This study evaluated beliefs regarding 25 content areas essential to the primary care of older adults and attitudes toward aging held by first-yearmedical students and Internal Medicine residents. A survey of 136 medical students and 61 Internal Medicine residents was conducted at an academic health-center. Beliefs were assessed by the 25-item Geriatrics Clinician-Educator Survey. Gap scores reflecting the difference in ratings between self-rated importance and knowledge were calculated. Attitudes toward aging was assessed by the Images of Aging Scale. Students and residents expressed similar beliefs about the importance of content areas, but students provided lower ratings in knowledge. Students reported larger gap scores in areas that reflected general primary care (e.g., chronic conditions, medications), whereas residents reported larger gap scores in areas that reflected specialists' expertise (e.g., driving risk, cognition, psychiatric symptoms). Attitudes toward aging did not differ appreciably between students and residents. Our findings suggest that primary care topics applicable for any age demographic were rated as most important by first-year medical students and Internal Medicine residents. Topics relevant to older populations--particularly those requiring specialists' knowledge of or requiring sensitive discussion with older adults-were rated as less important and were less well-mastered.
- MeSH
- geriatrie * výchova metody MeSH
- kultura MeSH
- kurzy a stáže v nemocnici metody MeSH
- lidé MeSH
- postoj zdravotnického personálu MeSH
- primární zdravotní péče * metody normy MeSH
- senioři MeSH
- stárnutí psychologie MeSH
- studenti lékařství psychologie MeSH
- zdraví - znalosti, postoje, praxe MeSH
- zdravotní služby pro seniory * organizace a řízení normy MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- Research Support, U.S. Gov't, Non-P.H.S. MeSH
Předkládáme výsledky analýzy review české literatury zabý-vající se potřebami hospitali-zovaných seniorů. Zjišťujeme, že toto téma není dosud v naší literatuře dostatečně řešeno.
Needs of senior patients in hospital care – analysis of Czech literature review results. We present results of a scop-ing review on needs of seniors during their hospitalization. There are very scarce resourc-es on this topic in the Czech literature.
Ageing people with disabilities (APwDs) are faced with challenges of ageing which is straightforwardly related to disability that adds to the burden related to their early-onset disability. The aim of the paper is to improve Physical and Rehabilitation Medicine (PRM) physicians' professional practice for APwDs (as a distinct group from those who are disabled due to the ageing process) in order to promote their functioning properties and to reduce activity limitations and/or participation restrictions. A systematic review of the literature and a Consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section. The systematic literature review is reported together with the 30 recommendations resulting from the Delphi procedure. The professional role of PRM physicians in relation to APwDs is extending, expanding and/or improving health-related rehabilitation services worldwide in various settings (getting beyond the rehabilitation facilities) emphasizing the concept of integrated care with collaboration across other sectors to meet the specific needs of APwDs. This evidence based position paper (EBPP) represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians in APwDs.
- MeSH
- Evropská unie MeSH
- fyziatrie MeSH
- hodnocení rizik MeSH
- hodnocení výsledků zdravotní péče * MeSH
- lékařská praxe založená na důkazech MeSH
- lidé středního věku MeSH
- lidé MeSH
- odborná praxe normy MeSH
- postižení rehabilitace MeSH
- progrese nemoci MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- stárnutí fyziologie MeSH
- zdravotní služby pro seniory normy MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: Autonomy has become a key organizing principle in the official and expert discourses of the social services focused on strengthening of clients' independence and self-sufficiency. While "caring" has been seen as a threat to the autonomy of an individual, the care dependency and need for palliative care for people with dementia living in residential institutions are growing. METHODS: Participatory action research was realized in 9 homes providing services for people with dementia with the aim to improve the quality of care. Research teams from the homes were involved in assisted self-assessment which included observation, documentation analysis, workshops, interviews and interventions targeting the issues arising from practice. Ethnographic research was performed by the consultant/researcher to reflect on the experience. RESULTS: Over the last 15 years, the needs of clients in the residential care institutions in the Czech Republic have changed significantly and the pressure on people involved in direct care is growing. I suggest that relational approach to care, enhancing personal commitment of care workers and their appreciation of sociomateriality of caring relations, is well suited for enacting autonomy and dignity of people living and dying with dementia. The relational approach to care improvement is embedded in everyday practices and thus brings a wider scope of possibilities for providing good care than the controlling mode of improvement, measuring evidence against the national standards. CONCLUSIONS: If we are, as a collective, to build up appropriate structures and resources in dementia care, more attention must be paid to the needs of residents and care workers alike, as well as to realities of the daily practices.
- MeSH
- demence ošetřování MeSH
- lidé MeSH
- paliativní péče etika normy MeSH
- pečovatelské domovy * MeSH
- zdravotní služby pro seniory etika normy MeSH
- zlepšení kvality MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- defibrilátory implantabilní etika MeSH
- dysfunkce levé srdeční komory komplikace MeSH
- lidé MeSH
- náhlá srdeční smrt etiologie prevence a kontrola MeSH
- péče o umírající etika zákonodárství a právo MeSH
- předběžné plánování péče etika MeSH
- rozšířená kardiopulmonální recuscitace etika metody přístrojové vybavení MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- věkové faktory MeSH
- zdravotní služby pro seniory normy MeSH
- Check Tag
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- přehledy MeSH
PURPOSE: Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Ireland. The aim of this study was to determine if this phenomenon is unique to Ireland or whether it is a more widespread problem in hospitals across Europe. METHODS: Prospective data were collected from 900 consecutive older patients admitted to six university teaching hospitals (150 patients per centre) in Geneva (Switzerland), Madrid (Spain), Oostende (Belgium), Perugia (Italy), Prague (Czech Republic) and Cork (Ireland). Age, gender, comorbidity, cognitive status, prescription medicines taken before admission and baseline haematological, biochemical and electrocardiographic data were recorded. STOPP and Beers' criteria were applied to detect potentially inappropriate medicines (PIMs). START criteria were applied to detect potentially inappropriate prescribing omissions (PPOs). RESULTS: The overall PIM prevalence rate was 51.3% using STOPP criteria, varying from 34.7% in Prague to 77.3% in Geneva, and 30.4% using Beer's criteria, varying from 22.7% in Prague to 43.3% in Geneva. Using START criteria, the overall PPO prevalence rate was 59.4%, ranging from 51.3% in Cork to 72.7% in Perugia. Polypharmacy predicted the presence of PIMs using STOPP criteria [with>10 medications: odds ratio (OR)7.22, 95% confidence interval (CI) 4.30-12.12, p<0.001] and Beers' criteria (with>10 medications: OR4.87, 95% CI 3.00-7.90, p<0.001). Increasing co-morbidity (Charlson Index>2) and age>85 years significantly predicted PPOs. CONCLUSION: Potentially inappropriate drug prescribing and the omission of beneficial drugs are highly prevalent in acutely ill hospitalized older people in six European centres.
- MeSH
- akutní nemoc * epidemiologie MeSH
- hodnocení spotřeby léčiv statistika a číselné údaje trendy MeSH
- léky na předpis * aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- lidé MeSH
- nemocnice univerzitní * normy statistika a číselné údaje MeSH
- nevhodné předepisování statistika a číselné údaje trendy MeSH
- prevalence MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zdravotní služby pro seniory normy statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
- MeSH
- dlouhodobá péče MeSH
- geriatrie metody organizace a řízení MeSH
- kongresy jako téma MeSH
- lidé MeSH
- senioři MeSH
- zdravotní služby pro seniory normy organizace a řízení trendy MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- novinové články MeSH
