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Home Population (home + population)
Kinds of Home Population Selected AbstractsUNDERDIAGNOSIS OF CHRONIC KIDNEY DISEASE IN THE NURSING HOME POPULATIONJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2009Jeffrey T. Cohen MD No abstract is available for this article. [source] Construction and validation of a patient- and user-friendly nursing home version of the Geriatric Depression Scale,INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2007K. Jongenelis Abstract Objective To construct a patient- and user-friendly shortened version of the Geriatric Depression Scale (GDS) that is especially suitable for nursing home patients. Methods The study was carried out on two different data bases including 23 Dutch nursing homes. Data on the GDS (n,=,410), the Mini Mental State Examination (n,=,410) and a diagnostic interview (SCAN; n,=,333), were collected by trained clinicians. Firstly, the items of the GDS-15 were judged on their clinical applicability by three clinical experts. Subsequently, items that were identified as unsuitable were removed using the data of the Assess project (n,=,77), and internal consistency was calculated. Secondly, with respect to criterion validity (sensitivity, specitivity, area under ROC and positive and negative predictive values), the newly constructed shortened GDS was validated in the AGED data set (n,=,333), using DSM-IV diagnosis for depression as measured by the SCAN as ,gold standard'. Results The eight-item GDS that resulted from stage 1 showed good internal consistency in both the Assess data set (,,=,0.86) and the AGED dataset (,,=,0.80). In the AGED dataset, high sensitivity rates of 96.3% for major depression and 83.0% for minor depression were found, with a specificity rate of 71.7% at a cut-off point of 2/3. Conclusion The GDS-8 has good psychometric properties. Given that the GDS-8 is less burdening for the patient, more comfortable to use and less time consuming, it may be a more feasible screening test for the frail nursing home population. Copyright © 2007 John Wiley & Sons, Ltd. [source] Sleep disturbances among nursing home residentsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2002Arne Fetveit MD Abstract Study objectives This study assesses the prevalence and characteristics of sleep disturbances among an entire nursing home population, consisting of 29, mainly demented, long-term patients. Design and setting Sleep was evaluated for 14 consecutive days using actigraphic measurements and nursing staff observations. No alterations were made in every-day routines or medications during the observation period. Measurements and results Actigraphy showed a mean sleep onset latency of one hour and a mean wake after sleep onset of more than two hours, while there was no findings of early morning awakening. Mean sleep efficiency was 75%, and more than 13 hours were spent in bed. 72% of the subjects had sleep efficiency below 85%. Nursing staff reported sleep onset latency of more than 30 minutes in 158 of the 203 analysed days, while early morning awakening was reported in only 12 of 203 days. Actigraphical measurements and nursing staff observations gave similar results. The validity of actigraphy in this population is discussed. Conclusion Sleep disturbances were common among the residents in this nursing home. Sleep onset latency was prolonged, and the patients experienced frequent wake bouts after sleep onset. The diminished ability of sustained sleep may have been influenced by the prolonged time in bed. Copyright © 2002 John Wiley & Sons, Ltd. [source] The effect of somatic symptom attribution on the prevalence rate of depression and anxiety among nursing home patientsINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2005Martin Smalbrugge Abstract The validity of diagnostic psychiatric instruments for depression and anxiety disorders may be compromised among patients with complex physical illness and disability. The objective of this study was to determine the effect on the prevalence rate of depression and anxiety in a nursing home population of attributing somatic symptoms of depression and anxiety to either somatic or psychiatric disorder. Symptoms of major depression (MD), generalized anxiety disorder (GAD) and panic disorder (PD) were measured using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Somatic symptoms of MD, GAD and PD were attributed to somatic causes when the interviewer was not sure about a psychiatric cause. To analyse the effect of this attribution on the prevalence rate of MD, GAD and PD, a sensitivity analysis was undertaken in which symptoms that were attributed to somatic causes were recoded as symptoms attributed to psychiatric disorder. Prevalence rates of MD, GAD and PD were calculated before and after recoding. The prevalence of MD after recoding rose from 7.5% to 8.1%. The prevalence of GAD did not change. The prevalence of PD rose from 1.5% to 1.8%. Attribution of somatic symptoms to either somatic or psychiatric disorder when the interviewer was not sure about a psychiatric cause of the somatic symptoms had only a very modest effect on the prevalence rate of major depression, generalized anxiety disorder and panic disorder in a nursing home population. Copyright © 2005 John Wiley & Sons, Ltd. [source] A Cost-Benefit Analysis of External Hip Protectors in the Nursing Home SettingJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2005Lisa A. Honkanen MD Objectives: To estimate potential cost savings generated by a program of hip protectors in the nursing home from a Medicare perspective. Design: A state-transition Markov model considering short-term and long-term outcomes of hip protectors for a hypothetical nursing home population, stratified by age, sex, and functional status. Costs, transition probabilities between health states, and estimates of hip protectors' effectiveness were derived from published secondary data. Setting: Nursing home facilities in the United States. Participants: Hypothetical cohort of permanent nursing home residents aged 65 and older without a previous hip fracture. Intervention: Program of hip protectors reimbursed by Medicare. Measurements: Number of fractures, life years, and dollars saved. Results: Three pairs of hip protectors replaced annually would result in a weighted average lifetime absolute risk reduction for hip fracture of 8.5%, with net lifetime savings to Medicare of $223 per resident. When the annual cost of hip protectors is less than $151 per person, relative risk of fracture is less than or equal to 0.65 with hip protectors, or adherence is greater than 42%, hip protectors are cost saving to Medicare over a wide range of assumptions. Extrapolating these results to the estimated population of U.S. nursing home residents without a previous hip fracture, Medicare could save $136 million in the first year of a hip-protector reimbursement program. Conclusion: From a Medicare perspective, hip protectors are a cost-saving intervention in the nursing home setting when hip protector effectiveness is less than or equal to 0.65 over the remaining lifetime of subjects. [source] Prevalence and incidence of urinary incontinence of Swiss nursing home residents at admission and after six, 12 and 24 monthsJOURNAL OF CLINICAL NURSING, Issue 18 2008Susi Saxer Aims and objectives., To study the prevalence and incidence of urinary incontinence in a Swiss nursing home population at admission and at six, 12, 18 and 24 months after admission. Background., No prevalence data for urinary incontinence in people older than 65 years living in nursing homes are available in Switzerland and other German-speaking parts of Europe. Prevalence of urinary incontinence elsewhere varies between 49% and 77%. Methods., This is a secondary analysis of the data of the minimum data set of the Resident Assessment Instrument 2.0 in which 2719 residents were assessed. Prevalence rates and incidence were calculated at admission and at six, 12, 18 and 24 months after admission. Special focus was placed on sex- and age-related differences. Results., Prevalence of urinary incontinence was 51·5% (men 51·4%, women 51·5%) and was found to rise with increasing age. At the time of admission, 37% (men 43%, women 34%) were urinary incontinent. The prevalence increased from admission to 24 months after admission. Conclusion., The high prevalence rates indicate the relevance of the problem for residents and caregivers alike. Early identification of individuals likely to become incontinent is crucial in the development of interventions and the prevention of urinary incontinence in this vulnerable population. Relevance to clinical practice., The study provides valuable data about the extent of the problem of urinary incontinence in nursing homes. [source] Prevalence and associated factors of pneumonia in patients with vegetative state in TaiwanJOURNAL OF CLINICAL NURSING, Issue 7 2008Li-Chan Lin PhD Aims., The aim of this study was to investigate the prevalence rate and influencing factors of pneumonia associated with long-term tube feeding in special care units for patients with persistent vegetative states (PVS) in Taiwan. Background., Pneumonia is a significant cause of morbidity, hospitalization and mortality in the nursing home population. Tube feeding has been found as a risk factor for the occurrence of pneumonia. Methods., Two hundred sixty subjects were chosen from three hospital-based special care units for patients with PVS and 10 nursing facilities for persons in PVS in Taiwan. All subjects, who were diagnosed with PVS, received either financial aid for institutional care or were means-tested from The Bureau of Social Welfare of cities and counties in Taiwan. Data were collected through chart review and observations. Results., The prevalence rate of pneumonia in nursing facilities for patients with PVS was 14·2%. The prevalence rate of tube-feeding in nursing facilities for PVS was 91·2%. The mean duration of tube-feeding was 73·21 SD 55·33 months. A total of 90·4% was fed with a nasogastric (NG) tube. Having a lower intake of food and fluids daily and having been institutionalized for a shorter period were three dominant factors associated with the occurrence of pneumonia. Conclusion., Research findings reveal that the incidence of pneumonia is higher in patients who do not receive adequate food and water. Continuing in-service training to improve caregivers' knowledge and skill in providing care to patients in PVS and monitoring their skills in feeding is needed to decrease the occurrence of pneumonia in this population. Relevance to clinical practice., Staff needs to be taught to monitor laboratory data and signs and symptoms of malnutrition and hydration deficit, and also be alert to early indicators of pneumonia in patients with PVS. [source] Between Pinochet and Kropotkin: state terror, human rights and the geographersTHE CANADIAN GEOGRAPHER/LE GEOGRAPHE CANADIEN, Issue 3 2001John Wiley Lecture The lecture develops a civil perspective on states engaged in systematic but arbitrary armed violence against their home populations: what the Nürnberg Tribunal called ,government by terror. Civilians, or most of them, appear uniquely vulnerable to such violence and the gross violations of human rights accompanying it. Moreover, this, rather than wars as usually understood, involved the largest uses of armed force in the twentieth century. It was the main cause of violent death of civilians. Two geographical concerns are addressed: the ,geographic' nature of such violence, and its implications for the thought and practice of geographers. They are explored especially through the work of two geographers whose lives bracket the past ,century of violence, Peter Kropotkin and Augusto Pinochet. Pinochet's dictatorship in Chile fully illustrates the scope of state terror. Geographies of coercion are seen in the system of political prisons and torture, the making of a society and landscapes of fear, and the unmaking of civil life. The atrocities also violated Chile's former commitment to human rights initiatives. Pinochet's geographical work, especially the geopolitics, is in accord with, or offers no counter to, the repressive, authoritarian regime he headed, Kropotkin's descriptions of imperial Russia show many parallels to the Chilean case, and the kind of repressive state power that he rejected to dedicate his life to its vulnerable and innocent victims. Almost alone among geographers he developed a coherent, influential vision of violence, social justice and interpersonal ethics, based on geographical investigations as well as an anarchist perspective. These two may also seem to represent conceptual and lived extremes - respectively, an extreme deployment of state violence, and a total rejection of the state because of the facts and potential of violent repression. Unfortunately, enquiries into violence and the state, let alone terrorist states, are virtually absent from contemporary geographical scholarship. Its emergence as an essentially ,civil field' has reinforced this - when it should have had the opposite effect. In part this involves a failure to temper our long, and less-than-critical, service to the state in all areas, and a continuing governmental mind-set. It is suggested that the absence of critical reflection on the contested relations of civil society and the state, especially as they involve state violence, undermines the intellectual value and ethical standards of our work. [source] | ||||||||||