实践和政策却常常迫使我们与护理伙伴分离。我们应该对这种分离感到恐惧。作为病人和护理伙伴,我们通常对自己的医疗经历感到沮丧。在许多医疗环境中,我们发现护士和护理宣传都缺失了,于是我们成为病人和护理伙伴,为自己,特别是为生活中与我们是护理伙伴的人,进行宣传、协调和整合医疗服务。我们病人和护理伙伴的亲身经历,无论是令人振奋的,还是令人失望的,都能推动我们的研究,以更好的方式确保前者成为普遍现象,后者成为偶然现象。我们希望看到关于护士和护理伙伴的身份如何影响老年人的健康、福祉和医疗体验的研究成果。与此同时,我们希望收到报告范围和权限的稿件,包括促进护士在其注册或执照的最高级别执业的试验。同样,我们也希望收到有关如何促进护理伙伴参与以及参与结果的研究报告。为了与我们积极的年龄友好型、气候友好型立场和承诺保持一致,我们希望在所有提交出版的文章中始终使用包容性语言,并认真考虑对地球和可持续性的影响。虽然我们认为您设计的研究需要时间来开发和实施,但我们知道,IJOPN 社区的许多成员已经在开展质量改进项目、文化变革举措和其他创造性手段,以改善其医疗和社会护理机构以及社区的健康和福祉。在 IJOPN,我们只发表研究、评论和综述。尽管如此,我们还是很乐意在我们的社交媒体流中阅读您的项目和倡议。您可以在 Facebook https://www.facebook.com/IJOPN/ 和 X/Twitter 上找到我们,账号为 @IntJnlOPN (https://twitter.com/intjnlopn?lang=en)。我们邀请您使用我们的标签 #GeroNurses 发布有关护理和照顾工作的意义以及如何支持这些角色的信息,这些角色对于全世界社区中的老年人和照顾他们的人的健康、功能和福祉至关重要。
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引用次数: 0
Preparing Graduate Registered Nurses for Independence in Aged Care 培养注册护士毕业生在老年护理领域的独立能力
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-16 DOI: 10.1111/opn.12660
Diane Piper, Sandra E. Carr, Elisabeth Ruth Jacob

Background

Graduate registered nurses (RNs) start their careers working in a variety of clinical areas including aged care. However, they may not be fully prepared to work in aged care settings that often require them to work independently as the only RN on the premises. A list of essential clinical skills is crucial for supporting the development and effective transition of graduate nurses into aged care.

Aims

To identify and rank a list of essential clinical skills for graduate RNs working in aged care settings on commencement of practice.

Methods

An explanatory sequential mixed-methods design was applied and included a modified Delphi Study and semi-structured interviews. Five expert aged care RNs engaged in the three iterative Delphi rounds and five graduate aged care RNs were interviewed to confirm the clinical skills and ranking from their perspective. Quantitative data were presented through descriptive statistics. Qualitative data were analysed using thematic analysis.

Results

Thirty-six essential clinical skills for graduate RNs working in aged care settings were identified and ranked by the experienced aged care RNs. Graduate RNs supported this list of essential clinical skills on commencement and identified palliative care as an additional skill required by graduate RNs working in aged care.

Conclusion

The derived essential skills offer aged care a guided approach to ensure that graduate RNs are work-ready, safe practitioners and supported to work independently.

Implications for Practice

The study recommends the essential clinical skills for graduate nurses transitioning in their role as RNs in aged care that will support safe, quality clinical care.

背景 毕业注册护士(RNs)的职业生涯开始于包括老年护理在内的各种临床领域。然而,他们可能还没有做好充分准备在养老护理环境中工作,因为养老护理环境通常要求他们作为场所中唯一的注册护士独立工作。一份基本临床技能清单对于支持护士毕业生的发展和有效过渡到老年护理工作至关重要。 目的 确定在老年护理机构工作的注册护士毕业生在开始执业时的基本临床技能清单,并对其进行排序。 方法 采用解释性顺序混合方法设计,包括改良德尔菲研究和半结构式访谈。五名老年护理注册护士专家参与了三轮反复的德尔菲研究,五名老年护理注册护士毕业生接受了访谈,以从他们的角度确认临床技能和排名。定量数据通过描述性统计呈现。定性数据采用主题分析法进行分析。 结果 经验丰富的老年护理注册护士为在老年护理环境中工作的注册护士毕业生确定了 36 项基本临床技能,并进行了排名。注册护士毕业生在入职时支持这份基本临床技能清单,并认为姑息护理是在老年护理领域工作的注册护士毕业生需要掌握的额外技能。 结论 衍生出的基本技能为老年护理提供了一种指导方法,以确保毕业的注册护士做好工作准备、安全从业并获得独立工作的支持。 对实践的启示 该研究为即将成为养老护理领域注册护士的护士毕业生推荐了基本临床技能,这些技能将支持安全、优质的临床护理。
{"title":"Preparing Graduate Registered Nurses for Independence in Aged Care","authors":"Diane Piper,&nbsp;Sandra E. Carr,&nbsp;Elisabeth Ruth Jacob","doi":"10.1111/opn.12660","DOIUrl":"https://doi.org/10.1111/opn.12660","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Graduate registered nurses (RNs) start their careers working in a variety of clinical areas including aged care. However, they may not be fully prepared to work in aged care settings that often require them to work independently as the only RN on the premises. A list of essential clinical skills is crucial for supporting the development and effective transition of graduate nurses into aged care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To identify and rank a list of essential clinical skills for graduate RNs working in aged care settings on commencement of practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An explanatory sequential mixed-methods design was applied and included a modified Delphi Study and semi-structured interviews. Five expert aged care RNs engaged in the three iterative Delphi rounds and five graduate aged care RNs were interviewed to confirm the clinical skills and ranking from their perspective. Quantitative data were presented through descriptive statistics. Qualitative data were analysed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-six essential clinical skills for graduate RNs working in aged care settings were identified and ranked by the experienced aged care RNs. Graduate RNs supported this list of essential clinical skills on commencement and identified palliative care as an additional skill required by graduate RNs working in aged care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The derived essential skills offer aged care a guided approach to ensure that graduate RNs are work-ready, safe practitioners and supported to work independently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Practice</h3>\u0000 \u0000 <p>The study recommends the essential clinical skills for graduate nurses transitioning in their role as RNs in aged care that will support safe, quality clinical care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"19 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.12660","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychometric Evaluation of the Medical Outcomes Study Social Support Survey in Brazilian Older People Psychometric Evaluation of MOS-SSS 巴西老年人医疗结果研究社会支持调查的心理计量评估 MOS-SSS 的心理计量评估
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-15 DOI: 10.1111/opn.12654
Tábatta Renata Pereira de Brito, Lilian Miranda Belineli, Greiciane da Silva Rocha, Ligiana Pires Corona, Carolina Neves Freiria, Celi Macedo Polo, Rogério Donizeti Reis, Daniela Braga Lima, Daniella Pires Nunes, Wanderson Roberto da Silva

Objectives

To evaluate the psychometric properties of different factorial models of the Medical Outcomes Study Social Support Survey (MOS-SSS) and screen the frequency of social support in older Brazilians.

Method

Methodological study. Five factorial models of the MOS-SSS were tested for their validity and reliability using three Brazilian samples from different locations in the country. The factorial invariance was assessed across locations using multigroup analysis. The global average score was calculated.

Results

A total of 1574 older people participated in the study. For all models, there was adequate factorial and convergent validity and good reliability; the discriminant validity was not achieved. Therefore, a second-order hierarchical model was proposed and showed validity, reliability and invariance across samples. In the three Brazilian samples, participants presented high frequency of social support.

Conclusion

A second-order hierarchical model was fitted the Brazilian samples, allowing the calculation of the global score of social support, which was high among the participants.

Implications for Practice

The MOS-SSS assesses social support levels among older individuals in community or clinical settings. Nurses can tailor interventions based on scale outcomes for personalised care for older people.

目的 评估医疗结果研究社会支持调查(MOS-SSS)不同因子模型的心理计量特性,并筛查巴西老年人获得社会支持的频率。 方法 研究方法。使用来自巴西不同地区的三个样本对 MOS-SSS 的五个因子模型的有效性和可靠性进行了测试。采用多组分析法对不同地点的因子不变性进行了评估。计算了全球平均得分。 结果 共有 1574 名老年人参与了研究。所有模型都具有充分的因子效度和收敛效度以及良好的可靠性,但没有达到判别效度。因此,我们提出了一个二阶分层模型,该模型在不同样本中都表现出有效性、可靠性和不变性。在巴西的三个样本中,参与者的社会支持频率较高。 结论 在巴西样本中采用了二阶分层模型,从而可以计算出社会支持的总体得分,参与者的得分较高。 实践意义 MOS-SSS 可评估社区或临床环境中老年人的社会支持水平。护士可以根据量表结果为老年人提供个性化护理,从而量身定制干预措施。
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引用次数: 0
Perception of Utility and Efficacy of Implementation of TEC-MED Model of Care for Frail Older People and Their Caregivers: A Qualitative Study 对体弱老年人及其护理人员实施 TEC-MED 护理模式的实用性和有效性的看法:定性研究
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-14 DOI: 10.1111/opn.12658
Marzia Lommi, Fabio D'Agostino, Giuseppe Esposito, Romina Belsito, Fausto Ciccacci, Maria Concetta Pellicciari, Ana Maria Porcel-Gálvez, Marta Lima-Serrano, Noemi Giannetta, Dhurata Ivziku

Introduction

The global population is ageing, and healthcare systems continue to adopt outdated social models of ageing that do not respond to older people's needs. The aim of this study was to explore the experiences of participants in the implementation of the Transcultural social-ethical-care (TEC-MED) model for integrated community care.

Methods

A qualitative descriptive research study was conducted. Qualitative data were collected through individual interviews and focus groups with purposive sampling.

Results

We gathered experiences from five older people, five informal caregivers, two training agents (nurses), six healthcare professionals and eight stakeholders (senior management of businesses, public administrators, researchers and educators). Four themes were extracted: TEC-MED as a new model of home care, TEC-MED model outcome, key role of training agent and platform and resources. Overall, all the participants were satisfied with the model and various positive outcomes were found. The TEC-MED model of care was inclusive and personalised and bridged the communication and integration gaps between different services for the care of dependent older people and their caregivers in the community. Recommendations were made for improvements to the model.

Conclusion

New models of care that are inclusive, personalised and integrated are necessary to respond to the multiple needs of the older people. A model that integrates the multiple skills of healthcare professionals is an optimum solution in the care of the older people and their caregivers in Mediterranean countries. Similar research is imperative for other healthcare systems to help them prepare adequately to respond effectively to the needs of present and new generations of older people.

Implications for Practice

The TEC-MED model presents a promising approach to addressing the complex care needs of older people and their caregivers by fostering inclusivity, personalisation and integration across services. For nursing practice, this model emphasizes the importance of multidisciplinary collaboration and the role of nurses in facilitating the adoption of new care strategies. Implementing such models in everyday practice could improve the quality of care provided to older adults, enhancing communication between healthcare providers and ensuring that care is more aligned with the individual needs of patients. Furthermore,

导言:全球人口正在老龄化,而医疗保健系统继续采用过时的老龄化社会模式,无法满足老年人的需求。本研究旨在探讨跨文化社会伦理护理(TEC-MED)综合社区护理模式实施过程中参与者的经验。 研究方法 采用描述性定性研究方法。通过个人访谈和焦点小组以及有目的的抽样收集定性数据。 结果 我们收集了五位老年人、五位非正式护理人员、两位培训人员(护士)、六位医疗保健专业人员和八位利益相关者(企业高级管理层、公共管理者、研究人员和教育工作者)的经验。从中提炼出四个主题:TEC-MED 作为一种新的家庭护理模式、TEC-MED 模式的成果、培训机构的关键作用以及平台和资源。总体而言,所有参与者都对该模式表示满意,并发现了各种积极成果。TEC-MED 护理模式具有包容性和个性化,弥合了不同服务之间的沟通和整合差距,为社区中需要照顾的老年人及其照顾者提供了护理服务。对该模式提出了改进建议。 结论 要满足老年人的多种需求,就必须采用包容性、个性化和一体化的新护理模式。在地中海国家,整合医疗保健专业人员多种技能的模式是护理老年人及其护理人员的最佳解决方案。其他医疗保健系统也必须开展类似的研究,帮助他们做好充分准备,有效应对当代和新一代老年人的需求。 对实践的启示 TEC-MED 模式通过促进包容性、个性化和跨服务整合,为满足老年人及其护理人员复杂的护理需求提供了一种可行的方法。对于护理实践而言,该模式强调了多学科合作的重要性以及护士在促进采用新护理策略方面的作用。在日常实践中实施这种模式可以提高为老年人提供的护理质量,加强医疗服务提供者之间的沟通,确保护理更加符合患者的个人需求。此外,正如 TEC-MED 模式所强调的那样,整合数字平台和有针对性的资源有助于克服医疗保健系统中的现有障碍,改善社区一级的护理协调。
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引用次数: 0
Examining the Safety of Dorsogluteal and Ventrogluteal Sites for Intramuscular Injection in Older Adults 研究老年人背臀部和腹股沟部位肌肉注射的安全性。
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-08 DOI: 10.1111/opn.12655
Nurdan Yalcin Atar, Melis Deniz Altan, Erhan Kaymaz
<div> <section> <h3> Background</h3> <p>Muscle, subcutaneous tissue and total tissue thicknesses are important factors in successful intramuscular injection. Muscle mass decreases and subcutaneous tissue increases with age. This may negatively affect the safety and effectiveness of intramuscular injection in older adults by increasing the risk of bone contact and subcutaneous drug administration. Intramuscular injection sites should be evaluated in this respect, but no previous study has evaluated the most appropriate sites for safe and effective intramuscular injection in older adults.</p> </section> <section> <h3> Objectives</h3> <p>This study aimed to examine the safety of dorsogluteal and ventrogluteal injection sites in older adults.</p> </section> <section> <h3> Methods</h3> <p>This cross-sectional study included 171 older adults who presented to the radiology clinic of a hospital between November 2022 and February 2023. We collected the study data using a descriptive characteristics form and an ultrasonographic measurement form. To complete the descriptive characteristics form, we interviewed the participants and measured their waist circumference, hip circumference, weight and height. Muscle, subcutaneous tissue and total tissue thicknesses at the ventrogluteal and dorsogluteal sites were determined by ultrasonography. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline.</p> </section> <section> <h3> Results</h3> <p>At the ventrogluteal and dorsogluteal sites, respectively, total tissue thicknesses were 59.43 ± 11.21 and 48.78 ± 9.68 mm, subcutaneous tissue thicknesses were 20.07 ± 6.64 and 22.97 ± 7.40 mm and muscle thicknesses were 40.13 ± 5.59 and 25.61 ± 4.30 mm. Tissue thicknesses at both sites differed according to sex, weight, hip circumference and waist circumference (<i>p</i> < 0.05). Although both sites were acceptable according to the tissue thickness thresholds for intramuscular injection given in the literature (subcutaneous tissue < 25 mm, total tissue > 35 mm), the ventrogluteal site was more advantageous in terms of greater muscle thickness and lower subcutaneous tissue thickness.</p> </section> <section> <h3> Conclusions</h3> <p>The results of this study indicated that both the ventrogluteal and dorsogluteal sites are safe for intramuscular injections in older adults in terms of tissue thickness. However, the ventrogluteal site may be safer for older adult
背景:肌肉、皮下组织和总组织厚度是成功进行肌肉注射的重要因素。随着年龄的增长,肌肉质量会下降,皮下组织会增加。这可能会增加骨骼接触和皮下注射药物的风险,从而对老年人肌肉注射的安全性和有效性产生负面影响。在这方面,应该对肌肉注射部位进行评估,但以前没有研究评估过最适合老年人安全有效肌肉注射的部位:本研究旨在探讨老年人黄体背侧和黄体腹侧注射部位的安全性:这项横断面研究纳入了 2022 年 11 月至 2023 年 2 月期间在某医院放射科门诊就诊的 171 名老年人。我们使用描述性特征表和超声波测量表收集研究数据。为了填写描述性特征表,我们对参与者进行了访谈,并测量了他们的腰围、臀围、体重和身高。通过超声波检查确定了腹臀部和背臀部的肌肉、皮下组织和总组织厚度。这项研究遵循了加强流行病学观察性研究报告(STROBE)指南:腹臀部和背臀部的组织总厚度分别为(59.43 ± 11.21)毫米和(48.78 ± 9.68)毫米,皮下组织厚度分别为(20.07 ± 6.64)毫米和(22.97 ± 7.40)毫米,肌肉厚度分别为(40.13 ± 5.59)毫米和(25.61 ± 4.30)毫米。两个部位的组织厚度因性别、体重、臀围和腰围而异(p 35 毫米),腹臀部部位的肌肉厚度更大,皮下组织厚度更小(p 35 毫米):本研究结果表明,就组织厚度而言,黄体腹侧和黄体背侧都是老年人肌肉注射的安全部位。不过,对老年人来说,黄体腹侧部位可能更安全,因为接触骨骼和皮下注射的风险较低。对实践的意义:这项研究对于确定 65 岁及以上老年人臀部注射 IM 的安全有效部位、预防因选择部位而可能引起的并发症以及制定护理政策,将老年人作为选择 IM 注射部位的特殊群体具有重要意义。
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引用次数: 0
Improving Nursing Oral Care Practice for Community-Dwelling Care-Dependent Older People 改善社区居住的依赖护理的老年人的口腔护理实践。
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-30 DOI: 10.1111/opn.12656
Keiko Oda, Nazahiah N. Bakri, Sarah Majeed, Shennae Bartlett, Murray W. Thomson, John Parsons, Michal Boyd, Anna C. Ferguson, Moira Smith

Aim

Oral care is one of the most neglected nursing practices owing to a lack of training, standard nursing oral care guidelines and low confidence and skills. There is little evidence to inform the development of oral care training and guidelines, which ideally should be done in collaboration with oral health professionals. Further, there is a lack of research, particularly in New Zealand, with nursing staff caring for care-dependent older people, including those ageing in their own homes. This pilot study aimed to determine the impact of oral care training on nursing staff knowledge, attitudes and confidence in supporting community-dwelling older peoples' oral care.

Method

Mixed methods design comprising delivery of an oral healthcare and assessment training intervention by a team comprising nursing and oral health professionals, pre- and post-intervention questionnaires (N = 14) and a post-intervention focus group with community-based nursing staff (N = 5).

Results

Staff knowledge significantly improved (p = 0.046) following interprofessional collaborative training, but attitude and confidence scores did not (p = 0.127), although focus group responses suggested that participants' confidence was heightened. Participants expressed the need to implement oral care practices to benefit clients' health, clarify roles and identify oral care as a core competency. They sought to make individual- and organisational-level practice changes accordingly.

Conclusion

Oral care training based on interprofessional collaboration and education enhances nursing staff knowledge but not their confidence in oral care provision. Ongoing, hands-on practical training for nursing staff in collaboration with oral health professionals has the potential to advance nursing oral-care practice and improve care-dependent older peoples' oral care.

Implication for Practice

Oral care training and education with oral health professionals is effective to enhance nursing staff knowledge and awareness in oral health care. However, transforming knowledge into nursing oral care practice requires hands on practical training and ongoing collaboration with oral health professionals to improve care-dependent older people's oral health care.

目的:由于缺乏培训、标准护理口腔护理指南以及信心和技能不足,口腔护理是最容易被忽视的护理实践之一。口腔护理培训和指南的制定几乎没有证据可循,理想的做法是与口腔卫生专业人员合作。此外,对护理依赖护理的老年人(包括在自己家中养老的老年人)的护理人员缺乏研究,尤其是在新西兰。这项试点研究旨在确定口腔护理培训对护理人员在支持社区老年人口腔护理方面的知识、态度和信心的影响:混合方法设计,包括由护理和口腔保健专业人员组成的团队提供口腔保健和评估培训干预、干预前后问卷调查(N = 14)以及干预后与社区护理人员的焦点小组(N = 5):结果:员工在接受跨专业合作培训后,知识水平明显提高(p = 0.046),但态度和信心得分却没有提高(p = 0.127),尽管焦点小组的回答表明参与者的信心有所增强。参与者表示有必要实施口腔护理实践,以惠及客户的健康,明确角色,并将口腔护理确定为一项核心能力。他们试图在个人和组织层面上做出相应的实践改变:基于跨专业合作和教育的口腔护理培训提高了护理人员的知识水平,但并没有增强他们提供口腔护理的信心。与口腔健康专业人员合作,对护理人员进行持续的实践培训,有可能促进护理人员的口腔护理实践,改善依赖护理的老年人的口腔护理:实践启示:与口腔卫生专业人员合作开展口腔护理培训和教育,可有效提高护理人员的口腔护理知识和意识。然而,要将知识转化为护理口腔护理实践,就需要进行实际操作培训,并与口腔保健专业人员持续合作,以改善依赖护理的老年人的口腔保健。
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引用次数: 0
Impact and Needs in Caregiving for Individuals With Dementia and Comorbid Posttraumatic Stress Disorder Living in Nursing Homes 护理居住在养老院的痴呆症和合并创伤后应激障碍患者的影响和需求。
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-30 DOI: 10.1111/opn.12653
Demi C. D. Havermans, Monica Cations, Jelte S. Woudsma, Isabelle Janssen, Janine Collet, Debby L. Gerritsen, Chris M. Hoeboer, Miranda Olff, Sjacko Sobczak
<p>Exposure to potential traumatic events (PTE) can result in long-lasting psychological disorders, such as posttraumatic stress disorder (PTSD). Most knowledge about PTSD is based on research on adults in specific survivor groups, including veterans and women who were in abusive relationships. In later life, cognitive and functional decline can make it harder to cope with PTE, resulting in delayed-onset PTSD symptoms.</p><p>There is limited information about the prevalence of PTSD in individuals with dementia, but recent research suggests it to be between 4.7% and 7.8% (Sobczak et al. <span>2021</span>). It is difficult to diagnose PTSD in this population due to a lack of appropriate tools (Havermans et al. <span>2023</span>). As the global dementia population triples by 2050, there is a critical need to improve the identification and treatment of PTSD in individuals with dementia.</p><p>The clinical manifestation of PTSD in individuals with dementia may differ from those without dementia (van Dongen et al. <span>2022</span>). PTSD symptoms can be difficult to distinguish from neuropsychiatric symptoms. For example, it is possible that ‘screaming’ is a fear response to a flashback that the individual is experiencing and, thus, a potential PTSD symptom. Another example is ‘resistance against caregivers’ due to a history of violence or sexual abuse, and ‘wandering’ as a form of avoidance behaviour. Earlier research showed that the DSM-5 PTSD symptoms of re-experiencing, anxiety and sleep disturbances are commonly reported in individuals with dementia, while avoidance behaviour was less commonly seen (Amano and Toichi <span>2014</span>; Martinez-Clavera et al. <span>2017</span>). This difference in clinical manifestation could lead to misinterpretation and misdiagnosis, potentially resulting in ineffective treatment.</p><p>Let us remember that nursing staff are facing challenges with individuals who suffer from PTE-related neuropsychiatric symptoms. It is time to improve trauma-sensitive care for these individuals. This can be achieved by: recognising possible PTSD, improving treatment and personalising an approach. The ultimate goal is to improve quality of life for people who have PTE-related symptoms in dementia. This approach will definitely promote staff and patient safety.</p><p><b>Demi C.D. Havermans:</b> conceptualization, methodology, writing – original draft preparation. <b>Monica Cations:</b> writing – original draft preparation, writing – reviewing and editing. <b>Jelte S. Woudsma:</b> writing – original draft preparation, writing – reviewing and editing. <b>Isabelle Janssen:</b> writing – reviewing and editing. <b>Janine Collet:</b> writing – reviewing and editing. <b>Debby L. Gerritsen:</b> writing – reviewing and editing. <b>Chris M. Hoeboer:</b> methodology, supervision, writing – reviewing and editing. <b>Miranda Olff:</b> methodology, supervision, writing – reviewing and editing. <b>Sjacko Sobczak:</b> methodology, supervision, wr
暴露于潜在的创伤事件(PTE)会导致长期的心理障碍,如创伤后应激障碍(PTSD)。有关创伤后应激障碍的大部分知识都是基于对特定幸存者群体中成年人的研究,包括退伍军人和曾遭受虐待的妇女。关于创伤后应激障碍在痴呆症患者中的发病率,目前资料有限,但最近的研究表明,发病率在 4.7% 到 7.8% 之间(Sobczak 等,2021 年)。由于缺乏适当的工具,很难在这一人群中诊断创伤后应激障碍(Havermans et al.)到 2050 年,全球痴呆症患者将增加三倍,因此亟需改善对痴呆症患者创伤后应激障碍的识别和治疗。痴呆症患者的创伤后应激障碍临床表现可能与非痴呆症患者不同(van Dongen 等,2022 年)。创伤后应激障碍症状可能很难与神经精神症状区分开来。例如,"尖叫 "可能是对患者正在经历的闪回的恐惧反应,因此也可能是创伤后应激障碍的症状。另一个例子是,"反抗照顾者 "是由于暴力或性虐待史,而 "徘徊 "则是一种回避行为。早前的研究表明,痴呆症患者通常会出现重新体验、焦虑和睡眠障碍等 DSM-5 PTSD 症状,而回避行为则不常见(Amano 和 Toichi,2014 年;Martinez-Clavera 等,2017 年)。这种临床表现上的差异可能会导致误解和误诊,从而可能导致治疗无效。让我们记住,护理人员正面临着与 PTE 相关的神经精神症状患者的挑战。现在是改善对这些人的创伤敏感护理的时候了。这可以通过以下方式实现:识别可能的创伤后应激障碍、改善治疗和个性化方法。最终目标是改善有 PTE 相关症状的痴呆患者的生活质量。Demi C.D. Havermans:构思、方法、写作--原稿编写。Monica Cations:撰写--原稿准备、撰写--审阅和编辑。Jelte S. Woudsma:写作--原稿准备、写作--审阅和编辑。Isabelle Janssen:写作--审阅和编辑。Janine Collet:写作--审阅和编辑。Debby L. Gerritsen:写作--审阅和编辑。Chris M. Hoeboer:写作方法、指导、写作--审阅和编辑。Miranda Olff:写作方法、指导、写作--审阅和编辑。Sjacko Sobczak:方法论、指导、写作--审阅和编辑。作者声明无利益冲突。
{"title":"Impact and Needs in Caregiving for Individuals With Dementia and Comorbid Posttraumatic Stress Disorder Living in Nursing Homes","authors":"Demi C. D. Havermans,&nbsp;Monica Cations,&nbsp;Jelte S. Woudsma,&nbsp;Isabelle Janssen,&nbsp;Janine Collet,&nbsp;Debby L. Gerritsen,&nbsp;Chris M. Hoeboer,&nbsp;Miranda Olff,&nbsp;Sjacko Sobczak","doi":"10.1111/opn.12653","DOIUrl":"10.1111/opn.12653","url":null,"abstract":"&lt;p&gt;Exposure to potential traumatic events (PTE) can result in long-lasting psychological disorders, such as posttraumatic stress disorder (PTSD). Most knowledge about PTSD is based on research on adults in specific survivor groups, including veterans and women who were in abusive relationships. In later life, cognitive and functional decline can make it harder to cope with PTE, resulting in delayed-onset PTSD symptoms.&lt;/p&gt;&lt;p&gt;There is limited information about the prevalence of PTSD in individuals with dementia, but recent research suggests it to be between 4.7% and 7.8% (Sobczak et al. &lt;span&gt;2021&lt;/span&gt;). It is difficult to diagnose PTSD in this population due to a lack of appropriate tools (Havermans et al. &lt;span&gt;2023&lt;/span&gt;). As the global dementia population triples by 2050, there is a critical need to improve the identification and treatment of PTSD in individuals with dementia.&lt;/p&gt;&lt;p&gt;The clinical manifestation of PTSD in individuals with dementia may differ from those without dementia (van Dongen et al. &lt;span&gt;2022&lt;/span&gt;). PTSD symptoms can be difficult to distinguish from neuropsychiatric symptoms. For example, it is possible that ‘screaming’ is a fear response to a flashback that the individual is experiencing and, thus, a potential PTSD symptom. Another example is ‘resistance against caregivers’ due to a history of violence or sexual abuse, and ‘wandering’ as a form of avoidance behaviour. Earlier research showed that the DSM-5 PTSD symptoms of re-experiencing, anxiety and sleep disturbances are commonly reported in individuals with dementia, while avoidance behaviour was less commonly seen (Amano and Toichi &lt;span&gt;2014&lt;/span&gt;; Martinez-Clavera et al. &lt;span&gt;2017&lt;/span&gt;). This difference in clinical manifestation could lead to misinterpretation and misdiagnosis, potentially resulting in ineffective treatment.&lt;/p&gt;&lt;p&gt;Let us remember that nursing staff are facing challenges with individuals who suffer from PTE-related neuropsychiatric symptoms. It is time to improve trauma-sensitive care for these individuals. This can be achieved by: recognising possible PTSD, improving treatment and personalising an approach. The ultimate goal is to improve quality of life for people who have PTE-related symptoms in dementia. This approach will definitely promote staff and patient safety.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Demi C.D. Havermans:&lt;/b&gt; conceptualization, methodology, writing – original draft preparation. &lt;b&gt;Monica Cations:&lt;/b&gt; writing – original draft preparation, writing – reviewing and editing. &lt;b&gt;Jelte S. Woudsma:&lt;/b&gt; writing – original draft preparation, writing – reviewing and editing. &lt;b&gt;Isabelle Janssen:&lt;/b&gt; writing – reviewing and editing. &lt;b&gt;Janine Collet:&lt;/b&gt; writing – reviewing and editing. &lt;b&gt;Debby L. Gerritsen:&lt;/b&gt; writing – reviewing and editing. &lt;b&gt;Chris M. Hoeboer:&lt;/b&gt; methodology, supervision, writing – reviewing and editing. &lt;b&gt;Miranda Olff:&lt;/b&gt; methodology, supervision, writing – reviewing and editing. &lt;b&gt;Sjacko Sobczak:&lt;/b&gt; methodology, supervision, wr","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"19 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.12653","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Experience of Hospitalisation for People Living With Dementia: A Qualitative Exploration of How Context Shapes Experiences 痴呆症患者的住院经历:对环境如何影响经历的定性探索。
IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-29 DOI: 10.1111/opn.12651
Elaine Moody, Gianisa Adisaputri, Heather McDougall, Lori E. Weeks, Anne Belliveau, Patricia Bilski, Kata Koller
<div> <section> <h3> Introduction</h3> <p>Dementia has become an increasingly pressing issue in healthcare systems, and acute care settings such as hospitals have been shown to be particularly problematic for people living with dementia. People living with dementia are hospitalised at higher rates than those without and often have poor experiences and outcomes of hospitalisation. To support the evolution of hospital systems to better meet the needs of people living with dementia, it is important to consider the relationship between the context of the hospital and the experiences of people living with dementia and their caregivers. The term context refers to the environment and conditions that shape experiences and includes elements such as policies, procedures, design and social norms. A greater understanding of the relationship between the hospital context and the experiences of people living with dementia will support the future development of interventions to modify contextual elements to improve the experiences of people living with dementia. Our aim was to explore the relationship between the experiences of people living with dementia and their caregivers in hospital, and the contextual elements of the hospital.</p> </section> <section> <h3> Methods</h3> <p>In this interpretive descriptive study, we conducted interviews with people living with dementia and caregivers of people living with dementia about their experiences in hospital. Interviews were conducted with people living with dementia (<i>n</i> = 3), caregivers of people living with dementia (<i>n</i> = 8) and one dyad of a person living with dementia and their caregiver (<i>n</i> = 1) about the hospitalisation of the person living with dementia. Using inductive and deductive methods of analysis, we describe contextual factors that shape their experiences.</p> </section> <section> <h3> Results</h3> <p>Our findings demonstrate how the hospital context shaped the experiences of people living with dementia and their caregivers while the person living with dementia was hospitalised. The themes reflect elements of the hospital context: communication systems, the value of caregivers, the focus on acute physical needs, staff capacity, the physical environment and normalised practices. The findings suggest that there are aspects of the hospital context that can be modified to influence the experiences of people living with dementia and their caregivers.</p> </section> <section> <h3> Conclusion</h3> <p>This study demonstrates how the context of hospital shapes the experiences of people living wi
导言:痴呆症已成为医疗保健系统中一个日益紧迫的问题,医院等急症护理环境对痴呆症患者来说尤其棘手。与非痴呆症患者相比,痴呆症患者的住院率更高,而且住院治疗的体验和结果往往很差。为了支持医院系统的发展,以更好地满足痴呆症患者的需求,考虑医院环境与痴呆症患者及其照护者的经历之间的关系非常重要。所谓环境是指影响体验的环境和条件,包括政策、程序、设计和社会规范等要素。进一步了解医院环境与痴呆症患者体验之间的关系,将有助于今后制定干预措施,改变环境因素,从而改善痴呆症患者的体验。我们的目的是探索痴呆症患者及其照护者在医院的经历与医院环境因素之间的关系:在这项解释性描述研究中,我们对痴呆症患者和痴呆症患者照护者进行了访谈,了解他们在医院的经历。访谈对象包括痴呆症患者(3 人)、痴呆症患者照护者(8 人)以及痴呆症患者及其照护者(1 人)。我们采用归纳和演绎的分析方法,描述了影响他们经历的背景因素:结果:我们的研究结果表明,在痴呆症患者住院期间,医院环境如何影响了痴呆症患者及其护理者的经历。这些主题反映了医院环境的要素:沟通系统、照护者的价值、对急性生理需求的关注、员工能力、物理环境和正常化实践。研究结果表明,医院环境的某些方面是可以改变的,从而影响痴呆症患者及其照护者的体验:本研究展示了医院环境如何影响痴呆症患者及其照护者的体验,并指出了医疗系统领导者可以探索的医院环境方面,以着手提高医院为痴呆症患者提供支持的能力:这项研究证明,医疗系统的领导者和从业人员有必要探索医院环境如何影响痴呆症患者及其照护者的体验,并开始探索改变环境以改善他们体验的方法。
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期刊
International Journal of Older People Nursing
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