Elderly Nursing Research Articles

Effect of Gapjil Victim Experience on the Service Quality of Elderly Nursing Facility Workers : Focusing on the Mediating Effect of Leisure Attitudes

Effect of Gapjil Victim Experience on the Service Quality of Elderly Nursing Facility Workers : Focusing on the Mediating Effect of Leisure Attitudes

Timed Up and Go and Six-Minute Walking Tests with Wearable Inertial Sensor: One Step Further for the Prediction of the Risk of Fall in Elderly Nursing Home People.

Assessing the risk of fall in elderly people is a difficult challenge for clinicians. Since falls represent one of the first causes of death in such people, numerous clinical tests have been created and validated over the past 30 years to ascertain the risk of falls. More recently, the developments of low-cost motion capture sensors have facilitated observations of gait differences between fallers and nonfallers. The aim of this study is twofold. First, to design a method combining clinical tests and motion capture sensors in order to optimize the prediction of the risk of fall. Second to assess the ability of artificial intelligence to predict risk of fall from sensor raw data only. Seventy-three nursing home residents over the age of 65 underwent the Timed Up and Go (TUG) and six-minute walking tests equipped with a home-designed wearable Inertial Measurement Unit during two sets of measurements at a six-month interval. Observed falls during that interval enabled us to divide residents into two categories: fallers and nonfallers. We show that the TUG test results coupled to gait variability indicators, measured during a six-minute walking test, improve (from 68% to 76%) the accuracy of risk of fall’s prediction at six months. In addition, we show that an artificial intelligence algorithm trained on the sensor raw data of 57 participants reveals an accuracy of 75% on the remaining 16 participants.

P1171DIALYSIS PRESCRIPTION FOR THE SPREAD OF PERITONEAL DIALYSIS IN THE ELDERLY PATIENTS CLARIFIED BY THE EXAMINATION OF RELATIONSHIP BETWEEN KT/V AND NURSING CARE LEVEL

Abstract Background and Aims Recently, more elderly patients who are independent or able to live at home with support of family are opting for peritoneal dialysis (PD). And assisted PD becomes the useful cure in the super-aging society. Japanese nursing-care insurance system which began in 2000 is useful for the spread of PD in the elderly. A purpose of this study is to check the current situation of the PD therapy in the elderly needing care. And it is to plan the spread of assisted PD in the elderly patients. Method Of the 789 elderly patients controlled by dialysis at our hospital between 2000 and 2018, 265 patients (33.6%) selected PD. 106 patients (30.1%) of young-old group (65-74 years, n=352), 108 patients (32.6%) of old group (75-84 years, n=331), and 51 patients (48.1%) of oldest old (≧85 years, n=106) started PD. We studied total Kt/V, total Ccr, volume of urine, volume of dialysate, the bag exchange number and dialysate retention time in 90 PD patients. We estimated total Kt/V and relations of the nursing care level in elderly PD patients. The data of patients divided into 4 groups: young group (≦64 years, n=30), young-old group (65-74 years, n=19), old group (75-84 years, n=27) and oldest-old group (≧85 years, n=14). Total Kt/V and relations of the nursing care level between 1 and 5 based on assessment of care requirements in PD patients with or without assisted PD were studied. Results The nursing-care insurance acquisition rate of each age group was 3.3%, 18.8%, 51.9%, 78.6% and assisted PD rate was 0%, 21.1%, 55.6%, 92.9%, respectively. Total urine volume was 759±506 L/day in the independent elderly patients and was 603±433 in the elderly patients with assisted PD. Dialysate volume was 5.5±2.0L/day in the independent elderly patients and was 4.0±2.1 in the elderly patients with assisted PD (p<0.05). The daily bag exchange number of times was 3.6±1.0 in the independent elderly patients and was 2.9±1.1 in the elderly patients with assisted PD (p<0.05). The volume of dialysate was 5.5 ±2.0 L/day in the independent elderly patients and was 4.0±2.1 L/day in the elderly patients with assisted PD (p<0.05). Though total Kt/V did not have the difference in each age group, total Kt/V was 1.74±0.36 in the non-need of nursing care elderly patients and was 1.37±0.30 (p <0.05) in the need of nursing care elderly patients. Total Kt/V was 1.72±0.30 in the independent elderly PD patients and was 1.53±0.44 in the elderly patients with assisted PD. Total Kt/V and the nursing care level were significantly inversely correlated (p = 0.011). Total Kt/V and the life independence degree of patients with dementia were significantly inversely correlated (p = 0.001) Conclusion Elderly PD patients can achieve improved levels of well-being with low volume peritoneal dialysates. The application of dialysis prescriptions using APD and and/or icodextorin decrease the burden of changing PD bags for elderly patients, nurses and families who support them (assisted PD). PD for elderly patients will create a paradigm shift of dialysis therapy in the super aging society.

The Relations of Locus of Control and Behavioral Approach and Inhibition Systems to General Health in Elderly Nursing Home Residents in Dubai

The Relations of Locus of Control and Behavioral Approach and Inhibition Systems to General Health in Elderly Nursing Home Residents in Dubai

Prevalence of Malnutrition in Elderly Nursing Home Residents and its Relationship with Cognitive Impairment

Prevalence of Malnutrition in Elderly Nursing Home Residents and its Relationship with Cognitive Impairment

Research on Stroke Rehabilitation Nursing Mode with Senior Nurses as Bond

Objective To explore the effect of rehabilitation nursing model for stroke patients with senior nurses. Methods From October 2017 to October 2018, 46 stroke patients with hemiplegia in community hospitals were selected. 23 stroke patients in community who were willing to accept rehabilitation nursing service package were included in the observation group. The elderly nurses in sinking community were the leading nurses in rehabilitation nursing and home rehabilitation nursing guidance. Community stroke patients without rehabilitation nursing package were selected as control group. Community nurses were the leading nurses in rehabilitation nursing and home-based rehabilitation nursing. The incidence of pressure sores, aspiration rate, accuracy rate of anti-spasm posture placement, and mastery rate of intermittent catheterization technique were compared between the two groups. Results After the intervention, the incidence of pressure ulcer and aspiration rate in the observation group were significantly lower than those in the control group (P < 0.05). The accuracy of anti-spasm posture placement and the mastery rate of intermittent catheterization were significantly higher in the observation group than in the control group (P < 0.05). Conclusion Stroke rehabilitation nursing model with senior nurses as a link has certain effect on rehabilitation nursing of stroke patients in community by strengthening the training, learning and guidance of rehabilitation nursing knowledge and skills of community nurses. Nurses in community hospitals have strengthened two-way linkage, which is of research value, but they are now voluntarily selected in the community. The number of patients choosing rehabilitation care packages is still relatively small, the number of senior nurses in sinking communities is relatively small, and there is still a lot of work to be done to achieve real results. This is a long-term project, which requires time and experience precipitation. Key words Senior nurses; Link; Stroke; Rehabilitation nursing

간호대학생의 노인요양시설 봉사 경험

본 연구는 간호대학생이 경험하는 노인요양시설 봉사경험의 의미 및 본질에 대하여 그들의 경험을 이해하고 심층적으로 탐구하여 교육정책 및 전략개발에 기초 자료를 제공하고자 시도되었다. 연구는 Colaizzi(1978)가 제시한 현상학적 연구방법을 이용한 질적 연구로 자료수집은 연구참여자의 자가기술지 작성 및 심층면담으로 진행되었으며, 새로운 내용이 발견되지 않는 시점에서 종료되었다. 연구참여자는 경기도 소재 대학교 3개월 이상 정기적인 노인요양시설 봉사경험이 있는 18명이었다. 연구결과 간호대학생의 노인요양시설 봉사경험은 ‘성숙한 자아를 찾음’, ‘봉사의 값진 의미를 깨달음’, ‘노인에게 다가감’, ‘미래를 위한 배움의 시간’으로 나타났다. 간호대학생의 노인요양시설 봉사경험에서 자기 성찰의 기회가 되는 긍정적인 측면이 있고, 노인에 대한 심층적 이해와 노인 간호를 위한 지식과 기술을 습득하게 된다. 이는 간호대학생 뿐만 아니라 보건복지 분야에 종사할 학생들의 노인에 대한 이해와 건강관리에 기여하는 전문가로 성장하도록 도움을 줄 것으로 기대할 수 있다. 이에 봉사활동이 긍정적인 효과를 극대화하기 위해서 자원봉사에 영향을 미치는 요인에 대한 추후 심층적인 연구를 제안하는 바이다.

Inertial Training Improves Strength, Balance, and Gait Speed in Elderly Nursing Home Residents.

PurposeThe aim of the study was to evaluate the impact of inertial training on upper and lower extremity strength in the elderly. The study also assessed the influence of inertial training on their independence, balance, and speed and quality of gait.MethodsTwenty physically inactive older residents of a nursing home (6 women and 14 men; age, 76.7 ± 8.77 years) were randomized to a training (T; n = 10) or control group (C; n = 10). The T group performed inertial training twice a week for 6 weeks using a Cyklotren inertial device. Each training session included 12 exercise sets involving the elbow and knee flexor and extensor muscles (3 sets per single muscle group). The training loads were 10 and 20 kg for the upper and lower extremities, respectively. Before and after training, the maximum force of trained muscles was evaluated under training conditions. Functional tests were also completed.ResultsParticipants from the T group had significantly increased (37.1–69.1%) elbow and knee flexor and extensor muscle strength. Improvement in upper and lower limb strength in non-specific conditions was also noted; 23.3% and 40.6%, respectively. Functional abilities improved significantly in the T group (Tinetti balance test: 29%, Tinetti gait tests: 18.6%, and gait speed (8-Foot Up-and-Go): 12.8%), while remaining unchanged in C.ConclusionWe strongly recommend a daily routine of inertial training for older adults. Benefits from inertial training can reduce the risk of falls and increase the safety and independence of the elderly.

REMOVED - IMPROVED QUALITY OF LIFE IN THE ELDERLY, AND NURSES AND CAREGIVERS BY KINAESTHETICS APPLICATIONS: A SURVEY IN GERMANY AND AUSTRIA

Background: The number of elderly people having physical disabilities and other chronic diseases has dramatically increased with the rapid aging of society. The importance of the care has been noticed again from the viewpoint of the prevention, and the effective care is expected for both sides to be assisted Kinästhetik/Kinaesthetics (hereinafter, referred to as Kinesthetics) and is noticed. The purpose of this study was to clarify the relationship between QOL and Kinsesthetics by conducting a comparative study on QOL, pain, and sensation of movement for elderly people under long-term medical treatment, and nurses and caregivers working at the same hospital and nursing homes.Methods: The subjects were elderly people, nurses and caregivers in geriatric wards of general hospitals and nursing homes in Austria, Germany, where Kinaesthetics clinical practice has been introduced the longest. We analyzed data from VSA-QOL (Visual Analog Scale for Quality of Life), SDS (Symptom Distress Scale) modified, pain (Numerical Rating Scale: NRS-Pain), Kinesthetic senses before and after assisting with movement, medical record surveys, functional evaluation BI (Barthel-Index), and Braden Scale for the elderly. SF -36 v2, pain (NRS-Pain) before and after the movement assistance, Kinesthetic senses in the movement support, problem on the health and countermeasure, and Kinaesthetics mastery situation were analyzed for nurses and caregivers. SOPMAS (Structure of the Observed Patient Movement Assistance Skill) evaluation was also carried out for both subjects.Results: The subjects were included in 115 elderly people of Kinaesthetics group, 34 Non-Kinaesthetics group, 149 nurses and caregivers of Kinaesthetics group, and 46 nurses and caregivers of Non-Kinaesthetics group. The QOL of the elderly in the Kinaesthetics group was significantly improved after 1 month (p=0.03). The eldely in the Kinaesthetics group showed a significant improvement for SDS after 1 month (p=0.01). There was a significant difference for Bowel in SDS in repeated measures analysis of variance (spherical assumption; time x group) (p=0.01). SF -36 v2 of Nurses and caregivers using Kinaesthetics showed a significant difference in the role emotional (p=0.04). The level of pain before and movement assistance (NRS) was further significantly enhanced in the Non-Kinaesthetics group. The muscle strain was significantly higher in the Non- Kinaesthetics group for both the elderly and nurses (p=0.01).Conclusion: Kinaesthetics applications enhance QOL among the elderly, nurses, and caregivers in Germany and Austria.

The Competency of Nurses Employed in Elderly Nursing Homes

The Competency of Nurses Employed in Elderly Nursing Homes

The Clinical Significance and Issues of Religious Involvement in Elderly Nursing Home: Interviews with Careworkers in Special Elderly Nursing Home

The Clinical Significance and Issues of Religious Involvement in Elderly Nursing Home: Interviews with Careworkers in Special Elderly Nursing Home

17개 시·도 지역 노인요양시설 효율성 분석

본 연구는 우리나라의 노인장기요양보험 제도 프로그램 가운데 하나인 노인요양시설의 효율적 운영을 위한 정책적 대안을 제시하고자 하는데 목적을 두고 연구를 수행하였다. 본 연구에선 우리나라 광역도시인 17개 시‧도 지역 별 노인요양시설의 효율성을 분석하기 위해 DEA분석 방법을 사용하였다. 분석자료는 국민건강보험공단 발표 자료인 「노인장기요양보험 통계연보」자료를 사용하였다. 이 자료를 이용한 효율성 분석은 DEA분석 방법에 맞추어 투입변수를 노인요양시설의 종사자, 시설 수, 정원으로 선정하였고, 산출 변수는 노인요양시설의 급여(수가)비용으로 선정하여 17개 지역 별 효율성을 분석하였다.<BR> 연구 결과는 다음과 같다. 첫째, CCR(기술 효율성) 측정 결과 서울, 세종지역이 효율적이었고, 제주지역이 가장 상대적 효율성이 낮은 것으로 나타났다. 둘째, BCC(규모 효율성) 측정 결과 서울, 세종지역이 효율적이었고, 제주지역이 가장 상대적 효율성이 낮은 것으로 나타났다. 셋째, SE(초 효율성) 측정 결과 서울, 세종지역이 효율적이었고, 제주지역이 가장 상대적 효율성이 낮은 것으로 나타났다. 넷째, 변수 기여도 측정 결과 제주도를 제외한 모든 지역에서 시설 수 변수와 급여(수가)비용 변수가 가장 크게 투입과 산출에 기여하는 요인으로 나타났다. 다섯째, 효율성 개선 가능성 측정 결과 가장 낮은 효율성을 보인 제주지역과 경기지역의 시설 수 변수가 개선 가능성 요인으로 나타났다.<BR> 본 연구는 노인요양시설 효율성을 17개 광역도시 별 분석한 연구라는 점에 그 의의가 있을 수 있다. 하지만, 본 연구는 DEA라는 효율성 분석방법에 따른 투입변수로 노인요양시설의 종사자, 시설 수, 정원을 선정하였고, 산출변수는 노인요양시설의 급여(수가)비용 만을 적용하는 한계가 있기 때문에 본 연구결과도 일반화하기에도 그 한계가 있을 것으로 판단된다. 그럼에도 불구하고 본 연구결과를 중심으로 노인요양시설 효율성 증대 방안을 제언하면 다음과 같다. 첫째, 제주지역과 경기지역의 노인요양시설 시설 수 점검과 조절 필요성을 제언한다. 둘째, 노인요양보험 급여(수가) 인상을 제언한다. 셋째, 본 연구의 한계를 극복하기 위해 추후 연구에서는 다양한 지역적 요인을 적용한 다양한 연구를 제언한다.

Mini Nutritional Assessment Score as a Potential Predictor of Pressure Ulcers in Elderly Nursing Home Patients With Dementia

This retrospective study compared the presence and severity of pressure ulcers in long-term care residents with dementia based on Mini Nutritional Assessment (MNA) scores. Participants included 50 older adults with pressure ulcers and 50 matched controls. MNA scores for subjects with and without ulcers were significantly different (8.34 ± 2.67 vs 9.98 ± 2.32, P = .001). Scores based on ulcer stage did not follow a linear pattern; however, subjects with stage 4 ulcers had significantly lower scores (6.33 ± 2.55) than subjects with stages 1 to 3 ulcers (8.90 ± 2.70, P = .009; 9.64 ± 2.16, P = .001; and 9.08 ± 2.02, P = .004, respectively). Results show a relationship between low MNA scores and pressure ulcers. Thus, MNA has the potential for use in implementation of preventive measures and mitigation of ulcer progression.

SUN-PO199: Anthropometry as Predictive Factor of FFMI in the Assessment of Malnutrition in Elderly Nursing Home Residents

SUN-PO199: Anthropometry as Predictive Factor of FFMI in the Assessment of Malnutrition in Elderly Nursing Home Residents

SUN-PO039: Drug-Induced Dysphagia in Elderly Nursing Home Residents

SUN-PO039: Drug-Induced Dysphagia in Elderly Nursing Home Residents

A qualitative study on the training experiences of gerontological clinical nurse specialist

Objective To understand the experience and needs of elderly specialist nurses during the period of specialist training, and to provide reference and basis for the establishment of a more perfect training plan for elderly specialist nurses. Methods A one-to-one in-depth interview was conducted among 5 students in the third training course of the Beijing Nursing Society with the method of phenomenological research. Colaizzi undefineds seven-step data method of phenomenology was used to analyze the results. Results Five topics were abstracted from the experience of training aged specialist nurses, including stress, safety awareness, harvest and growth, professional pride, teaching teachersundefined views and suggestions on scientific research. Conclusions The curriculum setup of elderly specialist nurses needs to be optimized. It is necessary to strengthen the training of scientific research, optimize the teachersundefined strength and perfect the training means, and the managers should formulate the specialty and standardization of the elderly nursing as soon as possible. To provide the necessary support for the training of elderly specialist nurses. Key words: Clinical nurse specialist; Aged; Training experience; Qualitative research

Surveillance of Respiratory Viruses in Long Term Care Facilities

ObjectiveTo assess the feasibility of conducting respiratory virus surveillance for residents of long term care facilities (LTCF) using simple nasal swab specimens and to describe the virology of acute respiratory infections (ARI) in LCTFs.IntroductionAlthough residents of LTCFs have high morbidity and mortality associated with ARIs, there is very limited information on the virology of ARI in LTCFs.[1,2] Moreover, most virological testing of LCTF residents is reactive and is triggered by a resident meeting selected surveillance criteria. We report on incidental findings from a prospective trial of introducing rapid influenza diagnostic testing (RIDT) in ten Wisconsin LTCFs over a two-year period with an approach of testing any resident with ARI.MethodsAny resident with new onset of respiratory symptoms consistent with ARI had a nasal swab specimen collected for RIDT by nursing staff. Following processing for RIDT (Quidel Sofia Influenza A+B FIA), the residual swab was placed into viral transport medium and forwarded to the Wisconsin State Laboratory of Hygiene and tested for influenza using RT-PCR (IVD CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panel), and for 17 viruses (Luminex NxTAG Respiratory Pathogen Panel [RPP]). The numbers of viruses in each of 7 categories [influenza A (FluA ), influenza B (FluB), coronaviruses (COR), human metapneumovirus (hMPV), parainfluenza (PARA), respiratory syncytial virus (RSV) and rhinovirus/enterovirus (R/E)], across the two years were compared using chi-square.ResultsTotals of 164 and 190 specimens were submitted during 2016-2017 and 2017-2018, respectively. RPP identified viruses in 56.2% of specimens, with no difference in capture rate between years (55.5% vs. 56.8%). Influenza A (21.5%), influenza B (16.5%), RSV (19.0%) and hMPV (16.5%) accounted for 73.5% of all detections, while coronaviruses (15.5%), rhino/enteroviruses (8.5%) and parainfluenza (2.5%) were less common. Specific distribution of viruses varied significantly across the two years (Table: X2=48.1, df=6; p&lt;0.001).ConclusionsSurveillance in LTCFs using nasal swabs collected for RIDT is highly feasible and yields virus identification rates similar to those obtained in clinical surveillance of ARI with collection of nasopharyngeal specimens by clinicians and those obtained in a school-based surveillance project of ARI with collection of combined nasal and oropharyngeal specimens collected by trained research assistants. Significant differences in virus composition occurred across the two study years. RSV varied little between years while hMPV demonstrated wide variation. Simple approaches to surveillance may provide a more comprehensive assessment of respiratory viruses in LTCF settings.References(1) Uršič T, Gorišek Miksić N, Lusa L, Strle F, Petrovec M. Viral respiratory infections in a nursing home: a six-month prospective study. BMC Infect Dis. 2016; 16: 637. Published online 2016 Nov 4. doi: 10.1186/s12879-016-1962-8(2) Masse S, Capai L, Falchi A. Epidemiology of Respiratory Pathogens among Elderly Nursing Home Residents with Acute Respiratory Infections in Corsica, France, 2013–2017. Biomed Res Int. 2017; 2017: 1423718. Published online 2017 Dec 17. doi: 10.1155/2017/1423718

Decision Support System for Household Labor Services Selection “Best Helper” Using AHP and TOPSIS Methods

Selection of household labor services was an important aspect in families who have a lot of activity. The existence of helpful household labour services would avoid the occurrence of problems that should be caused. Types of household labour services which were often used were maids, baby sitters, elderly nurses, gardeners, and drivers. The main problem arose in the difficulty of service seekers in choosing the desired service and how to minimize the time spent. To overcome this, a decision support system was used using the Analytical Hierarchy Process (AHP) method which was used to find the criteria for each alternative weight, and ranking calculations using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method. This research was implemented using PHP language with CodeIgniter framework. The result shows that the usability test obtains the average value with the system usability scale (SUS) method of 71.09%. It shows that the level of system usability is classified as good and can be accepted and used easily by the users. Meanwhile, the result of the user response test shows a percentage of 87.5%, so it can be concluded that the system belongs to good category and feasible to use.

Effective Factors for Development of Gerontological Nursing Competence: A Qualitative Study.

Many nurses working in hospitals are not prepared to provide appropriate care for older people. This qualitative study aimed to identify factors influencing the development of gerontological nursing competence in Iranian hospitals. Twenty-six participants (nine nurses, 12 nurse managers, four clinical instructors, one physician) who worked in four teaching hospitals and nursing schools were interviewed by semistructured interview method. Conventional content analysis was used. Two main categories emerged from the data: (a) management factors with the subcategories of meritocracy in elderly nursing, leadership style of nursing managers, educational system, the quality of working life, and performance management; (b) organizational factors with the subcategories of organizational learning, and organizational support. These findings can help nurse managers and clinical instructors identify, develop, and implement strategies for further development of gerontological nursing competence. [J Contin Educ Nurs. 2019;50(3):127-133.].

Can the unemployed be trained to care for the elderly? The effects of subsidized training in elderly care.

Demographic change has increased the need for elderly care. Training unemployed workers might be one way to increase the supply of elderly care nurses. This study analyzes the effectiveness of subsidized training for unemployed individuals in the elderly care professions in Germany over 11.5 years. We find that short further training and long retraining courses significantly increase workers' long‐term employment. As approximately 25% to 50% of trained nurses have permanent jobs in the care sector, we estimate that approximately 5% of all employed nurses are formerly trained unemployed workers.