Geriatric Hospital Patients Research Articles

Exploring depression, comorbidities and quality of life in geriatric patients: a study utilizing the geriatric depression scale and WHOQOL-OLD questionnaire

BackgroundThe increasing prevalence of depression among older adults is a growing concern. Chronic health conditions, cognitive impairments, and hospitalizations amplify emotional distress and depression levels in this population. Assessing the quality of life is crucial for the well-being of older adults.AimsOur study aimed to examine how comorbidities affect depression and quality of life in geriatric patients in both outpatient and hospital settings.Methods100 patients (50 from internal medicine outpatient clinic and 50 from internal medicine ward) were included in the study according to inclusion and exclusion criteria. Patients were classified into different age groups (65–74 years, 75–84 years and ≥ 85 years). Data on patients’ location of application, age, sex, living alone or with family status, number of comorbid diseases, types of accompanying diseases were recorded and WHOQOL-OLD and Geriatric Depression Scale (GDS) questionnaires were administered. Results were evaluated using SPSS.ResultsThe WHOQOL-OLD questionnaire score was higher in the 65–74 age group compared to other groups, but there was no significant difference between outpatient group and hospitalized group. Patients with comorbid diseases had lower WHOQOL-OLD questionnaire scores compared to those without comorbid diseases. In the 75–84 and ≥ 85 age groups, the GDS scores were higher compared to the 65–74 age group. In hospitalized group, GDS scores were higher than outpatient clinic group. In patients with comorbid diseases, GDS scores were higher than the ones without comorbid diseases.DiscussionOur findings indicate that quality of life is higher among those aged 65–74, with lower incidence of depression compared to other age groups. Hospitalization correlates with higher depression rates but not quality of life. As number of comorbid diseases increases in older adults, the frequency of depression rises and the quality of life declines.ConclusionsEarly detection and intervention for depression are crucial for enhancing older adults’ well-being.

Factors Affecting COVID-19 Incidences and Deaths of Geriatric Hospital Patients in Korea.

The current retrospective study aimed to investigate the association between organizational factors and nursing staff in geriatric hospitals and coronavirus disease 2019 (COVID-19) incidences and deaths using secondary data from governments nationwide in Korea. We used data on the number of COVID-19-confirmed cases and deaths among older adults in geriatric hospitals and nursing staff levels in those hospitals. We found that when the RN level was higher than the sample mean, the number of COVID-19-confirmed cases by geriatric hospital was significantly lower (4.3%; p = 0.05) and the number of deaths by geriatric hospital was marginally significantly lower (1.4%; p = 0.05). This study presented the national description of geriatric hospitals during the COVID-19 pandemic in terms of organizational and nursing staff factors. Findings highlight the impact of nursing staff skill mix and number of geriatric hospitals during the COVID-19 pandemic in Korea. It is necessary to allocate a realistic designation of infection control staff and establish a clear standard so infection control activities in geriatric hospitals can proceed systematically. [Research in Gerontological Nursing, 16(6), 302-311.].

Sarcopenic Dysphagia Revisited: A Cross-Sectional Study in Hospitalized Geriatric Patients.

Oropharyngeal dysphagia (OD) is a frequent finding in older patients with potentially lethal complications such as aspiration pneumonia, malnutrition, and dehydration. Recent studies describe sarcopenia as a causative factor for OD, which is occasionally referred to as "sarcopenic dysphagia" in the absence of a neurogenic etiology. In most of the previous studies on sarcopenic dysphagia, the diagnosis was based only on clinical assessment. In this study, flexible endoscopic evaluation of swallowing (FEES) was used as an objective method to evaluate the presence of OD, its association with sarcopenia, and the presence of pure sarcopenic dysphagia. In this retrospective cross-sectional study, 109 acute care geriatric hospital patients with suspected OD received FEES examination and bioimpedance analysis (BIA) in clinical routine. 95% of patients had at least one neurological disease, 70% fulfilled the criteria for sarcopenia, and 45% displayed moderate or severe OD. Although the prevalence of sarcopenia and OD was high, there was no significant association between OD and sarcopenia. Considering these results, both the association between sarcopenia and OD and pure sarcopenic dysphagia appear questionable. Further prospective studies are needed to elucidate if sarcopenia is merely an epiphenomenon of severe disease or whether it plays a causative role in the development of OD.

Clinical profile of geriatric cervical cancer patients in a tertiary hospital in Surabaya, Indonesia

HIGHLIGHTS Squamous cell carcinoma majorly covered in histopathologic of the records, while adenosquamous followed second. Most of the subjects were referral patients to Dr. Soetomo General Academic Hospital. They were mostly originated from Java outside Surabaya. ABSTRACT Objective: To identify the distribution of age, histopathology type, clinical stage, treatment type, parity, first complaint, and referral origin of geriatric cervical cancer patients at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Materials and Methods: This study was a retrospective study observing data from medical records and presented the data descriptively. The medical records were taken from Oncology Outpatient Clinic in Dr. Soetomo Hospital, from 2020-2021, covering geriatric patients aged more than 55 years old. The data were screened and processed. Results: At Dr. Soetomo Hospital, in 2020-2021 there were 228 cervical cancer patients. From 176 patient data that met the inclusion criteria, the average age was 65.38 ± 4.86 years, with 4 types of histopathology dominated by squamous cell carcinoma (82.39%), adenocarcinoma (11.93%), adenoquamous (3.41%) and others (4%), divided into 8 clinical stages and dominated by stages IIIB (77.27%), IIB (15.9%), IVB (2.84%), IIIA and IB had same number (1.14%), 1A (0.57%) and no cases of IIA were found. The treatments were dominated by chemotherapy (86.36%), radiation therapy (7.38%), no treatment (3.41%), hysterectomy (1.7%), while for conization and palliative therapy each in 1 case (0.57%). Most experienced 3 parity (29.5%), followed by 4 parity (17.61%), >5 (13.07%), 5 (10.23%), 1 (6.82%) and no parity (2.27%). The three first complaints were. vaginal bleeding (82.38%), vaginal discharge (46.02%), and pain (82.38%), and the patients were dominated by referrals from Java Island other than Surabaya City (78.40%), outside Surabaya in Java Island as many as 36 referrals (20.45%) and outside Java Island 2 referrals (1.14%). Conclusion: There were 176 geriatric patients with cervical cancer at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, in the 2020-2021 period, dominated by age 56-65 years, the histopathology type of squamous cell carcinoma, stage IIIB patients, most received therapy was chemotherapy, most were multiparous with 3 parities, the majority experienced complaints of vaginal bleeding when diagnosed with cervical cancer, and were dominated by referrals from Java Island outside Surabaya.

Post-stroke depression in Vietnamese patients is associated with decreased sleep quality and increased fatigue: a one-institution cross-sectional analysis.

This study aimed to determine the prevalence of post-stroke depression (PSD) during the first year and its associated factors, especially focusing on sleep quality and fatigue severity. A cross-sectional study was conducted among stroke patients in Vietnam's National Geriatric Hospital. Data were collected by using standardized questionnaires for interviewing and evaluating patients at the research site. Several covariables were presented including demographics, stroke-related characteristics, activities of daily living, post-stroke fatigue, and sleep quality (Pittsburgh Sleep Quality Index [PSQI] scale). PSD was assessed as an outcome variable through the Patient Health Questionnaire-9 scale. To summarize sociodemographic and clinical variables, descriptive statistics were performed. A logistic regression model was used to explore the factors related to PSD. Of 157 patients with stroke, mean age 73.1 (± 9.6),PSD was present in 60 patients (38%). The global score and all PSQI components of participants with PSD showed worse levels than those without depression. Furthermore, the prevalence of PSD was higher in patients with low IADL scores and functional disability at high levels. In the multivariate logistic regression analysis, the patients with PSDshowed higher Fatigue Severity Scale (FSS) scores (OR = 4.11; 95% CI = 1.39; 12.19) and higher scores in two domains of the PSQI scale including subjective sleep quality (OR = 3.03; 95% CI = 1.21; 7.58) and sleep disturbance (OR = 5.22; 95% CI = 1.33; 20.47). There is a significant prevalence of depression following stroke. Furthermore, post-stroke fatigue and two PSQI scale components (subjective sleep quality and sleep disturbance) were shown to be associated with PSD. This finding may guide early screening and intervention strategies to address depression following stroke.

Malnutrition and Poor Physical Function Are Associated With Higher Comorbidity Index in Hospitalized Older Adults.

BackgroundThe Charlson Comorbidity Index (CCI) is the most widely used method to measure comorbidity and predict mortality. There is no evidence whether malnutrition and/or poor physical function are associated with higher CCI in hospitalized patients. Therefore, this study aimed to (i) analyze the association between the CCI with nutritional status and with physical function of hospitalized older adults and (ii) examine the individual and combined associations of nutritional status and physical function of older inpatients with comorbidity risk.MethodsA total of 597 hospitalized older adults (84.3 ± 6.8 years, 50.3% women) were assessed for CCI, nutritional status (the Mini Nutritional Assessment-Short Form [MNA-SF]), and physical function (handgrip strength and the Short Physical Performance Battery [SPPB]).ResultsBetter nutritional status (p < 0.05) and performance with handgrip strength and the SPPB were significantly associated with lower CCI scores among both men (p < 0.005) and women (p < 0.001). Patients with malnutrition or risk of malnutrition (OR: 2.165, 95% CI: 1.408–3.331, p < 0.001) as well as frailty (OR: 3.918, 95% CI: 2.326–6.600, p < 0.001) had significantly increased the risk for being at severe risk of comorbidity. Patients at risk of malnutrition or that are malnourished had higher CCI scores regardless of being fit or unfit according to handgrip strength (p for trend < 0.05), and patients classified as frail had higher CCI despite their nutritional status (p for trend < 0.001).ConclusionsThe current study reinforces the use of the MNA-SF and the SPPB in geriatric hospital patients as they might help to predict poor clinical outcomes and thus indirectly predict post-discharge mortality risk.

Positioning the hand to act-Validation of the 8-point reaching range test

HintergrundDas standardisierte geriatrische Assessment der oberen Extremitäten beschränkt sich häufig auf die Messung der Handkraft. Als einziges weiteres Instrument nennt die S1-Leitlinie zum geriatrischen Assessment der Stufe 2 den 20-Cents-Test (20-C-T). Neben Kraft und Feinmotorik ist jedoch das erfolgreiche Platzieren der Hand eine Voraussetzung für die Selbstversorgung.Ziel der ArbeitZur standardisierten seitengetrennten Überprüfung des alltagsrelevanten Positionierens der Hand im Sitzen wurde der 8‑Punkte-Greifraum-Test (8P-GRT) entwickelt. Die Studie diente der Ermittlung von Gütekriterien des 8P-GRT bei geriatrischen Krankenhauspatienten.Material und MethodenZwischen dem 31.07.2019 und dem 23.09.2019 wurden im Krankenhaus Rotes Kreuz Lübeck – Geriatriezentrum 82 stationäre Patienten mithilfe des 8P-GRT, des Shoulder Pain and Disability Index (SPADI), einem zu den Handpositionen des 8P-GRT korrespondierenden Fragebogen zu Aktivitäten der Selbstversorgung, der Handkraftmessung und dem 20-C‑T untersucht.ErgebnisseDie Interrater-Reliabilität betrug 0,99, die Retest-Reliabilität 0,95 für die rechte und 0,90 für die linke Seite. Auf die Person bezogen, trat ein Deckeneffekt (beidseits Score 8) bei 4,1 % (n = 3) auf; kein Bodeneffekt wurde beobachtet. Die interne Konsistenz (Cronbachs α) des gemäß Faktorenanalyse zweifaktoriellen Tests betrug 0,78 (rechts) bzw. 0,76 (links). Jeder der anderen Tests korrelierte enger mit dem 8P-GRT auf der rechten Seite, wobei die Korrelation mit dem oben genannten Fragebogen am höchsten war (−0,72), gefolgt vom SPADI (−0,60).DiskussionEine standardisierte Erhebung der Handkraft, Feinmotorik und aktiven Positionierung der Hand (z. B. 8P-GRT) fügt die Hauptaspekte der Funktionsfähigkeit der oberen Extremitäten zu einem Gesamtbild zusammen.

Interrater reliability of routine screening for risk of malnutrition with the Mini Nutritional Assessment Short-Form in hospital

Background/objectivesThe Mini Nutritional Assessment Short-Form (MNA-SF) is the recommended screening tool for older persons. Data on interrater reliability in clinical routine are rare. Thus, we wanted to quantify the interrater reliability of the MNA-SF in hospital.Subjects/methodsThis observational cross-sectional study was undertaken retrospectively. The study population comprised 105 participants. Risk of malnutrition was measured twice with the routine MNA-SF performed by nurses (within 24 h after admission) and a dedicated dietician (one to three days after the first MNA-SF). The MNA-SF score was analyzed for interrater reliability between nurse and dietician.ResultsParticipants’ mean age was 82.4 (±7.1) years and 71 (68%) were women. The mean total MNA-SF score was 7.4 (±2.4) assessed by dietician and 7.8 (±2.3) assessed by nurse. The intra-class correlation coefficient between the total MNA-SF scores was 0.74 (0.61; 0.82), indicating moderate reliability. For the MNA-SF nutritional status, Cohens Kappa was 0.37 (p < 0.05) showing a fair agreement.ConclusionMultiple misclassifications were observed between malnutrition and risk of malnutrition. Because mean scores were near the border between malnutrition and risk of malnutrition, we recommend to consider the total MNA-SF score in addition to the three risk groups to assess nutritional risk in geriatric hospital patients.

A study on assessment of sleep pattern and perceived stress among geriatric patients in Medical College and Hospital, Kolkata

Background: In addition to risk of developing different non-communicable diseases, chronic diseases, and disabilities with increases of age, elderly people are more likely to suffer from mental and psychological distress and sleep disturbances which are again very much related to other physical problems of elderly. However, these two issues are often neglected and also were not addressed by research work adequately. Aims and Objectives: In above backdrop, our present study was conducted to determine sleep pattern and perceived stress among elderly population and their relationship with sociodemographic parameters. Materials and Methods: An observational descriptive cross-sectional study was conducted in Geriatric Outpatient Department (OPD) of Medical College and Hospital, Kolkata, from August to October 2022, among 161 geriatric OPD patients. A semi-structured questionnaire was used for eliciting sociodemographic information. Pittsburgh Sleep Quality Index and perceived stress scale were used for assessing sleep quality and perceived stress of participants respectively. Data were analyzed in the Statistical Package for the Social Sciences (version 20). Results: About 41.2% participants suffered from poor sleep pattern. About 41.2% of geriatric participants had low level of stress and rest had moderate stress. Age and marital status were significantly associated with both sleep pattern and perceived stress. Socioeconomic status was related to sleep score, whereas perceived stress was associated with education of elderly participants. Conclusion: Poor quality of sleep and stress has an impact on other physical health problems of elderly such as diabetes, hypertension, and cardiovascular diseases. Hence, awareness generation among general population and provision of adequate management in elderly health clinics regarding these two issues is required.

Profile and needs of primary informal caregivers of older patients in Belgian geriatric day hospitals: a multicentric cross-sectional study

BackgroundWith the improvement of life expectancy, the world faces increasing demands for care of older persons. In this manuscript, we define the characteristics of primary informal caregivers (PIC) of patients aged 75 years and older admitted to geriatric day hospitals (GDH) in Belgium. A PIC is defined as the person who most often provides care and assistance to persons who need to be cared for. We describe PIC socio-demographic characteristics, satisfaction, burden and wishes about caring; the type of assistance provided and received, their self-rated health, socio-demographic and medical characteristics of proxies, in particular the presence of behavioural disorders.MethodsWe conducted a cross-sectional study in 25 GDH.ParticipantsFour hundred seventy-five PIC of patients ≥75 years and their proxies. PIC completed a questionnaire at the GDH assessing burden by Zarit Burden Index-12 (ZBI-12), self-rated health, social restriction due to caregiving and financial participation. We compared the characteristics of PIC with high and low burden, and the characteristics of spouses and adult children PIC. We also analyzed factors associated with a high burden in a multivariable logistic regression model.ResultsPIC were mainly women (72%), adult children (53.8%) and spouses (30.6%). The mean age was 64 ± 14 years for PIC and 84 ± 5 years for care recipients. PIC helped for most of Activities in Daily Living (ADL) and Instrumental ADL (iADL). The median ZBI-12 score was 10 [IQR 5–18]. In multivariable regression analysis, a high burden was positively associated in the total group with living with the relative (p = 0.045), the difficulty to take leisure time or vacation (p < 0.001), behavioral and mood disorders (p < 0.001;p = 0.005), and was negatively associated with bathing the relative (p = 0.017) and a better subjective health status estimation (p < 0.001).ConclusionPrimary informal caregivers, who were predominantly women, were involved in care for ADL and iADL. A high burden was associated with living with the relative, the difficulty to take leisure time or vacation and the relative’s behavioral and mood disorders. Bathing the relative and a subjective health status estimated as good as or better than people the same age, were protective factors against a high burden.

Weight loss and malnutrition risk in geriatric patients

HintergrundMangelernährung stellt eine große Herausforderung im klinischen Alltag dar und ist mit einer erhöhten Mortalität assoziiert.Ziel der ArbeitIm vom Bundesministerium für Bildung und Forschung (BMBF) geförderten Forschungsprojekt Prävention und Behandlung von Mangelernährung bei geriatrischen Patienten im Krankenhaus werden Routinedaten ausgewertet. Ziel ist es, die Ursachen eines in der Klinik erworbenen Mangelernährungsrisikos aufzudecken.Material und MethodenAusgewertet werden anonymisierte Daten von insgesamt 2058 PflegeheimbewohnerInnen aus 19 Pflegeeinrichtungen mit mindestens 3‑tägigem Klinikaufenthalt. Mangelernährungsrisiko wird mithilfe der kombinierten Screenings MUST/PEMU (Malnutrition Universal Screnning Tool/Pflegerische Erfassung von Mangelernährung und deren Ursachen) , die manifeste Mangelernährung entsprechend den ESPEN-Kriterien (European Society for Clinical Nutrition and Metabolism) bestimmt.ErgebnisseEin initialer Anteil von 36,2 % (n = 744) weist ein Mangelernährungsrisiko und 12,7 % (n = 262) eine manifeste Mangelernährung auf; die Anteile steigen nach Klinikaufenthalt auf 48,6 % (n = 881) bzw. 14,3 % (n = 259). Die logistische Regressionsanalyse zeigt eine signifikant steigende Wahrscheinlichkeit, ein Mangelernährungsrisiko während des Klinikaufenthaltes zu entwickeln, wenn Einweisungsdiagnosen der ICD-10-Gruppen (International Classification of Diseases and Related Health Problems) Krankheiten des Atmungssystems (OR 2,686; 95 %-KI 1,111–4,575) und Nebendiagnosen der Gruppe Osteopathien und Chondropathien (OR 1,892; 95 %-KI 1,149–3,115) vorliegen sowie bei einem höheren BMI (OR 1,108; 95 %-KI 1,038–1,181), positiveren Gewichtsveränderungen 6 Monate vor Krankenhaus (OR 1,055; 95 %-KI 1,017–1,094) und einer steigenden Anzahl an Behandlungstagen (OR 1,048; 95 %-KI 1,029–1,067).DiskussionSowohl die Identifikation einer initialen Mangelernährung als auch die Prävention eines innerklinischen Mangelernährungsrisikos stellt eine große Herausforderung für die Kliniken dar. Beides ist aber gleichermaßen erforderlich.Zusatzmaterial onlineZusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00391-021-01900-z) enthalten.

Evaluation of Drug Utilization Pattern among Geriatric Patients in a District Head Quarters Government Hospital using World Health Organization Indicators

Evaluation of Drug Utilization Pattern among Geriatric Patients in a District Head Quarters Government Hospital using World Health Organization Indicators

Pattern of usage of psychotropic agents in geriatric patients in a teritiary care hospital

Psychotropic medications are used in the treatment of chronic psychotic disorders like anxiety, depression, insomnia, bipolar disorders, cognitive impairment, seizure, loss of consciousness, altered sensorium, delirium etc. The objective of this study is to describe the pattern of use of psychotropic medications in patients presenting to geriatrics department, to compare the pattern of usage of psychotropic medication at the time of admission versus at the time of discharge and to find out the dose optimization pattern in elderly patients. Observational retrospective study, conducted in the department of geriatrics. The sample size calculated for the study was 35. The study was carried out through AHIS and by reviewing case files. The data were collected on specially designed data collection forms. Consumption of the psychotropic drugs was the highest within 71-80 years of age group, of which 49.15% of patients fall in this age group. All of the patients prescribed with psychotropic medications had insomnia (26.70%), followed by anxiety (20.30%), seizure (20.30%) and depression (16.90%). Among the 2nd generation anti psychotropics, quetiapine was the most frequently prescribed drug (54.24%). Benzodiazepines were the preferred antidepressants (36%) followed by SSRIs. Sixty two percent of the patients continued the same dose prescribed from the outside hospital and a dose increment was done for 37.5% of the patients. The incidence of usage of psychotropic medications were found to be more with females. Atypical antipsychotic drugs were the most commonly used ones. Current evidence shows no superiority for atypical antipsychotics over haloperidol.

Ethical Conflicts Experienced by Nurses in Geriatric Hospitals in South Korea: "If You Can't Stand the Heat, Get Out of the Kitchen".

Ethical conflicts among nurses can undermine nurses’ psychological comfort and compromise the quality of patient care. In the last decade, several empirical studies on the phenomena related to ethical conflicts, such as ethical dilemmas, issues, problems, difficulties, or challenges, have been reported; however, they have not always deeply explored the meaning of ethical conflicts experienced by nurses in geriatric care. This study aims to understand the lived experiences of ethical conflict of nurses in geriatric hospitals in South Korea. A phenomenological study was conducted. In-depth, face-to-face interviews were performed with nine registered nurses who cared for elderly patients in geriatric hospitals in South Korea between August 2015 and January 2016. Three main themes emerged from the analysis: (1) confusing values for good nursing, (2) distress resulting from not taking required action despite knowing about a problem, and (3) avoiding ethical conflicts as a last resort. It was found that for geriatric nurses to cope with ethical conflicts successfully, clear ethical guidance, continuing ethics education to improve ethical knowledge and moral behaviors, and a supportive system or program to resolve ethical conflicts involving nurses should be established.

Comparative Analysis of Cognitive and Physical Function according to Dysphagia of Aged Patients in Geriatric Hospitals

Comparative Analysis of Cognitive and Physical Function according to Dysphagia of Aged Patients in Geriatric Hospitals

Prescribing Pattern of Medications in Geriatric Patients in a South Indian Tertiary Care Teaching Hospital

Prescribing Pattern of Medications in Geriatric Patients in a South Indian Tertiary Care Teaching Hospital

Frailty Levels In Geriatric Hospital paTients (FLIGHT)—the prevalence of frailty among geriatric populations within hospital ward settings: a systematic review protocol

IntroductionFrailty is a common and clinically significant condition in geriatric populations, associated with adverse health outcomes such as hospitalisation, disability and mortality. Although there are systematic reviews/meta-analyses assessing the prevalence...

가상현실 관광 콘텐츠 경험가치 요인이 노인 우울감 감소에 미치는 영향: 요양병원 노인환자를 중심으로

가상현실 관광 콘텐츠 경험가치 요인이 노인 우울감 감소에 미치는 영향: 요양병원 노인환자를 중심으로

HOMEFOOD Study - Home Delivered Food and Nutrition Therapy for Discharged Geriatric Hospital Patients

HOMEFOOD Study - Home Delivered Food and Nutrition Therapy for Discharged Geriatric Hospital Patients

The Relation between Hand Function and Sleep Disturbance Factors According to Quality of Sleep among Elderly Patients in Geriatric Hospitals

The Relation between Hand Function and Sleep Disturbance Factors According to Quality of Sleep among Elderly Patients in Geriatric Hospitals