Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background and question: Atrial fibrillation (AF) is the most common cardiac arrhythmia in the total population, and previous studies have already reported the prevalence of AF; however, AF is of special importance in geriatric patients due to demographic changes. Therefore, the aim of this study was to determine how many geriatric patients have a history of AF (prevalence) and how often AF can be newly diagnosed during an inpatient stay (incidence). Additionally, predictive factors for the incidence of AF in geriatric patients are described.

Study participants and methods: In a monocentric prospective observational study from April 2021 to April 2022, all admissions to a geriatric clinic were included in the study. Data collection was carried out using the patients' digital files. As part of the admission routine, all patients had a 12-lead ECG recorded. Additionally, a 24‑h long-term electrocardiogram (LTECG) was used in a subset of patients depending on the clinical need.

Results: A total of 1914 participants were included in the study. At the time of admission, 715 (37.4%) patients had a known history of AF. Of the remaining 1199 patients without a history of AF, AF could be newly detected in 73 cases (6.1%). Multivariate regression analysis identified age > 80 years (odds ratio, OR: 2.3) and heart failure (OR: 3.5) as significant risk factors for the incidence of AF (each p < 0.05).

Conclusion: Despite an already high prevalence, AF was newly diagnosed in 6% of patients during the stay at a geriatric clinic. Heart failure and age above 80 years were significantly associated with the presence of AF. This should be taken into account when screening for AF in this patient population.

Background: The dual nature of socio-technical systems requires new design paradigms that go beyond conventional informatic instrumental approaches. With the realization that digital applications change social practice but also that social influences affect design principles of digital technologies, design principles must be oriented towards real-world practices and thus towards situated forms of appropriation of the intended user groups. This is achieved with newer approaches of practice-based design, which are based on ethnography-based and participatory design principles and share a number of basic assumptions of participatory approaches in gerontology.

Objective: The aim of the article is to explain basic approaches of practice-based design from the field of socio-informatics and to relate them to participatory approaches in gerontology.

Material and methods: The article develops an interdisciplinary perspective on the design of socio-technical systems.

Results and discussion: Interdisciplinary connecting lines are listed that can inspire current development projects, thus opening a corridor for efforts in the further development of analytical, conceptual and methodological perspectives. The discussion provides interdisciplinary approaches for the conception, design and appropriation of IT applications and infrastructures for and with older people on the basis of participatory and qualitative empirical approaches. The aim is to align IT design more closely with situated practices, sociocultural contexts and sense-making processes of older people.

The unfavorable mutual influence of the kidney and heart functions in acute or chronic kidney and/or heart failure has defined the cardiorenal syndrome (CRS) since a consensus conference in 2004. The pathophysiological considerations and the subsequent treatment approaches determine the classification into five types. The syndrome has a high prevalence in geriatric patients. The interactions of medications on one or the other organ system require an interaction of treatment modalities in order to improve the prognosis and prevent acute deterioration. Exact knowledge of the respective indications, differential treatment approaches and specifics in dealing with CRS can improve the current undertreatment due to concerns about side effects.

Background: The approach of socio-technical systems (STS) for a successful life in old age focuses on the combination of technical and sociocultural factors in one. Technological systems have long since ceased to be limited to simple functions; instead, they enable customizable applications, interactive use combined with complex communication and action strands. The associated interactions with the technical system suggest a perspective on interactions and relationships.

Objective: Research results show that individualizable functions of STSs are rated positively in terms of acceptance and use by older people. From a geragogical perspective, questions arise regarding the appropriation of older people and the design of learning processes (socio-technical learning arrangements).

Material and methods: A relational view of learning and educational processes relating to the appropriation and acquisition of competences for designing and using STS in real-world situations is developed based on a formative qualitative research design of the "RUBYDemenz" project. In particular, data/results from interviews with voluntary learning facilitators, professional practice facilitators, focus groups and research workshops are utilized.

Results and discussion: Empirical findings can be used to develop starting points for educational and learning processes to expand competences in the context of technology use. Approaches to education, training and further training follow on from this as does the question of whether the research/development process itself must be designed as a learning process in which all participants are involved as learners, with the aim of achieving the best possible fit between the technical solutions and the intended areas of application in real-world situations.

Background: Nurses working in long-term care facilities were vaccinated first before residents as a matter of priority to protect the latter. Although the vaccination rate of nursing staff eventually rose due to a facility-based vaccination requirement, studies on associated factors of vaccination status are currently not available for the long-term care setting in Germany.

Objective: Associated factors of COVID-19 vaccination status among nursing staff in long-term care facilities were explored.

Methods: An online survey was conducted between October 26th 2021 and January 31st 2022. A total of 1546 nurses working in long-term care in Germany responded to questions concerning the Covid-19 vaccination campaign. Logistic regression analyses were performed.

Results: In this study 8 out of 10 nurses were vaccinated against COVID-19 (80.6%). Approximately 7 out of 10 nurses thought at least a few times about quitting their job since the pandemic began (71.4%). A positive COVID-19 vaccination status was associated with older age, full-time employment, COVID-19 deaths at the facility and working in northern or western Germany. Frequent thoughts of quitting their job were associated with negative COVID-19 vaccination status.

Conclusion: The present findings provide evidence on factors associated with the COVID-19 vaccination status of nurses in long-term care facilities in Germany for the first time. Further quantitative as well as qualitative studies are necessary for a more comprehensive understanding of the COVID-19 vaccination decision-making among nurses in long-term care, in order to implement target-oriented future vaccination campaigns in this care setting.