Australasian Journal on Ageing最新文献_第8页

Effects of smoking behaviour changes on depression in older people: A retrospective study 吸烟行为改变对老年人抑郁症的影响：一项回顾性研究。

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-05-14 DOI: 10.1111/ajag.13327

Touba Azeem, Shahzaib Khan, FNU Samiullah

引用次数: 0

‘It helps you forget your worries’: A pilot study exploring music therapy in the acute hospital aged care setting 它能帮助你忘记烦恼"：在急症医院老年护理环境中探索音乐疗法的试点研究。

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-05-13 DOI: 10.1111/ajag.13313

Neeraja Vadali, Danielle Ní Chróinín, Alison Short

Objectives

Few studies have explored music therapy (MT) in an acute aged care inpatient setting. We aimed to assess feasibility and patient/staff perceptions of an 8-week MT program on an acute geriatric ward.

Methods

An 8-week in-person MT program, comprising brief receptive musical interventions up to twice-weekly. All patients admitted to the aged care ward were eligible for inclusion. A hard copy survey was used to assess patient and staff perceptions of MT. Themes raised in free-text responses were manually coded within a thematic analysis approach. A mixed methods approach was used to obtain and analyse data relating to feasibility and patient and staff perceptions of the MT intervention.

Results

The 8-week program ran to completion and was delivered to a median of 11 patients (IQR 9–12) each session (median 8 new/day). In total, 10 patients completed surveys, mean age 81.1 (SD 7.7); 60% were women and all had cognitive impairment. Following an MT session, eight of eight responding patients reported feeling happy and eight of eight reported they would recommend MT. Staff respondents (n = 19) reported patients appeared happy (19/19), relaxed (13/19) and all would recommend MT to other patients. Common themes were that MT was followed by improved patient behaviour and mood, and stimulated patients.

Conclusions

An acute aged care inpatient MT program proves feasible and well-received by staff and patients. Future research may focus on more robust data collection in larger sample sizes, specific types of MT and more in-depth exploration of the patient and carer experiences.

研究目的：很少有研究探讨过急诊老年病住院环境中的音乐治疗（MT）。我们旨在评估在急诊老年病房开展为期 8 周的 MT 项目的可行性和病人/工作人员的看法：方法：为期 8 周的面对面 MT 计划，包括每周最多两次的简短接受性音乐干预。所有入住老年护理病房的患者均符合条件。使用硬拷贝调查表评估病人和员工对音乐治疗的看法。在主题分析方法中，对自由文本回复中提出的主题进行了人工编码。采用混合方法获取并分析与MT干预的可行性以及患者和员工对MT干预的看法有关的数据：该项目为期 8 周，每期向 11 名患者（IQR 9-12）提供服务（中位数为每天 8 名新患者）。共有 10 名患者完成了问卷调查，平均年龄为 81.1 岁（SD 7.7）；60% 为女性，所有患者均有认知障碍。在接受 MT 治疗后，8 位受访患者中有 8 位表示感觉快乐，8 位表示愿意推荐 MT。受访的工作人员（n = 19）表示，患者看起来很开心（19/19）、很放松（13/19），并且都会向其他患者推荐 MT。共同的主题是，MT 能改善患者的行为和情绪，并能刺激患者：结论：急性老年护理住院病人 MT 计划证明是可行的，并且深受员工和病人的欢迎。未来的研究可能会侧重于以更大的样本量、特定类型的 MT 以及对病人和照护者体验的更深入探讨来收集更有力的数据。

{"title":"‘It helps you forget your worries’: A pilot study exploring music therapy in the acute hospital aged care setting","authors":"Neeraja Vadali, Danielle Ní Chróinín, Alison Short","doi":"10.1111/ajag.13313","DOIUrl":"10.1111/ajag.13313","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Few studies have explored music therapy (MT) in an acute aged care inpatient setting. We aimed to assess feasibility and patient/staff perceptions of an 8-week MT program on an acute geriatric ward.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An 8-week in-person MT program, comprising brief receptive musical interventions up to twice-weekly. All patients admitted to the aged care ward were eligible for inclusion. A hard copy survey was used to assess patient and staff perceptions of MT. Themes raised in free-text responses were manually coded within a thematic analysis approach. A mixed methods approach was used to obtain and analyse data relating to feasibility and patient and staff perceptions of the MT intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 8-week program ran to completion and was delivered to a median of 11 patients (IQR 9–12) each session (median 8 new/day). In total, 10 patients completed surveys, mean age 81.1 (SD 7.7); 60% were women and all had cognitive impairment. Following an MT session, eight of eight responding patients reported feeling happy and eight of eight reported they would recommend MT. Staff respondents (<i>n</i> = 19) reported patients appeared happy (19/19), relaxed (13/19) and all would recommend MT to other patients. Common themes were that MT was followed by improved patient behaviour and mood, and stimulated patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An acute aged care inpatient MT program proves feasible and well-received by staff and patients. Future research may focus on more robust data collection in larger sample sizes, specific types of MT and more in-depth exploration of the patient and carer experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 3","pages":"609-615"},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916643","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

Beyond the stethoscope: Reflections from a dementia unit 听诊器之外来自痴呆症病房的思考

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-04-19 DOI: 10.1111/ajag.13319

Eleanor TKH Dunn

引用次数: 0

Patient, surgical and hospital factors predicting actual first-day mobilisation after hip fracture surgery: An observational cohort study 预测髋部骨折术后第一天实际活动能力的患者、手术和医院因素：观察性队列研究

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-04-14 DOI: 10.1111/ajag.13312

Victoria Woodcroft-Brown, Jack Bell, Chrysanth Ranjeev Pulle, Rebecca Mitchell, Jacqueline Close, Catherine McDougall, Sarah Hurring, Mitchell Sarkies

Objectives

To examine patient, surgical and hospital factors associated with Day-1 postoperative mobility after hip fracture surgery in older adults.

Methods

A cohort study using Australia and New Zealand Hip Fracture Registry was conducted. Participants were aged older than 50 years and underwent hip fracture surgery between 1 January 2020 and 31 December 2020 inclusive. The outcome was standing and step transferring out of bed onto a chair and/or walking Day-1 after hip fracture surgery.

Results

Mean age was 82 years and 68% were women. Of 12,318 patients with hip fracture, 5981 (49%) actually mobilised Day-1. Odds of actual first-day mobilisation were lower for individuals usually walking with either stick or crutch (OR = 0.71, 95% CI 0.62–0.82) or two aids or frame (OR = 0.57, 95% CI 0.52–0.64) or wheelchair/bed bound (OR = 0.24, 95% CI 0.17–0.33); who had impaired cognition preadmission (OR = 0.57, 95% CI 0.51–0.64); from aged care facilities (OR = 0.59, 95% CI 0.52–0.67); had an American Society of Anaesthesiologists grade 2 (OR = 0.63, 95% CI 0.41–0.97), 3 (OR = 0.31, 95% CI 0.20–0.47) or 4 or 5 (OR = 0.21, 95% CI 0.14–0.32); surgery delay >48 h (OR = 0.81, 95% CI 0.71–0.91); and restricted/non-weight-bearing status immediately postoperatively (OR = 0.53, 95% CI 0.42–0.67).

Conclusions

Both non-modifiable and modifiable patient and surgical factors influence first-day mobilisation after hip fracture surgery. Reducing time to surgery might assist future quality improvement efforts to increase Day-1 postoperative mobility.

目的研究与老年人髋部骨折术后第一天活动能力相关的患者、手术和医院因素。方法利用澳大利亚和新西兰髋部骨折登记处开展了一项队列研究。参与者年龄在 50 岁以上，在 2020 年 1 月 1 日至 2020 年 12 月 31 日（含）期间接受了髋部骨折手术。研究结果为髋部骨折术后第1天的站立、下床移步到椅子上和/或行走。结果平均年龄为82岁，68%为女性。在12318名髋部骨折患者中，有5981人（49%）在术后第一天进行了实际活动。通常使用手杖或拐杖行走（OR = 0.71，95% CI 0.62-0.82）或使用两种辅助工具或框架（OR = 0.57，95% CI 0.52-0.64）或使用轮椅/卧床（OR = 0.24，95% CI 0.17-0.33）；入院前认知能力受损（OR = 0.57，95% CI 0.51-0.64）；来自老年护理机构（OR = 0.59，95% CI 0.52-0.67）；美国麻醉医师协会 2 级（OR = 0.63，95% CI 0.41-0.97）、3（OR = 0.31，95% CI 0.20-0.47）或4或5（OR = 0.21，95% CI 0.14-0.32）；手术延迟>48 h（OR = 0.81，95% CI 0.71-0.91）；术后立即处于限制/非负重状态（OR = 0.结论髋部骨折术后第一天的活动能力既受不可改变因素的影响，也受患者和手术因素的影响。缩短手术时间可能有助于未来的质量改进工作，从而提高术后第一天的活动能力。

{"title":"Patient, surgical and hospital factors predicting actual first-day mobilisation after hip fracture surgery: An observational cohort study","authors":"Victoria Woodcroft-Brown, Jack Bell, Chrysanth Ranjeev Pulle, Rebecca Mitchell, Jacqueline Close, Catherine McDougall, Sarah Hurring, Mitchell Sarkies","doi":"10.1111/ajag.13312","DOIUrl":"10.1111/ajag.13312","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine patient, surgical and hospital factors associated with Day-1 postoperative mobility after hip fracture surgery in older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort study using Australia and New Zealand Hip Fracture Registry was conducted. Participants were aged older than 50 years and underwent hip fracture surgery between 1 January 2020 and 31 December 2020 inclusive. The outcome was standing and step transferring out of bed onto a chair and/or walking Day-1 after hip fracture surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean age was 82 years and 68% were women. Of 12,318 patients with hip fracture, 5981 (49%) actually mobilised Day-1. Odds of actual first-day mobilisation were lower for individuals usually walking with either stick or crutch (OR = 0.71, 95% CI 0.62–0.82) or two aids or frame (OR = 0.57, 95% CI 0.52–0.64) or wheelchair/bed bound (OR = 0.24, 95% CI 0.17–0.33); who had impaired cognition preadmission (OR = 0.57, 95% CI 0.51–0.64); from aged care facilities (OR = 0.59, 95% CI 0.52–0.67); had an American Society of Anaesthesiologists grade 2 (OR = 0.63, 95% CI 0.41–0.97), 3 (OR = 0.31, 95% CI 0.20–0.47) or 4 or 5 (OR = 0.21, 95% CI 0.14–0.32); surgery delay >48 h (OR = 0.81, 95% CI 0.71–0.91); and restricted/non-weight-bearing status immediately postoperatively (OR = 0.53, 95% CI 0.42–0.67).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both non-modifiable and modifiable patient and surgical factors influence first-day mobilisation after hip fracture surgery. Reducing time to surgery might assist future quality improvement efforts to increase Day-1 postoperative mobility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 3","pages":"600-608"},"PeriodicalIF":1.4,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588839","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

Social participation in Australian residential aged care: A human rights perspective 澳大利亚养老院的社会参与：人权视角

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-04-13 DOI: 10.1111/ajag.13311

Rachel Morrison-Dayan

The Royal Commission into Aged Care Quality and Safety emphasised the critical need for a human rights-based approach to protect the rights of older people in the Australian aged care context, including ‘the right to social participation’. This topic is important because of the widespread social isolation and loneliness in Australian residential aged care. This article demonstrates how a human rights-based framework can provide guidance to governments in approaching issues involving the protection of older people's need for social connection in aged care. In doing so, the article considers examples of how the Australian government can ensure choice of living arrangement, individualised support and access to community services and facilities in the residential aged care context to better protect the right to social participation.

皇家老年护理质量与安全委员会强调，在澳大利亚老年护理领域，亟需采用基于人权的方法来保护老年人的权利，包括 "社会参与权"。由于澳大利亚养老院普遍存在社会隔离和孤独现象，因此这一主题非常重要。本文展示了基于人权的框架如何为政府处理涉及保护老年人在养老护理中的社会联系需求的问题提供指导。在此过程中，文章举例说明了澳大利亚政府可以如何确保在老年寄宿护理中选择生活安排、提供个性化支持以及使用社区服务和设施，从而更好地保护老年人的社会参与权。

引用次数: 0

Mental health outcomes of family carers after admission to aged care: A cross-sectional survey study 家庭照护者入住养老院后的心理健康结果：横断面调查研究

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-04-10 DOI: 10.1111/ajag.13314

Vera Camões-Costa, Benjamin Taylor, Chris Barton, Samantha Chakraborty, Alana Hewitt, Xiaoping Lin, Bianca Brijnath

Objectives

This study investigated the predictors of poor mental health outcomes among family carers of residents after transitioning into residential aged care.

Methods

Using a cross-sectional design, five groups of variables were evaluated as predictors: caregiver demographics; caregiving load; resident-related variables; loneliness and visiting frequency; and the impact of the COVID-19 context. A total of 309 primary family contacts of all residents of two residential aged care organisations in the state of Victoria (Australia) participated in the study (response rate 19%). The K-10 and the Burden Scale for Family Caregivers were used to measure the primary outcomes. We compared psychological distress and burden outcomes between carers whose relative was admitted within the last 12 months, or longer than 12 months ago.

Results

Time since admission (<12 months or >12 months) did not affect the level of psychological distress (t (238) = −.08, p = .94) or subjective burden (t (245) = −.89, p = .38). Being a woman, a spouse, speaking a language other than English at home, being less satisfied with the support offered by the facility, not feeling supported in the decision to admit their relative, being lonely and providing higher levels of care preadmission were predictors of poor mental health outcomes.

Conclusions

Older women with low-English proficiency who were primary carers and are socially isolated, are more likely to experience poor mental health outcomes and need additional support. These findings may inform the development of screening tools and tailored interventions to support this population during and after the transition process.

方法采用横断面设计，对以下五组变量进行预测评估：照顾者的人口统计学特征；照顾负荷；与住院者相关的变量；孤独感和探视频率；以及 COVID-19 情境的影响。澳大利亚维多利亚州两家老年护理机构所有住院者的 309 位主要家庭联系人参与了研究（回复率为 19%）。我们使用 K-10 和家庭照顾者负担量表来测量主要结果。结果入院时间（12 个月或 12 个月）并不影响心理压力（t (238) = -.08，p = .94）或主观负担（t (245) = -.89，p = .38）。作为女性、配偶、在家中讲英语以外的语言、对医疗机构提供的支持不太满意、在决定收治其亲属时没有感受到支持、孤独以及在入院前提供了较高水平的护理，这些都是预测心理健康结果不佳的因素。结论英语水平较低的老年女性如果是主要照顾者且与社会隔绝，则更有可能出现心理健康结果不佳的情况并需要额外的支持。这些发现可为开发筛查工具和量身定制的干预措施提供参考，从而在过渡过程中和过渡后为这一人群提供支持。

{"title":"Mental health outcomes of family carers after admission to aged care: A cross-sectional survey study","authors":"Vera Camões-Costa, Benjamin Taylor, Chris Barton, Samantha Chakraborty, Alana Hewitt, Xiaoping Lin, Bianca Brijnath","doi":"10.1111/ajag.13314","DOIUrl":"10.1111/ajag.13314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigated the predictors of poor mental health outcomes among family carers of residents after transitioning into residential aged care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a cross-sectional design, five groups of variables were evaluated as predictors: caregiver demographics; caregiving load; resident-related variables; loneliness and visiting frequency; and the impact of the COVID-19 context. A total of 309 primary family contacts of all residents of two residential aged care organisations in the state of Victoria (Australia) participated in the study (response rate 19%). The K-10 and the Burden Scale for Family Caregivers were used to measure the primary outcomes. We compared psychological distress and burden outcomes between carers whose relative was admitted within the last 12 months, or longer than 12 months ago.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Time since admission (<12 months or >12 months) did not affect the level of psychological distress (<i>t</i> (238) = −.08, <i>p</i> = .94) or subjective burden (<i>t</i> (245) = −.89, <i>p</i> = .38). Being a woman, a spouse, speaking a language other than English at home, being less satisfied with the support offered by the facility, not feeling supported in the decision to admit their relative, being lonely and providing higher levels of care preadmission were predictors of poor mental health outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older women with low-English proficiency who were primary carers and are socially isolated, are more likely to experience poor mental health outcomes and need additional support. These findings may inform the development of screening tools and tailored interventions to support this population during and after the transition process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 3","pages":"616-627"},"PeriodicalIF":1.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588443","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

Adverse impacts in residential aged care facilities: The resident perspective 养老院中的不良影响：居民的观点

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-04-10 DOI: 10.1111/ajag.13306

Bella St Clair, Amy Nguyen, Mikaela Jorgensen, Andrew Georgiou

Objectives

Inclusion of consumer perspectives is a key component to person-centred health-care approaches. While current residential aged care systems focus on recording adverse events to meet the requirements of regulatory reporting, little is known about the views of residents. The aim of this research was to explore residents' responses on the types of incidents that have an adverse impact on them and how they are affected by these incidents.

Methods

The study used a qualitative, inductive approach to derive themes from interviews with 20 permanent residents of aged care facilities in New South Wales and the Australian Capital Territory.

Results

Four main themes surrounding adverse incidents emerged: (i) social relationships and the adverse impacts of lack of meaningful interactions, (ii) adjustment to life in the residential aged care facility and the loss of residents' former life and self-determination, (iii) the impact of COVID-19 lockdowns which meant that residents were not able to go out or interact with others and (iv) acceptance, resignation and resilience in coping with adverse incidents.

Conclusions

This research highlights the difference between health-care definition, used for incident management reporting and quality indicators, and the way residents respond when asked to describe an incident that has affected them. Resident responses discuss situations having an adverse effect on them in contrast to the way adverse events and incidents are reported and monitored. The findings suggest that within adverse event and incident management systems and resident governance systems, there is scope for incorporating periods of transitions and well-being measures that capture elements that matter to older people.

目标纳入消费者观点是以人为本的医疗保健方法的关键组成部分。虽然目前的安老院系统侧重于记录不良事件，以满足监管报告的要求，但对院友的看法却知之甚少。本研究旨在探讨住户对对其产生不良影响的事件类型的反应，以及他们如何受到这些事件的影响。研究方法本研究采用定性归纳法，从对新南威尔士州和澳大利亚首都领地 20 名养老机构长期住户的访谈中得出主题。结果围绕不良事件出现了四个主要的主题：(i) 社会关系以及缺乏有意义的互动所带来的不良影响；(ii) 适应老年护理机构的生活以及居民失去以往的生活和自决权；(iii) COVID-19 封锁的影响，这意味着居民无法外出或与他人交流；以及 (iv) 应对不良事件时的接受、顺从和适应能力。结论这项研究强调了用于事件管理报告和质量指标的医疗定义与居民在被要求描述对其产生影响的事件时的反应方式之间的差异。住院患者在回答中讨论了对他们产生不良影响的情况，这与不良事件和事故的报告和监控方式形成了鲜明对比。研究结果表明，在不良事件和事故管理系统以及居民管理系统中，可以纳入过渡时期和福利措施，以捕捉对老年人重要的因素。

{"title":"Adverse impacts in residential aged care facilities: The resident perspective","authors":"Bella St Clair, Amy Nguyen, Mikaela Jorgensen, Andrew Georgiou","doi":"10.1111/ajag.13306","DOIUrl":"10.1111/ajag.13306","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Inclusion of consumer perspectives is a key component to person-centred health-care approaches. While current residential aged care systems focus on recording adverse events to meet the requirements of regulatory reporting, little is known about the views of residents. The aim of this research was to explore residents' responses on the types of incidents that have an adverse impact on them and how they are affected by these incidents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study used a qualitative, inductive approach to derive themes from interviews with 20 permanent residents of aged care facilities in New South Wales and the Australian Capital Territory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four main themes surrounding adverse incidents emerged: (i) social relationships and the adverse impacts of lack of meaningful interactions, (ii) adjustment to life in the residential aged care facility and the loss of residents' former life and self-determination, (iii) the impact of COVID-19 lockdowns which meant that residents were not able to go out or interact with others and (iv) acceptance, resignation and resilience in coping with adverse incidents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This research highlights the difference between health-care definition, used for incident management reporting and quality indicators, and the way residents respond when asked to describe an incident that has affected them. Resident responses discuss situations having an adverse effect on them in contrast to the way adverse events and incidents are reported and monitored. The findings suggest that within adverse event and incident management systems and resident governance systems, there is scope for incorporating periods of transitions and well-being measures that capture elements that matter to older people.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 3","pages":"581-590"},"PeriodicalIF":1.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588449","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

Comparison of polypharmacy and potentially inappropriate medication use in older adults with and without dementia receiving residential medication management reviews 有痴呆症和无痴呆症的老年人接受住院用药管理审查时的多药和潜在用药不当情况比较

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-04-06 DOI: 10.1111/ajag.13316

Mouna J. Sawan, Alexander Clough, Jodie Hillen, Natalie Soulsby, Danijela Gnjidic

Objectives

Among residents who had a residential medication management review (RMMR), there is a lack of studies assessing exposure to polypharmacy and potentially inappropriate medications (PIMs) in people with dementia. This study compared the exposure to polypharmacy and PIMs in residents with dementia and without dementia receiving RMMR.

Methods

A retrospective analysis was performed using data of 16,261 residents living in 343 Australian residential aged care facilities who had an RMMR in 2019. Medication use was assessed as polypharmacy (defined as ≥9 medications) and use of ≥1 PIMs using the 2019 updated Beers criteria. Dementia diagnosis was determined with ICD-10 coding from medical records. Descriptive analyses reported resident demographics and patterns of medication use. Pearson's χ² tests and logistic regression analysis were conducted to compare medication exposure between residents with and without dementia.

Results

Among 16,261 residents, 6781 (42%) had dementia. Residents with dementia were significantly more likely to be exposed to polypharmacy and PIMs, compared to those without dementia (74% vs. 70% and 83% vs. 73%, p < .001 respectively). Residents with dementia had 1.31 times the odds of exposure to polypharmacy (adjusted OR: 1.31, 95% CI: 1.22–1.41, p < .001) and 1.88 times the odds of being prescribed ≥1 PIMs than people without dementia (adjusted OR: 1.88, 95% CI: 1.73–2.04, p < .001).

Conclusions

In a study of residents receiving RMMR, polypharmacy and PIMs were highly common, and those with dementia were more likely to be exposed to inappropriate polypharmacy. There is a need for targeted deprescribing strategies to immediately address inappropriate prescribing in residents, particularly those living with dementia.

目的在接受过住院用药管理审查（RMMR）的住院患者中，缺乏对痴呆症患者接触多种药物和潜在不适当药物（PIMs）情况的评估研究。本研究比较了痴呆症患者和非痴呆症患者在接受RMMR时的多药性和潜在不当用药暴露情况。方法利用2019年接受RMMR的343家澳大利亚养老院16261名住院患者的数据进行了回顾性分析。根据2019年更新的Beers标准，将药物使用情况评估为多药（定义为≥9种药物）和使用≥1种PIMs。痴呆诊断根据病历中的 ICD-10 编码确定。描述性分析报告了住院患者的人口统计学特征和用药模式。进行了皮尔逊χ2检验和逻辑回归分析，以比较有痴呆症和无痴呆症居民的用药情况。与非痴呆症患者相比，痴呆症患者接触多种药物和PIMs的几率明显更高（分别为74%对70%和83%对73%，P< .001）。与非痴呆症患者相比，痴呆症患者接触多种药物的几率是后者的 1.31 倍（调整后 OR：1.31，95% CI：1.22-1.41，p < .001），被开具≥1 种 PIMs 的几率是后者的 1.88 倍（调整后 OR：1.结论在一项对接受 RMMR 的住院患者进行的研究中，多药治疗和 PIMs 非常普遍，痴呆患者更有可能接触到不适当的多药治疗。有必要采取有针对性的去处方化策略，立即解决住院患者，尤其是痴呆症患者的不当处方问题。

{"title":"Comparison of polypharmacy and potentially inappropriate medication use in older adults with and without dementia receiving residential medication management reviews","authors":"Mouna J. Sawan, Alexander Clough, Jodie Hillen, Natalie Soulsby, Danijela Gnjidic","doi":"10.1111/ajag.13316","DOIUrl":"10.1111/ajag.13316","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Among residents who had a residential medication management review (RMMR), there is a lack of studies assessing exposure to polypharmacy and potentially inappropriate medications (PIMs) in people with dementia. This study compared the exposure to polypharmacy and PIMs in residents with dementia and without dementia receiving RMMR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was performed using data of 16,261 residents living in 343 Australian residential aged care facilities who had an RMMR in 2019. Medication use was assessed as polypharmacy (defined as ≥9 medications) and use of ≥1 PIMs using the 2019 updated Beers criteria. Dementia diagnosis was determined with ICD-10 coding from medical records. Descriptive analyses reported resident demographics and patterns of medication use. Pearson's <i>χ</i><sup>2</sup> tests and logistic regression analysis were conducted to compare medication exposure between residents with and without dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 16,261 residents, 6781 (42%) had dementia. Residents with dementia were significantly more likely to be exposed to polypharmacy and PIMs, compared to those without dementia (74% vs. 70% and 83% vs. 73%, <i>p</i> < .001 respectively). Residents with dementia had 1.31 times the odds of exposure to polypharmacy (adjusted OR: 1.31, 95% CI: 1.22–1.41, <i>p</i> < .001) and 1.88 times the odds of being prescribed ≥1 PIMs than people without dementia (adjusted OR: 1.88, 95% CI: 1.73–2.04, <i>p</i> < .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a study of residents receiving RMMR, polypharmacy and PIMs were highly common, and those with dementia were more likely to be exposed to inappropriate polypharmacy. There is a need for targeted deprescribing strategies to immediately address inappropriate prescribing in residents, particularly those living with dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 3","pages":"628-635"},"PeriodicalIF":1.4,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588997","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

Co-production processes for translation and validation of psychosocial assessments for older adults in aged care 翻译和验证老年人社会心理评估的共同生产过程

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-04-04 DOI: 10.1111/ajag.13315

Joyce Siette, Amy D. Nguyen, Laura Dodds, Lindsey Brett, Andrew Georgiou

Objective

Given the diverse ethnic backgrounds of aged care clients, there is a critical requirement to translate psychosocial assessment tools into various languages to effectively evaluate social engagement and quality of life in older adults receiving aged care services. This study aimed to translate psychosocial tools into Turkish, Korean and Mandarin, the primary languages spoken by clients of an Australian community aged care provider.

Methods

A co-development approach encompassing forward and backward translations of the Australian Community Participation Questionnaire and ICEpop CAPability measure for Older people tools, along with focus group discussions involving bilingual staff (n = 7) and clients (n = 16), was employed to ensure precision and cultural relevance. Multiple iterations were undertaken until linguistic, conceptual and scaling equivalence was achieved, with recorded sessions transcribed and analysed thematically.

Results

Cultural appropriateness significantly impacted the delivery of questions within the tools, emphasising translation challenges tied to specific queries. These difficulties included the lack of terms for unique places of worship, the use of outdated language (e.g., references to reading newspapers), and varying priorities in social and well-being matters between Western and Eastern/Asian cultures. Staff feedback identified that formal translated tool versions eased administration for culturally and linguistically diverse (CALD) clients, enabling them to independently interpret questions, resulting in improved questionnaire completion rates.

Conclusions

Insights indicate the need for continued efforts in tailoring assessment tools to diverse cultural contexts to ensure accurate and meaningful data collection.

目的鉴于老年护理客户的种族背景各不相同，因此迫切需要将社会心理评估工具翻译成各种语言，以便有效评估接受老年护理服务的老年人的社会参与度和生活质量。本研究旨在将社会心理评估工具翻译成土耳其语、韩语和普通话，这三种语言是澳大利亚一家社区养老服务机构的服务对象所使用的主要语言。研究采用了共同开发的方法，包括澳大利亚社区参与问卷和 ICEpop CAPability measure for Older people 工具的正向和反向翻译，以及有双语工作人员（n = 7）和服务对象（n = 16）参与的焦点小组讨论，以确保准确性和文化相关性。在实现语言、概念和比例的等效性之前，进行了多次反复，并对记录的会议内容进行了转录和专题分析。这些困难包括缺乏独特礼拜场所的术语、使用过时的语言（例如，提及阅读报纸），以及西方文化和东方/亚洲文化在社会和福利问题上的优先次序不同。工作人员的反馈意见表明，正式翻译版本的工具简化了对不同文化和语言（CALD）客户的管理，使他们能够独立地解释问题，从而提高了问卷的完成率。

{"title":"Co-production processes for translation and validation of psychosocial assessments for older adults in aged care","authors":"Joyce Siette, Amy D. Nguyen, Laura Dodds, Lindsey Brett, Andrew Georgiou","doi":"10.1111/ajag.13315","DOIUrl":"10.1111/ajag.13315","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Given the diverse ethnic backgrounds of aged care clients, there is a critical requirement to translate psychosocial assessment tools into various languages to effectively evaluate social engagement and quality of life in older adults receiving aged care services. This study aimed to translate psychosocial tools into Turkish, Korean and Mandarin, the primary languages spoken by clients of an Australian community aged care provider.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A co-development approach encompassing forward and backward translations of the Australian Community Participation Questionnaire and ICEpop CAPability measure for Older people tools, along with focus group discussions involving bilingual staff (<i>n</i> = 7) and clients (<i>n</i> = 16), was employed to ensure precision and cultural relevance. Multiple iterations were undertaken until linguistic, conceptual and scaling equivalence was achieved, with recorded sessions transcribed and analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cultural appropriateness significantly impacted the delivery of questions within the tools, emphasising translation challenges tied to specific queries. These difficulties included the lack of terms for unique places of worship, the use of outdated language (e.g., references to reading newspapers), and varying priorities in social and well-being matters between Western and Eastern/Asian cultures. Staff feedback identified that formal translated tool versions eased administration for culturally and linguistically diverse (CALD) clients, enabling them to independently interpret questions, resulting in improved questionnaire completion rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Insights indicate the need for continued efforts in tailoring assessment tools to diverse cultural contexts to ensure accurate and meaningful data collection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 3","pages":"645-650"},"PeriodicalIF":1.4,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588724","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

Prevalence of frailty according to the Hospital Frailty Risk Score and related factors in older patients with acute coronary syndromes in Vietnam 越南急性冠状动脉综合征老年患者根据医院虚弱风险评分得出的虚弱患病率及相关因素

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2024-04-04 DOI: 10.1111/ajag.13307

Tan Van Nguyen, Huy Minh Tran, Ha Bich Thi Trinh, Vu Hoang Vu, Vien Ai Bang

Objectives

(1) To investigate the prevalence of frailty defined by the Hospital Frailty Risk Score (HFRS), a new scale for assessing frailty, in older patients with acute coronary syndrome (ACS); (2) To identify associations between frailty and the prescriptions of cardiovascular medications, percutaneous coronary intervention (PCI) and in-hospital adverse outcomes.

Methods

An observational study was conducted in patients aged older than 60 years with ACS at Thong Nhat Hospital from August to December 2022. The Hospital Frailty Risk Score is retrospectively calculated for all participants based on ICD-10 codes, and those with HFRS scores ≥5 were defined as frail. Logistic regression models were applied to examine the relationship between frailty and the study outcomes.

Results

There were 511 participants in the study. The median age was 72.7, 60% were male and 29% were frail. Frailty was associated with lower odds of beta-blocker use at admission (OR .49 95% CI .25–.94), treatment with PCI during hospitalisation (OR .48, 95% CI .30–.75), but did not show an association with prescriptions of cardiovascular drugs at discharge. Frailty was significantly associated with increased odds of adverse outcomes, including major bleeding (OR 4.07, 95% CI1.73–9.54), hospital-acquired pneumonia (OR 2.55, 95% CI 1.20–5.42), all-cause in-hospital mortality (OR 3.14, 95% CI 1.37–7.20) and non-cardiovascular in-hospital mortality (OR 10.73, 95% CI 1.93–59.55).

Conclusions

The HFRS was an effective tool for stratifying frailty and predicting adverse health outcomes in older patients with ACS. Further research is needed to compare the HFRS with other frailty assessment tools in this population.

目的（1）调查急性冠状动脉综合征（ACS）老年患者中由医院虚弱风险评分（HFRS）定义的虚弱发生率，HFRS是评估虚弱的一种新量表；（2）确定虚弱与心血管药物处方、经皮冠状动脉介入治疗（PCI）和院内不良结局之间的关联。方法2022年8月至12月，在Thong Nhat医院对60岁以上的ACS患者进行了一项观察性研究。根据ICD-10编码对所有参与者进行医院虚弱风险评分（Hospital Frailty Risk Score）的回顾性计算，HFRS评分≥5分者定义为虚弱。应用逻辑回归模型来检验虚弱与研究结果之间的关系。中位年龄为 72.7 岁，60% 为男性，29% 为体弱者。体弱与入院时使用β-受体阻滞剂（OR.49，95% CI.25-.94）和住院期间接受 PCI 治疗（OR.48，95% CI.30-.75）的几率较低有关，但与出院时的心血管药物处方没有关系。虚弱与不良结局几率的增加有明显关联，包括大出血（OR 4.07，95% CI 1.73-9.54）、医院获得性肺炎（OR 2.55，95% CI 1.20-5.42）、全因院内死亡率（OR 3.结论HFRS是对ACS老年患者进行体弱分层和预测不良健康结局的有效工具。在这一人群中，还需要进一步研究将 HFRS 与其他虚弱评估工具进行比较。

{"title":"Prevalence of frailty according to the Hospital Frailty Risk Score and related factors in older patients with acute coronary syndromes in Vietnam","authors":"Tan Van Nguyen, Huy Minh Tran, Ha Bich Thi Trinh, Vu Hoang Vu, Vien Ai Bang","doi":"10.1111/ajag.13307","DOIUrl":"10.1111/ajag.13307","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>(1) To investigate the prevalence of frailty defined by the Hospital Frailty Risk Score (HFRS), a new scale for assessing frailty, in older patients with acute coronary syndrome (ACS); (2) To identify associations between frailty and the prescriptions of cardiovascular medications, percutaneous coronary intervention (PCI) and in-hospital adverse outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An observational study was conducted in patients aged older than 60 years with ACS at Thong Nhat Hospital from August to December 2022. The Hospital Frailty Risk Score is retrospectively calculated for all participants based on ICD-10 codes, and those with HFRS scores ≥5 were defined as frail. Logistic regression models were applied to examine the relationship between frailty and the study outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 511 participants in the study. The median age was 72.7, 60% were male and 29% were frail. Frailty was associated with lower odds of beta-blocker use at admission (OR .49 95% CI .25–.94), treatment with PCI during hospitalisation (OR .48, 95% CI .30–.75), but did not show an association with prescriptions of cardiovascular drugs at discharge. Frailty was significantly associated with increased odds of adverse outcomes, including major bleeding (OR 4.07, 95% CI1.73–9.54), hospital-acquired pneumonia (OR 2.55, 95% CI 1.20–5.42), all-cause in-hospital mortality (OR 3.14, 95% CI 1.37–7.20) and non-cardiovascular in-hospital mortality (OR 10.73, 95% CI 1.93–59.55).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The HFRS was an effective tool for stratifying frailty and predicting adverse health outcomes in older patients with ACS. Further research is needed to compare the HFRS with other frailty assessment tools in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 2","pages":"288-296"},"PeriodicalIF":1.4,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajag.13307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588990","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