Geriatric Nursing最新文献

Objectives: To determine the risk factors for oral frailty in the elderly by Meta-analysis.

Methods: A systematic search of China Knowledge,Wanfang,China Biomedical Service System, Pubmed,Embase,and Cochrane Library,to search for eligible studies published from the time of library construction up to November 2023,and risk factors on oral frailty were included and analysed by Meta-analysis.

Results: A total of 12 studies were included,including 26 risk factors. Statistically significant risk factors for oral frailty included age (OR=1.33,95% CI:1.03-1.72), physical frailty (OR=2.57,95%CI:1.25-5.32),and precorporeal frailty (OR=1.85,95% CI: 1.34-2.54).

Conclusion: Older adults who are physically frail or have preexisting conditions are more likely to develop oral frailty.Therefore, it is important to assess these risk factors early and emphasize prevention to reduce the incidence of oral frailty in older adults.

Older adults with cognitive frailty often have impaired dual-task walking and prefrontal cortex (PFC) activation. Combining cycling with interactive boxing offers an innovative and interesting dual-task training to challenge both physical and cognitive skills. This study investigated the effects of interactive boxing-cycling on this population. Thirty-nine participants were assigned to the interactive boxing-cycling group (n = 20) or the stationary cycling group (n = 19) for 36 sessions over 12 weeks. The outcomes included dual-task walking performance, PFC activation, cognitive function, and frailty scores. Results showed the interactive boxing-cycling group had greater improvements in dual-task walking speed and cost and beneficially reduced oxygenated hemoglobin levels compared to the stationary group. Furthermore, both groups improved in frailty and cognition, but the interactive boxing-cycling group had better effects on general and specific cognitive function. Interactive boxing-cycling is an efficient intervention to enhance dual-task walking and PFC activation in older adults with cognitive frailty.

This study examines how coping strategies and social support mediate the relationship between type D personality and psychological distress in COPD patients. A sample of 351 patients completed surveys on demographics, psychological distress (Kessler Psychological Distress Scale), social support (Social Support Self-Rating Scale), coping strategies (Chinese version of Medical Coping Modes Questionnaire), and type D personality (Type D Personality Scale). Using structural equation modeling (SEM) via AMOS 23.0 and SPSS, results showed that confrontation and acceptance-resignation coping strategies, as well as type D personality, were positively correlated with psychological distress, while social support was negatively correlated. SEM estimates revealed a chain mediating effect of social support and coping strategies between type D personality and psychological distress. Enhancing social support and coping strategies is crucial for reducing psychological distress, especially in COPD patients with type D personality.

Despite existing guidelines for constipation management, constipation remains a prevalent issue among older individuals in long-term care facilities. The aim of this qualitative study was to provide an overview of nursing constipation management and the associated challenges in Swiss-German nursing homes. From September to December 2022, 51 nursing staff from 20 nursing homes were surveyed online, using literature-based open questions. Using a content analysis approach, four categories were identified in relation to constipation management: Assessment of Constipation and Risks; Prevention and treatment process; Challenges and influencing factors; Impact of constipation. Data analysis revealed that nurses perceive the management of constipation to be extremely challenging, highlighting difficulties arising from limited resources, expertise, few physician visits, and prioritization demands of daily practice. Successful constipation management requires regular training of nursing staff to raise awareness of existing guidelines and screening tools, as well as the optimization of structural conditions for implementation.

Objective: The present study aims to analyze the effectiveness of a gait re-education program using a sequential square mat (Tapiz Fisior®, in advance SSM Fisior®) in aspects related to mobility, balance, muscle strength, and gait of elderly people.

Methods: The intervention lasted eight weeks through progressive resistance training designed specifically for older people, with an approximate duration of 30-40 min, and was carried out three times a week on non-consecutive days using the SSM Fisior®.

Result: The intervention improved gait, balance, physical performance, lower limb strength, and walking speed. The women improved in balance, gait, physical performance, and lower limb strength, while the men improved only in balance and gait. Better outcomes were seen in participants who were not functionally dependent at baseline. Older people who did not have functional dependence before the intervention improved in balance, gait, physical performance, and strength of the lower limbs.

Conclusion: In conclusion, our findings underscore that the SSM Fisior® program stands out as an effective strategy for enhancing the mobility domain of intrinsic capacity in older individuals. These results advocate for the implementation of the SSM Fisior® program as a promising approach to improve the overall well-being and functional abilities of older adults.

Background: The purpose was to investigate the impact of social determinants of health on healthcare utilization among older adults in two cognition groups: normal and dementia/impaired cognition.

Methods: We used cross-sectional data from the Health and Retirement Study (N = 16,339) to assess healthcare utilization: hospital stay, nursing home stay, hospice care, and doctor visits. The respondents were classified into two cognition groups using the Langa-Weir approach.

Results: A cohort comparison between normal (mean age = 66.1) and dementia/impaired cognition (mean age = 71.9) groups revealed dementia/impaired group included more individuals from racial and ethnic minorities (42.7 % Black/Other, 20.8 % Hispanic) compared to the normal cognition (24.7 % Black/Other, 12.1 % Hispanic). They experienced longer hospital, nursing home, and hospice stays and varied doctor visit frequencies. These differences were influenced by race, age, marital status, education, and rurality.

Conclusion: Social determinants of health play an important role in predicting disparities in healthcare utilization among older adults across cognition levels.

Purpose: To explore the predictive value of the geriatric nutritional risk index (GNRI) for postoperative complications and their severity in older adults with pancreatic cancer undergoing pancreaticoduodenectomy (PD).

Methods: This study conducted a retrospective analysis of 109 older adults with pancreatic cancer undergoing PD at the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Quzhou Medical University, between May 2019 and May 2022. Statistical analysis of clinical data was performed to assess the predictive value of the GNRI for postoperative complications and their severity in older adults with pancreatic cancer undergoing PD.

Results: Among the 109 individuals in this study, a total of 41 older adults undergoing PD experienced postoperative complications. The outcomes of the regression analysis showed that preoperative GNRI (OR = 0.184, 95 % CI = 0.023-0.457, P < 0.001), albumin levels (OR = 0.897, 95 % CI = 0.812-0.912, P < 0.001) and haemoglobin levels (OR = 1.231, 95 % CI = 1.043-1.451, P = 0.034) significantly influence the incidence of postoperative complications in older adults with pancreatic cancer. The prognostic value of the GNRI in predicting overall postoperative complications boasts a sensitivity of 83.2 %, specificity of 71.2 %, positive predictive value of 81.1 %, negative predictive value of 65.9 %, accuracy rate of 73.1 %, area under the curve (AUC) of 0.756 (P < 0.001) and a discriminative threshold of 97.0. Furthermore, the predictive efficacy of the GNRI in gauging the severity of postoperative complications demonstrates a sensitivity of 85.32 % and specificity of 79.54 %.

Conclusion: The GNRI can offer a faster, simpler and more effective method for evaluating nutritional risk in individuals with pancreatic tumours. Moreover, for older adults undergoing PD, it can serve as a convenient and efficient nutritional predictive indicator for postoperative complications and their severity.

This systematic review evaluated the diagnostic accuracy of multiple screening tools for dysphagia in older adults. The analysis covered 30 studies involving 13 tools and 2,697 participants. The results showed that the volume viscosity swallow test performed best in sensitivity, specificity, and area under the curve, making it a recommended screening tool. Other tools have low sensitivity, unstable results or insufficient research and need to be further validated. Overall, this study provides an important reference for the screening of dysphagia in older adults.

This study used a cross-sectional design to investigate the mediating role of a health-promoting lifestyle on mobile health technology acceptance and cognitive function. A total of 219 older adults, age 65 years or older, with diagnosed chronic diseases, were recruited from a northern Taiwan community. Participants completed questionnaires including demographic characteristics, the Senior Technology Acceptance Scale, the Health Promoting Lifestyle Profile Scale, and the Montreal Cognitive Assessment. Mediation analysis was conducted using the PROCESS macro. After controlling for demographic factors, health-promoting lifestyle proved to be a full mediator of mobile health technology acceptance and cognitive function. The results indicate that interventions to maintain or improve cognitive function in older adults with chronic diseases who are living in the community should also encourage the acceptance of mobile health technology and adoption of health-promoting lifestyle.