共查询到20条相似文献，搜索用时 500 毫秒
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Lien Van Malderen Patricia De Vriendt Tony Mets Dominique Verté Ellen Gorus 《Journal of the American Medical Directors Association》2017,18(6):495-502
Objectives
This study aimed to examine the effects of introducing participatory action research (PAR) within the nursing home (NH) on residents’ quality of life (QoL) and NH experience and participation, and to explore their experiences with PAR.Design
A mixed methods design was chosen, including a clustered randomized controlled trial (RCT) and qualitative interviews.Setting
For the RCT, 3 NHs were randomly allocated to 3 conditions: an intervention (weekly PAR activity), an active control (weekly reminiscence-activity), or passive control (care as usual). The qualitative study took place in the intervention NH.Participants
Within the RCT, about 30 residents were recruited for assessments per NH, including 9 PAR participants and 10 reminiscence participants. Qualitative interviews were held with all PAR participants (residents and internal moderator).Intervention
PAR is a method to structurally involve residents in the NH operation. Weekly PAR sessions were held with 9 residents and 2 moderators. Here, residents critically analyzed and discussed the NH operation, identified possible problems, suggested improvements, which were further implemented by the NH and monitored by the PAR group.Measurements
Residents’ NH experience (NH Active Aging Survey), QoL (Anamnestic Comparison Self-Assessment), and experienced participation (Impact on Participation and Autonomy) were measured in the RCT at pre-test, post-test (6 months), and follow-up (12 months). The qualitative study took into account interviews with the PAR stakeholders after 6 months.Results
The RCT showed residents’ QoL improving more between pre-test and follow-up in the intervention and active control NH compared with the passive control NH. No other effects were observed. The qualitative data revealed a positive PAR experience. Participants enjoyed the activity and indicated various positive influences. Still, there was room for improvement, including communication toward other residents and between staff.Conclusions
Notwithstanding the modest quantitative effects, PAR led to positive experiences and can have a future in the NH when solving some limitations. 相似文献4.
Jana Hummel Cecilia Weisbrod Leila Boesch Katharina Himpler Klaus Hauer Martin Hautzinger Andrea Gaebel Tania Zieschang Andrea Fickelscherer Slawomira Diener Ilona Dutzi Bertram Krumm Peter Oster Daniel Kopf 《Journal of the American Medical Directors Association》2017,18(4):341-349
Background
Comorbid depression is highly prevalent in geriatric patients and associated with functional loss, frequent hospital re-admissions, and a higher mortality rate. Cognitive behavioral psychotherapy (CBT) has shown to be effective in older depressive patients living in the community. To date, CBT has not been applied to older patients with acute physical illness and comorbid depression.Objectives
To evaluate the effectiveness of CBT in depressed geriatric patients, hospitalized for acute somatic illness.Design
Randomized controlled trial with waiting list control group.Setting
Postdischarge intervention in a geriatric day clinic; follow-up evaluations at the patients’ homes.Participants
A total of 155 randomized patients, hospitalized for acute somatic illness, aged 82 ± 6 years and suffering from depression [Hospital Anxiety and Depression Scale (HADS) scores >7]. Exclusion criteria were dementia, delirium, and terminal state of medical illness.Intervention
Fifteen, weekly group sessions based on a CBT manual. Commencement of psychotherapy immediately after discharge in the intervention group and a 4-month waiting list interval with usual care in the control group.Measurements
HADS depression total score after 4 months. Secondary endpoints were functional, cognitive, psychosocial and physical status, resource utilization, caregiver burden, and amount of contact with physician.Results
The intervention group improved significantly in depression scores (HADS baseline 18.8; after 4 months 11.4), whereas the control group deteriorated (HADS baseline 18.1; after 4 months 21.6). Significant improvement in the intervention group, but not in the control group, was observed for most secondary outcome parameters such as the Barthel and Karnofsky indexes. Intervention effects were less pronounced in patients with cognitive impairment or acute fractures.Conclusions
CBT is feasible and highly effective in geriatric patients. The benefits extend beyond effective recovery and include improvement in physical and functional parameters. Early diagnosis, good access to psychotherapy, and early intervention could improve care for depressive older patients.5.
John E. Morley Hidenori Arai Li Cao Birong Dong Reshma A. Merchant Bruno Vellas Renuka Visvanathan Jean Woo 《Journal of the American Medical Directors Association》2017,18(6):489-494
Background
Although the older population is increasing worldwide, there is a marked deficit in the number of persons trained in geriatrics. It is now recognized that early detection and treatment of geriatric syndromes (frailty, sarcopenia, anorexia of aging, and cognitive decline) will delay or avert the development of disability.Objectives
To identify simple screening programs available for primary health professionals to identify geriatric syndromes.Data sources
PubMed for the last 5 years and study authors.Results
A number of screening programs for early detection of geriatric syndromes have been developed for use by primary care health providers, for example, EasyCare, Gérontopôle Frailty Screening Tool, the Rapid Geriatric Assessment, the Kihon Checklist, and others.Limitations
This is an evolving area with limited information on the outcomes of intervention and possible harms.Conclusion
Validated screening programs exist but more work is required to determine their utility in improving outcomes of older persons. 相似文献6.
Amanda Reichard Michelle Stransky Kimberly Phillips Monica McClain Charles Drum 《Disability and health journal》2017,10(1):39-47
Background
While it is commonly accepted that disparities in unmet need for care vary by age, race/ethnicity, income, education, and access to care, literature documenting unmet needs experienced by adults with different types of disabilities is developing.Objective
The main objective was to determine whether subgroups of people with disabilities are more likely than people without disabilities to delay/forgo necessary care, in general and among the insured.Methods
We used pooled Medical Expenditure Panel Survey data (2004–2010) to examine delaying or forgoing medical, dental, and pharmacy care among five disability subgroups (physical, cognitive, visual, hearing, multiple) and the non-disabled population. Logistic regression was conducted to examine delayed/forgone care, controlling for sociodemographic, health, and health care factors.Results
Over 13% of all working-age adults delayed/forwent necessary care; lack of insurance was the strongest predictor of unmet needs. Among the insured, disability subgroups were greater than two times more likely to report delayed/forgone care than adults without disabilities. Insured working-age adults with multiple chronic conditions and those with ADL/IADL assistance needs had higher odds of delayed or forgone care than their peers without these characteristics. Reasons related to affordability were most often listed as leading to unmet needs, regardless of disability.Conclusion
Although insurance status most strongly predicted unmet needs for care, many people with insurance delayed/forewent necessary care. Even among the insured, all disability subgroups had significantly greater likelihood of having to delay/forgo care than those without disabilities. Differences also existed between the disability subgroups. Cost was most frequently cited reason for unmet needs. 相似文献7.
Shinya Tanaka Kentaro Kamiya Nobuaki Hamazaki Ryota Matsuzawa Kohei Nozaki Emi Maekawa Chiharu Noda Minako Yamaoka-Tojo Atsuhiko Matsunaga Takashi Masuda Junya Ako 《Journal of the American Medical Directors Association》2017,18(2):176-181
Objectives
A simple and inexpensive tool for screening of sarcopenia would be helpful for clinicians. The present study was performed to determine whether the SARC-F questionnaire is useful in screening of patients with cardiovascular disease (CVD) for impaired physical function.Design
Cross-sectional study.Setting
Single university hospital.Participants
A total of 235 Japanese patients ≥65 years old admitted to our hospital for CVD.Measurements
SARC-F, handgrip strength, leg strength, respiratory muscle strength, standing balance, usual gait speed, Short Physical Performance Battery (SPPB) score, and 6-minute walking distance were measured before discharge from hospital. The patients were divided into 2 groups according to SARC-F score: SARC-F < 4 (nonsarcopenia group) and SARC-F ≥ 4 (sarcopenia group).Results
The sarcopenia prevalence rate was 25.5% and increased with age (P trend < .001). The sarcopenia group (SARC-F score ≥ 4) had significantly lower handgrip strength, leg strength, and respiratory muscle strength, poorer standing balance, slower usual gait speed, lower SPPB score, and shorter 6-minute walking distance compared to the nonsarcopenia group (SARC-F score < 4). Patients in the sarcopenia group had consistently poorer physical function even after adjusting for covariates.Conclusion
The SARC-F questionnaire is a useful screening tool for impaired physical function in elderly CVD patients. These findings support the use of the SARC-F for screening in hospital settings. 相似文献8.
Ling Na Sean Hennessy Hillary R. Bogner Jibby E. Kurichi Margaret Stineman Joel E. Streim Pui L. Kwong Dawei Xie Liliana E. Pezzin 《Disability and health journal》2017,10(1):48-57
Background
Receipt of recommended care among older adults is generally low. Findings regarding service use among persons with disabilities supports the notion of disparities but provides inconsistent evidence of underuse of recommended care.Objective
To examine the extent to which receipt of recommended care among older Medicare beneficiaries varies by disability status, using a newly developed staging method to classify individuals according to disability.Methods
In a cohort study, we included community-dwelling Medicare beneficiaries aged 65 and older who participated in the Medicare Current Beneficiary Survey between 2001 and 2008. Logistic regression modeling assessed the association of receiving recommended care on 38 indicators across different activity limitation stages.Results
Nearly one out of every three elderly Medicare beneficiaries did not receive overall recommended care. Adjusted odds ratios (ORs) revealed a decrease in use of recommended care with increasing activity limitation stage. For instance, ORs (95% CIs) across mild, moderate, severe and complete limitation stages (stages I–IV) compared to no limitation (stage 0) in ADLs were 0.99 (0.94–1.05), 0.89 (0.83–0.95), 0.81 (0.75–0.89) and 0.56 (0.46–0.68). Disparities in receipt of recommended care by disability stage were most marked for care related to post-hospitalization follow-up and, to a lesser degree, care of chronic conditions and preventive care.Conclusions
Elderly beneficiaries at higher activity limitation stages experienced substantial disparities in receipt of recommended care. Tailored interventions may be needed to reduce disparities in receipt of recommended medical care in this population. 相似文献9.
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Kimberly J. Rask Jennifer Hodge Linda Kluge 《Journal of the American Medical Directors Association》2017,18(11):991.e11-991.e15
Objectives
Identify contextual and implementation factors impacting the effectiveness of an organizational-level intervention to reduce preventable hospital readmissions from affiliated skilled nursing facilities (SNFs).Design
Observational study of the implementation of Interventions to Reduce Acute Care Transfers tools in 3 different cohorts.Setting
SNFs.Participants
SNFs belonging to 1 of 2 corporate entities and a group of independent SNFs that volunteered to participate in a Quality Improvement Organization (QIO) training program.Intervention
Two groups of SNFs received INTERACT II training and technical assistance from corporate staff, and 1 group of SNFs received training from QIO staff.Measurements
Thirty-day acute care hospital readmissions from Medicare fee-for-service claims, contextual factors using the Model for Understanding Success in Quality framework.Results
All 3 cohorts were able to deliver the INTERACT training program to their constituent facilities through regional events as well as onsite technical assistance, but the impact on readmission rates varied. Facilities supported by the QIO and corporation A were able to achieve statistically significant reductions in 30-day readmission rates. A review of contextual factors found that although all cohorts were challenged by staff turnover and workload, corporation B facilities struggled with a less mature quality improvement (QI) culture and infrastructure.Conclusions
Both corporations demonstrated a strong corporate commitment to implementing INTERACT II, but differences in training strategies, QI culture, capacity, and competing pressures may have impacted the effectiveness of the training. Proactively addressing these factors may help long-term care organizations interested in reducing acute care readmission rates increase the likelihood of QI success. 相似文献11.
Nancy Bagatell Dara Chan Kimberly Karrat Rauch Deborah Thorpe 《Disability and health journal》2017,10(1):80-86
Background
The transition to adulthood, the gradual change in roles and responsibilities, is identified as a challenging time for adolescents and young adults with physical disabilities, including those with cerebral palsy. Health care, education, employment, independent living, and community engagement have been identified as areas of concern. However, relatively little research has been done to understand the experiences, perceptions, and needs of individuals with cerebral palsy as they transition toward adulthood.Objective
The objective of this study was to explore the transition experiences, perceptions, and needs of young adults with cerebral palsy living in one state in the southeastern United States.Methods
Focus groups with nine young adults with cerebral palsy (19–34 years) were conducted. The focus group interview explored the preparation for transition and experiences navigating adulthood. The audio-recorded groups were transcribed and analyzed using thematic analysis.Results
Young adults with cerebral palsy identified numerous challenges associated with navigating adulthood. The main themes were: 1) being thrust into adulthood; 2) navigating systems and services; 3) understanding and managing my body; and 4) dealing with stereotypes and prejudice.Conclusions
The findings highlight the need for a holistic approach to transition with a focus on building capacity and empowerment. To navigate complex systems of care, “navigators” or “facilitators” are needed. Additionally, practitioners and service providers in adult systems need further education about cerebral palsy. 相似文献12.
Background
To implement appropriate programs for promoting physical activity (PA) in people who are Deaf, it is important to have valid instruments for assessing PA in this population.Objective
The main purpose of this study was to examine the criterion validity of the short form of the International Physical Activity Questionnaire (IPAQ-S) in Deaf adults.Method
This study included 44 adults (18–65 years) of both genders (63.6% were females) who met the inclusion criteria. Objective measures of PA were collected using accelerometers, which were worn by each participant during one week. After using the accelerometer, the IPAQ-S was applied to assess participants' physical activity during the last 7 days.Results
There was no significant correlation between the average time spent in moderate to vigorous physical activity (MVPA) as measured by the accelerometer (40.1 ± 24.5 min/day) and by the IPAQ-S (41.3 ± 57.5 min/day). The IPAQ-S significantly underestimated the time spent in sedentary behavior (7.6 ± 2.7 h/day vs. 10.1 ± 1.6 h/day). Sedentary behavior and MVPA as measured by the accelerometer and the IPAQ-S showed limited agreement.Conclusions
Our results show some limitations on the use of IPAQ-S for quantifying PA among adults who are Deaf. The IPAQ-S tends to overestimate the MVPA and to underestimate sedentary behavior in adults who are Deaf. 相似文献13.
Vincenzo Solfrizzi Emanuele Scafato Davide Seripa Madia Lozupone Bruno P. Imbimbo Angela D&#x;Amato Rosanna Tortelli Andrea Schilardi Lucia Galluzzo Claudia Gandin Marzia Baldereschi Antonio Di Carlo Domenico Inzitari Antonio Daniele Carlo Sabbà Giancarlo Logroscino Francesco Panza 《Journal of the American Medical Directors Association》2017,18(1):89.e1-89.e8
Objectives
Cognitive frailty, a condition describing the simultaneous presence of physical frailty and mild cognitive impairment, has been recently defined by an international consensus group. We estimated the predictive role of a “reversible” cognitive frailty model on incident dementia, its subtypes, and all-cause mortality in nondemented older individuals. We verified if vascular risk factors or depressive symptoms could modify this predictive role.Design
Longitudinal population-based study with 3.5- and 7-year of median follow-up.Setting
Eight Italian municipalities included in the Italian Longitudinal Study on Aging.Participants
In 2150 older individuals from the Italian Longitudinal Study on Aging, we operationalized reversible cognitive frailty with the presence of physical frailty and pre-mild cognitive impairment subjective cognitive decline, diagnosed with a self-report measure based on item 14 of the Geriatric Depression Scale.Measurements
Incidence of dementia, its subtypes, and all-cause mortality.Results
Over a 3.5-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia [hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.02–5.18], particularly vascular dementia (VaD), and all-cause mortality (HR 1.74, 95% CI 1.07–2.83). Over a 7-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia (HR 2.12, 95% CI 1.12–4.03), particularly VaD, and all-cause mortality (HR 1.39, 95% CI 1.03–2.00). Vascular risk factors and depressive symptoms did not have any effect modifier on the relationship between reversible cognitive frailty and incident dementia and all-cause mortality.Conclusions
A model of reversible cognitive frailty was a short- and long-term predictor of all-cause mortality and overall dementia, particularly VaD. The absence of vascular risk factors and depressive symptoms did not modify the predictive role of reversible cognitive frailty on these outcomes. 相似文献14.
Young Choi Jaeyong Shin Kyoung Hee Cho Eun-Cheol Park 《Journal of epidemiology / Japan Epidemiological Association》2017,27(2):56-62
Background
Childhood attention deficit hyperactivity disorder (ADHD) is reported to be more prevalent among socioeconomically disadvantaged groups in various countries. The effect of poverty on child development appears to depend on how long poverty lasts. The timing of poverty also seems to be important for childhood outcomes. Lifetime socioeconomic status may shape current health. Thus, we investigated the effects of household income changes from birth to 4 years on the occurrence of ADHD.Methods
Data were obtained from 18,029 participants in the Korean National Health Insurance cohort who were born in 2002 and 2003. All individuals were followed until December 2013 or the occurrence of ADHD, whichever came first. Household income trajectories were estimated using the national health insurance premium and the group-based model. Cox proportional hazard models were used to compare incidence rates between different income trajectory groups after adjustment for possible confounding risk factors.Results
Of 18,029 participants, 554 subjects (3.1%) were identified as having ADHD by age 10 or 11. Seven household income trajectories within three categories were found. Children living in decreasing, consistently low, and consistently mid-low income households had an increased risk of ADHD compared to children who consistently lived in the mid-high household income group.Conclusions
Children who live in decreasing-income or consistently low-income households have a higher risk for ADHD. Promotion of targeted policies and priority support may help reduce ADHD in this vulnerable group. 相似文献15.
Iván De-Rosende Celeiro Sergio Santos-del-Riego Javier Muñiz García 《Disability and health journal》2017,10(1):145-151
Background
Homebound status is associated with poor health, comorbidity, and mortality and represents a major challenge for health systems. However, its prevalence among people with disabilities in the basic activities of daily living (ADLs) is unknown.Objectives
The objectives were to: (1) examine the prevalence of the homebound status among middle-aged and older adults with disabilities in ADLs, and (2) identify its clinical, functional, and environmental determinants.Methods
This study included 221 community-dwelling subjects, aged ≥50 years, who applied for long-term care services at the Office for Legal Certification of Long-term Care Need of Coruña (Spain). Each subject had a disability in ADLs and was interviewed by a trained examiner in the subject's home. The participants were considered homebound if they remained inside their home during the previous week.Measures
Demographic, clinical, functional, and environmental factors. Multiple logistic regression was used to determine the factors associated with homebound status.Results
The prevalence of homebound status was 39.8%. A multivariate analysis revealed that the presence of architectural barriers at the home entrance (stairs [OR: 6.67, p < 0.001] or a heavy door [OR: 2.83, p = 0.023]), walking ability limitations (OR: 3.26, p = 0.006), and higher age (OR: 1.05, p = 0.04) were associated with homebound status.Conclusions
Homebound status is a highly prevalent problem among middle-aged and older adults with disabilities in ADLs. Architectural factors in the home and walking ability limitations seem to be important predictors, suggesting that health care interventions should target home adaptations and mobility skills as a means to preventing or decreasing homebound status. 相似文献16.
Jennifer S. Albrecht Lindsay Croft Daniel J. Morgan Mary-Claire Roghmann 《Journal of the American Medical Directors Association》2017,18(2):158-161
Objectives
To explore current use and perceptions of glove and gown use in nursing homes.Design
Qualitative study using focus groups and semi-structured interviews.Setting
Three community-based nursing homes in Maryland.Participants
Direct care staff, administrators, and residents.Methods
We conducted three focus groups among nursing home staff, one focus group among nursing home administrators, and five interviews with residents. Topic guides were created based on our recent study results and a review of the literature. Two investigators separately analyzed the transcribed recordings and identified recurrent themes.Results
Direct care staff reported using gowns and gloves primarily as self-protection against contact with bodily fluids, not to prevent MRSA transmission. Glove use was described as common and more acceptable to staff and residents than gown use. Administrators were surprised that MRSA transmission to health care worker hands and clothing occurred during activities when direct care staff perceives no contact with bodily fluids. Staff and administrators expressed willingness to use gowns and gloves for high-risk care activities, particularly if use is targeted toward specific types of residents such as those with pressure ulcers. There was a knowledge deficit about MRSA transmission and infection among direct care staff and residents.Conclusions
Results from this study will inform a strategy to reduce MRSA transmission in long-term care. 相似文献17.
Felicita Urzi Boštjan Šimunič Elena Buzan 《Journal of the American Medical Directors Association》2017,18(11):991.e5-991.e10
Background
Sarcopenia is a major health problem of the older population. The European Working Group on Sarcopenia in Older People (EWGSOP) developed diagnostic criteria for diagnosis of sarcopenia that require assessing muscle mass and strength or physical performance. Recently, however, a rapid screening method SARC-CalF was developed.Objective
The aim of the present study was to validate the SARC-CalF test using EWGSOP sarcopenia diagnostic criteria in a sample of nursing home residents.Methods
Cross-sectional study. A sample of 80 nursing home residents [30% of men; mean age 84.3 (7.9) years]. Sarcopenia was determined as proposed by the EWGSOP diagnostic criteria, whereby muscle mass was measured by bioelectrical impedance, muscle strength by handgrip strength, and physical performance by usual gait speed and a Short Physical Performance Battery score. Sarcopenia was also assessed by the SARC-CalF screening test.Results
A total of 38.7% of sarcopenia was evaluated using EWGSOP diagnostic criteria and 36.2% using the SARC-CalF test. The SARC-CalF demonstrated a sensitivity level of 77.4% and specificity of 89.8%. The area under the receiver operating characteristic curves of SARC-CalF test was 0.84 (95% confidence interval 0.74, 0.94).Conclusions
SARC-CalF could be a useful screening test for sarcopenia in nursing home residents. The incorporation of the test as a basis for sarcopenia screening will provide additional value to current nursing home preventive measures. 相似文献18.
Megan Armstrong Christopher Morris Charles Abraham Mark Tarrant 《Disability and health journal》2017,10(1):11-22
Background
Children with disabilities are often the target of prejudice from their peers. The effects of prejudice include harmful health consequences. The Contact Hypothesis has previously shown to promote positive attitudes towards a range of social groups.Objective
To conduct a systematic review and meta-analysis on the effectiveness of school-based interventions for improving children's attitudes towards disability through contact with people with disabilities.Methods
A comprehensive search was conducted across multiple databases. Studies were included if it evaluated an intervention that aimed to improve children's attitudes towards disability and involved either direct (in-person) or indirect (e.g., extended) contact with people with disabilities. Data were synthesised in a meta-analysis.Results
Twelve studies met the inclusion criteria. Of these, 11 found significant effects: six used direct contact, two used extended contact, two used parasocial (media-based) contact and one used guided imagined contact. One parasocial contact intervention found no significant effects. Three meta-analyses showed direct contact (d = 0.55, 95% CI 0.20 to 0.90) and extended contact (d = 0.61, 95% CI 0.15 to 1.07) improved children's attitudes; there was no evidence for parasocial contact (d = 0.20, 95% CI -0.01 to 1.40).Conclusions
Direct, extended, and guided imagined contact interventions are effective in improving children's attitudes towards disability; there was no evidence for parasocial contact. 相似文献19.
Laura Coots Daras Joyce M. Wang Melvin J. Ingber Catherine Ormond Nathaniel W. Breg Galina Khatutsky Zhanlian Feng 《Journal of the American Medical Directors Association》2017,18(5):442-444
Objectives
Hospitalizations among nursing facility residents are frequent and often potentially avoidable. A number of initiatives and interventions have been developed to reduce excessive hospitalizations; however, little is known about the specific approaches nursing facilities use to address this issue. The objective of this study is to better understand which types of interventions nursing facilities have introduced to reduce potentially avoidable hospitalizations of long-stay nursing facility residents.Design
Cross-sectional survey.Setting
236 nursing facilities from 7 states.Participants
Nursing facility administrators.Measurements
Web-based survey to measure whether facilities introduced any policies or procedures designed specifically to reduce potentially avoidable hospitalizations of long-stay nursing facility residents between 2011 and 2015. We surveyed facilities about seven types of interventions and quality improvement activities related to reducing avoidable hospitalizations, including use of Interventions to Reduce Acute Care Transfers (INTERACT) and American Medical Directors Association tools.Results
Ninety-five percent of responding nursing facilities reported having introduced at least one new policy or procedure to reduce nursing facility resident hospitalizations since January 2011. The most common practice reported was hospitalization rate tracking or review, followed by standardized communication tools, such as Situation, Background, Assessment, Recommendation (SBAR). We found some variation in the extent and types of these reported interventions.Conclusions
Nearly all facilities surveyed reported having introduced a variety of initiatives to reduce potentially avoidable hospitalizations, likely driven by federal, state, and corporate initiatives to decrease hospital admissions and readmissions. 相似文献20.
Fiona A.H.M. Cleutjens Martijn A. Spruit Rudolf W.H.M. Ponds Lowie E.G.W. Vanfleteren Frits M.E. Franssen Jeanette B. Dijkstra Candy Gijsen Emiel F.M. Wouters Daisy J.A. Janssen 《Journal of the American Medical Directors Association》2017,18(5):420-426