Application of horticulture therapy as a health intervention for elderly people in nursing homes:a scoping review

Objective:To review the scope of interventional studies on horticultural therapy(HT)applied to elderly people in nursing institutions to support the efficient implementation of HT among this target group.Methods:In accordance with the scoping review framework proposed by the Joanna Briggs Institute(JBI),the Pub Med,JSTOR,Web of Science,CNKI,and Wanfang databases were searched.Data from the retrieved literature were summarized and analyzed.Results:In all,18 studies were included in this review.The target population groups of interventions included self-supporting elderly people,cognitively impaired elderly people,elderly people with negative emotions,and elderly people with frailty living in nursing institutions.HT interventions,including planting,craft activities,derivative activities,and outdoor viewing activities,are implemented indoors,outdoors,or in mixed settings.The most common duration of the intervention was 8 weeks,the most common frequency was once per week,and the most common session duration was 60 min.Conclusions:The measurements used in HT interventions included assessments of physical,psycho-mental,and social health;quality of life;and activity effects.Future studies should include partially dependent groups and completely dependent groups of elderly individuals,interventions that last at least 6 months,scientifically designed activity intensity and safety-guarantee plans,and outcomeevaluation indicators such as compliance and intervention benefits.

Neuroarchitecture Analysis in the Mis Abuelitos Nursing Home in Cochachinche, Huanuco, Peru - A Secondary Publication

Neuroarchitecture is a set of characteristics grouped into principles that seek to generate a certain behavior when applied.These principles will vary according to the type of user for whom the design is intended.In this research,these neuroarchitectural principles are identified in the nursing home Mis Abuelitos in Cochachinche,Huánuco.The home was designed and built with notions of nature and the Andean while emphasizing the occupants are the elderly.With this purpose,qualitative research was carried out using two sequential criteria,the first was to identify what these principles are and the second was to recognize the principles within the area.The principles that are assertively used for the elderly occupants were selected.The study observation was performed with observation and photographic sheets and was analyzed with ATLAS.ti processing software.It was obtained that the three neuroarchitectural principles are present in the nursing home which are 67%of the recommended characteristics for the elderly.

A randomized controlled trial of group mindfulness therapy on sleep quality of the elderly in nursing homes

Background:Poor sleep quality of the elderly in nursing homes will reduce the quality of life,which needs to be treated properly.The purpose of the study is to investigate the effect of group mindfulness therapy on sleep quality of the elderly in nursing homes.Methods:A parallel randomized controlled trial was used in this study.The semi-structure interview and the mindfulness therapy intervention was used as the intervention.The Pittsburgh sleep quality index scale and Glaizzi phenoenological data for a 7-step was used to analyze the results.Results:After 8 weeks of intervention,the sleep quality of elderly people was improved to a certain extent(P<0.05).Our investigation showed that some elderly people think that through this kind of training they had reduced the frequency of taking sleeping pills.Conclusion:Group mindfulness therapy could improve sleep quality to some extent.

Study of the Possible Use of a Home-Visit Nursing Interventional Lymphedema Care Program for Secondary Lymphedema in the Elderly at Home

Objective: This study aimed to clarify the possible use of and points to improve a home-visit nursing interventional lymphedema care program (plan) we developed. Methods: The subjects were visiting nurses with at least three years of home-visit nursing experience and experience with lymphedema care for the elderly at home. Semi-structured interviews were conducted, and the collected opinions were aggregated and summarized. Results: Based on interviews with nine subjects, opinions regarding the use of the program, such as “The assessment perspective at the time of introduction helps to grasp the needs for a wide variety of subjects”, and regarding points to improve, such as “It is necessary to set the duration and timing of the section considering the frequency of visits and degree of edema at the time of introduction” and “It is necessary to have a perspective concerning efforts to maintain motivation for care of the elderly and their families”, were aggregated. Discussion: The results of the interviews were generally useful for the structure and development of the program, care methods and content, and interventions for influencing factors. Consideration of setting the timing according to the degree of lymphedema, modification of the program’s development, development of a program that fully considers the degree of edema at the time of introduction and the acceptance of edema among the elderly, and the need to consider the care content that should be given priority were suggested as points for improvement.

The impact of mindfulness therapy on life happiness of the elderly in nursing homes

Background:Nursing homes have been developed as an important way to solve the old-age care problem.While,nursing homes in China pay attention to the life care of the elderly,but lack of promoting the life happiness of the elderly.Mindfulness therapy is an emerging approach to improve the individual's ability to regulate emotions and maintain the stability of emotions.Purpose:To explore the effect of mindfulness therapy on improving life happiness of elderly in nursing homes.Methods:The study was performed in 2019 in Tianjin,in China.Seventy-six participants eventually were included in the study to receive either daily life care or daily life care and mindfulness therapy.The treatment lasted for eight weeks.The Campbell Index of Well-being and Satisfaction With Life Scale were mainly adopted.The paired sample t-test was conducted for comparing between two groups,using SPSS 17.0.Results:Subjective well-being was shown to be a significant correlation with life satisfaction.Compared with before treatment,the well-being(9.57±3.00 vs 11.69±2.32)and life satisfaction scores(20.43±8.08 vs 26.70±5.61)were increased significantly in mindfulness therapy group(P<0.05).The means of the subjective well-being and life satisfaction scores in mindfulness therapy group were 11.69±2.32 and 26.70±5.61 after the intervention,respectively,whereas the means of the subjective well-being and life satisfaction scores in the control group were 10.27±2.16 and 23.03±5.59,respectively.A significant change was found between two groups(t=2.141,P<0.05;t=2.395,P<0.05).Conclusion:Mindfulness therapy may be an effective therapy to improve life happiness of elderly in nursing homes.

Research progress on frailty of the elderly and its influencing factors in Pension Institutions of China

Frailty is a kind of geriatric syndrome.In recent years,as a key research content in the field of gerontology,it has attracted extensive attention from researchers at home and abroad.With the increasingly severe situation of the aging of China's population,the problem of the frailty of the elderly in pension institution is becoming more and more prominent.This paper summarizes the present situation and influencing factors of the frailty of the elderly in institutions for the elderly in China,and puts forward intervention measures.It provides scientific basis for the prevention and treatment of the frailty of the elderly in pension institutions of China.

Predictors of Falls Efficacy Scale responses among nursing home residents in China

Objectives:The objective of this study was to examine the falls efficacy of older adults in nursing homes and the related predictors of falling.Methods:A sample of 317 older adults was recruited from 18 nursing homes in the Fujian province of China.The Modified Falls Efficacy Scale(MFES)and Kessler Psychological Distress Scale(K10)were employed to collect data.Results:The falls efficacy of older adults was moderate(7.80±1.17).The falls efficacy questionnaire item“Get dressed and undressed”scored the highest(9.12±1.440),while“Crossing roads”scored the lowest(5.77±3.371).Multiple regression analysis demonstrated that mental health status,degree of self-care,age and gender were each predictors of the falls efficacy of older adults.Conclusions:Falls efficacy enhancing programs for nursing home residents should take mental health status,degree of self-care,age and gender into account.

When Home Hospice Patients Discharge to Nursing Home: A Mixed Method

Background: Hospice care is to provide necessary medical care and support for patients and the families at the end of life (EOL). Hospice care patients typically withdraw from aggressive treatment. Even though home hospice has been shown to improve the quality of care, home hospice patients still revoke the services for various reasons. A little is known about where home hospice patients are being transferred. This study aims to address this gap and explore common reasons for home hospice discharge and placements, where patients being transferred other than home. Methods: Data were retrieved from the 2007 National Home and Hospice Care Survey (NHHCS). NHHCS is one in a series of nationally representative sample surveys of U.S. home health and hospice agencies. Results: Within identified home hospice patients, approximately 82.1% were deceased at discharge, and 846 (18.2%) were discharged for other reasons, including patients being stabilized or improved (30.2%), aggressive treatment (31.8%), moved (e.g., geographically, 13.5%) and others. Patients lived with a spouse were less likely to utilize external resources, like volunteers, thereby more likely to discharge patients to long-term facilities. Discussion: The current study suggest that it is difficult for the family to give all remaining care for their loved ones despite the support and resources for those home hospice patients. The characteristics of those who transferred to nursing facilities from home hospice will be discussed throughout.

Elderly Persons Aged 80 Years and Older and Their Nutritional Status

A challenge for health care providers is that there will be a distinct rise globally in the number of elderly people aged 80 years and over. Malnutrition is a well-known problem among elderly people;few studies have focused on the nutritional status of those aged over 80, irrespective of whether they live in nursing homes (NHs) or in ordinary housing. The aim of the study was to examine the nutritional status of elderly people aged 80 or older. The study was cross-sectional with 64 elderly persons (80 - 100 years old) living in NHs (n = 35) or in ordinary housing (n = 29). Their nutritional status was assessed with the Mini Nutritional Assessment. Among the elderly people living in NHs, half were at risk and one fourth were suffering from malnutrition. Ten percent of the elderly persons in ordinary housing were found to be at risk;none were malnourished. Thirty-one percent had BMI values <23. The majority of the participants ate 2 - 3 meals per day and were prescribed more than three medications daily. Although not statistically significant, well-nourished participants were more likely to be married, and to rate their psychological and physical health very good/good compared to participants who were at risk of becoming malnourished or were malnourished. In conclusion, the results indicate that special attention regarding nutritional intake is required for those aged 80 years and older irrespective of type of accommodation. The RNs have a responsibility to identify the problems and needs and to implement and evaluate nutritional care in this age group. There is a further need for knowledge regarding the effects of both nutritional interventions and of their optimum timing.

Patterns of Medication Use among Romanian Nursing Home Residents

Background: the elderly are frequently exposed to drug-related problems and their consequences. Information relating to the appropriateness of the medication used by Romanian elderly is scarce. Objective: to identify the main potential inappropriate prescribing (PIP) instances in a sample of Romanian elderly nursing-home residents, concerning prevalence and subtypes. Methodology: the residents’ medical data were reviewed by a clinical pharmacist considering published geriatric pharmacotherapy recommendations, including four published PIP evaluation tools (the Beers criteria, STOPP-START tools, the PRISCUS list). Results: 91 residents were evaluated;mean age (mean ± SD) was 80.77 ± 6.82 (years), 28 (31%) were ≥85 years old and 58 (64%) had dementia. The median number of diagnoses was 6 (range 2 - 11) and the mean number (±SD) of daily medications was 8.26 (±3.52). An estimated mean (±SD) of 2 (±1.41) PIP per resident was identified, with 117 misuse-PIP (46.24%), 60 underuse-PIP (23.72%), 41 lack of monitoring-PIP (16.21%) and 35 overuse-PIP (13.83%). The most frequent PIP subtypes were the use of nonsteroidal anti-inflammatory drugs as chronic analgesic treatment in osteoarthritis (29.67%), underuse of fall prevention (100%) and analgesic therapies (23.08%), overuse of nootropic medications (26.98%) and lack of annual creatinine assessment (30.77%). Conclusion: a more geriatric-oriented care seemed to be necessary, but larger studies are needed to confirm these findings.

远程运动想象疗法结合Barthel评分层级居家护理对脑卒中病人的影响

目的:探究基于远程运动想象疗法联合Barthel评分分层级居家康复护理策略对脑卒中病人的影响。方法:选取在医院进行脑卒中治疗的120例病人,采用随机数字表法,将其分为常规组及研究组,对常规组病人行常规居家护理,对研究组病人在常规居家护理基础上实施基于远程运动想象疗法联合Barthel评分分层级居家康复护理,比较两组病人干预前后日常生活能力、神经功能及生活质量。结果:出院3个月研究组病人日常生活能力评分及生活质量评分分别为(65.28±5.74)分及(64.41±4.13)分,均显著高于常规组(P<0.001),且其神经功能评分为(5.69±1.06)分,显著低于常规组(P<0.001);出院3个月,研究组焦虑、抑郁及焦虑抑郁测试量表(HAD)总分显著低于对照组,差异存在统计学意义(P<0.001)。结论:在脑卒中病人出院后对其实施基于远程运动想象疗法居家康复护理,能够显著提高病人日常生活能力及生活质量,同时能够促进病人神经功能的改善。

Nutritional Screening Tools in Institutionalized People: A Case Study of Using Nutritional Risk Screening (NRS 2002) and Mini Nutritional Assessment (MNA)

Nutritional status expresses the physiological and nutritional needs to maintain the composition and adequate functioning of the organism. NRS 2002 and MNA protocols were applied to short-term institutionalized patients in Rio Verde (Brazil). Older adults and people with special needs of all ages, both sexes, regardless of possible pathology they may have, except if it causes contagion, were included, patients duly authorized by the person responsible for the institution and who were able to undergo evaluation. Thirty-eight patients from the institution were evaluated, of which ten were excluded from the research according to pre-established criteria. More than 50% of participants were male, with an overall average age of 63.43 years. The characteristics related to nutritional status by NRS 2002 and MNA showed that the risk of malnutrition and its absence are associated with a wide age range. The MNA presents a more nuanced nutritional risk classification, showing that even 61% of the 96% of participants who would be out of nutrition risk, according to the NRS 2002, are “at risk of malnutrition”. Applying the MNA can demonstrate more conservative results than the NRS 2002.

Measuring the spatial quality of bedrooms in nursing homes with visual environmental performance

The elderly's perception of their environment largely depends on acquired visual information.This study provides a quantitative analytical method for designing bedrooms in nursing homes by developing a computational model that uses viewing distance,viewing angle,and viewing field as variables.The model is utilized to measure a range of visual environmental properties,including privacy,accessibility,permeability,and visibility,which reflect the quality of bedrooms in nursing homes.The suitability levels of bedroom planes for the elderly and their main living functions as well as the fitting degree of the functional layout are calculated based on these data.After validating the computational moders feasibility,this study optimizes the typical schemes of single and double rooms in nursing homes.Results reveal certain advantages of the arrangement where bathroom doors are set toward the inside of the bedroom and double rooms have a large width.The computational model can be used in measuring the spatial quality of bedrooms in nursing homes and as a mathematical model for related algorithm design and software programming to assist in the design and optimization of bedrooms for the elderly.

“互联网+居家护理”在志愿护理服务中的应用效果

目的探讨"互联网+居家护理"在志愿护理服务中的应用效果。方法选取2020年12月至2021年12月"党群服务365平台"82例需要服务人群作为研究对象,采用随机数字表法将其分为对照组(41例)和观察组(41例)。对照组实施常规医疗服务,观察组实施"互联网+居家护理"服务,两组均持续护理12个月。比较两组的医院看病次数、医疗花费情况、日常生活能力、精神状态、照护者照护技能水平以及生活满意度。结果观察组医院看病次数、医疗花费情况均少于对照组,差异有统计学意义(P<0.05);观察组护理后日常生活活动能力量表(ADL)评分低于对照组,简易精神状态检查量表(MMSE)评分、照护技能水平评分均高于对照组,差异有统计学意义(P<0.05);观察组护理后生活满意度调查表(LSR)各项评分均高于对照组,差异有统计学意义(P<0.05)。结论通过互联网平台,护理志愿者对服务人群进行居家护理,能够改善服务人群的精神状态,促使其保持身心健康,提高生活自理能力,还能提高照护者的护理技能,一定程度上减少看病次数和医疗花费,从而提升服务人员满意度。

我国不同场所老年人失能状况的差异化分析:基于23922例老年人的调查研究

背景随着失能老年人数逐年增多,亟须了解不同场所老年人失能状况,完善从专业机构到社区、家庭的失能长期照护服务模式。目的调查我国不同场所(医院、养老机构、社区)老年人的失能现状,并对比分析不同场所老年人失能状况的差异。方法本研究采用多阶段抽样的方法,于2022年1月—2023年1月在我国华东、华南、华中、华北、西南地区分别便利选取1~2个省市,每个省市分别便利选取3所三级医院、2所二级医院、2个社区卫生服务中心和1个养老机构作为研究场所。最终纳入9个省市(北京市、湖南省、江苏省、广东省、福建省、新疆维吾尔自治区、贵州省、海南省、四川省)的27所三级医院、18所二级医院、18个社区卫生服务中心和9个养老机构的老年人作为研究对象。采用巴氏指数(BI)量表评价基础性日常生活活动能力(BADL)、Lawton-Brody工具性日常生活活动能力量表评定工具性日常生活活动能力(IADL)。采用Logistic回归分析探讨来源场所与BADL失能程度、IADL失能程度以及不同方面功能失能发生状况的关系。结果本研究共回收问卷27344份,有效问卷23922份,有效回收率为87.5%。10318例(43.1%)老年人存在BADL失能,排在前三位的失能功能分别为床椅转移、上下楼梯与平地行走。各个场所BADL失能发生率为社区29.0%、养老机构74.9%、二级医院54.0%、三级医院44.6%。19200例(80.3%)存在IADL失能,排在前三位的失能功能分别为交通工具、家务维持、上街购物。各个场所IADL失能发生率分别为:社区74.6%、养老机构96.4%、二级医院83.6%、三级医院81.1%。不同场所是老年人失能程度和各类功能失能的影响因素(P<0.05)。结论养老机构老年人失能状况最不容乐观,建议鼓励更多养老机构开展专业失能护理服务,提升从业人员服务能力。

养老机构护理员照顾失能老人获益体验的质性研究

目的 深入了解养老机构护理员照顾失能老人的获益体验,为养老机构管理者采取措施维持护理员队伍稳定性提供借鉴。方法 采用现象学研究法,以目的抽样法选取某养老机构照顾失能老人的14名护理员为研究对象,并对其进行半结构式访谈,以Colaizzi 7步分析法分析访谈资料。结果 获取5个获益体验主题,分别是物质获益、能力获益、情感获益、精神获益、成长获益。结论 养老机构护理员能从失能老人的照顾工作中获得丰富的获益体验,管理人员可利用其获益体验,增加护理员正向职业感知,稳定养老护理服务队伍。

641名上海市老年人机构养老意愿及其影响因素

目的·了解上海市老年人的机构养老意愿情况,探讨影响其意愿的因素。方法·采用方便抽样法抽取641名在上海市6个社区卫生服务中心就诊的60周岁及以上的老年人,对其社会人口学因素、机构养老意愿、感知障碍和感知利益进行问卷调查。结果·调查问卷的结构效度(KMO统计量为0.862,Bartlett’s球性检验P=0.000)和内在信度(Cronbach’sα系数取值范围为0.739~0.824)良好。46%的受访者表示将来愿意入住养老机构;在人口学因素中,仅不同年龄层次之间入住意愿差异有统计学意义(P=0.045)。校正年龄后的多因素Logistic回归分析结果表明羞耻感(OR=0.76,95%CI=0.62~0.94)、适应性(OR=0.61,95%CI=0.50~0.74)以及感知利益(OR=1.63,95%CI=1.32~2.03)与老年人机构养老意愿显著相关(均P<0.05)。结论·上海老年人整体对机构养老的接受度已有所提高,其中60~69岁老年人接受度最高;羞耻感、适应性,以及养老机构所能提供的服务质量和种类是影响老年人机构养老意愿的主要影响因素。

家庭跟进照料模式对老年卧床患者家庭康复效果的评价

目的探讨家庭跟进照料模式对老年卧床患者家庭康复效果的影响。方法选择2012年10月—2013年7月在广东省人民医院出院的老年卧床患者120例,按照患者的出院时间顺序编号,奇数号为试验组,偶数号为对照组,每组各60例。试验组在出院时由医生、营养师、康复治疗师和康复专科护士根据患者的病情制定家庭康复计划,并通过家庭跟进照料来保证家庭康复计划的实施,指导照顾者减少老年卧床患者卧床时间及预防并发症的发生;对照组给予口头指导并告知患者家庭康复注意事项,定期电话随访。比较两组患者出院时及出院后3、6、9、12个月时Barthel指数评分与并发症发生情况。结果重复测量结果显示,干预措施与时间对Barthel指数评分的影响不存在交互作用(F=0.139,P=0.710);干预措施对Barthel指数评分的影响有统计学意义(F=10.272,P=0.002);时间对Barthel指数评分的影响有统计学意义(F=14.515,P<0.01)。干预12个月内压疮、尿路感染、肺炎、肌肉萎缩、便秘、尿失禁的发生率间差异均有统计学意义(P<0.01)。结论对老年卧床患者由医生、护士、康复治疗师和营养师进行评估,由经过康复专科培训的护士进行家庭跟进照料,能提高老年卧床患者的日常生活能力,减少压疮、尿路感染、肺炎、肌肉萎缩、便秘、尿失禁并发症的发生。

养老机构自理和半自理老年人护理服务框架及人员资质研究

目的:构建适合我国的养老机构自理和半自理老年人护理服务内容体系。方法:采用德尔菲法,通过对18名专家的两轮咨询,确定养老机构自理和半自理老年人护理服务框架及服务人员最低资质。结果:两轮咨询问卷的有效回收率分别为75%和100%,专家咨询的权威系数为0.874,判断系数为0.881,熟悉程度为0.867,专家意见协调性好;形成的养老机构护理服务内容体系包括3个服务业态,即独立生活区、辅助生活区和长期护理区;其中独立生活区包括2项一级指标、5项二级指标、18项三级指标,辅助生活区包括2项一级指标、13项二级指标、45项三级指标。结论:养老机构护理服务内容体系经检验,结果真实、科学、可靠,可为养老机构规范护理服务、配置护理人员等奠定基础。

云南省社区老年人居家护理需求现状调查研究

目的调查分析云南省社区老年人居家护理的需求现状,为开展社区老年人居家护理服务和制定内容规划提供依据.方法编制社区老年人居家护理需求问卷调查表,通过调查人员对105名老年人的健康功能状况、生活状况、居家护理服务需求进行走访调查.结果 76.20%的社区老年人有居家护理服务需求,其中社区老年人对于日常医疗护理需求最高.结论开展社区老年人居家护理服务能够有效加强老年人自我保健意识,提高老年人生存质量,对实现老年人健康养老有着重要的意义.