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41.
Characterizing Longitudinal Changes in Physical Activity and Fear of Falling after Falls in Glaucoma
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David A. Ganz MD PhD Anita H. Yuan PhD MPH Erich J. Greene PhD Nancy K. Latham PT PhD Katy Araujo MPH Albert L. Siu MD MSPH Jay Magaziner MSHyg PhD Jerry H. Gurwitz MD Albert W. Wu MD MPH Neil B. Alexander MD Robert B. Wallace MD MSc Susan L. Greenspan MD Jeremy Rich DPM Elena Volpi MD PhD Stephen C. Waring DVM PhD Patricia C. Dykes RN PhD MA Fred Ko MD MS Neil M. Resnick MD Siobhan K. McMahon PhD MPH GNP Shehzad Basaria MD Rixin Wang PhD Charles Lu MS Denise Esserman PhD James Dziura PhD Michael E. Miller PhD Thomas G. Travison PhD Peter Peduzzi PhD Shalender Bhasin MB BS David B. Reuben MD Thomas M. Gill MD 《Journal of the American Geriatrics Society》2022,70(11):3221-3229
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Jessica Gonçalves Juliana Hotta Ansai Fernando Arturo Arriagada Masse Francisco Assis Carvalho Vale Anielle Cristhine de Medeiros Takahashi Larissa Pires de Andrade 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(5):417-423
Background
A dual-task tool with a challenging and daily secondary task, which involves executive functions, could facilitate the screening for risk of falls in older people with mild cognitive impairment or mild Alzheimer's disease.Objective
To verify if a motor-cognitive dual-task test could predict falls in older people with mild cognitive impairment or mild Alzheimer's disease, and to establish cutoff scores for the tool for both groups.Methods
A prospective study was conducted with community-dwelling older adults, including 40 with mild cognitive impairment and 38 with mild Alzheimer's disease. The dual-task test consisted of the Timed up and Go Test associated with a motor-cognitive task using a phone to call. Falls were recorded during six months by calendar and monthly telephone calls and the participants were categorized as fallers or non-fallers.Results
In the Mild cognitive impairment Group, fallers presented higher values in time (35.2 s), number of steps (33.7 steps) and motor task cost (116%) on dual-task compared to non-fallers. Time, number of steps and motor task cost were significantly associated with falls in people with mild cognitive impairment. Multivariate analysis identified higher number of steps spent on the test to be independently associated with falls. A time greater than 23.88 s (sensitivity = 80%; specificity = 61%) and a number of steps over 29.50 (sensitivity = 65%; specificity = 83%) indicated prediction of risk of falls in the Mild cognitive impairment Group. Among people with Alzheimer's disease, no differences in dual-task between fallers and non-fallers were found and no variable of the tool was able to predict falls.Conclusion
The dual-task predicts falls only in older people with mild cognitive impairment. 相似文献47.
Karine Marques Costa dos Reis Cristine Alves Costa de Jesus 《Revista latino-americana de enfermagem》2015,23(6):1130-1138
Objective:
to determine the incidence of falls in elderly residents of long-stay institutions of the Federal District, to identify the aspects involved in the falls, in terms of risk factors, from the application of scales and the Taxonomy II of NANDA-I, and to define the level of accuracy with its sensitivity and specificity for application in the clinical nursing practice.Method:
this was a cohort study with the evaluation of 271 elderly people. Cognition, functionality, mobility and other intrinsic factors were evaluated. After six months, the elderly people who fell were identified, with significance analysis then performed to define the risk factors.Results:
the results showed an incidence of 41%. Of the 271 patients included, 69 suffered 111 episodes of falls during the monitoring period. Risk factors were the presence of stroke with its sequelae (OR: 1.82, 95% CI 1.01 - 3.28, p=.045), presenting more than five chronic diseases (OR: 2.82, 95% CI 1.43 - 5.56, p=.0028), foot problem (OR: 2.45, 95% CI 1.35 - 4.44, p=.0033) and motion (OR: 2.04, 95% CI 1.15 - 3.61, p=.0145).Conclusion:
the taxonomy has high validity regarding the detection of elderly people at risk of falling and should be applied consistently in the clinical nursing practice. 相似文献48.
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Falls in older persons are prevalent and costly for the individual and the health system. Falls prevention guidelines have been developed from best evidence to minimise falls in older persons.AimTo synthesise the literature on falls prevention strategies used by community dwelling older persons and/or their informal carers and to compare the commonly adopted strategies with those recommended by falls prevention guidelines.Data sourcesHealth sciences databases for full text articles published in English plus reference list searching of included articles.Review methodAn integrative review approach. Studies were included if they identified fall prevention management strategies used by community dwelling older adults and/or their informal carers. Quality appraisal was undertaken using appropriate Joanna Briggs Institute critical appraisal tools. Information relevant to the aim of the review were extracted and coded into categories then inductively sorted into sub-themes and themes.ResultsOf the seventeen studies included in the review, eleven identified older adults’ falls prevention strategies, two investigated fall prevention strategies used by carers, and four explored perspectives of older persons together with their carers, representing the perspectives of an estimated 501 older persons and 102 carers. Strategies used by older adults arose because of self-awareness about their changing physical ability, and advice and support mainly from family or friends. Carer fall prevention strategy was predominantly around protection of the older adult from falling by discouraging independence.ConclusionsThe fall self-management strategies adopted by older adults and their carers to prevent falls, in the main, do not align with international best practice fall prevention guidelines. 相似文献
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BackgroundCollaboration among healthcare providers has been considered a promising strategy for improving care quality and patient outcomes. Despite mounting evidence demonstrating the impact of collaboration on outcomes of healthcare providers, there is little empirical evidence on the relationship between collaboration and patient safety outcomes, particularly at the patient care unit level.ObjectivesThe purpose of this study is to identify the extent to which interdisciplinary collaboration between nurses and physicians and intradisciplinary collaboration among nurses on patient care units are associated with patient safety outcomes.MethodsThis is a cross-sectional study using nurse survey data and patient safety indicators data from U.S. acute care hospital units. Collaboration at the unit level was measured by two 6-item scales: nurse-nurse interaction scale and nurse-physician interaction scale. Patient outcome measures included hospital-acquired pressure ulcers (HAPUs) and patient falls. The unit of analysis was the patient care unit, and the final sample included 900 units of 5 adult unit types in 160 hospitals in the U.S. Multilevel logistic and Poisson regressions were used to estimate the relationship between collaboration and patient outcomes. All models were controlled for hospital and unit characteristics, and clustering of units within hospitals was considered.ResultsOn average, units had 26 patients with HAPUs per 1000 patients and 3 patient falls per 1000 patient days. Critical care units had the highest HAPU rate (50/1000 patients) and the lowest fall rate (1/1000 patient days). A one-unit increase in the nurse-nurse interaction scale score led to 31% decrease in the odds of having a HAPU (OR, 0.69; 95% CI, 0.56–0.82) and 8% lower patient fall rate (IRR, 0.92; 95% CI, 0.87–0.98) on a nursing unit. A one-unit increase in the nurse-physician interaction scale score was associated with 19% decrease in the odds of having a HAPU (OR, 0.81; 95% CI, 0.68–0.97) and 13% lower fall rates (IRR, 0.87; 95% CI, 0.82–0.93) on a unit.ConclusionsBoth nurse-physician collaboration and nurse-nurse collaboration were significantly associated with patient safety outcomes. Findings from this study suggest that improving collaboration among healthcare providers should be considered as an important strategy for promoting patient safety and both interdisciplinary and intradisciplinary collaboration are critical for achieving better patient outcomes. 相似文献