BACKGROUND: Loneliness, a major public health concern, could be alleviated through social interventions with nature contact as a primary component. "Friends in Nature" is a complex nature-based social intervention designed to be implemented as part of "Reimagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces" (RECETAS). This project aims to alleviate loneliness and promote health-related quality of life in six different geographic areas worldwide. Feasibility studies are crucial to assess the viability of complex interventions and study procedures before conducting definitive studies. This paper aims to describe the design, implementation, and evaluation of the six-related feasibility studies on the "Friends in Nature" intervention. These studies specifically evaluate feasibility of recruitment and study procedures, intervention implementation, and data collection and distribution. METHODS: We defined a comprehensive set of indicators to assess the feasibility of "Friends in Nature." For the first domain, recruitment procedures were assessed to determine their adequacy, while attrition rates were examined to assess participant retention. For the second domain, the implementation of interventions was evaluated, along with the study design's ability to adapt to unexpected situations and participant adherence to the intervention. Finally, for the third domain, completion rates and the acceptability of the study activities were also analyzed. The feasibility of using specific scales to assess loneliness and well-being was also explored. RESULTS: The feasibility indicators defined for this study were useful to assess the feasibility of "Friends in Nature." Recruitment procedures were generally found to be adequate, and the number of dropouts was low. Interventions were implemented with minor adjustments, and facilitators played a vital role in the well-functioning of the interventions. Although some unexpected situations occurred during the study, adaptations were made, and participants were generally satisfied with the activities proposed. Scales used to assess loneliness and quality of life showed potential for measuring the effects of nature-based social prescribing in the full trial. CONCLUSION: This paper offers valuable insights into the design and execution of feasibility studies for complex interventions like "Friends in Nature." Findings from these assessments explore the feasibility of "Friends in Nature" and will inform the main RECETAS studies, which are designed to strengthen the evidence base to support the use of nature-based social prescribing to reduce loneliness and promote quality of life. TRIAL REGISTRATION: Barcelona trial: NCT05488496, Prague trial: NCT05522140, and Helsinki trial: NCT05507684.
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Existing advance care planning (ACP) definitional frameworks apply to individuals with decision-making capacity. We aimed to conceptualize ACP for dementia in terms of its definition and issues that deserve particular attention. METHODS: Delphi study with phases: (A) adaptation of a generic ACP framework by a task force of the European Association for Palliative Care (EAPC); (B) four online surveys by 107 experts from 33 countries, September 2021 to June 2022; (C) approval by the EAPC board. RESULTS: ACP in dementia was defined as a communication process adapted to the person's capacity, which includes, and is continued with, family if available. We identified pragmatic boundaries regarding participation and time (i.e., current or end-of-life care). Three interrelated issues that deserve particular attention were capacity, family, and engagement and communication. DISCUSSION: A communication and relationship-centered definitional framework of ACP in dementia evolved through international consensus supporting inclusiveness of persons with dementia and their family. HIGHLIGHTS: This article offers a consensus definitional framework of advance care planning in dementia. The definition covers all stages of capacity and includes family caregivers. Particularly important are (1) capacity, (2) family, (3) engagement, and communication. Fluctuating capacity was visualized in relation to roles and engaging stakeholders.
- MeSH
- delfská metoda MeSH
- demence * terapie MeSH
- konsensus MeSH
- lidé MeSH
- péče o umírající * MeSH
- předběžné plánování péče * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
Úvod: Těsná kompenzace diabetu je u většiny pacientů optimálním cílem terapie. CSII zlepšuje kompenzaci a nezvyšuje přitom riziko hypoglykemie u pacientů s diabetes mellitus 1. i 2. typu, u diabetiků 1. typu snižuje kardiovaskulární mortalitu. Cíle práce: zhodnocení využívání CSII v terapii seniorů léčených inzulinem v České republice. Metodika: Pro analýzu byl využit anonymizovaný soubor pacientů s DM z dat Národního registru hrazených zdravotních služeb (NRHZS) v letech 2010–2021 (pacienti, u kterých byla v daném roce vykázána inzulinová pumpa, příslušenství nebo spotřební materiál). Výsledky: V roce 2021 bylo léčeno pouze inzulinem (ATC A10) 84 345 pacientů, z nichž bylo 55,7% (46 969) starších 65 let. Prevalence terapie CSII se postupně zvyšuje, z 5 067 pacientů v roce 2010 na 7285 v roce 2021. U 685 nemocných starších 65 let byla v roce 2021 vykázána terapie CSII (9,4% ze všech léčených CSII; 1,5% ze všech léčených pouze inzulinem). 6 597 pacientů ve věku do 65 let je léčeno CSII (17,7% ze všech léčených inzulinem). Závěr: U pacientů ve věku nad 65 let je prevalence využívání CSII významně nižší v porovnání s pacienty nižšího věku. Výsledky mohou napomoci směrování úsilí odborných společností, státní administrativy a vedení zdravotních pojišťoven k zlepšení podmínek pro poskytování terapie CSII a posílení odborné přípravy zdravotnického personálu mimo diabetologická centra.
Introduction: Good glucose control is the optimal goal of antidiabetic therapy in most patients. CSII improves results and does not increase the risk of hypoglycemia in patients with type 1 and type 2 diabetes mellitus; it reduces cardiovascular mortality in type 1 diabetics. Objectives: evaluation of the use of CSII in the therapy of elderly treated with insulin in the Czech Republic. Methodology: An anonymized set of patients with DM from the data of the National Register of Paid Health Services (NRHZS) in the years 2010-2021 (patients for whom an insulin pump, accessories or consumables were reported in the given year) was used for the analysis. Results: In 2021, 84,345 patients were treated with insulin alone (ATC A10), of which 55.7% (46,969) were older than 65 years. The prevalence of CSII therapy is gradually increasing, from 5067 patients in 2010 to 7285 in 2021. In 2021, CSII therapy was reported in 685 patients over 65 years of age (9.4% of all treated with CSII; 1.5% of all treated only insulin). 6597 patients under the age of 65 are treated with CSII (17.7% of all treated with insulin). Conclusion: In patients over 65 years of age, the prevalence of CSII use is significantly lower compared to younger patients. The results can help guide the efforts of professional societies, state administrations and management of health insurance companies to improve the conditions for the provision of CSII therapy and to strengthen the professional training of medical personnel outside diabetes centers.
- MeSH
- diabetes mellitus * farmakoterapie MeSH
- hodnocení rizik metody MeSH
- hypoglykemie prevence a kontrola MeSH
- inzulinové infuzní systémy * MeSH
- kontinuální monitorování glukózy metody přístrojové vybavení MeSH
- lidé MeSH
- registrace MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Lůžková zdravotnická zařízení následné péče soustředí medicínsky heterogenní skupinu seniorů velmi náročných na ošetřovatelskou, lékařskou, psychologickou a motivační péči. Tyto skutečnosti se významně dotýkají personálu všech profesí, které poskytují přímou péči o pacienty na lůžkách následné péče. Provedená studie hodnotí, jak personál těchto zařízení vnímá svou zejména psychickou zátěž při vykonávání profese a jestli a jakým způsobem se na jejich celkovém přístupu a spokojenosti odrazí absolvování edukačních seminářů zaměřených na komunikaci a přístup k pacientům s demencí. V dotazníkovém šetření byly použity dotazníky P-CAT a PCTB. Pracovníci byli rozděleni na skupinu intervenovanou, která absolvovala sérii edukačních seminářů, a neintervenovanou. Posléze bylo provedeno nové dotazníkové šetření (P-CAT a PCTB) a výsledky obou skupin byly porovnány. Výsledky studie prokázaly statisticky významné snížení vnímání zátěže intervenované skupiny v komunikaci s pacienty s demencí a také vyšší toleranci problémového chování těchto pacientů.
Inpatient aftercare facilities concentrate a medically heterogeneous group of seniors who are very demanding in terms of nursing, medical, psychological and motivational care. These realities have significant implications for staff from all professions that provide direct care to patients in aftercare beds. The present study evaluates how staff providing direct care to clients in aftercare facilities perceive their particular psychological burden in their profession and whether and how their overall attitude and satisfaction is affected by attending educational seminars on communication and approach to patients with dementia. The P-CAT and PCTB questionnaires were used in the survey, and the workers were divided into an intervention group, which received a series of educational seminars, and a non-intervention group, and then the two groups were compared. The results of the study showed a statistically significant reduction in the perceived burden of the intervention group in communicating with patients with dementia, as well as a higher tolerance of problem behaviors in these patients.
- MeSH
- dospělí MeSH
- klinické zkoušky jako téma MeSH
- komorbidita MeSH
- křehký senior MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemocnice pro chronická onemocnění MeSH
- ošetřovatelská péče * MeSH
- pracovní zátěž * MeSH
- průzkumy a dotazníky MeSH
- zátěž pečovatele MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Dysfagie je stále častějším problémem u pacientů seniorského věku, kterému dosud není věnována dostatečná pozornost v následné a dlouhodobé péči. Polykací funkce ve vyšším věku podléhají jak anatomickým, tak fyziologickým změnám. Jednou z nich je snížení svalové hmoty a síly v důsledku sarkopenie. Byla provedena kvantitativní retrospektivní studie, jejímž cílem bylo prokázat vztah mezi svalovou silou a dysfagií u hospitalizovaných seniorů ze skupiny tzv. oldest old (starších 90 let), a to za pomoci jednoduchých standardizovaných testů (WST a HGS) nezatěžujících pacienta. Zároveň jsme posuzovali využitelnost těchto testů v klinické praxi v rámci screeningového vyšetření u křehkých geriatrických pacientů. Výsledky studie prokázaly statisticky významnou korelaci mezi svalovou silou pacienta a stavem polykání. Pacienti se sníženou svalovou silou vykazovali častěji poruchu polykání. Dalším významným faktorem, který ovlivňoval svalovou sílu i polykání, byla míra soběstačnosti pacienta v ADL. Studie potvrdila užitečnost tohoto jednoduchého screeningového nástroje pro měření svalové síly (HGS) a hodnocení stavu polykání (WST) v praxi.
Dysphagia is becoming an increasingly common problem in older patients. The swallowing function in the oldage undergoes both anatomical and physiological changes as part of natural aging. One of these is a decrease in muscle mass and strength within the sarcopenia. A quantitative retrospective study was conducted to demonstrate the relationship between muscle strength and dysphagia in hospitalized older patients from the so-called oldest old group (over 90 years of age) using simple standardized tests (WST and HGS) that do not burden the patient, and to verify the wide applicability of these tests in practice for screening in frail geriatric patients. The results of the study showed a statistically significant correlation between the patient’s muscle strength and their swallowing status. Patients with reduced muscle strength were more likely to have swallowing disorders. Another significant factor that influenced both muscle strength and swallowing status was the patient’s level of self-sufficiency in ADL. The study also confirmed usability of using a simple screening tool to measure muscle strength (HGS) and assess swallowing status (WST) in practice.
- MeSH
- křehký senior MeSH
- lidé MeSH
- nemocnice pro chronická onemocnění MeSH
- poruchy polykání * diagnóza MeSH
- retrospektivní studie MeSH
- sarkopenie * diagnóza MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- svalová síla - dynamometr MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
OBJECTIVES: Mental illness affects approximately 1 in 8 people globally, with approximately 15% of adults aged 60 years and older experiencing a mental disorder. With the aging population, there is a growing demand for long-term care. This scoping review focuses on older adults with non-neurocognitive and non-neurodevelopmental mental illnesses (NNNDMIs) in nursing homes, exploring how the care is provided. DESIGN: A scoping review. SETTING AND PARTICIPANTS: The review includes studies addressing care for older adults with NNNDMI in nursing homes. METHOD: The PRISMA-ScR protocol was followed. Four research databases (EBSCO, PubMed, Web of Science, and Scopus) and article bibliographies were used for the literature search. Thematic analysis identified the main themes. RESULTS: From a total of 1948 search results, 13 articles were analyzed to reveal 5 themes: (1) challenges and recommendations in nursing home admission for older adults with mental illness; (2) impact on the quality of the care; (3) need for specialized staff training and competency; (4) contributions to psychiatric and behavioral symptoms; and (5) need for a range of interventions. CONCLUSION AND IMPLICATIONS: Older adults with NNNDMI face barriers during admission to long-term care facilities that highlight concerns about care quality and systemic issues. Behavioral symptoms require specialized mental health support, but access to such services is lacking. Deficiencies in staff education and burnout prevention initiatives further underscore the need for comprehensive reforms to address the unique needs of this overlooked population in long-term care settings.
