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5 results on '"geriatric nursing home"'

1. Boendes upplevelser av sexualitet inom äldrevården

Author

Laurell, Emma, Rocking Johansson, Nora, Laurell, Emma, and Rocking Johansson, Nora

Abstract

INTRODUKTION/BAKGRUND Sexualiteten är en grundläggande rättighet och central del genom livet som påverkar individens välbefinnande. Det är därav av värde att hälso- och sjukvårdspersonal inom äldrevården innehar kunskap i boendes upplevelser av sexualitet för att främja ett gott välbefinnande. SYFTE Att studera boendes upplevelser av sexualitet inom äldrevården. METOD Litteraturöversikt med beskrivande design, baserad på tio originalartiklar med kvalitativa studier. Litteratursökning genomfördes i databaserna PubMed och CINAHL. Artiklarna kvalitetsgranskades genom SBU:s mall för Bedömning av studier med kvalitativ metodik och resultatanalyserades enligt Fribergs analysmodell. Kari Martinsens omvårdnadsteori utgjorde arbetets teoretiska referensram. RESULTAT Många boende inom äldrevården ser sin sexualitet som en viktigt del i livet, medan andra har lämnat det sexuella livet bakom sig. Äldrevårdens utformning, brister i kommunikation gällande sexualitet och negativa attityder hör till faktorer som begränsar det sexuella uttrycket. Fyra kategorier identifierades - Skilda upplevelser av sexualitet, Sexuell autonomi och integritet, Bristande kommunikation och kunskap samt Upplevelser av attityder från personal och andra boende - med totalt åtta subkategorier. SLUTSATS Äldrevårdens sociala och fysiska miljö samt vårdpersonalens kunskapsbrist gällande sexualitet begränsar den boendes möjlighet till sexuella uttryck. En bredare förståelse och kunskap bör finnas hos hälso- och sjukvårdspersonal för att kunna identifiera och bemöta boendes sexuella behov., INTRODUCTION/BACKGROUND Sexuality is a fundamental right and central part throughout life that affects the individual's well-being. It is therefore of value that healthcare professionals within geriatric nursing homes have knowledge of residents' experiences of sexuality in nursing homes, in order to promote good well-being. AIM To examine residents’ experiences of sexuality in geriatric nursing homes. METHOD Literature overview with descriptive design, based on ten original articles with qualitative studies. Literature search was performed in the databases PubMed and CINAHL. The articles were quality audited through SBU’s quality assessment template for qualitative methodology and analyzed according to Friberg’s analysis model. The theoretical frame of reference for the work was Kari Martinsen’s nursing theory. RESULTS Many residents in geriatric care sees their sexuality as an important part of life, while others have left their sexual life behind. The design of the nursing home, deficiencies in communication regarding sexuality and negative attitudes are among the factors that limit the sexual expression. Four categories were identified - Different experiences of sexuality, Sexual autonomy and integrity, Lack of communication and knowledge and Experience of attitudes from staff and other residents - with a total of eight subcategories. CONCLUSION The nursing home's social and physical environment as well as the care staff's lack of knowledge regarding sexuality limits the resident's opportunity for sexual expression. A broader understanding and knowledge should be available among healthcare professionals in order to be able to identify and respond to the residents sexual needs.

Published
2022

2. Studies on simple and easy-to-use remote control system for robot assisted rehabilitation

Subjects
toy, RAT, robot, RAA, wireless LAN, server system, rehabilitation, geriatric nursing home
Abstract

Trial studies of the application of the robotic dog AIBO to rehabilitation are ongoing at geriatric hospitals and nursing homes. In this study, several remote control systems of AIBO have been developed for the purpose of bringing out the patient's positiveness in the robot assisted rehabilitation. Two kinds of system were developed. One is simple and easy-to-use control system that can be used by the therapist during rehabilitation treatment. The therapist can control AIBO while they care the patients. The other is the system that can be used by the patients themselves. In this case, steering method of AIBO should be much more simple and easy. As the interface device, we used the touch panel and the balance board which is sold as the interface device of TV action game. The patient pushes or strokes on the touch panel by the finger. The coordinates of the finger is sent to the control sever, then converted to be a control code and sent to AIBO through the wireless LAN. In the case of the balance board, the patient gets on the board and moves their center of gravity by swaying the body. Using four pressure sensors located at the corner of the board the center of gravity was calculated and used as control signal. The control server logs the real time coordinates and calculated results in the csv form that can be analyzed later. The developed system has some of the element of play or game and is easy to be a part of the daily recreation in the geriatric nursing home. Fun with steering the robot improves their positiveness in rehabilitation exercise.

Published
2010

3. Falls prevention for the elderly

Author

Dagmar Lühmann, Susanne Schramm, Martina Bremer, Katrin Balzer, and Heiner Raspe

Subjects
sight, economic evaluation, visual acuity, diagnosis, fall prophylaxis, eigene Häuslichkeit, TECHNOLOGY ASSESSMENT, BIOMEDICAL, Risikoabschätzung, Sehschärfenprüfung, falling consequences, environment design, accidents, home, prevention, randomisierte kontrollierte Studie, RISK ASSESSMENT, DIAGNOSTIK, Motorik, dose-response relationship, drug, geriatric nursing home, Vorsorge, aged/*psychology, Ältere, lcsh:R723-726, ACCIDENTAL FALLS, freiheitsentziehende Maßnahmen, DIETARY SUPPLEMENTS, Prophylaxe, Visusprüfung, HTA, review literature as topic, Health Technology Assessment, Übersichtsliteratur, HÜFTFRAKTUREN, 610 Medical sciences, Medicine, eyesight, meta-analysis as topic, adjustment of the living environment, MOTOR SKILLS, hip protectors, lcsh:R855-855.5, Diagnose, hip fracture, RISK FACTORS, customisation of the living environment, multi-factorial programs, geriatrisches Pflegeheim, humans, interventions, Umweltgestaltung, Senioren, evidenzbasierte Medizin, primäre Prävention, randomisierte kontrollierte Studien, Risikofaktoren, lcsh:Medical technology, motor activity/drug effects, Risiko-vermeidendes Verhalten, fall, fall risk, medical adjustment, private domesticity, eye test, Medikationsanpassung, Metaanalyse, biomedical, Hüftprotektoren, dose-response relationship, Article, NAHRUNGSERGÄNZUNGSMITTEL, aged, multimodal programs, DOSIS-WIRKUNGSBEZIEHUNG, ARZNEIMITTEL, gutachterbasierte Medizin, alte Menschen/*Psychologie, motor activity, Sturzfolgen, technology assessment, Krankenpflegeheime, systematische Übersicht, randomized controlled trial, Kataraktchirurgie, UNFALLBEDINGTE STÜRZE, lcsh:Medical philosophy. Medical ethics, PRIMARY PREVENTION, Sehschärfe, eyesight test, Technologiefolgenabschätzung, biomedizinische, EVIDENCE-BASED MEDICINE, VITAMIN D/ADMINISTRATION & DOSAGE, Sturz, randomized controlled trials as topic, nursing homes, power of movement, exercise program, Vitamin D/administration & dosage, FREEDOM, Sturzprophylaxe, systematic review, Übungsprogramm, HIP FRACTURES, correction of the visual acuity, home, Hüftfraktur, training program, alte Menschen, Interventionen, motor function, drug, HUMANS, motorische Aktivität/Arzneimittelwirkungen, ACTIVITIES OF DAILY LIVING, cataract surgery, fall prevention, Sturzgefährdung, MOTORISCHE GESCHICKLICHKEIT, multifaktorielle Programme, Unfälle, Haushalts, ddc: 610, prophylaxis, RISK REDUCTION BEHAVIOR, Seniorenheime, EXERCISE/PHYSIOLOGY, motorische Funktionen, RCT, EBM, TECHNIKFOLGEN-ABSCHÄTZUNG, BIOMEDIZINISCHE, systematisches Review, accidents, Fraktur, ökonomische Evaluation, Sturzrisiko, Aktivitäten des täglichen Lebens, Prävention, elderly, seniors, Mensch, HOMES FOR THE AGED, Freiheit, MOTORISCHE AKTIVITÄT, Visuskorrektur, GUTACHTENBASIERTE MEDIZIN, fall-related injuries, Sturzrisikofaktoren, Vitamin D/Verabreichung & Dosierung, Visus, fracture, fall risk factors, stabilisierend, falling danger, sturzbedingte Verletzung, freedom-depriving measures, stabilized, multimodale Programme, Training, körperliches/Physiologie, Anpassung der Wohnumgebung
Abstract

Background An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagnostic procedures for identifying individuals at risk of falling to complex interventions for the removal or reduction of identified risk factors. However, the clinical and economic effectiveness of the majority of recommended strategies for fall prevention is unclear. Against this background, the literature analyses in this HTA report aim to support decision-making for effective and efficient fall prevention. Research questions The pivotal research question addresses the effectiveness of single interventions and complex programmes for the prevention of falls and fall-related injuries. The target population are the elderly (> 60 years), living in their own housing or in long term care facilities. Further research questions refer to the cost-effectiveness of fall prevention measures, and their ethical, social and legal implications. Methods Systematic literature searches were performed in 31 databases covering the publication period from January 2003 to January 2010. While the effectiveness of interventions is solely assessed on the basis of randomised controlled trials (RCT), the assessment of the effectiveness of diagnostic procedures also considers prospective accuracy studies. In order to clarify social, ethical and legal aspects all studies deemed relevant with regard to content were taken into consideration, irrespective of their study design. Study selection and critical appraisal were conducted by two independent assessors. Due to clinical heterogeneity of the studies no meta-analyses were performed. Results Out of 12,000 references retrieved by literature searches, 184 meet the inclusion criteria. However, to a variable degree the validity of their results must be rated as compromised due to different biasing factors. In summary, it appears that the performance of tests or the application of parameters to identify individuals at risk of falling yields little or no clinically relevant information. Positive effects of exercise interventions may be expected in relatively young and healthy seniors, while studies indicate opposite effects in the fragile elderly. For this specific vulnerable population the modification of the housing environment shows protective effects. A low number of studies, low quality of studies or inconsistent results lead to the conclusion that the effectiveness of the following interventions has to be rated unclear yet: correction of vision disorders, modification of psychotropic medication, vitamin D supplementation, nutritional supplements, psychological interventions, education of nursing personnel, multiple and multifactorial programs as well as the application of hip protectors. For the context of the German health care system the economic evaluations of fall prevention retrieved by the literature searches yield very few useful results. Cost-effectiveness calculations of fall prevention are mostly based on weak effectiveness data as well as on epidemiological and cost data from foreign health care systems. Ethical analysis demonstrates ambivalent views of the target population concerning fall risk and the necessity of fall prevention. The willingness to take up preventive measures depends on a variety of personal factors, the quality of information, guidance and decision-making, the prevention program itself and social support. The analysis of papers regarding legal issues shows three main challenges: the uncertainty of which standard of care has to be expected with regard to fall prevention, the necessity to consider the specific conditions of every single case when measures for fall prevention are applied, and the difficulty to balance the rights to autonomous decision making and physical integrity. Discussion and conclusions The assessment of clinical effectiveness of interventions for fall prevention is complicated by inherent methodological problems (esp. absence of blinding) and meaningful clinical heterogeneity of available studies. Therefore meta-analyses are not appropriate, and single study results are difficult to interpret. Both problems also impair the informative value of economic analyses. With this background it has to be stated that current recommendations regarding fall prevention in the elderly are not fully supported by scientific evidence. In particular, for the generation of new recommendations the dependency of probable effects on specific characteristics of the target populations or care settings should be taken into consideration. This also applies to the variable factors influencing the willingness of the target population to take up and pursue preventive measures. In the planning of future studies equal weight should be placed on methodological rigour (freedom from biases) and transferability of results into routine care. Economic analyses require input of German data, either in form of a “piggy back study“ or in form of a modelling study that reflects the structures of the German health care system and is based on German epidemiological and cost data., GMS Health Technology Assessment; 8:Doc01; ISSN 1861-8863

Published
2012

4. Falls prevention for the elderly

Author

Balzer, K, Bremer, M, Schramm, S, Lühmann, D, Raspe, H, Balzer, K, Bremer, M, Schramm, S, Lühmann, D, and Raspe, H

Abstract

Background An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagnostic procedures for identifying individuals at risk of falling to complex interventions for the removal or reduction of identified risk factors. However, the clinical and economic effectiveness of the majority of recommended strategies for fall prevention is unclear. Against this background, the literature analyses in this HTA report aim to support decision-making for effective and efficient fall prevention. Research questions The pivotal research question addresses the effectiveness of single interventions and complex programmes for the prevention of falls and fall-related injuries. The target population are the elderly (> 60 years), living in their own housing or in long term care facilities. Further research questions refer to the cost-effectiveness of fall prevention measures, and their ethical, social and legal implications. Methods Systematic literature searches were performed in 31 databases covering the publication period from January 2003 to January 2010. While the effectiveness of interventions is solely assessed on the basis of randomised controlled trials (RCT), the assessment of the effectiveness of diagnostic procedures also considers prospective accuracy studies. In order to clarify social, ethical and legal aspects all studies deemed relevant with regard to content were taken into consideration, irrespective of their study design. Study selection and critical appraisal were conducted by two independent assessors. Due to clinical heterogeneity of the studies no meta-analyses were performed. Results Out of 12,000 references retrieved by literature searches, 184 meet the inclusion criteria. However, Hintergrund Vor dem Hintergrund des demografischen Wandels, der wachsenden Zahl chronischer Erkrankungen sowie der Verpflichtung, die zunehmend knapper werdenden Ressourcen angemessen einzusetzen, gewinnt die Vorbeugung von schweren Gesundheitseinschränkungen und Pflegebedürftigkeit im Alter an Bedeutung. Das Spektrum der Maßnahmen, die zur Verhinderung von Stürzen und den daraus resultierenden Verletzungen eingesetzt werden, ist breit. Es reicht von Testverfahren zur Erkennung sturzgefährdeter Personen bis zu komplexen Interventionen zur Beseitigung erkannter Risikofaktoren. Die Wirksamkeit und Wirtschaftlichkeit vieler empfohlener Maßnahmen sind dabei unklar. Vor diesem Hintergrund soll die im vorliegenden Health Technology Assessment (HTA) durchgeführte Literaturanalyse dazu beitragen, über einen rationalen und effizienten Einsatz von Ressourcen zu entscheiden. Fragestellungen Die zentrale Berichtsfragestellung befasst sich mit den Effekten sowohl von Einzelmaßnahmen als auch von komplexen Programmen zur Sturzprophylaxe auf die Sturzhäufigkeit und die Häufigkeit sturzassoziierter Verletzungen bei älteren (> 60 Jahre), in ihrer häuslichen Wohnumgebung oder im Pflegeheim lebenden Menschen. Weitere Fragestellungen behandeln die Kosteneffektivität sturzprophylaktischer Maßnahmen sowie deren ethische, soziale und juristische Implikationen. Methodik Die systematische Literaturrecherche umfasst 31 Datenbanken und den Suchzeitraum von Januar 2003 bis Januar 2010. Die Bewertung der Effektivität von Interventionen wird ausschließlich auf der Grundlage von randomisierten kontrollierten Studien (RCT) vorgenommen, für die Untersuchung der Effektivität diagnostischer Strategien werden außerdem prospektive Studien zur diagnostischen Genauigkeit berücksichtigt. Zur Beantwortung der ethischen, sozialen und juristischen Fragen werden inhaltlich relevante Studien unabhängig vom Design, juristische Dokumente und Kommentare sowie Positionspapiere herangezogen. Die Auswahl und kritisc

Published
2012

5. Falls prevention for the elderly.

Author

Balzer K, Bremer M, Schramm S, Lühmann D, and Raspe H

Abstract

Background: An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagnostic procedures for identifying individuals at risk of falling to complex interventions for the removal or reduction of identified risk factors. However, the clinical and economic effectiveness of the majority of recommended strategies for fall prevention is unclear. Against this background, the literature analyses in this HTA report aim to support decision-making for effective and efficient fall prevention., Research Questions: The pivotal research question addresses the effectiveness of single interventions and complex programmes for the prevention of falls and fall-related injuries. The target population are the elderly (> 60 years), living in their own housing or in long term care facilities. Further research questions refer to the cost-effectiveness of fall prevention measures, and their ethical, social and legal implications., Methods: Systematic literature searches were performed in 31 databases covering the publication period from January 2003 to January 2010. While the effectiveness of interventions is solely assessed on the basis of randomised controlled trials (RCT), the assessment of the effectiveness of diagnostic procedures also considers prospective accuracy studies. In order to clarify social, ethical and legal aspects all studies deemed relevant with regard to content were taken into consideration, irrespective of their study design. Study selection and critical appraisal were conducted by two independent assessors. Due to clinical heterogeneity of the studies no meta-analyses were performed., Results: Out of 12,000 references retrieved by literature searches, 184 meet the inclusion criteria. However, to a variable degree the validity of their results must be rated as compromised due to different biasing factors. In summary, it appears that the performance of tests or the application of parameters to identify individuals at risk of falling yields little or no clinically relevant information. Positive effects of exercise interventions may be expected in relatively young and healthy seniors, while studies indicate opposite effects in the fragile elderly. For this specific vulnerable population the modification of the housing environment shows protective effects. A low number of studies, low quality of studies or inconsistent results lead to the conclusion that the effectiveness of the following interventions has to be rated unclear yet: correction of vision disorders, modification of psychotropic medication, vitamin D supplementation, nutritional supplements, psychological interventions, education of nursing personnel, multiple and multifactorial programs as well as the application of hip protectors. For the context of the German health care system the economic evaluations of fall prevention retrieved by the literature searches yield very few useful results. Cost-effectiveness calculations of fall prevention are mostly based on weak effectiveness data as well as on epidemiological and cost data from foreign health care systems. Ethical analysis demonstrates ambivalent views of the target population concerning fall risk and the necessity of fall prevention. The willingness to take up preventive measures depends on a variety of personal factors, the quality of information, guidance and decision-making, the prevention program itself and social support. THE ANALYSIS OF PAPERS REGARDING LEGAL ISSUES SHOWS THREE MAIN CHALLENGES: the uncertainty of which standard of care has to be expected with regard to fall prevention, the necessity to consider the specific conditions of every single case when measures for fall prevention are applied, and the difficulty to balance the rights to autonomous decision making and physical integrity., Discussion and Conclusions: The assessment of clinical effectiveness of interventions for fall prevention is complicated by inherent methodological problems (esp. absence of blinding) and meaningful clinical heterogeneity of available studies. Therefore meta-analyses are not appropriate, and single study results are difficult to interpret. Both problems also impair the informative value of economic analyses. With this background it has to be stated that current recommendations regarding fall prevention in the elderly are not fully supported by scientific evidence. In particular, for the generation of new recommendations the dependency of probable effects on specific characteristics of the target populations or care settings should be taken into consideration. This also applies to the variable factors influencing the willingness of the target population to take up and pursue preventive measures. In the planning of future studies equal weight should be placed on methodological rigour (freedom from biases) and transferability of results into routine care. Economic analyses require input of German data, either in form of a "piggy back study" or in form of a modelling study that reflects the structures of the German health care system and is based on German epidemiological and cost data.

Published
2012
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