Elderly Patients In Community Research Articles

Adherence to Atrial Fibrillation Better Care (ABC) Pathway Management of Chinese Community Elderly Patients with Atrial Fibrillation: A Cross-Sectional Study.

Investigating adherence to the Atrial Fibrillation Better Care (ABC) pathway management and identifying gaps between the real world and established guidelines can lead to better integrated management of AF. Current data on adherence to ABC pathway management among community elderly patients with atrial fibrillation (AF) in Chinese communities is limited. To investigate the adherence to ABC pathway management among community elderly patients with AF in China. In this cross-sectional study, data were collected from the 2020 National Basic Public Health Service Program database that includes health examination information for all residents >65 years of age in Yuexiu, Guangzhou, Guangdong Province. Demographic and clinical characteristics data from 197 community AF patients were obtained. Among the 197 AF patients, 103 (52.3%) were male, 117 (59.4%) were ≥75 years of age, 127 (64.5%) had a senior middle school education or above, 84.3% were married, and 195 (99.0%) had medical insurance. The most common comorbidities were hypertension (72.1%, 142/197), dyslipidaemia (28.4%, 56/197), CAD (28.9%, 57/197), and diabetes (24.9%, 49/197). In terms of the ABC management pathway, 21.8% (43/197), 82.7% (163/197), and 31.5% (62/197) of AF patients were classified into the A-adherent group, B-adherent group, and C-adherent group, respectively. The level of adherence to ABC pathway management was very low (9.1%, 18/197) and independently associated with age and multimorbidity. The level of adherence to ABC pathway management in community elderly patients with AF was unsatisfactory.Further research is warranted to improve the integrated management of AF.

Students-as-Partners Project for Atrial Fibrillation in Hong Kong Elderly Patients in Community: Prevalence, Knowledge and Risk Factors

Students-as-Partners Project for Atrial Fibrillation in Hong Kong Elderly Patients in Community: Prevalence, Knowledge and Risk Factors

Application of Multidisciplinary Teamwork in Medication Safety Guidance for Elderly Population with Chronic Diseases in Community

[Objective] A randomized controlled trial was conducted to investigate a systematic intervention to improve medication safety among elderly people in the community. [Methods] 150 community elderly patients with chronic diseases were randomly selected and divided into intervention group and control group. In addition to conventional medication safety guidance methods, multidisciplinary team cooperation mode was added to the intervention group. After 2 months of intervention, the knowledge, belief and practice of elderly patients with chronic diseases in the two groups were compared and analyzed. [Results]After intervention, inter-group and intra-group comparison of the intervention results showed that the total scores of knowledge, attitude and behavior KAP of the elderly with chronic diseases in the intervention group were higher than those in the control group, with statistical significance (p < 0.05), and the overall drug safety of the elderly in the community increased from a low level (47.3%) before intervention to a high level (95.8%) after intervention.. [Conclusion] The overall level of medication safety of the elderly in the chronic disease clinic of a town health center in Zhuhai is low. The drug safety guidance program of multidisciplinary team cooperation can effectively improve the medication safety of the elderly with chronic diseases in the community, and has a wide popularization.

Construction and validation of cognitive frailty risk prediction model for elderly patients with multimorbidity in Chinese community based on non-traditional factors

Background and objectivesEarly identification of risk factors and timely intervention can reduce the occurrence of cognitive frailty in elderly patients with multimorbidity and improve their quality of life. To explore the risk factors, a risk prediction model is established to provide a reference for early screening and intervention of cognitive frailty in elderly patients with multimorbidity.MethodsNine communities were selected based on multi-stage stratified random sampling from May–June 2022. A self-designed questionnaire and three cognitive frailty rating tools [Frailty Phenotype (FP), Montreal Cognitive Assessment (MoCA), and Clinical Qualitative Rating (CDR)] were used to collect data for elderly patients with multimorbidity in the community. The nomogram prediction model for the risk of cognitive frailty was established using Stata15.0.ResultsA total of 1200 questionnaires were distributed in this survey, and 1182 valid questionnaires were collected, 26 non-traditional risk factors were included. According to the characteristics of community health services and patient access and the logistic regression results, 9 non-traditional risk factors were screened out. Among them, age OR = 4.499 (95%CI:3.26–6.208), marital status OR = 3.709 (95%CI:2.748–5.005), living alone OR = 4.008 (95%CI:2.873–5.005), and sleep quality OR = 3.71(95%CI:2.730–5.042). The AUC values for the modeling and validation sets in the model were 0. 9908 and 0.9897. Hosmer and Lemeshow test values for the modeling set were χ2 = 3.857, p = 0.870 and for the validation set were χ2 = 2.875, p = 0.942.ConclusionThe prediction model could help the community health service personnel and elderly patients with multimorbidity and their families in making early judgments and interventions on the risk of cognitive frailty.

Mediation Effect of Self-Efficacy Between Health Beliefs and Glycated Haemoglobin Levels in Elderly Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study.

To explore the mediating effect of self-efficacy in the relationship between glycated haemoglobin (HbA1c) levels and health beliefs in community elderly patients with type 2 diabetes. From January to March 2022, convenience sampling was adopted to investigate 200 elderly patients with type 2 diabetes in a community in Yangzhou, China. Data were collected using the Health Beliefs Questionnaire, Self-efficacy for Diabetes, and Medication Compliance Questionnaire. Laboratory parameters included HbA1c, fasting blood glucose, postprandial blood glucose, total cholesterol, triglyceride, high-density-lipoprotein cholesterol, and low-density-lipoprotein cholesterol levels. Correlation, linear regression, and mediation analyses were performed using SPSS 27.0. HbA1c levels were higher in men (women vs men: 6.80% [6.08%, 7.73%] vs.7.30% [6.30%, 9.18%]) and employed (employed vs not employed vs retired: 7.60% [6.90%, 10.45%] vs 5.85% [5.40%, 6.95%] vs 7.10% [6.20%, 8.20%]) and low self-efficacy (low vs high: 13.1% [6.55%, 13.85%] vs 6.8% [6.10%, 7.70%]). HbA1c levels were negatively associated with health beliefs (r = -0.246) and self-efficacy (r = -0.240; p<0.01). Linear regression showed that perceived susceptibility, severity, benefit, and barriers, cues to action, and self-efficacy explained 50% of the variance in HbA1c levels after adjusting for sex and current work status. The mediation effect of self-efficacy was partial between health beliefs and HbA1c levels and accounted for 24.65% of the total effect (p < 0.001). Health beliefs influenced the improvement of self-efficacy in older patients with type 2 diabetes mellitus, which in turn could improve HbA1c control. Self-efficacy plays a partial mediating role between health beliefs and Hba1c levels in elderly patients with type 2 diabetes.

Application Effect of Meticulous Nursing on Community Elderly Patients with Coronary Heart Disease under the Background of Medical Treatment Partnerships.

Objective To explore the application effect of meticulous nursing on community elderly patients with coronary heart disease (CHD) under the background of medical treatment partnerships. Methods A total of 96 elderly CHD patients treated in the community from July 2019 to July 2020 were selected as the research objects and divided into the experimental group (n = 48) and control group (n = 48) by the medical personnel according to their admission order. Clinical routine nursing was performed to the patients in the control group, and meticulous nursing under the background of medical treatment partnerships was conducted to the patients in the experimental group, so as to evaluate their quality of life (QOL) and self-care agency after intervention by the Chinese Questionnaire on Quality of Life in Patients with Cardiovascular Disease (CQQC) and Exercise of Self-Care Agency (ESCA) scale. Results Compared with the control group after intervention, the patients in the experimental group presented significantly higher ESCA scores, HHI scores, and CQQC scores and longer 6 min walking distance (P < 0.001) and remarkably lower POMS scores (P < 0.001) and had obviously higher numbers of cases with various health-related actions (P < 0.05). Conclusion Meticulous nursing under the background of medical treatment partnerships is a reliable method for improving the QOL and mood state of community elderly CHD patients, which greatly promotes patients' self-care agency and expectation. Further research will be conducive to establishing a better solution for patients.

Application of General Nursing Model in Community Elderly Patients with Chronic Diseases

Application of General Nursing Model in Community Elderly Patients with Chronic Diseases

Effect of Valsartan Combined with Amlodipine on Community Elderly Patients with Essential Hypertension Complicated with Diabetes

Effect of Valsartan Combined with Amlodipine on Community Elderly Patients with Essential Hypertension Complicated with Diabetes

A nonlinear association between resting heart rate and ischemic stroke among community elderly hypertensive patients

ABSTRACT Background: Ischemic stroke is a major public health problem and a main cause of death in China. However, how resting heart rate may associate with ischemic stroke among patients with hypertension remains unclear. Objective: To investigate the association between resting heart rate and ischemic stroke among elderlies with hypertension in China. Methods: We conducted a retrospective study of elderlies with hypertension who aged ≥60 years and were free from a stroke at baseline. Resting heart rate at baseline was treated as both continuous and categorical variable. Hazard ratios for ischemic stroke were estimated by multivariate Cox proportional hazards models. Results: A total of 3071 elderlies with hypertension [1369 (44.6%) men, an average age of 71.3 ± 7.1 years] were enrolled, and 182 cases of ischemic stroke occurred during a mean follow-up period of 5.5 years. Multivariate Cox regression showed that every 10 bpm increment in resting heart rate elevated the risk of ischemic stroke by 21% (95%CI: 1.05, 1.73; P = 0.018). After adjusting for confounders, resting heart rate ≥90 bpm significantly associated with the risk of ischemic stroke (HR: 1.35, 95% CI = 1.16, 2.78) when using the resting heart rate <60 bpm as a referent. Subgroup analysis showed that the relation between resting heart rate and risk of ischemic stroke was seem to be stronger in female (HR: 1.32 vs 1.11), those with uncontrolled hypertension (HR: 1.32 vs 1.12), people with combined diabetes and hypertension (HR: 1.31 vs 1.12), people with overweight (HR: 1.39 vs 1.02) and those who aged >75 (HR: 1.33 vs 1.11). Smoothing spline plots suggested the optimal resting heart rate for the lowest risk of ischemic stroke was between 60 and 80 bpm. Conclusions: In Chinese elderly hypertensive patients, elevated resting heart rate was an independent predictor of ischemic stroke, and the optimal resting heart rate was around 70 bpm.

Effectiveness of group visits for elderly patients with type 2 diabetes in an urban community in China

The purpose of this study is to evaluate the effectiveness of a group visit intervention in comparison with the usual care for elderly patients with type 2 diabetes in a community. We randomized 109 community elderly patients with type 2 diabetes to the intervention group (n = 55) of monthly group visits sessions or to a control group (n = 54) of usual care. Repeated measures analysis of variance was used to compare the changes in HbA1C, diabetes knowledge, self-efficacy, and self-management behavior in both groups. At the 6-month follow-up, although no significant difference was observed between the groups regarding HbA1C (p = 0.272). Diabetes knowledge, self-efficacy and self-management scores were higher in patients in the intervention group than that in the control group (p < 0.05). The group visits model increased diabetes knowledge and self-efficacy and improved patients’ self-management behavior. The model was found suitable for helping these elderly patients with type 2 diabetes achieve effective self-management.

A WeChat-Based Self-Management Intervention for Community Middle-Aged and Elderly Adults with Hypertension in Guangzhou, China: A Cluster-Randomized Controlled Trial.

This study aimed to assess whether a WeChat-based self-management intervention would be effective for community middle-aged and elderly adults with hypertension in Guangzhou, China. We conducted a cluster-randomized control trial with a total of 464 participants (intervention, n = 186; control, n = 276) between March 2018 and May 2019. The self-management intervention lasted for 6 months, consisting of health education, health promotion, group chat, and blood pressure (BP) monitoring. All individuals in the baseline and follow-up surveys were assessed for BP and completed a hypertension knowledge questionnaire, self-efficacy scale, self-management scale, and social support scale. A total of 253 participants (intervention, n = 110; control, n = 143) completed the follow-up survey and were included in the analysis. The adjusted mean differences in the changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the intervention and control groups were −6.9 (95% Confidence Interval (CI) −11.2 to −2.6; p = 0.002) and −3.1 (95% CI −5.7 to −0.6; p = 0.016) mmHg, respectively. Individuals who participated in the intervention program had better BP monitoring, improved their hypertension self-management as well as parts of their disease knowledge and self-efficacy. The WeChat-based self-management intervention may be a feasible and efficient program to help Chinese community middle-aged and elderly hypertensive patients lower BP and improve self-management.

Relationship between triglyceride levels and ischaemic stroke in elderly hypertensive patients

BackgroundAlthough hyperlipidaemia was a well-known risk factor for ischaemic stroke, the association between triglyceride and first ischaemic stroke remains uncertain.ObjectivesThe present study attempted to explore the relationship between triglyceride and...

Analysis of the research hotspots of traditional Chinese medicine nursing of diabetes mellitus based on data mining and co-word analysis

Objective To understand and analyze the research status of traditional Chinese medicine nursing for diabetes mellitus, and to provide reference for its clinical application and research direction. Methods China Journal Full Text Database (CNKI) , VIP database and WanFang Database were searched to get the relevant articles on diabetes Traditional Chinese medicine nursing published from the establishment date to December 2018. Data mining and keyword clustering analysis were used to analyze the literature features and research hotspots. Results Finally, 1 963 articles related to traditional Chinese medicine nursing of diabetes mellitus were included, and 2 389 keywords and 27 high frequency keywords were obtained. Bibliometric analysis showed that the amount of relevant research fluctuated and increased year by year. Cluster analysis result revealed that the research of traditional Chinese medicine nursing of diabetes mainly focused on the nursing of elderly patients in community, the nursing of diabetic complications, the application of traditional Chinese medicine nursing technology and the evaluation of traditional Chinese medicine nursing program. Conclusions Diabetes traditional Chinese medicine nursing has made some progress in the traditional field, but the expansion and innovation of the research still need to be strengthened. In the later stage, we should attach importance to the exploration of talent training mode, encourage the development of basic theory and interdisciplinary exchanges and cooperation, adhere to the combination of inheritance and innovation, and improve the scientific nature of diabetes traditional Chinese medicine nursing. Key words: Diabetes; Bibliometrics; Traditional Chinese Medicine nursing; Cluster analysis; Research hotspots

Relationship among depression, anxiety and social support in elderly patients from community outpatient clinic

Objective To explore the relationship among depression, anxiety and social support in elderly patients in community outpatient clinic. Methods A total of 551 elderly outpatients from two community health service centers of Hongkou District in Shanghai were evaluated with patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7), perceived social support scale(PSSS) for depression, anxiety, physical health and social support. Results The prevalence rates of depression and anxiety were 26.1% and 17.2%, respectively. The scores of PHQ-9 and GAD-7 were 2.0(4.0) and 1.0(2.0). There were statistically significant differences in the scores of family support, friend support, other support and social support among the elderly patients with different degrees of depression or anxiety (P<0.01). Family support(B=-0.196) and friend support(B=-0.171) were protective factors of depression in elderly patients in community outpatient clinic.Age, family support and friend support were protective factors of anxiety in elderly patients, while gender and fluctuation of physical diseases were protective factors of anxiety(P<0.05). Conclusions The depression and anxiety is intimately related to social support in elderly outpatients. Appropriate measures should be taken to optimize social support, mitigate bad mood negative improve their quality of life. Key words: Elderly outpatients; Depression; Anxiety; Social support

Depression of community elderly patients with mild cognitive impairment and its influencing factors

Objective To investigate the depression of community elderly patients with mild cognitive impairment (MCI) and to analyze its influencing factors so as to provide a basis for relieving the depression and delaying the conversion of MCI among elderly patients to dementia. Methods From December 2016 to March 2018, we selected 1 093 community elderly people (≥60 years old) complained of cognition hypofunction by convenience sampling. All of the aged were investigated with the general information questionnaire, Peking Union Medical College Hospital Version of Montreal Cognitive Assessment (MoCA-P) and Activities of Daily Living (ADL) . Outpatient doctors of neurology department at a ClassⅢ Grade A hospital in Beijing provided clinical diagnosis for elderly patients with primary screening of MCI. The Geriatric Depression Scale-30 (GDS-30) was used to assess depression of MCI patients. SPSS 21.0 was used to the date entry and statistical analysis, and multiple Logistic regression was used to analyze the influencing factors of depression. Results A total of 271 community elderly people were diagnosed as MCI. After excluding 30 depression assessment questionnaires with glaring holes and regularity, a total of 241 valid questionnaires were collected finally with 88.93% for the effective rate. Among 241 community elderly patients with MCI, 71 cases of them were with depression and the incidence was 29.46%; the score of depression was (15.99±4.31) ; a total of 59 cases (83.10%) of them had the moderate depression and 12 cases (16.90%) had severe depression. Multiple Logistic regression analysis showed that the risk factors of depression included insomnia (OR=2.09) , negative emotions such as anxiety or agitation (OR=6.25) , recent major events (OR=3.93) and poor ADL (OR=1.45) , the protective factors of depression included ages of over 80 years (OR=0.29) compared with the ages from 60 to 65 years among elderly MCI patients. Conclusions The incidence of elderly MCI patients with depression is high. Based on comprehensive evaluation for elderly MCI patients, nurses should pay attention to their depression emotions and help patients to improve sleep and ADL, and help them positively deal with negative influences brought by major events. Key words: Aged; Mild cognitive dysfunction; Depression; Cognition; Activity of daily living; Influencing factors

The Life Experiences of Community Older Adults With Mental Illness in Taiwan: A Qualitative Study

Aims: The risk of mental illness and mental health problems is known to increase with aging, there is a continuing need for research and information about the daily life and care needs of elderly people with mental illness. The aim of this study was to examine the real-life experience of elderly outpatients with mental illnesses in Taiwan communities through in-depth interviews.Methods: A qualitative study involving semi-structured interviews of mentally ill elderly patients was conducted in 15 participants (3 men and 12 women, mean age = 74.67 years, SD = 10.04 years).Results: The willpower to survive and cope with aging and mental health problems was identified as the core category of the life experiences in the older adults in this study. The struggle with the stress of aging and mental health problems was categorized in life-experience terms as ‘bear the bitterness of life,’ ‘adhere to psychiatric treatment and use resources to cope with life’s stress,’ ‘maintain the willpower to survive’. Results of this study shown that although elderly patients in community have had many stressful life experiences and problems with mental illness, they will continue to show strength to coping with the problems of aging and mental illnesses.Conclusions: The elderly mental illness patients could coping with their problems, and maintain an active lifestyle, accept the reality and arrange life, and connect with the community. Therefore, health professionals should help elderly people find new strategies to maintain their mental health and to function in their communities.

The rehabilitation services current situation and reference of developed countries in elderly patients with tumor

The tumor is a kind of age-related chronic diseases. Nearly 60% tumors appear in 65 years or older. With the growth of elderly population and worsen of environment. There is an upward trend in elderly patients with tumor. Most of patients with tumor, their subsequent treatment, rehabilitation or end-stage care outside the hospital. Rely on the community′s long-term rehabilitation services at home. However, due to various factors, limit the elderly patients with physical and mental needs. Unmet effective needs. This paper is based on extensive researching and reading lots of literature, to summarize and analyze the rehabilitation services between the elderly patients with tumor at the present stage, in order to attract attention to community elderly patients with tumor at home, further improve the service system and quality of life for the elderly patient with tumor. Key words: Geriatric oncology; Comprehensive evaluation; Rehabilitation service

Correlation between medication compliance and social relational quality of elderly patients with hypertension in community

Objective To investigate current status and correlation between medication compliance and social relational quality of elderly patients with hypertension in community and to provide reference for intervention on chronic disease in community. Methods Totally 300 elderly patients with hypertension in Beihu Nanmian Community, Xixiangtang District, were recruited by convenience sampling method. Social relational quality scale (SRQS) and Morisky questionnaire were applied to investigate their social relational quality and medication compliance. Results The score of social relational quality was (48.45±5.48) , and the score of medication compliance was (10.45±2.71) . There was a significant difference in the score of medication compliance among patients with different education level and monthly income (P<0.05) . Education level, monthly income, and social relational quality were positively correlated with medication compliance of community elderly patients with hypertension (β’=0.349, 0.376, 0.411; P<0.05). Conclusions Elderly patients with hypertension in community with higher social relational quality tend to have a better medication compliance. Key words: Aged; Hypertension; Community; Medication compliance; Social relational quality

Investigation and analysis on risk factors of falls and balance force in elderly patients with orthostatic hypotension in community

Objective To investigate the risk factors of falls and balance force in community elderly patients with orthostatic hypotension, so as to prevent from fall risk. Methods The elderly fall risks assessment tool and the elderly balance force test table were investigated in community elderly patients with orthostatic hypotension in community. Results The average score in fall risk assessment of 189 elderly patients with orthostatic hypotension in community was (6.78±5.49) and the average score in balance ability was (5.42±5.23) , and there were statistically significant differences in occupation, gender and marital status (P<0.05) .The fall risk assessment was positively correlated with the balance ability (r=0.637, P< 0.01) . Conclusions The elderly patients with orthostatic hypotension in community have a higher risk of falls and balance problems, so the community should carry out comprehensive measures to improve the environment of community and home, strengthen the balance ability training, and reduce the risk of falls. Key words: Elderly; Hypotension, orthostatic; Accidental falls; Balance ability

Status and related factors of chronic functional constipation in community elders

Objective To investigate the status and related factors of chronic functional constipation in community elders. Methods Totally 892 elders of 11 communities at Lucheng district of Wenzhou from August 2013 to December 2015 were investigated by sample survey; methods as household survey, survey in community public health station and outpatient survey, etc. were used to develop a unified questionnaire to collect information. The chronic functional constipation was evaluated by Rome III diagnostic criteria, and statistical processing was analyzed by single-factor analysis and multi-factor logistic regression analysis. Results Totally 257 elders acquired functional constipation, and the morbidity was 28.81%, and bowel movements were less than 3 times per week. Defecation laborious and poor stool were the main symptoms of functional constipation in elders. Independent risk factors of functional constipation in community elderly patients were: too much meat intake, few vegetables and fruit intake, drinking little water, few daily activities and depression (P<0.05). Conclusions Eating habits of partial fine diet fatness, little fiber and water intake, little exercise etc. and depression are closely related to chronic functional constipation in community elderly patients. Key words: Constipation; Elders; Risk factors; Investigation