社区护理干预对老年痴呆病人照顾者的影响

目的探讨社区护理干预对老年痴呆病人照顾者的作用,通过有针对性社区护理干预措施,提高病人的生活质量,延缓痴呆的进程。方法通过对38例老年痴呆病人照顾者的社区护理干预,总结在社区开展老年痴呆护理的方法。结果干预后病人家居安全(误服、跌倒、自伤),精神症状(睡眠障碍、焦虑、抑郁)发生率低于干预前(p<0.05),生活可自理人数明显增加(p<0.05)。结论针对性地对老年痴呆照顾者实施社区护理干预,能够有效地改善老年痴呆病人的生活质量,提高其健康水平。     

老年痴呆患者主要照顾者照顾负荷现状及影响因素分析

目的 调查老年痴呆患者主要照顾者(下简称"照顾者")照顾负荷现状,并分析其影响因素.方法 采取方便抽样法,选取2018年8月-2019年5月在湖州市中心医院老年科住院的176例老年痴呆患者的照顾者为研究对象.采用照顾者负荷调查量表、一般资料问卷对研究对象进行问卷调查,采用多元线性回归分析照顾者照顾负荷的影响因素.结果 ...     

老年痴呆病人家庭照顾者心理健康状况及干预研究

随着人口的老龄化,老年痴呆患者日益增加,对痴呆患者的照顾也成为困扰现代人生活的问题。本文通过阐述老年痴呆病人家庭照顾人员的心理健康状况,归纳各种干预措施,指出对家庭照顾人员的护理干预可以减轻照顾者的心理负担、改善照顾者的身心状况、减轻疾病负担,希望为开展适合我国国情的、针对老年痴呆病人家庭照顾人员的心理健康干预提供依据。     

对老年痴呆照顾者身心健康的分析探讨

随着人口老龄化的到来,老年痴呆患者人数的上升,这一严峻的现实给社会及家庭带来巨大的压力,尤其是对直系亲属照顾者所产生的无法回避的心理压力和生活负担的加重,已引起了社会的关注;另一方面,反过来又影响到老年痴呆患者生存质量的保障与具体落实.     

老年痴呆患者家庭照顾者负担及干预研究现状分析

目的 明确老年痴呆症患者家庭照顾者负担和干预的研究现状,为减轻照顾者负担提供依据。方法 通过中国知网、万方、维普、Pubmed、Embase、Web of Science等数据库进行文献检索,从老年痴呆患者家庭照顾者的负担情况及其评估工具、干预模式等方面分析。结果 老年痴呆患者家庭照顾者的负担较重;标准化的负担评估工具及有效的干预方法较为缺乏。结论 建议借鉴国内外成功经验,对老年痴呆患者家庭照顾者的负担开发标准化评估工具,及有效的干预策略和方法。     

上海社区老年痴呆患者照顾者的负担调查与分析

目的调查上海徐家汇街道老年痴呆患者照顾者的负担。方法首先采用整体随机抽样的方法,由专业人员根据诊断量表明确诊断出其中肯定和很可能痴呆患者206例;然后再针对这些痴呆患者家庭采用问卷调查与访谈相结合的方法入户调查痴呆患者的照顾者,采用一般情况调查表、照顾者负担问卷、能力感受问卷进行综合分析照顾者的负担分项。结论老年痴呆患是老年人的常见疾病之一,而痴呆患者的照料者负担重,有痴呆患者的家庭负担重,呼吁社会重视。     

老年痴呆长期卧床患者压疮预见性护理效果分析

目的:以分组形式明确预见性护理在老年痴呆长期卧床患者中的应用意义.方法:以2017年7月至2020年8月为时间线,将研究主体设为我院收治的60例老年痴呆长期卧床患者.采取随机均分的形式分组,对照组(n=30)以常规护理为干预方案,观察组(n=30)以预见性护理为干预方案,基于压疮相关知识水平、新发压疮情况、护理满意度等...     

社区居家长期卧床老年患者主要照顾者对尿路感染认知的调查分析

目的调查居家长期卧床老年患者主要照顾者对尿路感染的认知状况,并分析影响认知得分的相关因素,旨在为预防居家长期卧床老年患者尿路感染提供依据。方法采用自行设计问卷对社区居家长期卧床老年患者主要照顾者进行一般资料和尿路感染认知调查,对主要照顾者尿路感染认知水平影响因素进行单因素和多元线性回归分析。结果居家长期卧床老年患者主要照顾者对尿路感染的认知总分为(45.49±6.30)分,条目得分为(3.05±0.05)分,及时就医维度得分最低,四个维度得分比较差异有统计学意义(P0.05);多元线性回归分析显示,主要照顾者的性别、年龄、文化程度及照顾时间是影响居家长期卧床老年患者主要照顾者尿路感染认知得分的影响因素。结论社区居家长期卧床老年患者主要照顾者尿路感染的总体认知水平较低,文化程度高、照顾时间长、年龄小的女性照顾者尿路感染认知水平相对较高。     

老年住院患者照顾者照顾感受的质性研究

目的深入了解老年住院患者照顾者在看护期间内心深处的感受,以探索促进照顾者身心健康的相关因素。方法采用质性研究中的现象学研究方法,对12名老年住院患者照顾者进行访谈,并用现象学分析法进行资料分析。结果采用类属分析法升华出4个主题:心理负担过重;被患者的护理问题困扰;健康水平下降;个人生活受限。结论在研究和关注老年人健康问题的同时,不应忽视照顾者的身心健康,并为之提供有效的干预措施。     

Healthcare-associated infection among residents of long-term care facilities: a cohort and nested case-control study

Knowledge of infection control measures in nursing homes is limited. This study aimed to assess the incidence of, and potential risk factors for, healthcare-associated infection in long-term care facilities in Norway. Incidence of healthcare-associated infection was recorded prospectively in six long-term care facilities located in two major cities in Norway between 1 October 2004 and 31 March 2005. For each resident with an infection we aimed for two controls in a nested case-control study to identify potential risk factors. Incidence of infection was 5.2 per 1000 resident-days. Urinary and lower respiratory tract infections were the most common. Patients confined to their beds [odds ratio (OR=2.7)], who stayed <28 days (OR=1.5), had chronic heart disease (OR=1.3), urinary incontinence (OR=1.5), an indwelling urinary catheter (OR=2.0) or skin ulcers (OR=1.8) were shown to have a greater risk for infection. Age, sex and accommodated in a two- versus single-bed room were not significant factors. Incidence of infection in nursing homes in Norway is within the range reported from other countries. This study identified several important risk factors for healthcare-associated infection. There is a need to prevent infection by implementing infection control programmes including surveillance in long-term care facilities.     

A sense of home for people with dementia in a long-term care facility: A design perspective

The study aims to provide new insights into the approach to the spatial design of homelike dementia care facilities. This paper builds on Molony's (2010) findings that home meaning in care facilities is a process of people-place integration, and then proposes that people living with dementia can accomplish this process through their bodily habit. This research adopted an ethnographic case study approach. Three cases from a long-term care facility were studied by using semi-structured interviews and observations. According to the findings, having a sense of home for people living with dementia can be understood as a process of re-establishing people-place integration through their bodily habits in a long-term care facility. As a result, designers can consider which design features can assist people living with dementia in re-establishing this integration through bodily habit to create home feelings in a dementia care facility.     

Prevalence of nosocomial infections and use of antibiotics in long-term care facilities in Norway, 2002 and 2003

There were 42900 institution-beds in long-term care facilities for elderly persons in Norway in 2000. This is twice as many as in 1984. Of those living in an elderly people's care institution 77% were above 80 years. To determine the magnitude and distribution of nosocomial infections in such institutions, the Norwegian Institute of Public Health initiated a surveillance system. The system is based on two annual one-day prevalence surveys recording the four most common nosocomial infections: urinary tract infections, lower respiratory tract infections, surgical-site infections and skin infections, as well as antibiotic use. All long-term care facilities were invited to participate in the four surveys in 2002 and 2003. The total prevalence of the four recorded nosocomial infections varied between 6.6 and 7.3% in the four surveys. Nosocomial infections occurred most frequently in the urinary tract (50%), followed by infections of the skin (25%), of the lower respiratory tract (19%) and of surgical sites (5%). The prevalence of nosocomial infections was highest in rehabilitation and short-term wards, whereas the lowest prevalence was found in special units for persons with dementia. In all the surveys the prevalence of the four recorded nosocomial infections was higher than the prevalence of patients receiving antibiotics. The frequency of nosocomial infections in such facilities highlights the need for nosocomial infection surveillance in this population and a need to implement infection control measures, such as infection control programmes including surveillance of nosocomial infections.     

Prevalence and predictors of influenza vaccination among residents of long-term care facilities

Influenza is a respiratory illness which results in significant morbidity and mortality, especially in the older population. Older people living in Long-Term Care Facilities (LTCFs) have a significantly higher risk of infection and complications from influenza. Influenza vaccine is considered the best strategy to prevent infection in high-risk populations. In Australia, the Communicable Diseases Network Australia (CNDA) suggests a vaccination coverage rate of 95% in both staff and residents¹. This study aims to measure the vaccination coverage rates for residents in LTCFs and identify predictors of vaccination uptake for these individuals.This study was conducted in nine LTCFs in four sites from March to September 2018. This was done via medical record reviews for residents over 65 years old in these LTCFs, collecting information such as vaccination status, age, gender, ethnicity and occupation. Simple and multivariable logistic regression was used to calculate the Odds Ratio (OR) to determine significant predictors of influenza vaccination uptake.The overall vaccination rate among LTCF residents was 83.6%. Significant predictors of vaccination were LTCF location, ethnicity and previous year vaccination status. Residents in LTCF Site D were less likely to be vaccinated compared to Site A (OR 0.11, 95% CI 0.02–0.61), non-Caucasians were less likely to get vaccinated (OR 0.09, 95% CI 0.01–0.67), and residents who refused the 2017 vaccine were less likely to be vaccinated (OR 0.04, 95% CI 0.01–0.15).Compared with previous Australian studies on LTCF vaccination rates, the overall vaccination rate was high in these LTCFs (83.6% versus 66–84%), but it varied across different sites. Reasons for varying vaccination rates should be explored further – for example, lower rates in non-Caucasians with diverse cultural backgrounds. Better understanding the causes of under-vaccination can help improve vaccination programs in LTCFs.     

Creating a dementia-friendly environment through the use of outdoor natural landscape design intervention in long-term care facilities: A narrative review

There is an increasing volume of literature on the positive effects of outdoor natural landscapes on health and well-being. However, to date, there is a paucity of research on the effect of outdoor natural landscapes designed for people with dementia living in long-term care (LTC) facilities, in particular, those which have incorporated the characteristics of a dementia-friendly environment (DFE). This narrative literature review synthesizes current knowledge on the effect of outdoor natural landscape design, which is aligned with the characteristics of a DFE, to improve agitation, apathy and engagement of people with dementia living in LTC facilities. The reviewed studies predominantly support the positive effects of outdoor natural landscapes on agitation, apathy and engagement of people with dementia. However, there are concerns about the methodological approaches, principles incorporated in the applied outdoor natural landscapes' designs, and the environmental assessment. Further rigorous research is required to understand the impact of the outdoor natural landscapes, with the application of DFE characteristics in the design, on agitation, apathy and engagement of people with dementia living in LTC facilities.     

Plan for the control of Legionella infections in long-term care facilities: role of environmental monitoring

In accordance with the international and national guidelines, the Emilia-Romagna Region (Italy) has established regional guidelines for the surveillance and prevention of legionellosis based on the concept of risk assessment, with particular attention to environmental monitoring. The aim of this study was to verify how environmental surveillance in the context of risk assessment plans could help to guide decisions about preventive strategies against Legionella infections in Long Term Care Facilities (LTCF). In six LTCFs in the city of Bologna (Emilia-Romagna Region) a self-control plan was implemented that included the environmental monitoring of Legionella spp. and the surveillance of hospital-acquired Legionnaires' Disease. At baseline, four hot water systems were colonized by Legionella pneumophila (3 LCTFs) and Legionella londiniensis (1 LCTF). In each establishment specific control measures were adopted based on the characteristics of the system, the virulence of the strain and the level of the contamination. The monitoring, carried out for around two years, was also extended to the ways in which the system and the distal water distribution points were used and maintained with respect to the good practices in operation and management. The adopted actions (shock and/or continuous disinfection treatments) and the implementation of the good practice measures reduced the contamination to acceptable and stable levels. No cases of hospital-acquired legionellosis occurred during the period of study. The environmental surveillance was successful in evaluating the risk and identifying the most suitable preventive strategies.     

Subjective quality of life and positive appraisal of care among Japanese family caregivers of older adults

Most family caregiving research has portrayed caregiving as a negative life experience for caregivers, but a broader perspective is necessary to examine its impact on the caregiver quality of life (QL). The role that positive appraisal of care plays in the caregiving experience among Japanese families of older adults was examined in relation to the caregiver's subjective QL. Positive as well as negative appraisal of care was measured by a newly developed multi-dimensional scale, which included the domains of 'relationship satisfaction,' 'role confidence,' 'consequential gain,' 'normative fulfillment' (positive appraisal), 'role exhaustion,' 'isolation,' 'relationship difficulty,' and 'symptom management difficulty' (negative appraisal). Subjective QL was measured by WHO/QL-26. Altogether 337 Japanese family caregivers participated in this survey. Stepwise multiple regression analyses revealed that 'role confidence,' 'normative fulfillment,' and 'role exhaustion' had a significant independent impact on physical QL, while 'role confidence' and 'role exhaustion' on psychological QL. The association of 'normative fulfillment' with physical QL was negative while that of 'role confidence' was positive, despite the positive correlation between the two domains. The results underline the importance of considering positive as well as negative appraisal of care when examining subjective QL of the family caregivers.     

The quality of life of spouse dementia caregivers: changes associated with yielding to formal care and widowhood

The focus of the study was the effect on spouse dementia caregivers of relinquishing care. The study used a longitudinal design, in which a group of 150 dementia caregivers were interviewed 2 years apart (designated Time 1 and Time 2), with data collected from both continuing caregivers and those who had relinquished care. The aims were to determine the extent to which changes over time in quality of life differed between continuing caregivers, those who had yielded to formal care, and those who had been widowed; and to examine whether change in quality of life variables was associated with time since yielding to formal care and time since death of the spouse. Quality of life was defined in terms of health status, psychological well-being, and activity participation. All participants were interviewed in their own homes. Three groups of participants were identified at Time 2: those who continued to provide care for their spouses (n=60); those who had yielded their caregiver role by admitting their spouses to permanent residential care (n=53); and those who had admitted their spouses to permanent institutional care, but whose spouse had then died (n=37). Different patterns of quality of life changes were observed between the three groups, with both positives and negatives associated with disengagement from the caregiving role. Positive changes were particularly evident in psychological well-being and activity participation. These findings were discussed in terms of their relevance for a life transitions approach to the relinquishment of caregiving.