Social Care Burden Research Articles

Changes in instrumental activities daily living limitations and their associated factors according to gender in community-residing older adults: A longitudinal cohort study.

Increases in dependence among older adults cause increases in care needs and social care burden. Instrumental activities of daily living (IADL) are often used to assess the independence of older adults residing in communities. Various factors affect IADL limitations, but few studies confirm gender differences in IADL limitations in older adults. This study explored the changes in incidence of IADL limitations across 14 years and identified the factors associated with IADL limitations according to gender among older adults in Korea. This study uses secondary data analysis with 2006-2020 data from the Korean Longitudinal Study of Aging (KLoSA), a longitudinal cohort study. Among the total 10,254 participants, 1,230 adults aged 65 years and over who met the criteria were included in the final analysis. For each IADL item, a limitation was defined when the response was partial or complete dependence. Multivariate logistic regression was performed to identify the factors (in 2006) associated with IADL limitations in 2020. The mean age of the participants at baseline was 69.64 years (SD 3.93), and 61.0% of participants were female. Total scores for IADL limitations increased gradually across 14 years in all participants, and observed changes were statistically significant. The top three ranked items of IADL limitations differed according to gender in 2020: the top limitations in men were preparing meals, laundry, and using public transportation, and the top limitations in women were using public transportation, going out, and handling money. Factors associated with total IADL limitations were grip strength in men and age, dementia, fear of fall, and grip strength in women. Factors associated with the top three ranked items of IADL limitations differed according to gender. The incidence of IADL limitations gradually increased in all participants over a 14-year period. In older adults in Korea, gender differences were confirmed in the factors associated with IADL limitations, as well as in the main limited activities. To minimize IADL limitations in community-residing older adults, it is necessary to plan tailored interventions.

COVID-19 is associated with increased care needs and a decreased likelihood of returning home following a hip fracture: The IMPACT frailty study.

The primary aim was to evaluate the impact of COVID-19 on frailty in patients surviving a hip fracture. Secondary aims were to assess impact of COVID-19 on (i) length of stay (LoS) and post-discharge care needs, (ii) readmissions, and (iii) likelihood of returning to own home. This propensity score-matched case-control study was conducted in a single centre between 01/03/20-30/11/21. A 'COVID-positive' group of 68 patients was matched to 141 'COVID-negative' patients. 'Index' and 'current' Clinical Frailty Scale (CFS) scores were assigned for frailty at admission and at follow-up. Data were extracted from validated records and included: demographics, injury factors, COVID-19 status, delirium status, discharge destination, and readmissions. For subgroup analysis controlling for vaccination availability, the periods 1 March 2020-30 November 2020 and 1 February 2021-30 November 2021 were considered pre-/post-vaccine periods. Median age was 83.0years, 155/209 (74.2%) were female and median follow-up was 479days (interquartile range [IQR] 311). There was an equivalent median increase in CFS in both groups (+1.00 [IQR 1.00-2.00, p=0.472]). However, adjusted analysis demonstrated COVID-19 was independently associated with a greater magnitude change (Beta coefficient [β] 0.27, 95% confidence interval [95% CI] 0.00-0.54, p=0.05). COVID-19 in the post-vaccine availability period was associated with a smaller increase versus pre-vaccine (β -0.64, 95% CI -1.20 to -0.09, p=0.023). COVID-19 was independently associated with increased acute LoS (β 4.40, 95% CI 0.22-8.58, p=0.039), total LoS (β 32.87, 95% CI 21.42-44.33, p<0.001), readmissions (β 0.71, 95% CI 0.04-1.38, p=0.039), and a four-fold increased likelihood of pre-fracture home-dwelling patients failing to return home (odds ratio 4.52, 95% CI 2.08-10.34, p<0.001). Hip fracture patients that survived a COVID-19 infection had increased frailty, longer LoS, more readmissions, and higher care needs. The health and social care burden is likely to be higher than prior to the COVID-19 pandemic. These findings should inform prognostication, discharge-planning, and service design to meet the needs of these patients.

Physiologically-obtainable polyphenol exposures modulate reactive oxygen and nitrogen species signaling in the C2C12 model of skeletal muscle ageing

Age-related frailty is a significant health and social care burden, with limited treatment options. There is a lack of suitable cell culture model for screening large numbers of test compounds to identify those which promote healthy skeletal muscle function. This paper describes the characterization of reactive oxygen and nitrogen species (RONS) signalling changes in young and aged myoblasts and myotubes using C2C12 cells, and the application of aged cultures to assess the effect of dietary polyphenols on RONS signalling. Aged myoblasts and myotubes showed significantly increased reactive oxygen species (p < 0.01 and p < 0.001 respectively), nitric oxide (p < 0.05 for myoblasts and myotubes), and lipid peroxidation (p < 0.05 for myoblasts and myotubes). Nine polyphenols were assessed in aged myoblasts and myotubes using concentrations and incubation times consistent with known pharmacokinetic parameters for these compounds. Although several polyphenols were seen to reduce single markers of RONS signalling, only kaempferol and resveratrol significantly reduced multiple markers in both cell models. Modulation of enzymatic antioxidant activities was assessed as a possible mechanism of action, although superoxide dismutase and catalase activities were significantly reduced in aged (versus young) myotubes (p < 0.01 and p < 0.05 respectively), no effect of polyphenol treatment on these enzyme activities were observed. Overall, this research has shown the utility of the C2C12 model (myoblasts and myotubes) for screening compounds in aged muscle, and that resveratrol and kaempferol (using pharmacokinetically-informed exposures) can modulate RONS signalling in skeletal muscle cells after an acute exposure.

The knowledge and attitudes regarding pressure ulcer prevention among healthcare support workers in the UK: A cross-sectional study

BackgroundPressure ulcers cause significant, detrimental effects on personal wellbeing. They represent a serious health and social care burden. Nurses and those working in support roles are primarily accountable for preventing pressure ulcers. Healthcare support workers are an expanding group of key workers in the UK. ObjectiveTo examine healthcare support workers’ knowledge and attitudes regarding pressure ulcer prevention. MethodsA cross-sectional study was conducted from December 2020 to June 2021, using Knowledge and Attitudes toward Pressure Ulcer Prevention Assessment Tool. ResultsA total of 164 participants completed the questionnaire fully. A low mean knowledge score of 0.42 ± 0.14, but a positive attitude score of 0.76 ± 0.10 per item were reported. The weakest areas of knowledge include aetiology, risk assessment and addressing pressure-reducing interventions for patients at risk. Higher mean scores per item in knowledge of pressure ulcer prevention were reported in participants working in acute hospital wards and nursing homes (0.468 ± 0.15, 0.47 ± 0.08 respectively) than those in other settings (p < 0.05). Participants working in primary care scored lowest (0.33 ± 0.12). The scores of participants with more positive attitudes towards pressure ulcer prevention significantly correlated with higher score of knowledge (p < 0.005). ConclusionWhile positive attitudes towards pressure ulcer prevention exist among healthcare support workers, this is overshadowed by significant knowledge deficits. Findings highlight the importance of continuing structured education for support workers across both acute and community settings. A future national survey and interventional study are needed to examine support workers’ pressure ulcer knowledge and to inform a national continuous education strategy.

Investigating the Caregiver Burden and Related Factors in Parents of 4 to 12 Years Old Children With Down Syndrome Living in Tehran City, Iran, in 2020

Objective Having a child with a disability profoundly affects the family and can impose many problems and challenges on parents. Children with Down syndrome (DS) are a large group with special needs at risk for chronic physical illness, developmental problems, and behavioral and emotional problems. These problems create more health and care needs in these children. Therefore, the present study aimed to investigate the caregiver burden and related factors in parents of 4 to 12 years old children with DS living in Tehran City, Iran, in 2020. Materials &amp; Methods In this cross-sectional study, 150 parents (91 females and 59 males) of children with DS participated. They were referred to rehabilitation centers and Down Syndrome Center in Tehran City, Iran, and were selected using a convenience sampling method. The demographic information questionnaire and Novak caregiver burden questionnaire (1989) were used to collect the study data. The participants were asked to complete these questionnaires carefully. The non-parametric tests, including the Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests, were used to analyze the data in SPSS v. 21 software. Results Based on data analysis, the Mean±SD age of the parents was 38.78±7.92 years. Sixty percent of children with DS were boys, and 40% were girls with a Mean±SD age of 7.14±2.38 years. The mean and standard deviation of the total parental care burden score and its subscales were as follows: overall care burden, 68.12±17.51; temporal care burden, 15.95±5.2; developmental care burden, 15.46±4.84; mental care burden, 12.22±4.85; physical care burden, 11.24±4.47; and social care burden, 11.18±4.94. There was a significant relationship between care burden and the following variables: age of parents (r=-0.66, P=0.001), parents’ income (r=-0.6, P=0.001), number of children (r=0.55, P=0.001), and age of the child (r=0.6, P=0.001). While factors such as parents’ gender, child gender, parents’ marital status, receiving special education, care needs, and care status did not affect the amount of parental care burden (P&gt;0.05). Conclusion The results of the present study showed that parents of children with DS experience moderate care burden in caring for their child. The findings of this study provide the opportunity for relevant government agencies, specialists, and health centers to understand the needs of children with DS and their parents at different stages of the disease, treatment, and care. So they can develop appropriate strategies to reduce the caring stress of their caring parents.

Sectoral development of ICT for care

Because of disability and or aging or illness people need long term care services in specific part of their life. Health and social care burden is increasing day by day in the world and our country. These services are home care, daily care, residental care, nursing home and paliative care services. These services are provided elderly people by formal and informal caregivers. Both burden of care and cost of care is increasing because of growing population of World. For this reason, using ICT technologies in care services is an important issue that cost of care services can minimize by using this technologies in care. To illustrate, following individual diabete rate by far, home security systems for Alzheimer, easy use technological products for elderly people. Because these products are popular for people who every aged and from different socio- cultural levels that they need them. In Turkey, there are techno-parks and entrepreneurs that work in ICT for care. Nowadays, little part of consumers use ICT for care in home care services&mobile health care. In Turkey, families are caregivers in long term care services system mostly. Caring of disabled and elderly people is costly and hard. For increasing access of care services, families should be supported by ICT. Thus, existence structure will be sustainable care and health and social care expenditures will decrease. There is need of feasible study in ICT for care in our country. To sum up, using of ICT for care provide spreading of all care services models and relevant sectoral development.