International Journal of Environmental Research and Public Health

Research

8 pages, 309 KiB

Open AccessArticle

Cough Test Results during Screening for Silent Aspiration Are Affected by Risk Factors for Silent Cerebral Infarct in Older Adults with Chronic Disease

by Ayako Nakane, Kazuharu Nakagawa, Kohei Yamaguchi, Kanako Yoshimi, Yoshiko Hara and Haruka Tohara

Int. J. Environ. Res. Public Health 2022, 19(16), 10202; https://doi.org/10.3390/ijerph191610202 - 17 Aug 2022

Cited by 1 | Viewed by 1518

Abstract

The cough reflex does not change with age. However, older adults with chronic diseases often have a reduced cough reflex. The effects of several risk factors on reduced cough sensitivity in older adults remain unclear. This study aims to clarify the risk factors [...] Read more.

The cough reflex does not change with age. However, older adults with chronic diseases often have a reduced cough reflex. The effects of several risk factors on reduced cough sensitivity in older adults remain unclear. This study aims to clarify the risk factors for reduced cough sensitivity in older adults with chronic diseases. This cross-sectional study included participants aged <65 years (young group; n = 21), those aged ≥65 years (older adults with chronic disease group; n = 18), and those with dysphagia (dysphagia group; n = 16). A cough test was performed on all participants using an ultrasonic nebulizer with a mist of 1% w/v citric acid physiologic saline. Cough response was observed in the young (21/21), older adult (9/18), and dysphagia (13/16) groups. The difference between the young and older adult groups was significant (p < 0.01). The older adult and dysphagia groups had decreased cough sensitivity compared to the younger group. Cough sensitivity was affected by risk factors for silent cerebral infarct and age. Our findings show that cough test results might be affected by risk factors for silent cerebral infarction in older adults with chronic diseases. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

15 pages, 1789 KiB

Open AccessArticle

Quality-of-Life Evaluation among the Oldest-Old in China under the “Active Aging Framework”

by Xin Xu, Yuan Zhao, Jianfang Zhou and Siyou Xia

Int. J. Environ. Res. Public Health 2022, 19(8), 4572; https://doi.org/10.3390/ijerph19084572 - 11 Apr 2022

Cited by 7 | Viewed by 2782

Abstract

China is facing an increasingly contradictory challenge between growing demand for health services for the oldest-old and the unbalanced and inadequate development in the context of rapid population aging. This study sought to evaluate the quality of life of the oldest-old in China [...] Read more.

China is facing an increasingly contradictory challenge between growing demand for health services for the oldest-old and the unbalanced and inadequate development in the context of rapid population aging. This study sought to evaluate the quality of life of the oldest-old in China under the active aging framework. Health, participation, and security data were sourced from China Statistics/Labor Statistics/Civil Affairs Yearbook 2000–2016 and National 1% Sample Survey Data 2005–2015. Then, we used the current life table, entropy method, coefficient variation, and panel data regression to evaluate the quality of life among the oldest-old and reveal its regional differences and mechanisms. The results show: (1) From 2005 to 2015, the overall quality of life in China steadily improved, and the quality of health, participation, and security of the oldest-old increased by 6.06%, 5.64%, and 47.48%, respectively. (2) Distinct regional disparities exist in the distribution of quality of life for the oldest-old in China; the “east–northeast–middle–west” stepped-declining pattern existed stably. (3) Population and family structure, economic development, and social security were the main reasons for the regional differences in quality of life for the oldest-old. Narrowing the socioeconomic gap between regions, promoting the function of family pension, and improving social old-age service supply will help improve the quality of life of the oldest-old. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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11 pages, 373 KiB

Open AccessArticle

by Raquel Díez, Raquel Cadenas, Julen Susperregui, Ana M. Sahagún, Nélida Fernández, Juan J. García, Matilde Sierra and Cristina López

Int. J. Environ. Res. Public Health 2022, 19(7), 4313; https://doi.org/10.3390/ijerph19074313 - 4 Apr 2022

Cited by 11 | Viewed by 3764

Abstract

At present, 19.2% of the Spanish population is aged 65 or older. Polypharmacy is a frequent condition among the elderly, especially in those living in nursing homes, which is associated with adverse outcomes, such as adverse drug events or drug-drug interactions. This study [...] Read more.

At present, 19.2% of the Spanish population is aged 65 or older. Polypharmacy is a frequent condition among the elderly, especially in those living in nursing homes, which is associated with adverse outcomes, such as adverse drug events or drug-drug interactions. This study aimed to assess the pattern of polypharmacy in a nursing home in Leon, one of Spain’s most ageing regions, and its relationship with different drug-related problems. A descriptive, observational, and cross-sectional study design was used; 222 residents were involved in this study. Data on drug use were collected from medical charts. Information was screened with the software CheckTheMeds, BOT PLUS and Drug-Reax. Residents were on a median of 7 medicines. Polypharmacy and inappropriate medications were present in 78.8% and 96.8% of residents, respectively. Drug-related problems were present in almost all the populations evaluated. Drug-drug interactions were very common in participants (81.1%), being severe/moderate in 24.7%. A high prevalence of polypharmacy and drug-related problems in the nursing home population assessed has been observed. A significantly higher risk of suffering drug-drug interactions was revealed for increasing polypharmacy and anticholinergic risk. A regular evaluation of drug prescribing in nursing home residents is necessary to minimize drug-related problems risk. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

11 pages, 4219 KiB

Open AccessArticle

Radial-EBUS: CryoBiopsy Versus Conventional Biopsy: Time-Sample and C-Arm

by Paul Zarogoulidis, Christoforos S. Kosmidis, Wolfgang Hohenforst-Schmidt, Dimitrios Matthaios, Konstantinos Sapalidis, Dimitrios Petridis, Eleni-Isidora Perdikouri, Nikos Courcoutsakis, Dimitris Hatzibougias, Christos Arnaoutoglou, Lutz Freitag, Aristeidis Ioannidis, Haidong Huang, Christos Tolis, Chong Bai and J. Francis Turner

Int. J. Environ. Res. Public Health 2022, 19(6), 3569; https://doi.org/10.3390/ijerph19063569 - 17 Mar 2022

Cited by 8 | Viewed by 2314

Abstract

Introduction: Diagnosis of lung nodules is still under investigation. We use computed tomography scans and positron emission tomography in order to identify their origin. Patients and Methods: In our retrospective study, we included 248 patients with a single lung nodule or multiple lung [...] Read more.

Introduction: Diagnosis of lung nodules is still under investigation. We use computed tomography scans and positron emission tomography in order to identify their origin. Patients and Methods: In our retrospective study, we included 248 patients with a single lung nodule or multiple lung nodules of size ≥1 cm. We used a radial-endobronchial ultrasound and a C-Arm. We used a 1.1 mm cryoprobe versus a 22G needle vs. forceps/brush. We compared the sample size of each biopsy method with the number of cell-block slices. Results: Central lesions indifferent to the method provided the same mean number of cell-block slices (0.04933–0.02410). Cryobiopsies provide less sample size for peripheral lesions due to the higher incidence of pneumothorax (0.04700–0.02296). Conclusion: The larger the lesion ≥2 cm, and central, more cell-blocks are produced indifferent to the biopsy method (0.13386–0.02939). The time of the procedure was observed to be less when the C-Arm was used as an additional navigation tool (0.14854–0.00089). Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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14 pages, 373 KiB

Open AccessArticle

Relationship between Health Literacy and Knowledge, Compliance with Bowel Preparation, and Bowel Cleanliness in Older Patients Undergoing Colonoscopy

by Minju Gwag and Jaeyong Yoo

Int. J. Environ. Res. Public Health 2022, 19(5), 2676; https://doi.org/10.3390/ijerph19052676 - 25 Feb 2022

Cited by 5 | Viewed by 2502

Abstract

Compared to young adults, it is difficult for the older people with relatively low health literacy to perform proper bowel preparation for a colonoscopy. This study aims to identify the relationship between knowledge, compliance with bowel preparation, and bowel cleanliness with health literacy [...] Read more.

Compared to young adults, it is difficult for the older people with relatively low health literacy to perform proper bowel preparation for a colonoscopy. This study aims to identify the relationship between knowledge, compliance with bowel preparation, and bowel cleanliness with health literacy in older patients undergoing colonoscopy. The participants were 110 older people undergoing colonoscopy, recruited from an endoscopy hospital in G metropolitan city, South Korea. Data obtained from a structured questionnaire that included items on health literacy and knowledge of and compliance with bowel preparation, and the Aronchick bowel cleanliness scale. The data were analyzed using descriptive statistics, χ-test, Pearson’s correlation, t-test, and ANCOVA. Participants who were younger and those with a higher education level and better economic status had a statistically significantly higher health literacy level. Older people with a health literacy level of 7 points and above had a higher knowledge level and bowel cleanliness index, a showed better compliance with bowel preparation. The results highlight the need for developing a customized education intervention program that can improve health literacy for successful bowel preparation and examination of the older population undergoing colonoscopy. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

17 pages, 784 KiB

Open AccessArticle

Quality of Life among Next of Kin of Frail Older People in Nursing Homes: An Interview Study after an Educational Intervention concerning Palliative Care

by Gerd Ahlström, Helena Rosén and Eva I. Persson

Int. J. Environ. Res. Public Health 2022, 19(5), 2648; https://doi.org/10.3390/ijerph19052648 - 24 Feb 2022

Cited by 1 | Viewed by 2412

Abstract

One cornerstone of palliative care is improving the family’s quality of life (QoL). The principles of palliative care have not been sufficiently applied in nursing homes. The aim of this study was to investigate the experiences of QoL of next of kin of [...] Read more.

One cornerstone of palliative care is improving the family’s quality of life (QoL). The principles of palliative care have not been sufficiently applied in nursing homes. The aim of this study was to investigate the experiences of QoL of next of kin of frail older persons in nursing homes after an educational intervention concerning palliative care. This qualitative interview study with 37 next of kin used an abductive design with deductive and inductive content analysis. The deductive analysis confirmed the three themes of QoL from the study before the implementation: (1) orientation to the new life-situation, (2) challenges in the relationship, and (3) the significance of the quality of care in the nursing home. The inductive analysis resulted in the sub-theme “Unspoken palliative care”. Being the next of kin of an older person living in a nursing home can be distressing despite round-the-clock care, so staff need to apply a more explicitly palliative care perspective. Future research needs to evaluate the influence of meaning-focused coping on next of kin’s QoL and integrate this knowledge in psychosocial interventions. Clinical Trial Database for Clinical Research: KUPA project NCT02708498. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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16 pages, 3464 KiB

Open AccessArticle

A Night-Time Monitoring System (eNightLog) to Prevent Elderly Wandering in Hostels: A Three-Month Field Study

by James Chung-Wai Cheung, Eric Wing-Cheung Tam, Alex Hing-Yin Mak, Tim Tin-Chun Chan and Yong-Ping Zheng

Int. J. Environ. Res. Public Health 2022, 19(4), 2103; https://doi.org/10.3390/ijerph19042103 - 13 Feb 2022

Cited by 20 | Viewed by 3806

Abstract

Older people are increasingly dependent on others to support their daily activities due to geriatric symptoms such as dementia. Some of them stay in long-term care facilities. Elderly people with night wandering behaviour may lose their way, leading to a significant risk of [...] Read more.

Older people are increasingly dependent on others to support their daily activities due to geriatric symptoms such as dementia. Some of them stay in long-term care facilities. Elderly people with night wandering behaviour may lose their way, leading to a significant risk of injuries. The eNightLog system was developed to monitor the night-time bedside activities of older people in order to help them cope with this issue. It comprises a 3D time-of-flight near-infrared sensor and an ultra-wideband sensor for detecting human presence and to determine postures without a video camera. A threshold-based algorithm was developed to classify different activities, such as leaving the bed. The system is able to send alarm messages to caregivers if an elderly user performs undesirable activities. In this study, 17 sets of eNightLog systems were installed in an elderly hostel with 17 beds in 9 bedrooms. During the three-month field test, 26 older people with different periods of stay were included in the study. The accuracy, sensitivity and specificity of detecting non-assisted bed-leaving events was 99.8%, 100%, and 99.6%, respectively. There were only three false alarms out of 2762 bed-exiting events. Our results demonstrated that the eNightLog system is sufficiently accurate to be applied in the hostel environment. Machine learning with instance segmentation and online learning will enable the system to be used for widely different environments and people, with improvements to be made in future studies. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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14 pages, 947 KiB

Open AccessArticle

Bridging the Knowledge Gap for Pressure Injury Management in Nursing Homes

by Ye-Na Lee, Dai-Young Kwon and Sung-Ok Chang

Int. J. Environ. Res. Public Health 2022, 19(3), 1400; https://doi.org/10.3390/ijerph19031400 - 27 Jan 2022

Cited by 6 | Viewed by 4687

Abstract

Background: Pressure injuries in nursing homes remain a consistent problem. Unfortunately, despite the variety of pressure injury education offered in nursing homes, the knowledge learned cannot be applied in practice, and as a result, the prevalence and incidence of such injuries are consistently [...] Read more.

Background: Pressure injuries in nursing homes remain a consistent problem. Unfortunately, despite the variety of pressure injury education offered in nursing homes, the knowledge learned cannot be applied in practice, and as a result, the prevalence and incidence of such injuries are consistently high. This study aimed to address those gaps by analyzing the nursing competency for pressure injury management and implementing pressure injury education programs in nursing homes. Methods: Two phases were conducted based on the action cycle in the knowledge to action model. During the first phase, a framework was constructed by analyzing nursing experience. The second phase consisted of the implementation and monitoring of the program to evaluate the effects of the framework. Results: The main results for nursing competencies for pressure injury management in nursing homes are integrated thinking, understanding in an environmental context, interpersonal relationships for efficient decision making, and meeting any challenges to professional development. The results concerning the program’s effects showed significant differences in the participants’ knowledge, attitude, stage discrimination ability, and clinical management judgment ability. Conclusion: The educational framework and program derived from this study are expected to improve nurses’ pressure injury management competency in nursing homes and to contribute to effective pressure injury management and quality of life for residents in nursing homes. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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13 pages, 1140 KiB

Open AccessArticle

Impact of Intrinsic and Extrinsic Motivation on Work Engagement: A Cross-Sectional Study of Nurses Working in Long-Term Care Facilities

by Derong Zeng, Nozomu Takada, Yukari Hara, Shoko Sugiyama, Yoshimi Ito, Yoko Nihei and Kyoko Asakura

Int. J. Environ. Res. Public Health 2022, 19(3), 1284; https://doi.org/10.3390/ijerph19031284 - 24 Jan 2022

Cited by 35 | Viewed by 12491

Abstract

Nurses’ work motivation impacts their job satisfaction and work engagement, affecting their quality of care. Work motivation, a personal resource, can be categorized into intrinsic and extrinsic motivation, each of which may function differently in the job demands–resources (JD–R) model. To study the [...] Read more.

Nurses’ work motivation impacts their job satisfaction and work engagement, affecting their quality of care. Work motivation, a personal resource, can be categorized into intrinsic and extrinsic motivation, each of which may function differently in the job demands–resources (JD–R) model. To study the effect of nurses’ intrinsic and extrinsic work motivation on work engagement in long-term care (LTC) facilities, we randomly selected 1200 facilities from 6055 LTC facilities in eastern Japan. Two nurses from each facility completed a self-report questionnaire—newly developed for this study for evaluating intrinsic and extrinsic work motivation—to assess their work engagement, job satisfaction, and work motivation. Multiple regression analysis of 561 valid questionnaires investigated the relationship between work motivation and work engagement, indicating that intrinsic work motivation, job satisfaction, and age had a significant positive effect on work engagement, while extrinsic work motivation had no significant effect. However, half the nurses chose to work because of extrinsic work motivation, explaining the high turnover rate of nursing staff in LTC facilities. Findings indicate the importance of measures to foster nurses’ intrinsic motivation to improve work engagement. Further research should investigate how to improve the intrinsic motivation of nurses working in LTC facilities. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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12 pages, 663 KiB

Open AccessArticle

Stages of Change in Dairy Intake among Older Adults: Application of the Transtheoretical Model

by Cheng-Fen Chang, Jiun-Yi Wang, Tien-Ho Kuo, Ying-Lien Lin and Shang-Yu Yang

Int. J. Environ. Res. Public Health 2022, 19(3), 1146; https://doi.org/10.3390/ijerph19031146 - 20 Jan 2022

Cited by 2 | Viewed by 3425

Abstract

Adequate dairy product intake can reduce the risk of chronic disease, mortality, low quality of life, and healthcare expenditure. However, the insufficient consumption of dairy products is a serious issue in Eastern societies. To the authors’ knowledge, few studies have explored dairy intake [...] Read more.

Adequate dairy product intake can reduce the risk of chronic disease, mortality, low quality of life, and healthcare expenditure. However, the insufficient consumption of dairy products is a serious issue in Eastern societies. To the authors’ knowledge, few studies have explored dairy intake among Taiwanese older adults, especially using the transtheoretical model. The study aims were to address the following unknowns: (i) the distribution of dairy product intake behavior on stages of change (SOC); (ii) differences in variables (intake knowledge (IK), intake cons (IC), intake pros (IP), and intake self-efficacy (ISE)) among SOCs; (iii) discriminative abilities of variables on SOCs; and (iv) predictive ability of variables (IK, IC, IP, and ISE) for dairy product intake behavior on SOC for older adults. An explorative cross-sectional study was conducted to collect data from northern Taiwan using a questionnaire. A total of 342 older adults were recruited. Data were analyzed using multivariate analysis of variance, discriminant analysis, and multiple linear regression. There was a significant difference between the variables and SOCs. There was a better discriminant among the five SOCs. Dairy product intake behaviors were significantly associated with knowledge and self-efficacy in the pre-action stage, and with cons, pros, and self-efficacy in the post-action stage. In conclusion, appropriate nutritional empowerment could benefit older adults by improving dairy intake among the different SOCs. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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11 pages, 7693 KiB

Open AccessCommunication

Meal-Monitoring Systems Using Weight and Temperature Sensors for Elder Residents in Long-Term Care Facilities

by Yu Hu, Ji-Eun Joo, Eunju Choi, Leeho Yoo, Dukyoo Jung, Juh-Hyun Shin, Jeong-Ho Kim and Sung-Min Park

Int. J. Environ. Res. Public Health 2022, 19(2), 808; https://doi.org/10.3390/ijerph19020808 - 12 Jan 2022

Cited by 1 | Viewed by 2440

Abstract

This paper presents a few meal-monitoring systems for elder residents (especially patients) in LTCFs by using electronic weight and temperature sensors. These monitoring systems enable to convey the information of the amount of meal taken by the patients in real-time via wireless communication [...] Read more.

This paper presents a few meal-monitoring systems for elder residents (especially patients) in LTCFs by using electronic weight and temperature sensors. These monitoring systems enable to convey the information of the amount of meal taken by the patients in real-time via wireless communication networks onto the mobile phones of their nurses in charge or families. Thereby, the nurses can easily spot the most patients who need immediate assistance, while the families can have relief in seeing the crucial information for the well-being of their parents at least three times a day. Meanwhile, the patients tend to suffer burns of their tongues because they can hardly recognize the temperature of hot meals served. This situation can be avoided by utilizing the meal temperature-monitoring system, which displays an alarm to the patients when the meal temperature is above the reference. These meal-monitoring systems can be easily implemented by utilizing low-cost sensor chips and Arduino NANO boards so that elder-care hospitals and nursing homes can afford to exploit them with no additional cost. Hence, we believe that the proposed monitoring systems would be a potential solution to provide a great help and relief for the professional nurses working in elder-care hospitals and nursing homes. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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12 pages, 1412 KiB

Open AccessArticle

The Development and Effectiveness of a Web-Based Emergency Management Educational Program for Long-Term Care Facility Interprofessional Practitioners

by Young-Rim Choi, Dai-Young Kwon and Sung-Ok Chang

Int. J. Environ. Res. Public Health 2021, 18(23), 12671; https://doi.org/10.3390/ijerph182312671 - 1 Dec 2021

Cited by 3 | Viewed by 2087

Abstract

Long-term care facility (LTCF) interprofessional practitioners who care for residents at high risk of emergencies due to old age, frailty, and complex diseases must be able to manage such emergencies collaboratively. A shared mental model (SMM) enhances performance toward a common goal by [...] Read more.

Long-term care facility (LTCF) interprofessional practitioners who care for residents at high risk of emergencies due to old age, frailty, and complex diseases must be able to manage such emergencies collaboratively. A shared mental model (SMM) enhances performance toward a common goal by allowing effective collaboration through promoting the sharing of knowledge and skills among interprofessional team members. Therefore, this study developed a web-based educational program for LTCF interprofessional practitioners based on an SMM. We followed a network-based instructional system design that consists of analysis, design, development, implementation, and evaluation for developing the program. A total of 54 participants completed the educational program in four LTCFs in South Korea. A significant improvement was identified in communication knowledge, communication confidence, role recognition, transactive memory system, and team effectiveness in the experimental group. The results show that the program improved the emergency management process and reliability among interprofessional practitioners, positively impacting interprofessional collaboration and ensuring the safety of patients during emergencies in LTCFs. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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11 pages, 623 KiB

Open AccessArticle

Exploring the Mediating Effects of Cognitive Function, Social Support, Activities of Daily Living and Depression in the Relationship between Age and Frailty among Community-Dwelling Elderly

by Lin-Yen Chen, Tzu-Jung Fang, Yu-Chih Lin and Hsiu-Fen Hsieh

Int. J. Environ. Res. Public Health 2021, 18(23), 12543; https://doi.org/10.3390/ijerph182312543 - 28 Nov 2021

Cited by 12 | Viewed by 3421

Abstract

With 16.15% of its total population aged 65 or above, Taiwan is already an aging society. Frailty is a natural consequence of aging, which may decrease physical strength and deteriorate physiological functioning. We examined the mediating effects of cognitive function, social support, activities [...] Read more.

With 16.15% of its total population aged 65 or above, Taiwan is already an aging society. Frailty is a natural consequence of aging, which may decrease physical strength and deteriorate physiological functioning. We examined the mediating effects of cognitive function, social support, activities of daily living (ADL), and depression in the relationship between age and frailty in older people living in the community. This cross-sectional study used a structured questionnaire to collect data from a convenience sample of 200 pre-frail to mildly frail older adults in southern Taiwan. Structural equation modeling was used for data analysis, with data collected from July to November 2020. ADL mediated the relationship between age and frailty, while cognitive function also mediated the relationship between age and frailty, indicating that ADL and cognitive function were significant determinants of frailty. The path from age to frailty was significant, indicating that age was a significant determinant of frailty. The standardized total effect of age affected frailty through the mediating roles of ADL and cognitive function. Age, depression, ADL, and cognitive function explained 59% of the variance in frailty among older adults. ADL and cognitive function are significant mediators of frailty among older adults. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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8 pages, 320 KiB

Open AccessArticle

An Analysis of the Effects of Psychosocial Work Environment on the Retention Intentions of Primary Care Coordinators Nursing Patients with Chronic Illness

by Hyesoo Lee and Juh Hyun Shin

Int. J. Environ. Res. Public Health 2021, 18(22), 12104; https://doi.org/10.3390/ijerph182212104 - 18 Nov 2021

Cited by 1 | Viewed by 1939

Abstract

This study aimed to investigate the effects of psychosocial work environment on the retention intentions of care coordinators taking care of patients with chronic illness. A descriptive survey study was conducted with a convenience sample of care coordinators who organized patients and treatment [...] Read more.

This study aimed to investigate the effects of psychosocial work environment on the retention intentions of care coordinators taking care of patients with chronic illness. A descriptive survey study was conducted with a convenience sample of care coordinators who organized patients and treatment teams that offered professional and persistent treatment. A total of 132 participants were recruited from 19 October to 19 November 2020. The data were analyzed through descriptive statistics, t-tests, ANOVA, Scheffé post hoc, and hierarchical multiple regression using SPSS 26.0. The results showed that work organization and job content (β = 0.254, p = 0.014) and value at the workplace (β = 0.245, p = 0.034) had significant effects on the retention intentions of participants. The final model of the study explained 40.1% of participants’ retention intentions (F = 11.830, p < 0.001). The development of educational programs and implementation of policies for improving the psychosocial work environment were found to be essential for increasing the retention intentions of professional care coordinators. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

15 pages, 447 KiB

Open AccessArticle

Solving Social Problems in Aging Rural Japanese Communities: The Development and Sustainability of the Osekkai Conference as a Social Prescribing during the COVID-19 Pandemic

by Yumi Naito, Ryuichi Ohta and Chiaki Sano

Int. J. Environ. Res. Public Health 2021, 18(22), 11849; https://doi.org/10.3390/ijerph182211849 - 12 Nov 2021

Cited by 16 | Viewed by 3317

Abstract

Social prescribing is critical during the coronavirus disease 2019 (COVID-19) pandemic. Social prescribing refers to non-medical interventions related to culture and traditions; they are increasingly being proposed to address wider determinants of health as well as help patients improve health behaviors and manage [...] Read more.

Social prescribing is critical during the coronavirus disease 2019 (COVID-19) pandemic. Social prescribing refers to non-medical interventions related to culture and traditions; they are increasingly being proposed to address wider determinants of health as well as help patients improve health behaviors and manage their conditions effectively. Traditional and cultural behaviors in the community can be utilized for effective social prescribing. Due to the pandemic, social participation opportunities have decreased, resulting in the absence of Osekkai, a traditional Japanese behavior. A driver of Osekkai is the Osekkai conference; it is the model through which Osekkai is implemented in communities to bring resources and individuals together to address community needs. This research aims to clarify the Osekkai conference’s development process and how it can solve social problems, thereby leading to the creation of sustainable communities. We conducted semi-structured interviews with Osekkai conferences’ participants and organizers during the COVID-19 pandemic. We used thematic analysis to achieve the research aims. A total of 12 participants were interviewed. Five themes were developed from the thematic analysis: driver of the Osekkai conference’s development, trajectory of continuity, chain of Osekkai, changes in communities and participants, and sustainability of the conferences. This study showed how reviving traditional behaviors helps face initial difficulties. It described these increasing traditional behaviors in terms of social prescribing that changes the community’s and citizens’ social capital. Reviving traditional behaviors created new challenges and solutions during the pandemic. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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10 pages, 306 KiB

Open AccessArticle

Relationship between Psychological Status and Health Behaviors during the Coronavirus Disease Pandemic in Japanese Community-Dwelling Older Adults

by Shuichi Hara, Hiroko Miura, Tsuyoshi Hita, Sahara Sasaki, Hidetoshi Ito, Yumi Kozaki and Yoshiko Kawasaki

Int. J. Environ. Res. Public Health 2021, 18(21), 11512; https://doi.org/10.3390/ijerph182111512 - 2 Nov 2021

Cited by 2 | Viewed by 2046

Abstract

The coronavirus disease (COVID-19) continues to be a widespread pandemic. We investigated the relationship between anxiety/stress and health behaviors during the COVID-19 pandemic in homebound Japanese older adults during January and February 2021. We surveyed 1507 community-dwelling, older Japanese adults using a self-administered [...] Read more.

The coronavirus disease (COVID-19) continues to be a widespread pandemic. We investigated the relationship between anxiety/stress and health behaviors during the COVID-19 pandemic in homebound Japanese older adults during January and February 2021. We surveyed 1507 community-dwelling, older Japanese adults using a self-administered questionnaire on primary attributes, including family structure, evaluation of psychological anxiety/stress, and health behaviors. Participants were divided into four anxiety/stress groups based on the frequency of experiencing anxiety/stress, and their association with health behaviors was analyzed using bivariate and multivariate analyses. Responses were received from 469 (31.1%) respondents. In the bivariate analysis, age and family structure were significantly associated with anxiety/stress (p < 0.01). The health behaviors significantly associated with anxiety/stress were walking, balanced eating habits, limited snacking, regular lifestyle, and dental visits. Logistic regression analysis was performed using the variables in the bivariate analysis that showed a significant association with anxiety/stress status as independent variables. Finally, age and dietary habits were significantly associated with anxiety/stress status. No significant associations were found between any other variables. Among older adults living in the rural areas of Japan during the COVID-19 pandemic, anxiety/stress status was significantly associated with age and dietary habits but not with other health behaviors. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

11 pages, 344 KiB

Open AccessArticle

Identifying Frequently Used NANDA-I Nursing Diagnoses, NOC Outcomes, NIC Interventions, and NNN Linkages for Nursing Home Residents in Korea

by Juh Hyun Shin, Gui Yun Choi and Jiyeon Lee

Int. J. Environ. Res. Public Health 2021, 18(21), 11505; https://doi.org/10.3390/ijerph182111505 - 1 Nov 2021

Cited by 8 | Viewed by 5648

Abstract

This study aimed to identify the terminologies of NANDA-I, NOC, NIC, and NNN linkages that have been used for nursing home (NH) residents. This study used a retrospective descriptive design. Data accrued from 57 registered nurses (RNs) in 25 Korean NHs. The RNs [...] Read more.

This study aimed to identify the terminologies of NANDA-I, NOC, NIC, and NNN linkages that have been used for nursing home (NH) residents. This study used a retrospective descriptive design. Data accrued from 57 registered nurses (RNs) in 25 Korean NHs. The RNs randomly selected one resident and assessed for applied NANDA-I, NOC, and NIC from the previous 7 days by reviewing nursing charts and records. Finally, the data of 57 residents in 25 NHs were collected. Results: We identified seven NNN linkages: risk for falls–fall prevention behavior–fall prevention; self-care deficit: bathing/hygiene–self-care: activities of daily living (ADL)–self-care assistance: bathing/hygiene; impaired memory–memory–cognitive stimulation; chronic confusion–neurological status: consciousness–medication management; chronic confusion–memory–medication management; impaired walking–mobility–exercise promotion: strength training; and impaired walking–ambulation–exercise promotion: strength training. The identified core NANDA-I, NOC, NIC, and NNN linkages for NH residents from this study provide a scope of practice of RNs working in NHs. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

9 pages, 696 KiB

Open AccessArticle

Recognition of Anemia in Elderly People in a Rural Community Hospital

by Shiho Amano, Ryuichi Ohta and Chiaki Sano

Int. J. Environ. Res. Public Health 2021, 18(21), 11179; https://doi.org/10.3390/ijerph182111179 - 25 Oct 2021

Cited by 15 | Viewed by 2237

Abstract

Anemia in the elderly is a common disease associated with increased mortality and hospitalization rates. It is not clear how adequately elderly patients are assessed and treated in actual clinical practice. This study clarifies the frequency of anemia recognition before assessment and the [...] Read more.

Anemia in the elderly is a common disease associated with increased mortality and hospitalization rates. It is not clear how adequately elderly patients are assessed and treated in actual clinical practice. This study clarifies the frequency of anemia recognition before assessment and the factors related to recognition among older people in a rural community hospital. This cross-sectional study evaluated 156 elderly patients aged > 65 years. Data on several different variables were collected from patient medical records. Anemia was defined as a hemoglobin level < 11 g/dL. Patients were classified into “anemia recognition” and “no anemia recognition” groups. Statistical analysis of the data included multivariable logistic regression to examine the association between anemia recognition and other factors. The anemia recognition group comprised 63 (40.4%) patients. Age was significantly associated with the recognition of anemia (adjusted odds ratio = 0.70, 95% confidence interval: 0.53–0.92, p = 0.011). Appropriate medical care should be provided to the elderly; however, it may be limited according to age. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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12 pages, 363 KiB

Open AccessArticle

Predictive Model of Preventive Behaviors against COVID-19 in the Older Adult: The PREASOC-COVID-19 Study

by Carmen María Sarabia-Cobo, Aroa Delgado Uria, Marta García Lecue, Eva Izaguirre Palazuelos, César Martínez Ruiz and Ángela Fernández-Rodríguez

Int. J. Environ. Res. Public Health 2021, 18(21), 11067; https://doi.org/10.3390/ijerph182111067 - 21 Oct 2021

Cited by 4 | Viewed by 2346

Abstract

Background: The purpose of this study was to analyze the relationship between COVID-19 preventive behaviors, as the dependent variable, with risk perception, coping style and sense of coherence, as independent variables, in older people living in the community. Methods: An observational design for [...] Read more.

Background: The purpose of this study was to analyze the relationship between COVID-19 preventive behaviors, as the dependent variable, with risk perception, coping style and sense of coherence, as independent variables, in older people living in the community. Methods: An observational design for predictive model development. This study was reported following the STROBE statement. The subjects were people over 65 years of age living in the community. Data collection included sociodemographic variables related to COVID-19, risk perception and types, coping styles in the face of contagion, sense of coherence, and preventive behaviors in the face of COVID-19. The data collection period was from November 2020 to January 2021. Results: A total of 305 people participated in this study (71.5% women, mean age 71.34 years; 6.9% suffered from COVID-19 and 44.3% knew someone close to them who suffered from the virus). The coping style variables problem-focused, emotion-focused, and sense of coherence subscales Significance and manageability explained 17% of the variable preventive behaviors against COVID-19. There were statistically significant differences by gender in all subscales, with women scoring higher in all of them; Conclusions: Men with low risk perception, extrinsic risk perception, and low sense of coherence presented worse COVID-19 preventive behaviors. It would be interesting to develop specific prevention and health education campaigns for this population. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

9 pages, 467 KiB

Open AccessArticle

Changes in the Comprehensiveness of Rural Medical Care for Older Japanese Patients during the COVID-19 Pandemic

by Ryuichi Ohta, Akinori Ueno and Chiaki Sano

Int. J. Environ. Res. Public Health 2021, 18(20), 10772; https://doi.org/10.3390/ijerph182010772 - 14 Oct 2021

Cited by 11 | Viewed by 2109

Abstract

Help-seeking behaviors (HSBs) refer to how people use lay and medical care to address their symptoms and diseases. The COVID-19 pandemic may have changed older, rural patients’ preferences and experiences regarding HSBs, thereby, affecting the comprehensiveness of medical support for communities. This study [...] Read more.

Help-seeking behaviors (HSBs) refer to how people use lay and medical care to address their symptoms and diseases. The COVID-19 pandemic may have changed older, rural patients’ preferences and experiences regarding HSBs, thereby, affecting the comprehensiveness of medical support for communities. This study identified changes in the comprehensiveness of medical care for older, rural patients, who are often dependent on others for accessing medical services. This observational study was performed with patients who lived in Unnan City. Patients’ dependency and changes in comprehensiveness of medical services were assessed and calculated. The total usage of medical care decreased from 2018 to 2020 at all medical care levels. The proportion of patients who received comprehensive care was higher in 2020 than in 2018, at all care levels. At care dependent levels 3 to 5, the differences in the proportions were statistically significant. This study illustrates an association between the COVID-19 pandemic and the proportion of comprehensiveness of medical care among older rural patients with a decrease in medical care usage. Moreover, an improved proportion of comprehensiveness of medical care leads to appropriate HSBs. Going forward, HSBs and patient-centered care should be promoted by policy makers. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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8 pages, 669 KiB

Open AccessArticle

Analysis of Burnout Syndrome and Resilience in Nurses throughout the COVID-19 Pandemic: A Cross-Sectional Study

by Noel Rivas, María López, María-José Castro, Sofía Luis-Vian, Mercedes Fernández-Castro, María-José Cao, Sara García, Veronica Velasco-Gonzalez and José-María Jiménez

Int. J. Environ. Res. Public Health 2021, 18(19), 10470; https://doi.org/10.3390/ijerph181910470 - 5 Oct 2021

Cited by 26 | Viewed by 7748

Abstract

Background: The COVID-19 pandemic has contributed to the occurrence of work-related stress on nursing staff. Being resilience an essential element to countering adversity. The aim of the study was to assess burnout syndrome as well as resilience in hospital-care nurses during the first [...] Read more.

Background: The COVID-19 pandemic has contributed to the occurrence of work-related stress on nursing staff. Being resilience an essential element to countering adversity. The aim of the study was to assess burnout syndrome as well as resilience in hospital-care nurses during the first outbreak of the COVID-19 pandemic. Methods: A cross-sectional descriptive study of burnout syndrome and resilience of 101 nurses during the first COVID-19 outbreak. The Maslach Burnout Inventory and the Scale of Resilience of Connor-Davidson were used. Results: The burnout average score was 74.35 ± 12.78 points, and resilience was 27.94 ± 5.84. Temporary nurses reached a lower average score for the emotional fatigue dimension (23.80 ± 10.39 points) p < 0.05. The emotional fatigue dimension correlated adversely with the average score of resilience (r = −0.271; p < 0.001). Conclusions: The level of burnout in nurses was high, being higher on those who took care of COVID-19 patients. Resilient nurses were able to better cope with stressful situations. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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10 pages, 334 KiB

Open AccessArticle

Effects of Community-Based Physical-Cognitive Training, Health Education, and Reablement among Rural Community-Dwelling Older Adults with Mobility Deficits

by Chen-Yi Song, Pay-Shin Lin, Pei-Lun Hung and ADLers Occupational Therapy Clinic

Int. J. Environ. Res. Public Health 2021, 18(17), 9374; https://doi.org/10.3390/ijerph18179374 - 5 Sep 2021

Cited by 3 | Viewed by 2923

Abstract

Reablement services are approaches for maintaining and improving the functional independence of older adults. Previous reablement studies were conducted in a home environment. Due to the limited evidence on the effects of multicomponent interventions and reablement in a community-based context, this study aimed [...] Read more.

Reablement services are approaches for maintaining and improving the functional independence of older adults. Previous reablement studies were conducted in a home environment. Due to the limited evidence on the effects of multicomponent interventions and reablement in a community-based context, this study aimed to develop and evaluate the effect of community-based physical–cognitive training, health education, and reablement (PCHER) among rural community-dwelling older adults with mobility deficits. The trial was conducted in rural areas of New Taipei City, Taiwan. Older adults with mild to moderate mobility deficits were recruited from six adult daycare centers, and a cluster assignment was applied in a counterbalanced order. The experimental group (n = 16) received a PCHER intervention, comprising 1.5 h of group courses and 1 h of individualized reablement training, while the control group (n = 12) underwent PCHE intervention, comprising 1.5 h of group courses and 1 h of placebo treatment. A 2.5-h training session was completed weekly for 10 weeks. The outcome measures contained the de Morton Mobility Index (DEMMI), the Saint Louis University Mental Status (SLUMS) Examination, the Barthel Index (BI), the Short Physical Performance Battery (SPPB), and the Canadian Occupational Performance Measure (COPM). The PCHER significantly improved the DEMMI, SLUMS, BI, SPPB, and COPM (all p < 0.05), with medium-to-large effect sizes. PCHER also showed an advantage over PCHE in terms of the SPPB (p = 0.02). This study verified that combining individualized reablement with group-based multicomponent training was superior to group courses alone in enhancing the functional abilities of community-dwelling older adults with mobility deficits. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

15 pages, 2039 KiB

Open AccessArticle

by Juhhyun Shin, Sunok Jung, Hyeonyoung Park, Yaena Lee and Yukyeong Son

Int. J. Environ. Res. Public Health 2021, 18(14), 7398; https://doi.org/10.3390/ijerph18147398 - 11 Jul 2021

Cited by 3 | Viewed by 3189

Abstract

Purpose: The purpose of this study was to investigate what opinions and perceptions people have about nursing and the role of nursing staff in nursing homes (NHs) on Social Networking Service (SNS) by analyzing large-scale data through social big-data analysis. Methods: This study [...] Read more.

Purpose: The purpose of this study was to investigate what opinions and perceptions people have about nursing and the role of nursing staff in nursing homes (NHs) on Social Networking Service (SNS) by analyzing large-scale data through social big-data analysis. Methods: This study investigated changes in perception related to nursing and nursing staff in NHs during the COVID-19 pandemic era using target channels (blogs, cafes, Instagram, communities, Twitter, etc.). Data were collected on the channel from 12 September 2019 to 11 September 2020, 6 months before and after 12 March 2020 when the COVID-19 pandemic was declared. Selected keywords included “nursing,” “nurse,” and “nursing staff,” and included words were “long-term care settings,” “geriatric hospital,” and “nursing home.” Text mining, opinion mining, and social network analysis were conducted. Results: After the COVID-19 pandemic, the frequency of keywords increased about 1.5 times compared to before. In March 2020 when the COVID-19 pandemic was declared, the negative phrase “be infected” ranked number one, resulting in a sharp 8% rise in the percentage of negative words in that month. The related words that have risen in rank significantly, or were newly ranked in the Top 30 after the pandemic, were related with COVID-19. Conclusion: The public began to realize the role of nursing staff in the prevention and management of mass infection in NHs and the importance of nursing staff after the pandemic. Further studies should examine the perceptions of those who have received nursing services and include a wide range of foreign channels. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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10 pages, 1062 KiB

Open AccessArticle

Effects of a Web-Based Educational Program Regarding Physical Restraint Reduction in Long-Term Care Settings on Nursing Students: A Cluster Randomized Controlled Trial

by Eun-Hi Kong, Myoungsuk Kim and Seonho Kim

Int. J. Environ. Res. Public Health 2021, 18(13), 6698; https://doi.org/10.3390/ijerph18136698 - 22 Jun 2021

Cited by 6 | Viewed by 2841

Abstract

Physical restraint is still frequently used in many countries. However, a lack of education hinders physical restraint reduction in long-term care facilities. No study has yet to examine the effects of physical restraint reduction education on nursing students. This study aimed to evaluate [...] Read more.

Physical restraint is still frequently used in many countries. However, a lack of education hinders physical restraint reduction in long-term care facilities. No study has yet to examine the effects of physical restraint reduction education on nursing students. This study aimed to evaluate the effects of a web-based educational program of physical restraint reduction on nursing students’ knowledge and perceptions. A cluster randomized controlled and single-blind design was used. This study was conducted at four nursing schools in South Korea. A total of 169 undergraduate nursing students completed this study. Using random allocation, two nursing schools (85 students) were allocated as the experimental group and the other two schools (84 students) as the control group. The experimental group received the web-based educational program, and the control group did not receive the educational program. Data were collected immediately before and after the web-based educational program. The experimental group’s knowledge and perceptions significantly improved between pre-test and post-test. The analysis of covariance showed statistically significant differences between groups in knowledge (p < 0.001) and perceptions (p < 0.001) over time, revealing positive effects of the web-based educational program. The web-based educational program regarding physical restraint reduction positively affected nursing students’ knowledge and perceptions. Future studies are required to examine the educational program’s longitudinal effects with more rigorous measurements and research methods. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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33 pages, 889 KiB

Open AccessArticle

The Health Behaviour of German Outpatient Caregivers in Relation to Their Working Conditions: A Qualitative Study

by Natascha Mojtahedzadeh, Elisabeth Rohwer, Felix Alexander Neumann, Albert Nienhaus, Matthias Augustin, Birgit-Christiane Zyriax, Volker Harth and Stefanie Mache

Int. J. Environ. Res. Public Health 2021, 18(11), 5942; https://doi.org/10.3390/ijerph18115942 - 1 Jun 2021

Cited by 7 | Viewed by 4795

Abstract

Ongoing demographic change is leading to an increasingly older society and a rising proportion of people in need of care in the German population. Therefore, the professional group of outpatient caregivers is highly relevant. Their work is characterised not only by interacting with [...] Read more.

Ongoing demographic change is leading to an increasingly older society and a rising proportion of people in need of care in the German population. Therefore, the professional group of outpatient caregivers is highly relevant. Their work is characterised not only by interacting with patients in a mobile setting but also by working in shifts. Health behaviour under these specific working conditions is crucial for ensuring long-term work ability and performance. Little is known about the health behaviour of German outpatient caregivers and its potential impact on their work. The aims of the study were (1) to examine health behavioural patterns (nutrition, exercise, smoking, regeneration) of outpatient caregivers, (2) to illuminate their personal health-promoting behaviours, and (3) to identify potential work-related factors influencing their health behaviour. Fifteen problem-centred interviews were conducted with outpatient caregivers working in Northern Germany in the period January–April 2020. Interviews were analysed by using qualitative content analysis. Outpatient caregivers reported improvable nutrition and hydration, with simultaneous high coffee consumption, low physical activity, poor regeneration (breaks and sleep quality), and good personal health-promoting behaviour (e.g., back-friendly habits), although the majority were smokers. Barriers to the implementation of health-promoting behaviours were a high perception of stress due to increased workload and time pressure, while aids to better health-promoting behaviour were described as being social support and personal resources. The respondents perceived their working conditions as potentially influencing their health behaviour. On the basis of their descriptions, various practice-relevant strategies were derived. The data explore a potential need for outpatient care services to develop interventions on behavioural and structural levels that can help create healthier working conditions for their employees so these caregivers can adopt better health behaviours. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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12 pages, 334 KiB

Open AccessArticle

Person-Centered Care Practice, Patient Safety Competence, and Patient Safety Nursing Activities of Nurses Working in Geriatric Hospitals

by Ayoung Huh and Juh Hyun Shin

Int. J. Environ. Res. Public Health 2021, 18(10), 5169; https://doi.org/10.3390/ijerph18105169 - 13 May 2021

Cited by 11 | Viewed by 6787

Abstract

Geriatric nursing activities are closely related to patient safety; therefore, nurses’ efforts to improve patient safety in geriatric hospitals are important. In the present study, we investigated the relationships between person-centered care practice, patient safety competence, and patient safety during nursing activities in [...] Read more.

Geriatric nursing activities are closely related to patient safety; therefore, nurses’ efforts to improve patient safety in geriatric hospitals are important. In the present study, we investigated the relationships between person-centered care practice, patient safety competence, and patient safety during nursing activities in geriatric hospitals. We used the following tools to investigate the factors affecting patient safety during nursing activities: (a) the Korean version of the Person-Centered Care Assessment Tool (P-CAT), (b) the Patient Safety Competence Assessment Tool for Nurses, and (c) the Patient Safety Nursing Activities Assessment Tool for geriatric nurses. The questionnaire survey was completed by 186 geriatric nurses in 12 geriatric hospitals from 1 August to 31 August 2018. We analyzed the survey data using a t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression. We identified patient safety skills (β = 0.417, p < 0.001) and age (β = 0.209, p = 0.035) as key factors that influence patient safety during nursing activities. Therefore, to improve the quality of patient safety during nursing activities conducted by geriatric nurses, it is necessary to develop strategies to improve patient safety skills and expand the pool of competent nurses with clinical experience. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

11 pages, 341 KiB

Open AccessArticle

Factors Influencing Oral Health-Related Quality of Life in Older Adults in Rural Areas: Oral Dryness and Oral Health Knowledge and Behavior

by Eunju Choi and Dukyoo Jung

Int. J. Environ. Res. Public Health 2021, 18(8), 4295; https://doi.org/10.3390/ijerph18084295 - 18 Apr 2021

Cited by 7 | Viewed by 3735

Abstract

The oral health of older adults is an important factor affecting their overall health and quality of life. This study aimed to identify the characteristics of oral health of older adults living at home in rural areas and investigate factors affecting oral health-related [...] Read more.

The oral health of older adults is an important factor affecting their overall health and quality of life. This study aimed to identify the characteristics of oral health of older adults living at home in rural areas and investigate factors affecting oral health-related quality of life (OHRQoL), especially oral dryness and oral health knowledge and behavior. A descriptive correlational study was conducted. In total, 117 participants were included in the final analysis. Data were collected using questionnaires for oral dryness, oral health knowledge and behavior, and OHRQoL. In addition, oral dryness was measured by mechanical measurements. Oral health knowledge was positively correlated with oral health behavior (r = 0.18, p = 0.029) and OHRQoL (r = 0.25, p = 0.003). In addition, a positive correlation between oral health behavior and OHRQoL (r = 0.24, p = 0.005) was observed. Multiple regression analysis revealed that subjective oral dryness (β = −4.99, p = 0.001) had a significant effect on OHRQoL. To improve OHRQoL in the rural elderly, health providers should pay attention to oral dryness and comprehensively evaluate it. The development of prevention programs and continuous education that can improve oral health knowledge and behavior is also required. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

10 pages, 356 KiB

Open AccessArticle

Health Promotion Behavior among Older Korean Family Caregivers of People with Dementia

by Aram Cho and Chiyoung Cha

Int. J. Environ. Res. Public Health 2021, 18(8), 4123; https://doi.org/10.3390/ijerph18084123 - 13 Apr 2021

Cited by 5 | Viewed by 2861

Abstract

People adopt health promotion behaviors to promote their health as they interact within the environment. The purpose of this study was to examine factors influencing health promotion behaviors among older adults caring for family members with dementia. For this cross-sectional study, data from [...] Read more.

People adopt health promotion behaviors to promote their health as they interact within the environment. The purpose of this study was to examine factors influencing health promotion behaviors among older adults caring for family members with dementia. For this cross-sectional study, data from 135 older adults who were the main caregivers were collected at an outpatient clinic at a university hospital in the capital city of South Korea between September and October in 2020. Sociodemographic characteristics, caregiver-related characteristics, dementia knowledge, fear of dementia, and health promotion behaviors were measured. Univariate analysis revealed that the level of health promotion behaviors differed by age, sex, educational level, monthly income, relationship with the family member with dementia, and cohabitation with family members with dementia. In the multivariate analysis, a hierarchical multiple regression model explained 33.9% of the variance. Sex, duration of caregiving, use of long-term care service, and fear of dementia predicted health promotion behavior. A strategic tailored care plan for target population is needed to improve the health promotion behavior of older adults caring for family members with dementia. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

13 pages, 374 KiB

Open AccessArticle

Quality of Gerontological Nursing and Ageism: What Factors Influence on Nurses’ Ageism in South Korea?

by Eun Hee Hwang and Kon Hee Kim

Int. J. Environ. Res. Public Health 2021, 18(8), 4091; https://doi.org/10.3390/ijerph18084091 - 13 Apr 2021

Cited by 12 | Viewed by 3850

Abstract

With the aging of the population, age-related problems are emerging, which has caused age discrimination. Particularly, most nurses care for a large number of old patients in the clinical setting. Nurses’ attitude toward the clients has a significant effect on the quality of [...] Read more.

With the aging of the population, age-related problems are emerging, which has caused age discrimination. Particularly, most nurses care for a large number of old patients in the clinical setting. Nurses’ attitude toward the clients has a significant effect on the quality of nursing, so it is time to identify their perspective to the aged. The quality of nursing could greatly depend on who provides and how to provide care. If older patients meet nursing staff with an ageist perspective, whether intentionally or unintentionally, they experience negative attitudes toward them during served health care, and trust cannot be formed, resulting in a deterioration in the quality of medical services. This study aimed to identify factors influencing nurses’ ageism attitudes. A total of 162 general hospital nurses completed a questionnaire consisting of the Wong and Law Emotional Intelligence Scale (WLEIS), the Contact with Elderly People (CEP), the Anxiety about Aging Scale (AAS), and the Fraboni Scale of Ageism (FSA). Data were analyzed by descriptive statistics, t-test, one-way ANOVA, Scheffé post hoc, Pearson’s correlation coefficients, and stepwise multiple regression using SPSS/WIN 26.0 program. The average score of FSA was 2.63 ± 0.36 (range 1–4); FSA showed a statistical difference according to cohabitation with an old adult in the past (t = 2.42, p = 0.017). Factors influencing FSA were the fear of old people (β = 0.34, p < 0.001) and fear of loss (β = 0.28, p < 0.001) of the AAS; and these variables explained 21.1% of FSA (F = 22.56, p < 0.001). Based on these results, the development and application of nursing education focused on intergenerational contact is needed in order to reduce the anxiety about aging and to acquire a high quality of gerontological nursing with a reduction of ageism. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

8 pages, 581 KiB

Open AccessArticle

Identifying the Risk Factors Associated with Nursing Home Residents’ Pressure Ulcers Using Machine Learning Methods

by Soo-Kyoung Lee, Juh Hyun Shin, Jinhyun Ahn, Ji Yeon Lee and Dong Eun Jang

Int. J. Environ. Res. Public Health 2021, 18(6), 2954; https://doi.org/10.3390/ijerph18062954 - 13 Mar 2021

Cited by 11 | Viewed by 4092

Abstract

Background: Machine learning (ML) can keep improving predictions and generating automated knowledge via data-driven predictors or decisions. Objective: The purpose of this study was to compare different ML methods including random forest, logistics regression, linear support vector machine (SVM), polynomial SVM, radial SVM, [...] Read more.

Background: Machine learning (ML) can keep improving predictions and generating automated knowledge via data-driven predictors or decisions. Objective: The purpose of this study was to compare different ML methods including random forest, logistics regression, linear support vector machine (SVM), polynomial SVM, radial SVM, and sigmoid SVM in terms of their accuracy, sensitivity, specificity, negative predictor values, and positive predictive values by validating real datasets to predict factors for pressure ulcers (PUs). Methods: We applied representative ML algorithms (random forest, logistic regression, linear SVM, polynomial SVM, radial SVM, and sigmoid SVM) to develop a prediction model (N = 60). Results: The random forest model showed the greatest accuracy (0.814), followed by logistic regression (0.782), polynomial SVM (0.779), radial SVM (0.770), linear SVM (0.767), and sigmoid SVM (0.674). Conclusions: The random forest model showed the greatest accuracy for predicting PUs in nursing homes (NHs). Diverse factors that predict PUs in NHs including NH characteristics and residents’ characteristics were identified according to diverse ML methods. These factors should be considered to decrease PUs in NH residents. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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9 pages, 344 KiB

Open AccessArticle

Factors Influencing the Dementia-Preventive Behaviors among Middle-Aged Persons with Chronic Diseases in Korea

by Jisung Park and Juh Hyun Shin

Int. J. Environ. Res. Public Health 2021, 18(6), 2936; https://doi.org/10.3390/ijerph18062936 - 13 Mar 2021

Cited by 5 | Viewed by 2467

Abstract

The purpose of this study was to investigate the influence of dementia literacy, internal health locus of control, and fear of dementia on dementia-preventive behaviors among middle-aged people with chronic diseases. The participants were middle-aged individuals with chronic diseases who had been taking [...] Read more.

The purpose of this study was to investigate the influence of dementia literacy, internal health locus of control, and fear of dementia on dementia-preventive behaviors among middle-aged people with chronic diseases. The participants were middle-aged individuals with chronic diseases who had been taking medications for at least three months, recruited using convenience sampling. A total of 123 participants were recruited between 13 and 31 March 2020, using self-reported questionnaires. Data were then analyzed through independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple linear regression using the SPSS/WIN 25.0. The results showed that health condition perceived as healthy and dementia literacy were the leading factors influencing dementia-preventive behaviors. These variables showed a 16% explanatory power for dementia-preventive behaviors. Therefore, when the participants’ perceived health condition was healthy and the dementia literacy score was higher, the level of dementia-preventive behaviors was also higher. It is necessary to develop educational programs to increase dementia literacy as a major variable in dementia-preventive behaviors, and further research on its efficacy should be conducted. When providing dementia-preventive education programs to middle-aged people who have been exposed to chronic diseases, it is necessary to consider their level of perceived health condition and dementia literacy. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

Review

Jump to: Research, Other

13 pages, 734 KiB

Open AccessReview

A Meta-Synthesis Study of Person-Centered Care Experience from the Perspective of Nursing Home Residents

by Eun-Young Kim and Sung-Ok Chang

Int. J. Environ. Res. Public Health 2022, 19(14), 8576; https://doi.org/10.3390/ijerph19148576 - 14 Jul 2022

Cited by 3 | Viewed by 2218

Abstract

Purpose: To systematically review and synthesize the evidence for the experience of person-centered care from the perspective of nursing home residents to understand their views in depth. Methods: The seven steps of Nobit and Hare’s meta-ethnography, a well-known meta-synthesis method, were applied. We [...] Read more.

Purpose: To systematically review and synthesize the evidence for the experience of person-centered care from the perspective of nursing home residents to understand their views in depth. Methods: The seven steps of Nobit and Hare’s meta-ethnography, a well-known meta-synthesis method, were applied. We used four databases for the literature search (PubMed, Web of Science, EMBASE, and CINAHL). Results: A total of seven studies were included for review. As a result of synthesizing the results, three themes (“promotion of mutual understanding through communication”, “care that acknowledges the independence of residents” and “finding the optimized state”) and six sub-themes were derived. Conclusions: This study has provided an in-depth understanding of person-centered care and will contribute to increasing its practical application. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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Other

Jump to: Research, Review

12 pages, 511 KiB

Open AccessSystematic Review

Older People’s Help-Seeking Behaviors in Rural Contexts: A Systematic Review

by Ryuichi Ohta, Yoshinori Ryu and Chiaki Sano

Int. J. Environ. Res. Public Health 2022, 19(6), 3233; https://doi.org/10.3390/ijerph19063233 - 9 Mar 2022

Cited by 50 | Viewed by 5693

Abstract

Help-seeking behavior (HSB) is vital for older people to sustain their health. As people in aging societies increasingly demand management of their multiple symptoms, communities should encourage HSBs. In rural communities, insufficient healthcare and human resources influence older people’s health. However, no related [...] Read more.

Help-seeking behavior (HSB) is vital for older people to sustain their health. As people in aging societies increasingly demand management of their multiple symptoms, communities should encourage HSBs. In rural communities, insufficient healthcare and human resources influence older people’s health. However, no related comprehensive evidence exists so far. This study investigates the present condition of older people’s HSBs in rural contexts in aging societies. We conducted a systematic review by searching six databases (PubMed, Cochrane Library, EMBASE, Medline, and Web of Science) for original studies regarding HSBs of older people in rural contexts published until January 2022. Extracted articles were analyzed based on participants, settings, HSB causes and contents, and older people’s HSB outcomes in rural contexts. Sixteen studies were included in the systematic review: seven investigated the associations between HSBs and participants’ backgrounds, and three the quality of life. Six studies investigated HSB perception, diagnosis, clarifying HSB contents, professional care trend, self-rated health, and mortality. Unlike few studies investigating the association between HSBs and health-related outcomes, this systematic review explains the current evidence regarding rural older people’s HSBs. Due to insufficient evidence from longitudinal studies in clarifying interventions for effective HSBs, future studies should use observational and interventional designs. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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Open AccessBrief Report

Modification of Apremilast from Pills to Aerosol a Future Concept

by Paul Zarogoulidis, Christoforos Kosmidis, Nikolaos Kougkas, Aimilios Lallas, Dimitris Petridis, Wolfgang Hohenforst-Schmidt, Haidong Huang, Lutz Freitag and Chrisanthi Sardeli

Int. J. Environ. Res. Public Health 2021, 18(21), 11590; https://doi.org/10.3390/ijerph182111590 - 4 Nov 2021

Cited by 1 | Viewed by 2026

Abstract

Background: Inhaled drugs have been available in the market for several years and for several diseases. Drugs for chronic obstructive pulmonary disease, cystic fibrosis, and diabetes have been used for several years. In the field of drug modification, these drugs range from tablets [...] Read more.

Background: Inhaled drugs have been available in the market for several years and for several diseases. Drugs for chronic obstructive pulmonary disease, cystic fibrosis, and diabetes have been used for several years. In the field of drug modification, these drugs range from tablets to aerosol. Methods: Milling as used to break down the tablets to powder and nebulisers are used to produce aerosol droplets. A mastersizer was used to measure the mass median aerodynamic diameter of the aerosol droplets. Results: Apremilast produced mmad diameters (2.43 μm) without any statistical difference between the different jet-nebulizers. The residual cup B contributed to greater mmad diameters as the 95% interval of mean values, based on those the ANOVA mean square clearly indicated, followed by cups C and F. The previous interval plot is much better clarified when the interaction means between drug and residual cap are plotted. The residual cups B, C and F produce mmad between (2.0–3.2). Conclusion: In the current research study we demonstrated our methodology to create apremilast powder and produce apremilast aerosol droplets with different nebulisers and residual cups. Full article

(This article belongs to the Special Issue To Be Healthy for the Elderly: Long Term Care Issues around the World)

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