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Bibliometric Analysis of Social Support for the Older Adults 老年人社会支持的文献计量分析
IF 1 Q4 GERONTOLOGY Pub Date : 2024-10-18 DOI: 10.1007/s12126-024-09578-5
Mohammad Shahadat Hossen, Hezzrin Mohd Pauzi

This bibliometric analysis endeavors to bridge a gap in existing research on social support for the older adults, focusing on the theme of ageing. The primary objective is to provide a comprehensive overview of scholarly advancement of previous research papers in this domain, employing a bibliometric approach. A dataset inclusive of publications up to February 2024 from Scopus database has been compiled, capturing pertinent information on older adults’ social support. Employing both quantitative and qualitative methodologies, the study offers a historical panorama of research trends. Through bibliometric techniques, significant articles, authors, journals, organizations, and countries contributing to this field are identified. The analysis unveils the current research status, elucidating key contributors, influential publications, and emerging thematic trajectories within ageing studies. Citation patterns and literature examination aid in identifying influential factors shaping the scholarly landscape. This research significantly enhances understanding of formal and informal social support for the older adults, filling existing research lacunae while spotlighting key contributors and burgeoning areas of interest. The findings of relevant studies based on PRISMA screening, a total of 152 research papers were screened. Seventeen papers were excluded because they did not specifically address social support for older adults. Three review papers and four others were removed due to being out of scope. Finally, 128 documents were retained for bibliometric analysis. The publication trend stands at 3.73%, indicating a significant increase in scholarly interest in social support for older adults.

本文献计量学分析报告以老龄化为主题,致力于弥补现有老年人社会支持研究的不足。主要目的是采用文献计量学方法,全面概述该领域以往研究论文的学术进展情况。我们从 Scopus 数据库中汇编了截至 2024 年 2 月的论文数据集,以获取有关老年人社会支持的相关信息。本研究采用定量和定性方法,提供了研究趋势的历史全景。通过文献计量技术,确定了该领域的重要文章、作者、期刊、组织和国家。分析揭示了当前的研究状况,阐明了老龄化研究的主要贡献者、有影响力的出版物和新出现的主题轨迹。引用模式和文献检查有助于确定影响学术格局的因素。这项研究极大地增进了人们对老年人正式和非正式社会支持的了解,填补了现有研究的空白,同时突出了主要贡献者和新兴的兴趣领域。基于 PRISMA 筛选的相关研究结果共筛选出 152 篇研究论文。有 17 篇论文被排除在外,因为它们没有专门针对老年人的社会支持。三篇综述论文和另外四篇论文因超出研究范围而被删除。最后,保留了 128 篇文献用于文献计量分析。发表趋势为 3.73%,表明学术界对老年人社会支持的兴趣显著增加。
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引用次数: 0
Telehealth use by older New Yorkers during the COVID-19 Pandemic COVID-19 大流行期间纽约老年人使用远程保健的情况
IF 1 Q4 GERONTOLOGY Pub Date : 2024-09-04 DOI: 10.1007/s12126-024-09572-x
Kiana Chan, Monique Millington, Andrea Low, Shannon M. Farley, David Hoos, Wafaa M. El-Sadr, Melissa Reyes, Abigail R. Greenleaf

Telehealth during the COVID-19 pandemic grew expansively and provided patients with care when there were substantial movement restrictions. We examined access to internet and telehealth services as well as factors associated with telehealth use among older New York City residents. From December 2020 to March 2021, we conducted a random digit dial phone survey, calling listed New York City landline phone numbers. A total of 676 individuals 70 years or older were recruited; 62% were ages 70–79 and 38% were 80 years or older. Forty-five percent self-identified as White, 21% as Non-Hispanic Black or African American, 20% as Latinx, and 14% as another race. Sixty-three percent were female and 37% were male. Twenty percent did not have access to internet. During the prior three months, 44% indicated having a phone or video telehealth visit. Compared to White participants, Black participants had 2.15-fold higher telehealth use (CI: 1.33–3.44, P-Value: < .001), Latinx participants had 2.27-fold higher telehealth usage (1.19–4.27, P-Value: < .001), and those of another race had 3.45-fold higher telehealth usage (CI: 1.67–7.08, P-Value: < .001). Older Black, Latinx, and those of another race were more likely to use telehealth than White older New Yorkers. However, overall, a substantial percent did not have access to the internet, limiting their access to telehealth and their ability to seek pandemic related resources.

在 COVID-19 大流行期间,远程医疗得到了广泛发展,并在行动受到严重限制的情况下为患者提供了医疗服务。我们研究了纽约市老年居民使用互联网和远程医疗服务的情况以及与使用远程医疗相关的因素。2020 年 12 月至 2021 年 3 月,我们进行了随机数字拨号电话调查,拨打了列出的纽约市固定电话号码。共招募了 676 名 70 岁或以上的老年人;其中 62% 年龄在 70-79 岁之间,38% 年龄在 80 岁或以上。45%的人自我认同为白人,21%为非西班牙裔黑人或非裔美国人,20%为拉丁裔,14%为其他种族。63%为女性,37%为男性。20%的人无法上网。在过去的三个月中,44% 的人表示曾接受过电话或视频远程保健访问。与白人参与者相比,黑人参与者的远程保健使用率高出 2.15 倍(CI:1.33-3.44,P 值:< .001),拉丁裔参与者的远程保健使用率高出 2.27 倍(CI:1.19-4.27,P 值:< .001),其他种族的参与者的远程保健使用率高出 3.45 倍(CI:1.67-7.08,P 值:< .001)。与纽约白人老年人相比,黑人、拉丁裔和其他种族的老年人更有可能使用远程保健。然而,总体而言,相当大比例的人无法访问互联网,这限制了他们获得远程保健服务以及寻求大流行病相关资源的能力。
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引用次数: 0
Violence and Abuse Towards Grandparent Kinship Carers in Informal Kinship Care Context 在非正式亲属照护背景下针对祖父母亲属照护者的暴力和虐待行为
IF 1 Q4 GERONTOLOGY Pub Date : 2024-09-04 DOI: 10.1007/s12126-024-09574-9
Hajara Bentum, Vicki Banham, Kwadwo Adusei-Asante

Violence and abuse by grandchildren towards their grandparent kinship carers is an important but under-researched issue. Research evidence on the perceived legitimacy of aged-related myths, beliefs, and witchcraft accusations against older people, especially grandparents, in Ghana and Africa suggest that violence and abuse against grandparent kinship carers could be common. This study explored the types of violence or abuse experienced by grandparent kinship carers, and the meanings grandparents associate with the abuse. Thirty-one grandparents were recruited from four communities in Ghana following a horizontal network sampling approach and interviewed using a qualitative in-depth narrative storytelling strategy. Analysis of the narratives revealed three common types of abuse experienced by the grandparent kinship carers which were perpetrated by children living under their care: (1) insults and verbal abuse, (2) stealing and financial exploitation, and (3) physical threats. However, the grandparents rationalised and justified the abusive behaviours by attributing them to factors within the children’s eco-system, such as friends and household members. The findings highlighted three crucial interrelated factors that underlie these incidents of violence including cultural beliefs around witchcraft, family structural dynamics, and grandparents’ attitudes towards violence. Practical recommendations, including the development of a community normative change program, have been proposed to address violence by grandchildren towards grandparent kinship carers in Ghana.

孙辈对祖辈亲属照护者的暴力和虐待是一个重要问题,但研究不足。在加纳和非洲,与老年人有关的神话、信仰和针对老年人(尤其是祖父母)的巫术指控被认为是合法的,这些研究证据表明,针对祖父母亲属照护者的暴力和虐待行为可能很常见。本研究探讨了祖父母亲属照护者所经历的暴力或虐待类型,以及祖父母与虐待相关的含义。研究人员采用横向网络抽样法从加纳的四个社区招募了 31 名祖父母,并采用定性深入叙事策略对他们进行了访谈。对叙事的分析表明,祖父母亲属照护者经历过三种常见的虐待,这些虐待是由生活在他们照护下的儿童实施的:(1) 侮辱和谩骂,(2) 偷窃和经济剥削,以及 (3) 人身威胁。然而,祖父母将这些虐待行为归咎于儿童生态系统中的因素,如朋友和家庭成员,从而使这些行为合理化和正当化。研究结果强调了导致这些暴力事件的三个相互关联的关键因素,包括巫术文化信仰、家庭结构动态和祖父母对暴力的态度。为解决加纳孙辈对祖辈亲属照顾者的暴力问题,提出了一些切实可行的建议,包括制定社区规范改变计划。
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引用次数: 0
Risk Factors of Social Exclusion Among Older Persons: Evidence from a Cross-Sectional Survey 老年人被社会排斥的风险因素:来自横断面调查的证据
IF 1 Q4 GERONTOLOGY Pub Date : 2024-08-26 DOI: 10.1007/s12126-024-09573-w
T. Maheshkumar, S. Irudaya Rajan

The study examines the exclusion of older people using a multidimensional approach to understand the different domains of exclusion. Particularly, it evaluates the risk factors of old-age social exclusion, focusing on the level of exclusion across three domains such as social relations, economic and material resources, and social activities, as well as the total exclusion score. Using secondary data from the Building Knowledge Base on Population Ageing in India (BKPAI) survey, the study employed bivariate descriptive and multinomial logistic regression models to assess the factors that affect social exclusion for all three domains, as well as the total exclusion score. Results for the total social exclusion score reveal that older people in their later ages, women, from rural areas, without schooling, living alone, without work, and having poor physical health, experienced a severe risk of exclusion. Notably, older people at later ages (70+) from rural areas without schooling experienced both moderate and severe exclusion in all the domains, as well as in the total exclusion score. While analysing exclusion across all three domains, the study found that older people were most at risk of exclusion in the domains of economic and material resources, followed by the domain of social relations. Thus, ageing policies should consider these micro-level risk factors associated with these two domains to combat the exclusion and improve their quality of life.

本研究采用多维方法研究老年人受排斥的情况,以了解排斥的不同领域。特别是,它评估了老年社会排斥的风险因素,重点关注社会关系、经济和物质资源、社会活动等三个领域的排斥程度以及排斥总分。该研究利用印度人口老龄化知识库(BKPAI)调查的二手数据,采用二元描述模型和多项式逻辑回归模型来评估影响所有三个领域的社会排斥因素以及社会排斥总分。社会排斥总分的结果显示,晚年老年人、女性、来自农村地区、没有受过教育、独居、没有工作、身体健康状况不佳,都面临着严重的社会排斥风险。值得注意的是,来自农村地区、没有上过学的晚年老年人(70 岁以上)在所有领域以及在社会排斥总分中都经历了中度和严重社会排斥。在分析所有三个领域的排斥情况时,研究发现老年人在经济和物质资源领域面临的排斥风险最大,其次是社会关系领域。因此,老龄政策应考虑与这两个领域相关的微观风险因素,以消除排斥现象,提高老年人的生活质量。
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引用次数: 0
Sexuality and Ageing in Latin America: A Systematic Review 2017–2021 拉丁美洲的性与老龄化:2017-2021 年系统回顾
IF 1 Q4 GERONTOLOGY Pub Date : 2024-08-10 DOI: 10.1007/s12126-024-09571-y
Francisca Ortiz Ruiz

The study of sexuality in the ageing population had a more recent development than other topics, even though it is undoubling its relevance as part of the well-being of each individual. Therefore, to advance more in research is essential to look back and have a prospect of what kind of research has been done on it, identifying gaps in the literature for future studies. This paper aims to present a panorama of the research on sexuality and ageing in Latin America for the last five years (2017–2021). The data collection was done through the Web of Science platform and focused on those papers with the SciELO Citation Index, one of the most prestigious indexations among Latin-American journals. There were included papers from Latin-American countries written in Spanish or English. There were analyzed 26 research articles in total. The results give a panorama of what had been done in studies about sexuality and ageing in Latin America. Among those highlights, the absence of studies concentrates only on sexuality and ageing. Also, more quantitative studies are not comparable between countries, cross-sectional and descriptive. Finally, it is identified some gaps and challenges that need to be addressed by researchers in the future.

与其他课题相比,对老龄人口性行为的研究是最近才开始的,尽管作为每个人福祉的 一部分,它的相关性正在成倍增长。因此,要想在研究方面取得更多进展,就必须回顾过去,展望未来,找出文献中的空白点,以便今后开展研究。本文旨在介绍过去五年(2017-2021 年)拉丁美洲性与老龄化研究的全景。数据收集是通过 Web of Science 平台进行的,重点关注那些具有 SciELO 引文索引的论文,该索引是拉丁美洲期刊中最负盛名的索引之一。这些论文来自拉美国家,用西班牙语或英语撰写。共分析了 26 篇研究文章。结果概括了拉丁美洲在性与老龄化研究方面所做的工作。其中的亮点是,缺乏只关注性行为和老龄化的研究。此外,更多的定量研究在国家之间不具有可比性、横截面性和描述性。最后,确定了研究人员今后需要解决的一些差距和挑战。
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引用次数: 0
Is Sleep Behavior Impacted by Sharing a Bed or Room with a Partner? A Cross-Sectional Study with Older Adults 与伴侣同床或同室会影响睡眠行为吗?一项针对老年人的横断面研究
IF 1 Q4 GERONTOLOGY Pub Date : 2024-08-02 DOI: 10.1007/s12126-024-09570-z
Jéssica Fernanda Corrêa Cordeiro, Leonardo Santos Lopes da Silva, Pedro Pugliesi Abdalla, Carolina Vila-Chã, Kessketlen Miranda, Emerson Sebastião, Anelise Gaya, Dalmo Roberto Lopes Machado, André Pereira dos Santos, Lucimere Bohn

Despite exploring factors, little is known about sleep quality and room sharing in older adults. To examine differences in sleep quality among older adults as a function of bed/room sharing during the first wave of the COVID-19 pandemic. This cross-sectional study was conducted in Brazil and enrolled 1,123 older adults aged 60 years and older. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and sleep duration. Bed or room sharing was assessed using a single question (“do you have a bed partner or a roommate?” “no bed partner or roommate”; “partner/roommate in other room”; “partner in the same room, but not same bed”; “partner in same bed”). Between group comparisons were performed with ANCOVA adjusting for confounders. The group “partner in the same bed” reported significant lower global PSQI scores compared to the “no bed or roommate partner” group (6.00 ± 0.27 versus 7.22 ± 0.23, respectively; p = 0.029). Furthermore, the group “partner in same bed” reported superior (p < 0.001) sleep duration (7.42 ± 0.09 hours) compared with older adults in the “no bed or roommate partner” (6.82 ± 0.08 hours), “partner or roommate in another room” (6.77 ± 0.14 hours; p < 0.001), and “partner in the same room but not in same bed” (6.82 ± 0.11 hours; p < 0.001) groups. The findings suggest that sharing a bed with a partner seems to be associated with significant better quality and duration of sleep among older adults.

尽管对各种因素进行了探讨,但人们对老年人的睡眠质量和合住问题知之甚少。在 COVID-19 大流行的第一波期间,研究老年人因共用床位/房间而导致的睡眠质量差异。这项横断面研究在巴西进行,共招募了 1,123 名 60 岁及以上的老年人。研究采用匹兹堡睡眠质量指数(PSQI)来评估睡眠质量和睡眠时间。共用床位或房间通过一个问题进行评估("您有床伴或室友吗?"没有床伴或室友";"床伴/室友在其他房间";"床伴在同一房间,但不在同一张床";"床伴在同一张床")。组间比较采用方差分析,对混杂因素进行调整。与 "无床或室友伴侣 "组相比,"同床伴侣 "组的 PSQI 总分明显较低(分别为 6.00 ± 0.27 对 7.22 ± 0.23;p = 0.029)。此外,与 "无床或室友伴侣 "组(6.82 ± 0.08 小时)、"伴侣或室友在另一房间 "组(6.77 ± 0.14 小时;p <;0.001)和 "伴侣在同一房间但不在同一张床上 "组(6.82 ± 0.11 小时;p <;0.001)的老年人相比,"伴侣在同一张床上 "组的睡眠时间更长(7.42 ± 0.09 小时)(p <;0.001)。研究结果表明,在老年人中,与伴侣同睡一张床似乎与睡眠质量和睡眠时间的明显改善有关。
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引用次数: 0
Global Prevalence of Urinary Tract Infections in the Older Persons: A Systematic Review and Meta-Analysis 全球老年人尿路感染患病率:系统回顾与元分析
IF 1 Q4 GERONTOLOGY Pub Date : 2024-07-06 DOI: 10.1007/s12126-024-09569-6
Reza Pourmirza Kalhori, Azam Faraji, Mohadeseh Yari, Maryam Ganjabi, Mohsen Kazeminia

Urinary Tract Infections (UTIs) as a type of bacterial infection are the most common infections in older people. The present study was conducted with the aim of combining, summarizing, unifying, resolving inconsistencies in the results of preliminary studies, investigating the effect of potential factors and estimating the global prevalence of UTIs in the older persons through a systematic review and meta-analysis. In this systematic review and meta-analysis, the articles published in the period of 1982–2022 were analyzed. The articles were searched in Iranian databases of SID and MagIran, as well as international databases including PubMed, Embase, Scopus, Web of Science (WoS), and Google Scholar through the relevant and validated keywords using MeSH/Emtree. Thirty-six articles with a sample size of 4,207,470 people met the inclusion criteria for meta-analysis. Global prevalence of UTIs in the older persons was 23.6% (95% Confidence Interval: 19.4–28.4). The highest prevalence of UTIs in the older persons was in the following sub-groups: Africa (30%; 95% CI: 12.7–55.8), women (30%; 95% CI: 14.6–51.7), diagnosis with urine culture (25.3%; 95% CI: 18.3–33.8), and residents in the nursing home (47.2%; 95% CI: 24.2–71.5). The results of the present study showed that the prevalence of UTIs was high in the older persons, especially in women and residents of nursing homes. Therefore, it is recommended that health officials and policymakers pay more attention to the prevention and control of UTIs in older adults.

尿路感染(UTI)作为细菌感染的一种,是老年人最常见的感染。本研究旨在通过系统综述和荟萃分析,合并、总结、统一、解决初步研究结果中的不一致之处,调查潜在因素的影响,并估计全球老年人尿路感染的患病率。在此次系统回顾和荟萃分析中,对 1982-2022 年间发表的文章进行了分析。文章通过使用 MeSH/Emtree 的相关有效关键词在伊朗 SID 和 MagIran 数据库以及 PubMed、Embase、Scopus、Web of Science (WoS) 和 Google Scholar 等国际数据库中进行了检索。符合荟萃分析纳入标准的文章有 36 篇,样本量达 4,207,470 人。老年人尿毒症的总体发病率为 23.6%(95% 置信区间:19.4-28.4)。以下亚群的老年人尿毒症发病率最高:非洲(30%;95% 置信区间:12.7-55.8)、女性(30%;95% 置信区间:14.6-51.7)、经尿液培养确诊(25.3%;95% 置信区间:18.3-33.8)和疗养院居民(47.2%;95% 置信区间:24.2-71.5)。本研究结果表明,尿毒症在老年人中的发病率很高,尤其是女性和疗养院居民。因此,建议卫生官员和政策制定者更加关注老年人尿毒症的预防和控制。
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引用次数: 0
Multi-Dimensional Healthy Aging Interventions: Evidence from an Age-Friendly Community Program in Italy 多维健康老龄化干预:来自意大利老年友好社区计划的证据
IF 1 Q4 GERONTOLOGY Pub Date : 2024-06-24 DOI: 10.1007/s12126-024-09567-8
Claudio Lucifora, Elena Villar

In this paper, we evaluate a pre-pandemic multi-dimensional healthy aging program promoted by an Italian private Foundation to provide new insights on interventions that address both health and social needs within an age-friendly community framework. Using propensity score matching and linear regression models, with specific controls for individuals’ self-selection into the program, we compare lifestyles, physical health, mental conditions, and healthy life expectancy of subjects enrolled into the program with those of similar, but non-enrolled, subjects. Our main finding is that, to be more effective, healthy aging interventions should target the key dimensions of aging - physical, mental, and social - in a holistic approach. Indeed, we show that the multi-dimensionality of the healthy aging intervention under study - the contemporaneous target of older adults’ physical, mental, and social health - is crucial in improving both quantity and quality of life.

在本文中,我们评估了一项由意大利私人基金会推广的大流行前多维健康老龄化计划,以便为在老年友好社区框架内解决健康和社会需求的干预措施提供新的见解。我们使用倾向得分匹配和线性回归模型,并对个人自主选择加入该计划进行了特定控制,比较了加入该计划的受试者与类似但未加入该计划的受试者的生活方式、身体健康、精神状况和健康预期寿命。我们的主要发现是,健康老龄化干预措施应针对老龄化的主要方面--身体、精神和社会--采取综合方法,这样才能更加有效。事实上,我们的研究表明,健康老龄化干预的多维性--同时针对老年人的身体、精神和社会健康--对于提高生活的数量和质量至关重要。
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引用次数: 0
What Makes Effective Acute Geriatric Care? - A mixed Methods Study From Aotearoa New Zealand 什么是有效的急性老年病护理?- 新西兰奥特亚罗瓦混合方法研究
IF 1 Q4 GERONTOLOGY Pub Date : 2024-06-18 DOI: 10.1007/s12126-024-09568-7
Abtin Ijadi Maghsoodi, Jewel Barlow-Armstrong, Valery Pavlov, Paul Rouse, Cameron Graham Walker, Matthew Parsons

Current policies for older patients do not adequately address the barriers to effective implementation of optimal care models in New Zealand, partly due to differences in patient definitions and the in-patient pathway they should follow through hospital. This research aims to: (a) synthesise a definition of a complex older patient; (b) identify and explore primary and secondary health measures; and (c) identify the primary components of a care model suitable for a tertiary hospital in the midland region of the North Island of New Zealand.

This mixed-methods study utilised a convergence model, in which qualitative and quantitative data were investigated separately and then combined for interpretation. Semi-structured interviews (n=11) were analysed using a general inductive method of enquiry to develop key codes, categories and themes. Univariate data analysis was employed using six years of routinely collected data of patients admitted to the emergency department and inpatient units (n=261,773) of the tertiary hospital.

A definition of a complex older patient was determined that incorporates chronic conditions, comorbidities and iatrogenic complications, functional decline, activities of daily living, case fatality, mortality, hospital length of stay, hospital costs, discharge destination, hospital readmission and emergency department revisit and age – not necessarily over 65 years old. Well-performing geriatric care models were found to include patient-centred care, frequent medical review, early rehabilitation, early discharge planning, a prepared environment and multidisciplinary teams.

The findings of this New Zealand study increase understanding of acute geriatric care for complex older patients by filling a gap in policies and strategies, identifying potential components of an optimal care model and defining a complex geriatric patient.

The findings of this study present actionable opportunities for clinicians, managers, academics and policymakers to better understand a complex older patient in New Zealand, with significant relevance also for international geriatric care and to establish an effective acute geriatric care model that leads to beneficial health outcomes and provides safeguard mechanisms.

目前针对老年患者的政策没有充分解决新西兰有效实施最佳护理模式的障碍,部分原因是患者定义和住院路径不同。本研究旨在:(a) 综合复杂老年患者的定义;(b) 确定并探讨主要和次要健康措施;(c) 确定适合新西兰北岛中部地区一家三级医院的护理模式的主要组成部分。这项混合方法研究采用了一种融合模式,即先分别调查定性和定量数据,然后再结合起来进行解释。采用一般归纳法对半结构式访谈(n=11)进行分析,以形成关键代码、类别和主题。确定了复杂老年患者的定义,其中包括慢性疾病、合并症和先天性并发症、功能衰退、日常生活活动能力、病死率、死亡率、住院时间、住院费用、出院目的地、再次入院和急诊科复诊以及年龄(不一定是 65 岁以上)。这项新西兰研究的结果填补了政策和战略方面的空白,确定了最佳护理模式的潜在组成部分,并定义了复杂老年病人,从而加深了人们对复杂老年病人急性老年病护理的了解。研究结果为临床医生、管理人员、学者和政策制定者提供了可操作的机会,以更好地了解新西兰的复杂老年病人,这对国际老年病护理也具有重要意义,并建立有效的急性老年病护理模式,从而带来有益的健康结果并提供保障机制。
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引用次数: 0
Evaluation of Discrepancies Identified in Medication Reconciliation at Admission and Discharge of Older Patients in a Hospital Ward 评估医院病房老年患者入院和出院时药物核对中发现的差异
IF 1 Q4 GERONTOLOGY Pub Date : 2024-06-07 DOI: 10.1007/s12126-024-09565-w
Barbara Falaschi Romeiro, Alan Maicon de Oliveira, João Paulo Vilela Rodrigues, Marília Silveira de Almeida Campos, Fabiana Rossi Varallo, Leonardo Régis Leira Pereira

The aging population, often burdened with multimorbidity and polypharmacy complexities, requires comprehensive care during healthcare transitions. These transitions contribute to increased prescriptions, exacerbating polypharmacy and frailty in older individuals. Medication reconciliation, a preventive strategy, optimizes medication lists through systematic analysis, particularly benefiting older patients grappling with polypharmacy. This practice holds substantial potential in enhancing patient safety during care transitions. Therefore, the aim of this study is to evaluate the discrepancies detected during the practice of medication reconciliation at the admission, discharge, or transfer of older individuals in a ward in Brazil. This is a single-cohort study of patients admitted to an older adult care ward in Brazil, monitored from September 2021 to April 2022. Older individuals hospitalized in the ward, exhibiting the characteristic clinical profile of multimorbidity and polypharmacy, were observed to identify discrepancies in the practice of medication reconciliation conducted as part of pharmaceutical care services. Medication reconciliation was carried out upon admission, discharge from the ward for older adult care, or transfer to other healthcare units. Sixty older individuals were monitored during the study period in the ward. The use of polypharmacy at home was evident in more than 70% of patients, and multimorbidity was present in over 90% of patients. On average, 8.6 discrepancies were identified per patient (± 4.7). Upon admission to the older adult care ward, 501 discrepancies were identified and assessed, decreasing to 200 at the time of hospital discharge or transfer to other units. In total, 48 medication errors were identified in the evaluated prescriptions and ongoing pharmacotherapy. The use of polypharmacy proved to be a contributing factor that increased the identification of discrepancies in medication reconciliation (p < 0.001). Analyzing medication reconciliation discrepancies uncovers intentional and unintentional aspects in prescriptions, with medication quantity, especially in polypharmacy, linked to potential harm. Continuous monitoring proved crucial, significantly enhancing patient safety in the older adult care ward.

老龄化人口通常身患多种疾病,且多重用药复杂,因此在医疗保健过渡期间需要全面的护理。这些转变导致处方增加,加剧了老年人的多药并发症和虚弱。药物协调作为一种预防性策略,可通过系统分析来优化用药清单,尤其有益于饱受多种药物困扰的老年患者。这种做法在加强护理过渡期间的患者安全方面具有很大的潜力。因此,本研究旨在评估巴西某病房中老年人在入院、出院或转院时的用药核对过程中发现的差异。这是一项单一队列研究,研究对象为巴西一家老年护理病房的住院患者,监测时间为 2021 年 9 月至 2022 年 4 月。在病房住院的老年人表现出多病和多药的临床特征,研究人员对他们进行了观察,以确定作为药物护理服务一部分的药物协调实践中存在的差异。在老年人入院、出院或转入其他医疗单位时,都要进行药物协调。在研究期间,对病房中的 60 名老年人进行了监测。超过 70% 的患者在家中使用多种药物,超过 90% 的患者患有多种疾病。平均每名患者发现 8.6 项差异(± 4.7)。在入住老年人护理病房时,共发现并评估了 501 项差异,在出院或转至其他病房时,差异减少至 200 项。在评估的处方和正在进行的药物治疗中,共发现了 48 处用药错误。事实证明,使用多种药物是导致在药物核对中发现差异增多的一个因素(p < 0.001)。分析用药核对差异可发现处方中有意和无意的方面,用药量,尤其是多种药物的用药量与潜在的伤害有关。事实证明,持续监测至关重要,可显著提高老年人护理病房的患者安全。
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Ageing International
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