Using routine HbA1c measurements in stroke and the associations of dysglycaemia with stroke outcomes

Aims

Diabetes is a major risk factor for stroke. We aimed to investigate the prevalence of diabetes and pre-diabetes within a stroke cohort and examine the association of glycaemia status with mortality and morbidity.

Utilization of medical healthcare among people receiving long‐term care at home or in special accommodation

Scand J Caring Sci; 2010; 24; 404–413
Utilization of medical healthcare among people receiving long‐term care at home or in special accommodation Aim: To investigate the utilization of medical healthcare, hospital care and outpatient care, during a 1‐year period in relation to informal care, multimorbidity, functional status and health complaints and to long‐term care at home or in special accommodation among people aged 65+, with one or more hospital admissions and receiving long‐term care. Method: A total of 694 people receiving long‐term care during the year 2001 were studied. Data were collected by means of the administrative registers Patient Administrative Support in Skåne and PrivaStat and through the study Good Ageing in Skåne. Those at home and those in special accommodation were compared regarding utilization of medical healthcare, informal care, multimorbidity, functional status and health complaints. Multiple logistic regression analysis was performed using at home vs. in special accommodation as the dependent variable and also two multiple linear regression analyses using the number of hospital stays and the number of contacts with the physician in outpatient care separately as dependent variables. Findings: Those at home were significantly younger (mean age: 81 vs. 84 years) and less dependent in personal and instrumental activities of daily living (PADL/IADL) than those in special accommodation. A larger proportion of those at home was admitted to hospital three times or more (21 vs. 14%) and they had significantly more contacts with physicians in outpatient care (md: 10 vs. md: 7). Informal care was associated with care at home (OR = 0.074) and with utilization of outpatient care (B = 2.045). Dependency in PADL was associated with care in special accommodation (OR = 1.375) and with utilization of hospital care (B = ?0.060) and outpatient care (B = ?0.581). Conclusion: Medical healthcare seems more accessible to those who live at home are younger, less dependent and who have access to informal caregivers.     

Sense of coherence among cognitively intact nursing home residents – a five-year longitudinal study

Aim and objectives: To examine how stable the sense of coherence (SOC) is over a five-year period among residents of nursing homes (NH) who are not cognitively impaired and whether components of social support influence SOC.Background: Many studies have investigated the stability of SOC, and the findings have been inconsistent. Social support is a crucial resource in developing SOC. Few researchers have studied the stability of SOC and how various social support dimensions influence changes in SOC among older NH residents who are cognitively intact.Design: The study was prospective and included baseline assessment and five-year follow-up.Methods: The sample comprised 52 cognitively intact NH residents (Clinical Dementia Rating score ≤0.5). We obtained data through direct interviews using the Social Provisions Scale and Sense of Coherence Scale.Results: SOC increased statistically significantly from baseline to follow-up. The social support subdimension reassurance of worth predicted change in SOC after adjustment for sociodemographic factors. When controlled for baseline SOC, attachment was associated with change in SOC, but reassurance of worth was not.Conclusions: The study indicates that the change in SOC over time during the 5 years of follow-up and the social support dimension attachment appear to be important components of change in SOC. Nursing personnel should be aware of the residents’ individual needs for attachment and the importance of emotional support for personal strength and ability to cope.