• MeSH
• Home Care Agencies MeSH
• Humans MeSH
• Health Care Costs MeSH
• Home Care Services * economics   organization & administration   statistics & numerical data   MeSH
• Health Care Quality, Access, and Evaluation MeSH
• Check Tag
• Humans MeSH
• Publication type
• Guideline MeSH
• Geographicals
• Czech Republic MeSH

• Keywords
• mobilní paliativní péče, domácí hospic,
• MeSH
• Hospice and Palliative Care Nursing organization & administration   statistics & numerical data   MeSH
• Humans MeSH
• Palliative Care MeSH
• Terminal Care MeSH
• Home Care Services organization & administration   statistics & numerical data   MeSH
• Check Tag
• Humans MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Publication type
• závěrečné práce

OBJECTIVE: The study aimed to determine the clinical effectiveness of honey dressings in the management of non-healing wounds in elderly persons receiving home care. MATERIAL AND METHODS: Design: a prospective interventional study. The sample comprised 40 Czech home care clients (aged over 65 years) with non-healing wounds who were randomly assigned to two groups. Wounds were treated with honey (intervention group) or conventional (controls) dressings. Each wound was studied for three months. A detailed description of a wound (location, size, wound bed, edges, amount of exudate, odor, adjacent skin) were recorded. Wounds were assessed with the Wound Healing Continuum and pain intensity with the Visual Analog Scale. RESULTS: Over the 3-month period, 16 (80%) individuals in the intervention group had their wounds completely healed, as compared with only six (30%) controls. There was no statistically significant difference in wound size between the groups on Day 1 (p = 0.1801). Ninety days later, the difference in wound size between the groups was statistically significant (p = 0.0041). There was a statistically significant difference in pain intensity between the two groups (p = 0.0007), with higher pain scores being indicated by controls. CONCLUSION: The study results showed that the application of honey dressings to non-healing wounds resulted in faster healing, wound size reduction and lower pain intensity.

• MeSH
• Biological Dressings standards   statistics & numerical data   MeSH
• Time Factors MeSH
• Geriatrics instrumentation   methods   MeSH
• Wound Healing drug effects   physiology   MeSH
• Humans MeSH
• Honey * MeSH
• Prospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Home Care Services standards   statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czechoslovakia MeSH

Úvod: Současným trendem je podpora setrvání seniorů v jejich domácím prostředí ve stavu nemoci či snížené soběstačnosti. Tuto skutečnost podporují jak mezinárodní, tak i národní strategické dokumenty, které si ve svých doporučeních kladou za cíl snížit počet hospitalizací u seniorů a péči o seniory přesunout do jejich domácího prostředí. Metody: Pro analýzu vývoje počtu pacientů v domácí zdravotní péči, hospitalizovaných pacientů a klientů pobytových zařízení sociálních služeb byly dány do souvislostí dostupné statistické údaje a přehledy. Výsledek: Mezi roky 2000 a 2016 stoupl počet obyvatel starších 65 let, stejně tak stoupl i počet pacientů domácí zdravotní péče starších 65 let (o 8,68 %), nicméně procento pacientů této věkové kategorie ošetřených v rámci domácí zdravotní péče vzhledem ke stejně staré populaci a počtu pacientů ošetřených v instituci kleslo ze 7,52 % v roce 2000 na 5,84 % v roce 2016. Mezi roky 2000 a 2016 vzrostl počet hospitalizací u pacientů starších 65 let o 30,66 %. Rovněž v tomto období vzrostl počet pacientů přeložených do pobytových zařízení sociálních služeb. Vývoj počtu klientů v pobytových zařízeních sociálních služeb měl výrazně vzestupný charakter. V těchto zařízeních došlo v období let 2006 až 2016 k 15% nárůstu počtu klientů. Počet neuspokojených žádostí o pobyt v zařízeních sociálních služeb zaznamenal v tomto období také stoupající tendenci, a to zejména v případě pobytové služby "domov se zvláštním režimem", kde došlo k 171% nárůstu počtu neuspokojených žádostí. Závěr: I přes cíle strategických dokumentů nedošlo v posledních letech k nárůstu počtu pacientů starších 65 let v domácí zdravotní péči vzhledem k pacientům z řad stejně staré populace. Naopak došlo k výraznému nárůstu počtu hospitalizací u pacientů starších 65 let a zároveň došlo k rychlému nárůstu počtu klientů pobytových zařízení sociálních služeb, včetně neuspokojených žádostí o tyto služby.

Purpose: The current trend is to support seniors staying in their homes in a state of illness or reduced self-sufficiency. This fact is supported by both international and national strategy papers, which aim to reduce the number of hospitalizations in older adults and move the care for the elderly in to their homes. Methods: Available statistics and overviews were put into the context for the analysis of the development of the number of home health care patients, hospitalized patients and clients of the residential care facilities. Results: The number of people aged 65 and older, as well as the number of home health care patients aged 65 and older (by 8.68%) grew between 2000 and 2016, however the percentage of home health care patients of this age group decreased in the context of the same old population from 7.52% in 2000 to 5.84% in 2016. The number of hospitalizations in patients aged 65 years and older increased by 30.6% between 2000 and 2016. Likewise, the number of patients transferred from hospitals to residential care facilities increased during this period. The number of clients in residential care facilities was rising significantly. In these facilities, the number of clients increased by 15% between 2006 and 2016. The number of unsatisfied applications for residential care facilities grew during this period as well, especially in the case of residential service "residential care facility for people with dementia", where the number of unsatisfied applications increased by 171%. Conclusion: In spite of the strategic documents objectives, the number of home health care patients aged 65 and older has not grown in recent years considering the same old population. Instead, there has been a significant increase in the number of hospitalizations in patients aged 65 years and older and there has been a rapid increase in the number of clients of residential care facilities as well, including unsatisfied applications for these services.

• MeSH
• Hospitalization statistics & numerical data   MeSH
• Humans MeSH
• Nursing Homes statistics & numerical data   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Home Care Services statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

AIM: Drugs may interact with geriatric syndromes by playing a role in the continuation, recurrence or worsening of these conditions. Aim of this study is to assess the prevalence of interactions between drugs and three common geriatric syndromes (delirium, falls and urinary incontinence) among older adults in nursing home and home care in Europe. METHODS: We performed a cross-sectional multicenter study among 4023 nursing home residents participating in the Services and Health for Elderly in Long-TERm care (Shelter) project and 1469 home care patients participating in the Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (IBenC) project. Exposure to interactions between drugs and geriatric syndromes was assessed by 2015 Beers criteria. RESULTS: 790/4023 (19.6%) residents in the Shelter Project and 179/1469 (12.2%) home care patients in the IBenC Project presented with one or more drug interactions with geriatric syndromes. In the Shelter project, 288/373 (77.2%) residents experiencing a fall, 429/659 (65.1%) presenting with delirium and 180/2765 (6.5%) with urinary incontinence were on one or more interacting drugs. In the IBenC project, 78/172 (45.3%) participants experiencing a fall, 80/182 (44.0%) presenting with delirium and 36/504 (7.1%) with urinary incontinence were on one or more interacting drugs. CONCLUSION: Drug-geriatric syndromes interactions are common in long-term care patients. Future studies and interventions aimed at improving pharmacological prescription in the long-term care setting should assess not only drug-drug and drug-disease interactions, but also interactions involving geriatric syndromes.

• MeSH
• Delirium epidemiology   MeSH
• Long-Term Care statistics & numerical data   MeSH
• Geriatric Assessment methods   MeSH
• Urinary Incontinence epidemiology   MeSH
• Humans MeSH
• Nursing Homes statistics & numerical data   MeSH
• Prevalence MeSH
• Cross-Sectional Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Home Care Services statistics & numerical data   MeSH
• Syndrome MeSH
• Accidental Falls statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe epidemiology   MeSH

• MeSH
• Humans MeSH
• Persons with Disabilities statistics & numerical data   legislation & jurisprudence   MeSH
• Home Care Services economics   statistics & numerical data   legislation & jurisprudence   MeSH
• Health Services for Persons with Disabilities economics   statistics & numerical data   legislation & jurisprudence   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Newspaper Article MeSH
• Geographicals
• Czech Republic MeSH

Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 countries (year: 2008), covering place of death, underlying cause of death, and demographic information. We included patients dying from lung cancer or chronic obstructive pulmonary disease and used descriptive statistics and multivariable logistic regressions to describe patterns in place of death. Of 5,568,827 deaths, 5.8% were from lung cancer and 4.4% from chronic obstructive pulmonary disease. Among lung cancer decedents, home deaths ranged from 12.5% in South Korea to 57.1% in Mexico, while hospital deaths ranged from 27.5% in New Zealand to 77.4% in France. In chronic obstructive pulmonary disease patients, the proportion dying at home ranged from 10.4% in Canada to 55.4% in Mexico, while hospital deaths ranged from 41.8% in Mexico to 78.9% in South Korea. Controlling for age, sex, and marital status, patients with chronic obstructive pulmonary disease were significantly less likely die at home rather than in hospital in nine countries. Our study found in almost all countries that those dying from chronic obstructive pulmonary disease as compared with those from lung cancer are less likely to die at home and at a palliative care institution and more likely to die in a hospital or a nursing home. This might be due to less predictable disease trajectories and prognosis of death in chronic obstructive pulmonary disease. LUNG DISEASE: IMPROVING END-OF-LIFE CARE: Structured palliative care similar to that offered to cancer sufferers should be in place for patients with chronic lung disease. Joachim Cohen at Vrije University in Brussels and co-workers examined international death certificate data collected from 14 countries to determine place of death for patients with lung cancer and chronic obstructive pulmonary disease (COPD). While patients with COPD suffer similar symptoms to lung cancer in their final days, few COPD patients receive palliative care or achieve the common wish of dying at home. This may be partly due to the inherent unpredictability of final-stage COPD compared with lung cancer. Cohen's team found that, with the exception of Italy, Spain, and Mexico, patients with COPD were significantly more likely to die in hospital than at home. They highlight the need for improved COPD palliative care provision.

• MeSH
• Pulmonary Disease, Chronic Obstructive * MeSH
• Adult MeSH
• Hospices * MeSH
• Hospitalization statistics & numerical data   MeSH
• Middle Aged MeSH
• Humans MeSH
• Logistic Models MeSH
• Marital Status MeSH
• Adolescent MeSH
• Young Adult MeSH
• Multivariate Analysis MeSH
• Lung Neoplasms * MeSH
• Hospitals * MeSH
• Palliative Care MeSH
• Terminal Care statistics & numerical data   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Home Care Services statistics & numerical data   MeSH
• Death * MeSH
• Death Certificates MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH
• Republic of Korea MeSH
• New Zealand MeSH
• North America MeSH

BACKGROUND: Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales. METHODS: Data for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology. RESULTS: A total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark. CONCLUSIONS: The interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions.

• MeSH
• Activities of Daily Living MeSH
• Ethnicity MeSH
• Geriatric Assessment methods   statistics & numerical data   MeSH
• Cohort Studies MeSH
• Quality of Life * MeSH
• Humans MeSH
• Models, Organizational MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Home Care Services * organization & administration   standards   statistics & numerical data   MeSH
• Aging * physiology   psychology   MeSH
• Quality Indicators, Health Care standards   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH
• Denmark MeSH
• Finland MeSH
• Italy MeSH
• Germany MeSH
• Netherlands MeSH

• Keywords
• zařízení sociálních služeb, domácí péče, veřejnost, převis žadatelů,
• MeSH
• Home Nursing trends   utilization   MeSH
• Middle Aged MeSH
• Humans MeSH
• Surveys and Questionnaires utilization   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Home Care Services statistics & numerical data   MeSH
• Social Welfare economics   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH

Cíl: Cílem studie bylo ověřit využitelnost ošetřovatelských intervencí NIC v ošetřovatelské praxi domácí péče a porovnat záznam aktuálních ošetřovatelských intervencí evidovaných v ošetřovatelské dokumentaci agentury domácí péče s navrhovaným souborem ošetřovatelských intervencí NIC. Metodika: Pilotní soubor o velikosti 110 ošetřovatelských intervencí a 2150 ošetřovatelských aktivit byl sestaven podle taxonomie NIC (Nursing Intervention Classification), jeho ověřování proběhlo u 30 klientů agentury domácí péče v roce 2011. Analýzou ošetřovatelské dokumentace 200 klientů stejné agentury byly pak sledovány reálné intervence a aktivity sester zaznamenané v ošetřovatelském plánu. Výsledky: Z pilotního souboru intervencí NIC využily sestry celkem 39 ošetřovatelských intervencí pro 221 potvrzených ošetřovatelských diagnóz NANDA-I. Nejvíce intervencí (73 %) bylo indikováno pro ošetřovatelské diagnózy Zhoršená pohyblivost, Riziko infekce, Riziko deficitu tělesných tekutin a Riziko porušení kožní integrity. Mezi nejčetnější ošetřovatelské intervence, které sestry ze souboru NIC vybíraly, patřily: Hospodaření s energií, Prevence pádu, Péče o ránu, Učení: předepsané činnosti/cvičení a Podpora cvičení. Ošetřovatelské činnosti reálně vykonávané sestrami u klientů ADP a zaznamenané v ošetřovatelském plánu (44 různých ošetřovatelských intervencí, 1406 provedených výkonů) se lišily od ošetřovatelských intervencí, které byly potvrzeny při pilotním ověřování. Pojmenování ošetřovatelských intervencí sestrami agentury domácí péče nereflektovalo terminologii NIC, proto nebyla data vzájemně porovnávána. Závěr: Používání jednotné ošetřovatelské terminologie je důležité pro přesnou a jednoznačnou komunikaci ošetřovatelských profesionálů, pro popis a evidenci práce sester a doložitelné vykazování ošetřovatelských činností.

Aim: The aim of this study was to verify the utilization of nursing interventions NIC in home care and to compare the report of current nursing interventions recorded in nursing documentation in home care agency with proposed set of nursing interventions NIC. Methods: The sample of 110 nursing interventions and 2150 nursing activities was compiled according to taxonomy NIC (Nursing Intervention Classification), its verification was carried out in 30 home care agency clients in 2011. Using the analysis of nursing documentation in 200 clients of the same agency, were then monitored real interventions and activities by nurses recorded in nursing care plan. Results: From the pilot set of NIC interventions nurses have used 39 of nursing interventions for 221 confirmed nursing diagnoses NANDA-I. The most of interventions (73%) were indicated for nursing diagnoses: Impaired physical mobility, Risk for infection, Risk for deficient fluid volume and Risk for impaired skin integrity. Among the most frequent nursing interventions, which nurses have selected from NIC file, were: Energy management, Fall prevention, Wound care, Teaching: prescribed activities/exercise. Nursing activities actually performed by nurses in home care clients and recorded in nursing care plan (44 different nursing interventions, 1406 performed procedures) differed from nursing interventions that were confirmed during the pilot verification. Naming of nursing interventions by the nurses in home care agency did not reflect the NIC terminology, thus the data were not mutually compared. Conclusion: The use of uniform nursing terminology is essential for accurate and unambiguous communication of nursing professionals, for description and record of the work of nurses and for provable reporting of nursing activities.

• Keywords
• klienti, ověřování,
• MeSH
• Home Nursing methods   statistics & numerical data   MeSH
• Financing, Organized MeSH
• Humans MeSH
• Nursing Diagnosis MeSH
• Nursing Care methods   manpower   statistics & numerical data   MeSH
• Nursing Process statistics & numerical data   utilization   MeSH
• Home Care Services organization & administration   statistics & numerical data   utilization   MeSH
• Statistics as Topic MeSH
• Terminology as Topic MeSH
• Check Tag
• Humans MeSH
• Publication type
• Comparative Study MeSH