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Implementation Strategies for Improving the Care of Depressed Elderly Persons—Summary of an International Workshop  [PDF]
Elisabeth Severinsson, Anne Lise Holm
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.411076
Abstract: The aim of the study was to identify the most important research priorities as well as future strategies for promoting and implementing evidence-based care of depressed elderly persons. An interdisciplinary workshop was organized using a focus group format and the transcript of the discussion was interpreted by means of the qualitative content analysis. The most important research priorities for improving the care of depressed elderly persons, implementation levels, theoretical approaches as well as possible outcomes were analysed on individual consumer, healthcare system, and policy level. A wide range of theories and methods are necessary to identify and explain implementation processes and results. Qualitative and quantitative methodologies in combination with knowledge synthesis were discussed. In addition, the need to summarize the literature in terms of specific issues was emphasized. In conclusion, the implementation strategies for improving the care of depressed elderly persons should be addressed on three levels: individual consumer, healthcare system and policy. Although some aspects of the implementation model may need to be enhanced, the fact that it includes conditions on individual level, i.e. self-management support, is of importance. The expansion and maintenance of evidence-based care generate potential for change in mental healthcare, thus improving outcomes for individual elderly patients. Areas that require further research are organization, cost and leadership. The use of mixed methods could strengthen future studies. Implementation researchers need a broad repertoire in order to plan and perform evidence-based research. To improve practice, implementation strategies should be developed in clinical and community guidelines.
The Effects of Progressive Resistive Exercises on Activities of Daily Living of Elderly Persons
Hossein Bagheri,Mehdi Abdolvahab,parvin Raji,Mahmood Jalili
Modern Rehabilitation , 2010,
Abstract: Background and Aim: Aging is a natural phenomenon that affects on different systems of our body. This process is not due to diseases and accidents. Activity of Daily Living (ADL) is important for elderly persons. The aims of this study are to investigate the effects of progressive resistive exercises on Activities of Daily Living of elderly persons. Material and Methods: Fifty elder men with age above 61 years old participated in this study. Twenty five elder men in exercise group with mean age of 69.45 and 25 elder men in control group whit mean age of 72.24. Strength of shoulder and knee extensors were evaluated by Tekdyne Incentive Dynamometers (TID). Activities of Daily Living were evaluated by Barthel - Index Results: The measurements of shoulder and knee extensors of elder men were evaluated with TID. The data showed significant differences between mean score of pre and post interventions (p ≤ 0/0001). The measurements of self care activities, mobility and total score of elder men were evaluated with Barthel-Index. The data showed significant differences between mean score of pre and post interventions (p ≤ 0.0001).Conclusion: Presents data showed that progressive resistive exercises could be an effective approach to increase strength upper and lower body and improve Activities of Daily Living of elder men.
SPECIFIC FEATURES RELATED TO THE QUALITY OF MATERIAL LIFE OF ELDERLY PERSONS LIVING IN THE VILLAGE DEALU BABI” (IN THE JIU VALLEY)
ROXANA GHITA – PLESA
Lucr?ri ?tiin?ifice : Management Agricol , 2009,
Abstract: The sociological research was carried out during the last November in the village called “Dealu Babi” that is under the administration of Vulcan town in Hunedoara County. It was a more extensive research, focusing on aspects that are related to the quality of the material, family, social and spiritual life of elderly persons living in that village.
Cuidadores del adulto mayor residente en asilos Caretakers of elderly persons living in asylums
Zoila Edith Hernández Zamora
Index de Enfermería , 2006,
Abstract: Se reitera el incremento que en los últimos a os ha tenido la población de adultos mayores, hecho que repercute en el número también cada vez más alto de personas residentes en asilos para ancianos, lugares que por lo regular dependen del estado y cuyas características tanto materiales como su infraestructura en cuanto a personal especializado para atender a las personas que ahí viven, deja mucho que desear. Este último aspecto es el punto cardinal de este trabajo, ya que los cuidadores, trátese de enfermeras, psicólogo, médicos, trabajadoras sociales, entre otros, realizan un papel crucial en el funcionamiento de tales instituciones. El cuidador, al igual que los residentes, es un ser humano, con una carga inherente a la labor que realiza y que, además, transita por todas las emociones o conflictos que implica desempe ar su puesto, al igual que los que cuida, necesita ser cuidado y atendido para el logro del bienestar de ambos. This article underlines the increase in the population of elderly persons that has occurred in recent years and has resulted in ever-increasing numbers of residents living in asylums for the aged, or old people’s homes. Such institutions are generally dependent on the state, and their material characteristics as well as their infrastructure in regard to the specialized personnel for attending to the people residing there leave much to be desired. This last aspect is the central point of this work since the caretakers, be they nurses, psychologists, doctors, social workers or others, perform a crucial role in the functioning of such institutions. The caretaker, like the residents, is a human being with a duty that is inherent in his/her work and who, in addition, is subject to all the emotions or conflicts that the job implies. Just like the persons under his care, he requires care and attention in order to maintain the well-being of all those concerned.
Comparative study of active and inactive elderly persons through the assessment of activities of daily living and quality of life  [PDF]
S. Caporicci,M.F.O. Neto
Motricidade , 2011,
Abstract: This study aimed at evaluating the activities of daily living and quality of active and inactive seniors’ life. This is a descriptive research of a quantitative nature. Participants were 24 seniors, 12 physical activity practitioners (PPA) and 12 non-practitioners (NPPA). The instrument was a demographic questionnaire and SF-36 for measuring the quality of life and tests proposed by GDLAM. SPSS 15.0 was used for data analysis. The results obtained by the sociodemographic questionnaire for PPA and NPPA groups were, respectively: age 69.5 and 70.0 years, marital status 50.0% widower and 41.7% were married; education 50.0% with complete elementary school and 58.3% with incomplete elementary school; health problems 25.0% and 58.33% hypertension. In functional autonomy tests, the PPA group had shorter execution time when compared with the NPPA group; however, both groups found themselves in the rating of "weak" according to the protocol GDLAM. We concluded that there was no statistical difference between groups.
A randomized controlled trial of a senior centre group programme for increasing social support and preventing depression in elderly people living at home in Norway
Hege B?en, Odd Steffen Dalgard, Rune Johansen, Erik Nord
BMC Geriatrics , 2012, DOI: 10.1186/1471-2318-12-20
Abstract: A questionnaire was sent to a random sample of 4,000 persons over 65 in Oslo, and a total of 2,387 completed questionnaires were obtained. These subjects served as a basis for recruitment of participants for a trial, with scores on HSCL-10 being used as a main inclusion criterion. A total of 138 persons were randomized into an intervention group (N?=?77) and control group (N?=?61). Final analyses included 92 persons. Social support (OSS-3), depression (BDI), life satisfaction and health were measured in interviews at baseline and after 12?months (at the end of the intervention programme). Perceptions of benefits from the intervention were also measured. Mean scores, SD, SE and CI were used to describe the changes in outcomes. Effect sizes were calculated based on the original scales and as Cohen’s d. Paired sample tests and ANOVA were used to test group differences.There was an increase in social support in both groups, but greatest in the intervention group. The level of depression increased for both groups, but more so in the control than the intervention group. There was a decrease in life satisfaction, although the decrease was largest among controls. There were almost no differences in reported health between groups. However, effect sizes were small and differences were not statistically significant. In contrast, most of the participants said the intervention meant much to them and led to increased use of the centre.In all probability, the intervention failed to meet optimistic targets, but possibly met quite modest ones. Since intention-to-treat analysis was not possible, we do not know the effect on the intervention group as a whole. A further evaluation of these programmes is necessary to expand the group programme. For the depressed, more specialized programmes to cope with depression may be a more appropriate intervention.DRKS00003120 on DRKS
Depressed Older Patients’ Need for and Expectations of Improved Health Services—An Evaluative Approach to the Chronic Care Model  [PDF]
Anne Lyberg, Ingela Berggren, Anne Lise Holm, Elisabeth Severinsson
Open Journal of Nursing (OJN) , 2015, DOI: 10.4236/ojn.2015.54041
Abstract: Depression in later life is an underrepresented yet important research area. The aim of the study was to explore depressed older persons’ need for and expectations of improved health services one year after implementation of the Chronic Care Model (CCM). A qualitative evaluative design was used. Data were collected through individual interviews with older persons living in Norway. The qualitative content analysis revealed two themes: The need to be safeguarded and Expectation of being considered valuable and capable. Evaluation of the improvement in care with focus on the CCM components showed that the most important components for improving the depressed older person’s daily life were: delivery system re-design, self-management support, productive interaction and a well-informed active patient. The findings highlight the need for a health services designed for persons suffering from chronic ill-health, where the CCM could serve as a framework for policy change and support the redesign of the existing healthcare system. We conclude that older persons with depression need attention, especially those who have been suffering for many years. The identified components may have implications for health professionals in the promotion of mental healthcare.
Elderly persons in the risk zone. Design of a multidimensional, health-promoting, randomised three-armed controlled trial for "prefrail" people of 80+ years living at home
Synneve Dahlin-Ivanoff, Gunilla Gosman--Hedstr?m, Anna-Karin Edberg, Katarina Wilhelmson, Kajsa Eklund, Anna Duner, Lena Ziden, Anna-Karin Welmer, Sten Landahl
BMC Geriatrics , 2010, DOI: 10.1186/1471-2318-10-27
Abstract: The study is a randomised three-armed single-blind controlled trial with follow-ups 3 months, 1 and 2 years. The study group should comprise a representative sample of pre-frail 80-year old persons still living at home in two municipalities of Gothenburg. To allow for drop-outs, it was estimated that a total of about 450 persons would need to be included in the study. The participants should live in their ordinary housing and not be dependent on the municipal home help service or care. Further, they should be independent of help from another person in activities of daily living and be cognitively intact, having a score of 25 or higher as assessed with the Mini Mental State Examination (MMSE).We believe that the design of the study, the randomisation procedure, outcome measurements and the study protocol meetings should ensure the quality of the study. Furthermore, the multi-dimensionality of the intervention, the involvement of both the professionals and the senior citizens in the planning of the intervention should have the potential to effectively target the heterogeneous needs of the elderly.ClinicalTrials.gov, NCT00877058The very old are often described as a "frail" group that is particularly exposed to diseases and functional disability and who are at great risk of losing their ability to manage their activities of daily living independently [1-4]. It is a heterogeneous group, consuming a large proportion of the resources of both the health and the care and special services. It is also a group whose care, special service and rehabilitation needs vary considerably and change rapidly [5,6], requiring different professional contributions to be able to offer as adequate and appropriate intervention as possible. The ageing population is posing a challenge to the Swedish welfare system, which will increase future costs for elderly care and health care. The parliamentary bill [7]points out that research will be essential to support the development of effective and evi
Risco de queda em idosos da comunidade: avalia o com o teste Timed up and go Risk of falling among elderly persons living in the community: assessment by the Timed up and go test  [cached]
Onivaldo Bretan,José Elias Silva Júnior,Odilon R. Ribeiro,José Eduardo Corrente
Brazilian Journal of Otorhinolaryngology , 2013,
Abstract: Risco de queda em idosos pode ser avaliado por meio de um teste simples de mobilidade. OBJETIVO: Avaliar o equilíbrio de idosos usando o teste "Timed up and go". MéTODO: Os indivíduos tiveram o tempo medido desde o momento em que se levantaram de uma cadeira, caminharam 3 metros para a frente e retornaram à cadeira. Os idosos também responderam quest es sobre desequilíbrio, tontura e queda. RESULTADOS: Cerca de 69% dos sujeitos realizaram o teste em até 19 segundos. Houve correla o significativa entre desequilíbrio, tempo dispendido e queda, assim como entre tontura e queda. CONCLUS O: A maior parte dos idosos mostrou baixos valores no teste, o que sugere boa mobilidade funcional. Entretanto, um número expressivo de indivíduos com valores mais elevados est o, provavelmente, mais propensos a quedas e à dependência menor ou maior nas atividades da vida diária. The risk of falling in elderly can be analyzed by a simple mobility test. OBJECTIVE: To assess the balance of elderly subjects through the 'Timed up and go' test. METHOD: Subjects were timed for the moment they got up from a chair, walked for three meters, and came back to the chair. They also answered questions on imbalance, dizziness, and falls. RESULTS: Approximately 69% of the subjects completed the test in up to 19 seconds. There was a significant correlation between imbalance, time spent in the test, dizziness, and falls. CONCLUSION: Most of the elderly subjects performed well in the test, thus attesting to their good level of functional mobility. However, a significant number of poor-performers is probably more prone to falling and to depending on others to perform activities of daily living.
Acute exercise improves cognition in the depressed elderly: the effect of dual-tasks
Vasques, Paulo Eduardo;Moraes, Helena;Silveira, Heitor;Deslandes, Andrea Camaz;Laks, Jerson;
Clinics , 2011, DOI: 10.1590/S1807-59322011000900008
Abstract: objective: the goal of this study was to assess the acute effect of physical exercise on the cognitive function of depressed elderly patients in a dual-task experiment. introduction: physical exercise has a positive effect on the brain and may even act as a treatment for major depressive disorder. however, the effects of acute cardiovascular exercise on cognitive function during and after one session of aerobic training in elderly depressive patients are not known. methods: ten elderly subjects diagnosed with major depressive disorder performed neuropsychological tests during and after a moderate physical exercise session (65-75%hrmax). a digit span test (forward and backward) and a stroop color-word test were used to assess cognitive function. the elderly participants walked on an electric treadmill for 30 minutes and underwent the same cognitive testing before, during, immediately after, and 15 minutes after the exercise session. in the control session, the same cognitive testing was conducted, but without exercise training. results: the results of the digit span test did not change between the control and the exercise sessions. the results of the stroop color-word test improved after physical exercise, indicating a positive effect of exercise on cognition. conclusions: these data suggest that the cognitive functions of depressed elderly persons, especially attention and inhibitory control, are not impaired during and after an acute session of physical exercise. in contrast, the effect of dual-tasks showed beneficial results for these subjects, mainly after exercise. the dual-task may be a safe and useful tool for assessing cognitive function.
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