Geriatric Facilities Research Articles

Validation of the German version of the SarQoL® questionnaire in sarcopenic and probable sarcopenic patients

BackgroundThe German version of the SarQoL®, a sarcopenia-specific quality of life (QoL) questionnaire, has not been validated hindering its widespread use. This study aimed to evaluate the psychometric properties of the German SarQoL®.MethodsVia a cross-sectional study participants were recruited in two geriatric outpatient facilities and one acute geriatric ward in Munich (Germany). Sarcopenia and probable sarcopenia were diagnosed with the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm. From 185 participants (age 79.8 ± 6.1), 77 had probable sarcopenia, and 51 had sarcopenia. Participants completed the SarQoL® and the European Quality-of-Life 5-Dimension (EQ-5D) questionnaires. The validation included examination of the discriminative power, construct validity, internal consistency, test-retest reliability, and floor/ceiling effects.ResultsLower SarQoL®scores for sarcopenic (p = 0.002) and probable sarcopenic subjects (p < 0.001) compared to controls indicated good discriminative power. Consistent construct validity was found for sarcopenic subjects: moderate to high correlations with domains capturing similar constructs of the EQ-5D: ‘Activities of daily living’ (r = -0.58, p < 0.001), ‘Mobility’ (r = -0.72, p < 0.001) and low correlations with domains related to different constructs like ‘Pain’ (r = -0.32, p < 0.022). Similar correlations were found for probable sarcopenic subjects. The Cronbach’s alpha was 0.8. Test-retest reliability was excellent (intraclass coefficient correlation of = 0.96; 95% CI = 0.91–0.99), and no floor/ceiling effects were observed.ConclusionQoL was similarly reduced in both patient cohorts compared to controls. The German SarQoL® is a valid and reliable instrument for measuring QoL in patients > 65 years of age with sarcopenia and probable sarcopenia and can now be used in epidemiological studies and clinical trials in a German-speaking population.Trial registrationGerman Clinical Trials Register (DRKS)-ID: DRKS00020504 (March 12th, 2021) .

Occupational low back pain among Japanese caregivers: A large-scale cross-sectional study.

Caregivers in Japan experience a high prevalence of low back pain (LBP), with age, sex, individual pain experiences, and central sensitization symptoms potentially influencing its chronic progression. To determine the prevalence of LBP among caregivers, as well as its relation to age and sex, and explore work status, psychological factors, and central sensitization symptoms as contributing factors to chronic LBP (CLBP). A large-scale cross-sectional survey was conducted among 1214 caregivers in 35 geriatric healthcare facilities. The survey assessed LBP and CLBP prevalence, work status, psychological factors, and central sensitization-related symptoms. Multivariate logistic regression analysis was used to identify factors influencing CLBP. Among 936 valid respondents, the LBP prevalence was 69.2%. No significant sex differences were found in the prevalence of LBP and CLBP. Old age, higher pain severity, and severe symptoms related to central sensitization increased the risk of CLBP. However, work status and psychological factors did not significantly contribute to CLBP. There is a high prevalence of LBP among caregivers, age and individual pain experience significantly impact CLBP. These findings emphasize the need for therapeutic strategies to manage pain intensity, especially in the acute phase, to prevent the progression to chronicity.

Reasons influencing the nurses’ prioritization process while preventing and managing delirium: findings from a qualitative study

BackgroundNurses play an important role in the prevention and management of delirium episodes. However, some studies have reported that not all interventions recommended are applied due to time and resource constraints, resulting in patients receiving less care than required because other patients and/or interventions are prioritised. The concept of prioritization is part of the broader concept of decision-making as the ability to choose between two or more alternatives to ensure patient safety. Understanding the reasons influencing the prioritization process in patients at risk or with delirium may inform interventions to prevent and/or minimise the unfinished nursing care.AimThe purpose of this study was to explore the reasons that inform the prioritisation process among nurses when they are challenged to make decisions for patients at risk and with delirium.MethodsA descriptive qualitative study performed according to the COnsolidated criteria for Reporting guidelines, in 2021. An intentional sample of nurses working full-time with older patients in medical, geriatric, and post-acute care facilities affiliated with the National Health System was involved. Semi-structured interviews were conducted and narratives thematic analysed.ResultsA total of 56 nurses (55.4% in internal medicine, 26.8% in geriatrics and 17.8% in post-acute/intermediate care) participated with an average age of 31.6 years. The reasons informing the prioritisation process while providing preventive or managerial interventions towards a patient at risk of or with delirium are set at three levels: (1) unit level, as reasons belong to the inadequacy of the ‘Environment’, the ‘Human Resources’, and the ‘Organisation and Work Processes’, (2) nurse’s level, as issues in ‘Competencies’ and ‘Attitudes’ possessed, and (3) patient level, due to the ‘Multidimensional Frailty’.ConclusionNurses caring for patients at risk of and with delirium face several challenges in providing care. To prioritise preventive and managerial interventions, it is essential to implement multilevel and multifaced organizational and educational strategies.

Unveiling the digital horizon: Perspectives and progress in digital adoption among German geriatric care facilities

Unveiling the digital horizon: Perspectives and progress in digital adoption among German geriatric care facilities

Nurses prioritization processes to prevent delirium in patients at risk: Findings from a Q-Methodology study

BackgroundThis study aimed at (a) exploring how nurses prioritise interventions to prevent delirium among patients identified at risk and (b) describing the underlying prioritisation patterns according to nurses’ individual characteristics. MethodsThere was used the Q-methodology a research process following specific steps: (a) identifying the concourse, (b) the Q-sample, and (c) the population (P-set); (d) collecting data using the Q-sort table; (e) entering the data and performing the factor analysis; and (f) interpreting the factors identified. ResultsThere were involved 56 nurses working in medical, geriatric and log-term facilities (46; 82.2 %). The preventive intervention receiving the highest priority was ‘Monitoring the vital parameters (heart rate, blood pressure, oxygen saturation)’ (2.96 out of 4 as the highest priority; CI 95 %: 2.57, 3.36). Two priority patterns emerged among nurses (explained variance 44.78 %), one ‘Clinical-oriented’ (36.19 %) and one ‘Family/caregiver-oriented’ (8.60 %) representing 53 nurses out 56. ConclusionAlongside the overall tendency to prioritise some preventive interventions instead of others, the priorities are polarised in two main patterns expressing two main individual characteristics of nurses. Knowing the existence of individual patterns and their aggregation informs how to shape educational interventions.

Demands, resources, and work engagement of lower and middle level nurse managers: a cross-sectional study

Demands, resources, and work engagement of lower and middle level nurse managers: a cross-sectional study Abstract. Background: Given their responsibilities, lower- and middle-level nurse managers hold a key role in the health care system. Their performance and health are affected by their work engagement, which according to the Job-Demands-Resources-Model depends on job-related demands and resources. To date, there is a lack of studies on the demands, resources, and work engagement of nurse managers in Germany. Objective: First, the study aimed to describe the job demands and resources as well as the work engagement of lower and mid-level nurse managers in hospitals and geriatric care facilities in Germany. Second, the aim was to explore potential differences in these areas between different groups, particularly regarding gender, age, and management level. Methods: The study used a cross-sectional design. Data were collected by an online survey. N = 408 cases could be evaluated. Results: Work overload is the most prominent demand, followed by emotional demands. In terms of resources, nurse managers can primarily draw on positive social relationships. The available professional resources are rated critically. Work engagement is moderate. Conclusions: The study indicates a clear need for action regarding an improvement in work engagement. In particular, work overload and professional resources need to be addressed by appropriate systemwide and organization-related measures.

Understanding Frailty: Perspectives and Experiences of Rural Older Adults in India.

In India, frailty has been predominantly studied as a physiological aspect, overlooking the subjective perceptions of community-dwelling older adults, which holds global significance. This study aims to explore frailty perceptions among community-dwelling older adults, comparing those enrolled in a geriatric welfare program facility to those not-enrolled. A cross-sectional design with a qualitative descriptive framework was employed, using focus group methodology. The study took place in rural West Bengal, located in eastern India, with a sample of 27 participants aged 60-87 years. Data collection occurred between October 2018 and January 2020, conducted through a face-to-face, semistructured discussion guide. Thematic analysis was performed to ensure data saturation and reliability. Three key themes emerged from the analysis: (a) Perceptions of frailty were associated with aging, functional dependence, and psychosocial health, (b) Exposure to a scientific definition led to an ideological dilemma influenced by personal experiences, (c) Walking speed and grip strength were prominent components of frailty. The findings revealed that there was no difference in perception between program-enrolled and nonenrolled older adults, likely due to the concept of frailty being new to all participants. However, it was noteworthy that participants enrolled in the welfare program exhibited a resilient mindset toward the definition and demonstrated a proactive interest in preserving their overall health. This novel study underscores the necessity of enhancing community awareness and integrating frailty management into the Indian health care system, which is yet to be fully integrated, aiming to promote the well-being of older adults.

Changes in Psychiatric Medication Use During the COVID-19 Pandemic in a Pediatric Long-Term Care Facility.

Background: Coronavirus disease 2019 (COVID-19) caused a global pandemic that dramatically altered infection control procedures in long-term care facilities. Mental health decline among residents of geriatric facilities during the pandemic has been described (Ferro Uriguen et al., 2022). Our study aims to evaluate psychological effects of the pandemic on residents of a pediatric long-term care facility, a population comprised of medically complex children. To characterize this, we compared patterns of psychotropic medication use during the COVID-19 pandemic to those of the prepandemic period among residents of a 76-bed pediatric long-term care facility. Methods: We conducted a retrospective study of psychotropic medication use from January 2019 to August 2022 using de-identified monthly facility medication refill data. Linear multivariable regression models were used to estimate the level and trends in the monthly rates of medication refills per 10,000 bed days among resident children before and after the pandemic onset. Six classes of psychotropic medications were analyzed including antipsychotics, antidepressants and anxiety medications, trazodone, clonidine, mood stabilizers, and gabapentin. Results: The pandemic onset was associated with a significant increase in the monthly prescribing rates of antidepressant and anxiety medications (20.83; 95% CI, 3.96-37.71; p = 0.017), mood stabilizers (10.44; 95% CI, 5.79-15.09; p < 0.001), and trazodone (-27.66; 95% CI, -40.44 to 14.88; p < 0.001) above those expected by prepandemic trends. The trend in trazodone use changed significantly during the pandemic from decreasing prepandemic to increasing (2.21; 95% CI, 1.28-3.14; p < 0.001). Antidepressant, anxiety medication, and gabapentin use increased throughout the study. Antidepressant and anxiety medication use surged early in the pandemic, but then continued growth at their prior rates of use. Discussion: Increased use of antidepressant and anxiety medications and trazodone suggests a possible impact of the COVID-19 pandemic on rates of anxiety, depression, sleep disturbance, and agitation among children with severe intellectual and developmental disabilities living in long-term care.

Gaps and opportunities in addressing the needs of older adults in the Philippines and Vietnam: a qualitative exploration of health and social workers' experiences in urban care settings.

Despite numerous government initiatives, concerns and disparities among older adults have continually been growing. Empirical studies focused on older adults in the Philippines and Vietnam appear minimal and mostly regarding perceptions of aging. An effective geriatric care strongly relies on functional service providers requiring their perspectives to be explored toward inclusive service delivery. To investigate the perceived gaps and opportunities in geriatric care service delivery among health and social care workers in selected urban areas in the Philippines and Vietnam. A qualitative case study approach drawn on social constructivism theory, examined working experiences, observed characteristics of older adults, geriatric services and needs, difficulties on service delivery, and recommended solutions. A total of 12 semi-structured interviews and 29 focus group discussions were conducted in the Philippines, with 174 health and social care workers, while in Vietnam, there were 23 semi-structured interviews and 29 focus group discussions with 124 participants. An inductive thematic analysis was employed. Interview participants highlighted the increasing unmet needs such as accessibility, availability, and acceptability of geriatric care services. The implementation of interventions on the older population faced multiple challenges, including issues related to older adult conundrums and dilemmas in geriatric care providers and facilities. The participants from the two countries felt that strengthening implementation of collaboration toward an integrated geriatric care structure and expansion of training and capability in handling older adults can be potential in addressing the gaps at both individual and institutional levels. Additionally, a committed leadership was viewed to be the important step to effectively operationalize the strategy. Health and social workers emphasized that the needs of older adults are exacerbated by various challenges within a fragmented geriatric care system. To address this issue, an establishment of an integrated service delivery mechanism with dedicated leadership is needed. The findings from this study may help develop appropriate solutions for addressing the health and social care needs of older adults in similar settings across Southeast Asia. Further examination of the impact of these challenges and solutions on service delivery and the wellbeing of older adults is essential.

Feasibility of an oral health promotion program among older people in geriatric care facilities, Shanghai, China: a pre/post-implementation study

BackgroundThe oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs).MethodsThe OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT).ResultsThe oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0–3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP.ConclusionsThis study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents.Trial registrationChiCTR2000035236 (registration date: 04/08/2020).

Factors influencing interprofessional collaboration in general and during multidisciplinary team meetings in long-term care and geriatric rehabilitation: a qualitative study

BackgroundInterprofessional collaboration is essential to maintain high-quality care in long-term care and geriatric rehabilitation. However, little is known regarding perceived factors influencing interprofessional collaboration by people involved in care. This concerns both long-term care and geriatric rehabilitation. Moreover, knowledge of using patient outcome measures to enhance interprofessional collaboration during multidisciplinary team meetings is insufficient. This study examined the perceived facilitators of and barriers to interprofessional collaboration in general and during multidisciplinary team meetings, specifically according to healthcare professionals, patients, and informal caregivers. Differences between long-term care and geriatric rehabilitation were also investigated. Finally, it was examined which patient outcome measures were used in multidisciplinary team meetings.MethodsA constructivist qualitative study using 10 focus groups and 18 semi-structured interviews with 14 patients, 13 informal caregivers,10 managers, and 22 healthcare professionals from eight Dutch long-term care and geriatric rehabilitation facilities. A combined inductive and deductive approach to a thematic analysis was performed.ResultsThe perceived influencing factors of interprofessional collaboration were classified into two general themes: (1) ‘Involvement of patient, informal caregiver, and healthcare professional’, categorised into: ‘participation of patients and informal caregivers’, ‘behaviour and attitude of team members’, ‘expectations of team members towards each other’, and ‘exchange of information, knowledge, and reciprocity in communication’; and (2) ‘A systematic approach to providing care for older people’, consisting of: ‘coordination of team procedures’, and ‘coordination of organisational procedures’. Also, one theme for multidisciplinary team meetings was identified: ‘Organised participation of patient, informal caregiver, and healthcare professional in multidisciplinary team meeting, categorised into: ‘team procedures’, ‘working systematically’, and ‘participation in multidisciplinary team meetings. Standardised patient outcome measures were scarcely used in multidisciplinary team meetings.ConclusionPeople involved in long-term care and geriatric rehabilitation indicated that, apart from working systematically, being involved in care and multidisciplinary team meetings are essential factors for interprofessional collaboration. These factors must be taken into consideration to provide valuable, high-quality care to older people residing in long-term care and geriatric.Trial registrationNot applicable.

A preliminary study on the development of care staff's Final-Stage Decision-Making Support Scale for older adults with dementia.

This preliminary study aimed to develop a care staff Final Life-Stage Decision-Making Support Scale (FS-DM) for older adults with dementia (OwDs) in geriatric facilities. The FS-DM items were developed from focus group interviews with care staff and reviewed through discussions with several experts in dementia care. A questionnaire survey was conducted among care staff in geriatric facilities from February to March 2021. In total, 138 carers (110 [79.7%] women and 28 [20.3%] men, mean age: 41.5 ± 2.3 years) participated. Among them, 91 (65.9%) were professional caregivers, and 36 (26.1%) were nurses. The FS-DM was developed using a factor analysis, which resulted in 11 items grouped into three factors', as it is the three factors: (1) support for the realization of the wills of OwDs in their final life-stages through collaboration with families and multiple professionals; (2) consideration of communication regarding the formation and expression of the wills of OwDs in their final life-stages; and (3) support for eliciting the wills of OwDs during their final life-stages according to their decision-making ability and values. The factor loadings ranged from 0.385 to 0.827, and the accumulated contribution ratio was 61.03%. The reliability analysis yielded a Cronbach's α of 0.740-0.855. The first and second factors of the FS-DM were significantly correlated with the Approaches to Dementia Questionnaire item "Nurses' attitudes towards support for decision-making." Our results suggest that the FS-DM could provide supportive care for OwDs to formulate, express, and realize their will, and that it has a degree of reliability and validity. Geriatr Gerontol Int 2024; 24: 130-134.

Topical Effect of Silver Diamine Fluoride in Preventing and Arresting Root Caries in Elderly Patients.

Aim of the study: The purpose of the present investigation was to see how efficient silver diamine fluoride (SDF) solution treatment to prevent dental root caries.&#x0D; Materials and method: This research was done at Iraq's geriatric facilities. Forty seniors with active caries lesions were fortuitously assigned into two groups: Group 1 (placebo control)—doubles Twice-Annual treatment with soda water; Group 2—Doubles Twice-Annual treatment with silver diamine fluoride solution.&#x0D; Results: After 18 months, the arrest rates of root caries were 28 percent in group1 (control) and 88 percent group 2 silver diamine fluoride solutions (x2 test, p &lt; 0.05). There was a considerable relation (dependent) between silver diamine fluoride and stopping root surface dental caries Chi=7.08, df=2, P&lt;0.05, which means that silver diamine fluoride was efficient in stopping dental caries while there was no relation (independent) between placebo dye and arresting caries, Chi=1.33 df=2 P&gt;0.05.&#x0D; Conclusions: Silver diamine fluoride solution was helpful in avoiding root caries in elderly people who do not have access to fluoridated water.

노인요양시설 요양보호사의 직무환경이 이직의도에 미치는 영향

This study empirically verified the mediating effect of job stress on the effect of job environment of care workers in Elderly care facilities on turnover intention. The purpose of this study was to provide basic data to reduce turnover intention of care workers in elderly care facilities. For this purpose, a self -administered questionnaire survey was conducted on 302 care workers at nursing homes in Ulsan Metropolitan City.&#x0D; As a result, it was found that job environment had negative on job stress and turnover intention. However, job stress had no mediating effect on the effect of job environment of care workers in geriatric care facilities on turnover intention. Based on the above result, the following suggestions are made. First, it is necessary to clearly define duties of care workers and make efforts to strengthen staffing. Second, psychological and emotional support should be provided through regular consultation with care workers along with establishment of a risk management system. Based on results of this study, a follow-up study on human rights and treatment of care workers in terms of strengthening their work environment is proposed.

Exploring the needs and wishes of next of kin for future reablement programs: a qualitative study

Introduction: Reablement promotes independent living among older people by, amongst other strategies, involving their social network. However, previous studies have shown that next of kin are seldom involved in the reablement process, and when they are, they are insufficiently supported, often resulting in a higher experienced burden. Little is known how next of kin can be involved and supported more effectively in the reablement process. Therefore, in this study we studied the experience of next of kin, who care for somebody who has been temporarily admitted to a geriatric rehabilitation facility since it, as reablement, focuses on regaining skills and independence in meaningful activities. We aimed to get an in-depth understanding of the types of support next of kin receive, how they experience this, which support they value most, and what could be improved.&#x0D; Material and methods: A qualitative exploratory design was used. A purposive sample of next of kin caregivers of people temporarily admitted to a geriatric rehabilitation facility. Semi-structured interviews were conducted until data saturation was reached. If possible informal caregivers were interviewed two times; first during the stay of their relative at the GR facility, and second 4 to 6 weeks after discharge. A thematic analysis approach was used to analyze the data, combining open, axial and selective coding in an iterative manner.&#x0D; Results: Three themes became apparent during the analyses; 1) their role and experience as an informal caregiver; 2) support they received and how they experienced this; and 3) their needs and wishes regarding the support they/their relative receive. Next of kin found it self-evident that they took on the role of caregiver, although they expressed that getting that role rather suddenly is stressful and frustrating. If caregivers had to work, work played an important role in terms of support, but also in experienced burden. They indicated that they do not receive a lot of support from care professionals involved in the care for their relative, but they also do not expected this from them. A permanent contact person was experienced as helpful and pleasant. Most participants indicated few to none needs and wishes regarding support, again because they do not expect additional support.&#x0D; Conclusions: In general, next of kin expressed that they experience a lot of stress and frustration throughout the rehabilitation process. Regarding the support and involvement in the care process, experiences were mixed. It became apparent that next of kin are often unaware that they are entitled to receive additional support and to play a role in the care process of their relative.&#x0D; Implications: The results of this research may inform the development of future reablement programs on how they should integrate adequate support for next of kin, and the role next of kin can play in the reablement process. It remains a challenge to make next of kin aware that there are opportunities for support and that they are entitled to receive this. &#x0D; &#x0D; &#x0D; &#x0D;

Oral Health Assessment Tools for Elderly Adults: A Scoping Review.

The aim of this study was to synthesize the Oral Health Assessment Tool for elderly adults and determine its psychosocial properties. We conducted a scoping review. The Arkey and O'Malley methodology was employed to conduct scoping reviews involving the exploration of both national and international databases, as well as a manual search of the reference lists of the selected studies. We focused on oral health assessment tools for elderly adults (>60 years). The review report adhered to the standards outlined in the PRISMA-ScR guidelines. The study protocol was officially filed with the Open Science Framework. A total of 19 documents were included. The literature search included a time frame ranging from 1995 to 2023 and covered a diverse range of 13 countries. Of the 19 assessment tools examined, it was found that only the Oral Assessment Sheet had multidimensional characteristics, while the remaining tools were unidimensional in nature. The evaluation of oral health assessment tools was conducted across several contexts, including nursing homes, geriatric facilities, communities, and hospitals. A total of eleven studies underwent reliability testing, whereas two studies were alone validated for validity and did not undergo reliability testing. Additionally, seven studies were exclusively validated for reliability and did not undergo validity testing. Multidimensional oral health assessment tools for elderly adults that integrate social and psychological aspects need to be developed and validated. It is necessary to develop oral health assessment tools based on hospitalized elderly patients to meet the oral and dental health needs of elderly patients.

Antibody responses after BNT162b2 vaccination in Japanese geriatric intermediate care facilities

BackgroundTo evaluate antibody responses against the primary series of vaccination of severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2] vaccines in the staff and residents of Japanese geriatric intermediate care facilities. MethodsAll subjects (159 staff and 96 residents) received two doses of the BNT162b2 mRNA vaccine 3 weeks apart. Baseline data of subject were collected using a structured form. Serum samples were collected three times: before vaccination, 3 weeks after the first dose, and 4 weeks after the second dose, and anti-receptor binding domain of the spike protein of SARS-CoV-2 [anti-RBD] IgG was measured using two immunoassays. ResultsAfter the second dose, geometric mean titers [GMT] of anti-RBD with both the Abbott and Roche assay were significantly lower in residents than staff (2282 AU/mL vs. 8505 AU/mL, and 258 U/mL vs. 948 U/mL, respectively). Multivariate analysis of characteristics affecting antibody responses (≥1280 AU/mL for Abbott and > 210 U/mL for Roche) showed lower odds ratios [ORs] for older age (adjusted OR per 10 year increase [aOR] = 0.62, 95 % confidence interval [95 %CI]; 0.38–1.02), steroid usage (aOR = 0.09, 95 %CI; 0.01–0.60) and regular nonsteroidal anti-inflammatory drugs [NSAIDs] usage (aOR = 0.16, 95 %CI; 0.03–0.88). ConclusionsElderly people and steroid and NSAID users had lower antibody responses following the second vaccine dose.

Potential determinants of the quantity and duration of COVID-19 outbreaks in geriatric long-term care facilities

BackgroundWe analyzed potential factors for the number and duration of COVID-19 outbreaks in nursing homes based on routine and structural data.MethodsAll outbreaks during 03/2020-01/2022 in N = 687 of a total of 879 geriatric long-term care facilities (LTCFs) in the Federal State of Hesse, Germany were analyzed using t-tests and logistic regressions in a retrospective cohort study.ResultsLarger LTCFs have more (+ 1.57, p = .009) and longer outbreaks (+ 10.04 days, p > .001). A higher proportion of registered nurses reduces the number (-0.1, p = .036) and duration (-6.02 days, p > .001) of outbreaks. Single-bed rooms provide less duration of outbreaks (-4.5, p = .004). A higher proportion of infected residents (+ 24.26 days, p < .001) and staff (+ 22.98 days, p < .001) prolong outbreaks the most. LTCFs in areas with intermediate population density have an increased risk of prolonged outbreaks (OR: 1.537, p = .036).ConclusionsTo prevent outbreaks and shorten their duration, LTCFs should increase the proportion of registered nurses and single-bed rooms, and control staff infections.

Contention en gériatrie : le retard de la France

Passive physical restraint methods in geriatrics were defined at the start of this century, accompanied by recommendations relating to their use and more recently by legislation. Despite the frequency of these measures of restraint, there are few French publications on this subject. It seems that this practice varies according to the geriatric establishments and prevails in hospital more than in nursing home. The most widespread method is the dual barrier on the bed, as well as in hospital than in nursing home. To this should be added restraint provided by the premises themselves, intended to secure access to a facility, found in 90% of residences for the dependent elderly, and also medication. Passive physical restraint, mainly implemented to prevent falls, has however clearly shown its deleterious effects, particularly in the USA where it is thought to be responsible for 1/1000 deaths in nursing homes, although when it is absent there appears to be no increased risk of falls. Medication-based restraint is more readily used to sedate in case of disruptive behaviors (agitation, aggressiveness) although no clear data is available to date. Restraint provided by the premises themselves, used preventively in case of wandering and straying, is nevertheless a deprivation of freedom, and seems to concern the majority of geriatric facilities today. In the absence of legislation to regulate more clearly these practices, the present authors discuss the need for ethical reflection before the implementation of measures of restraint, whatever their nature, and they propose certain ideas on possible methods for passive physical restraint: raising awareness among caregivers and family members who often call for these measures, the existence of alternative measures, and the delaying of implementation as long as possible and/or sequentially.

Factors associated with nurses’ attitudes for providing oral care in geriatric care facilities: a cross-sectional study

BackgroundThe world’s population is getting older. This issue is accompanied by a rise in the number of older people suffering from dementia and disability, for whom oral hygiene care is challenging. Nurses’ attitudes toward providing oral care (POC) are critical for the elderly, while few studies have investigated the determinant factors of nurses’ attitudes by identifying the current work pressure, resilience and self-efficacy in geriatric care facilities (GCFs). It is of great significance to explore the nurses’ attitudes toward POC and associated influencing factors related to psychological aspects including resilience, self-efficacy, and stress from the workplace.MethodsAttitudes for Providing Mouth Care (A-PMC) in Chinese version were used in this cross-sectional study with 160 nurses in 2 GCFs. Data were collected using online questionnaires and analyzed by multiple linear regression analysis. Statistically significant values were considered at p < 0.05.ResultsA total of 160 nurses participated in this study, with an average age of 32.86 ± 7.43. The mean score for the A-PMC was 2.81 ± 0.47. The score of A-PMC was negatively correlated with work pressure (r=-0.332, p < 0.01), and positively correlated with resilience (r = 0.735, p < 0.01) and self-efficacy (r = 0.425, p < 0.01) respectively. Multiple linear regression analyses identified that the potential influencing factors of A-PMC were education background, work hours every shift, self-efficacy, work pressure and resilience.ConclusionsThe study results indicate nurses’ attitudes regarding PMC were at a low level, which is influenced by many factors. To improve nurses’ attitudes toward PMC and the oral hygiene (OH) of the elderly in GCFs, it is necessary to increase nurses’ education and training, establish a reasonable and effective incentive mechanism to improve nurses’ work motivation and other intervention measures to reduce work pressure.