Academic literature on the topic 'Aged Patient Participation'
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Journal articles on the topic "Aged Patient Participation"
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Pigozzi, Fabio, and Vincenzo Denaro. "Elderly or ageless? Physical Activity in the Aged Orthopaedic Patient." Journal of Clinical Medicine 9, no. 10 (October 10, 2020): 3243. http://dx.doi.org/10.3390/jcm9103243.
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Lilleheie, Ingvild, Jonas Debesay, Asta Bye, and Astrid Bergland. "Experiences of elderly patients regarding participation in their hospital discharge: a qualitative metasummary." BMJ Open 9, no. 11 (November 2019): e025789. http://dx.doi.org/10.1136/bmjopen-2018-025789.
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BackgroundAgeing patients are discharged from the hospital ‘quicker and sicker’ than before, and hospital discharge is a critical step in patient care. Older patients form a particularly vulnerable group due to multimorbidity and frailty. Patient participation in healthcare is influenced by government policy and an important part of quality improvement of care. There is need for greater insights into the complexity of patient participation for older patients in discharge processes based on aggregated knowledge.ObjectiveThe aim of this study was to review reported evidence concerning the experiences of older patients aged 65 years and above regarding their participation in the hospital discharge process.MethodsWe conducted a qualitative metasummary. Systematic searches of Medline, Embase, Cinahl, PsycINFO and SocINDEX were conducted. Data from 18 studies were included, based on specific selection criteria. All studies explored older patients’ experience of participation during the discharge process in hospital, but varied when it came to type of discharge and diagnosis. The data were categorised into themes by using thematic analysis.ResultsOur analysis indicated that participation in the discharge process varied among elderly patients. Five themes were identified: (1) complexity of the patients state of health, (2) management and hospital routines, (3) the norm and preference of returning home, (4) challenges of mutual communication and asymmetric relationships and (5) the significance of networks.ConclusionsCollaboration between different levels in the health systems and user-friendly information between staff, patient and families are crucial. The complexity of patient participation for this patient group should be recognised to enhance user involvement during discharge from hospital. Interventions or follow-up studies of how healthcare professionals can improve their communication skills and address the tension between client-centred goals and organisational priorities are requested. Organisational structure may need to be restructured to ensure the participation of elderly patients.
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Lee, Nam-Ju, Shinae Ahn, and Miseon Lee. "Mixed-method investigation of health consumers’ perception and experience of participation in patient safety activities." BMJ Open 10, no. 3 (March 2020): e035831. http://dx.doi.org/10.1136/bmjopen-2019-035831.
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ObjectivesThis study aimed to examine the factors influencing patient safety behaviours and to explore health customers’ experiences of patient participation in the healthcare system.DesignA mixed-method sequential explanatory design was employed using a survey and focus group interviews with health consumers.SettingThe study was conducted in South Korea using an online survey tool.ParticipantsSurvey data were collected from 493 Korean adults, aged 19 years or older, who had visited hospitals within the most recent 1 year. Focus group interviews were conducted in two groups of six participants each among those of the survey participants who agreed to participate in focus groups.Main outcome measuresThe survey measured the recognition of the importance of participation, extent of willingness to participate and experience of engaging in patient safety activities using a 4-point Likert scale. Qualitative data were collected through focus group interviews to explore health consumers’ experience of patient participation in hospital care, and the data were analysed using content analysis.ResultsThe average score for experience of participation in patient safety behaviours (2.13±0.63) was found to be lower than those of recognition of the importance of participation (3.27±0.51) and willingness to participate (2.62±0.52). By integrating the results of the quantitative and qualitative data analysis, the factors associated with the experience of engaging in healthcare behaviour included patient-related factors, illness-related factors, factors involving relationship between patients and healthcare providers, and healthcare environment factors.ConclusionsTo improve patient participation, it is necessary to create a healthcare environment in which patients can speak comfortably and to provide an education programme reflecting the patients’ needs. Also, healthcare providers must consider patients as partners for patient safety. Shared decision-making procedures and patient-centred care and patient safety policies should be established in hospitals.
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Levenberg, Kate, David N. Proctor, Stephan R. Maman, J. Carter Luck, Amanda J. Miller, Faisal Aziz, John F. Radtka, and Matthew D. Muller. "A prospective community engagement initiative to improve clinical research participation in patients with peripheral artery disease." SAGE Open Medicine 8 (January 2020): 205031212093091. http://dx.doi.org/10.1177/2050312120930915.
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Objective: Patients diagnosed with peripheral artery disease are difficult to recruit into clinical trials. However, there is currently no high-quality, patient-centered information explaining why peripheral artery disease patients choose to participate or not participate in clinical research studies. Methods: The current study was a prospective community engagement initiative that specifically asked patients with and without peripheral artery disease: (1) what motivates them to participate in clinical research studies, (2) their willingness to participate in different research procedures, (3) the barriers to participation, (4) preferences about study design, and (5) demographic and disease-related factors influencing participation. Data were gathered through focus groups ( n = 19, participants aged 55–79 years) and mailed questionnaires ( n = 438, respondents aged 18–85 years). Results: More than half of the respondents stated that they would be willing to participate in a study during evening or weekend time slots. Peripheral artery disease patients ( n = 45) were more willing than those without peripheral artery disease ( n = 360) to participate in drug infusion studies (48% versus 18%, p < 0.001) and trials of investigational drugs (44% versus 21%, p < 0.001). Motivating factors and barriers to participation were largely consistent with previous studies. Conclusion: Adults in our geographic region are interested in participating in clinical research studies related to their health; they would like their doctor to tell them what studies they qualify for and they prefer to receive a one-page advertisement that has color pictures of the research procedures. Peripheral artery disease patients are more willing than those without peripheral artery disease to participate in drug infusion studies, trials of investigational drugs, microneurography, and spinal/epidural infusions.
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Fredriksson, Mio, Max Eriksson, and Jonathan Q. Tritter. "Involvement that makes an impact on healthcare: Perceptions of the Swedish public." Scandinavian Journal of Public Health 46, no. 4 (November 1, 2017): 471–77. http://dx.doi.org/10.1177/1403494817738692.
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Aim: ‘Participation and influence in society’ is the first of 11 objective domains in Swedish public health policy. The aim of this article is to investigate the views of the Swedish general population on the impact of a range of health participation activities, and whether these views were associated with sociodemographic characteristics. Methods: The study utilizes a national representative survey of the Swedish population, aged 15 years and over ( n = 1500). Results: Apart from voting in regional elections – which most of the respondents believed to be an influential way to make improvements in healthcare (74%) – respondents believed more in individual patient activities than activities associated with adopting a citizen role and acting collectively. A majority of respondents believed in the impact of replying to patient surveys (67%), making a complaint (61%), talking directly to staff (58%) or changing their healthcare provider (54%). Fewer believed in the impact of joining a patient organization (46%), taking part in a citizen council (35%) or joining a political party (34%). Beliefs in impact increased with educational attainment and decreased with age. Conclusions: The results suggest people have more confidence in the impact of participating as individual patients rather than collectively and as citizens. To ensure that activities enable ‘participation and influence in society’, complementary opportunities for collective involvement that also take into account under-represented voices such as those with a low level of education need to be developed.
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Bonnin, Michel P., Jean-Charles Rollier, Jean-Christophe Chatelet, Tarik Ait-Si-Selmi, Julien Chouteau, Laurent Jacquot, Gerjon Hannink, Mo Saffarini, and Michel-Henri Fessy. "Can Patients Practice Strenuous Sports After Uncemented Ceramic-on-Ceramic Total Hip Arthroplasty?" Orthopaedic Journal of Sports Medicine 6, no. 4 (April 1, 2018): 232596711876392. http://dx.doi.org/10.1177/2325967118763920.
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Background: Patients are often concerned about returning to sports after total hip arthroplasty (THA). Purpose: To (1) evaluate sports participation and motivation rates in a large cohort of patients who underwent uncemented THA with ceramic-on-ceramic bearings and (2) determine whether patients’ participation was associated with their motivation for each sport, preoperative demographics, or patient-reported outcomes. Study Design: Case-control study; Level of evidence, 3. Methods: We surveyed 1310 patients (aged <75 years) who underwent uncemented ceramic-on-ceramic THA and collected levels of motivation and participation for 22 different sports as well as patient-reported outcome measure scores. A total of 1042 patients (1206 hips) returned questionnaires; the mean age at index surgery was 60.6 ± 8.8 years. Results: At least 51% of patients participated regularly or frequently in at least 1 light sport, 73% in at least 1 moderate sport, and 20% in at least 1 strenuous sport. Sports participation was strongly correlated with motivation ( r = 0.97, P < .001) but not with level of discomfort ( r = 0.22, P = .292). Participation in strenuous sports was significantly associated with age, body mass index, and sex. There were significant differences among patients who practiced various categories of sports as determined using the Oxford Hip Score ( P = .008), but not with regard to the Forgotten Joint Score ( P = .054). Conclusion: Only 20% of patients practiced strenuous sports regularly or frequently after THA, regardless of pain or discomfort. Participation in sports after THA is strongly correlated with motivation but not with level of discomfort. Longer term studies with a greater focus on complications and survival are necessary to determine whether high-impact sports compromise patient safety or implant longevity.
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Tang, Ni-Hu, Shang-Feng Tsai, Jaw-Horng Liou, Yuan-Hui Lai, Shih-An Liu, Wayne Huey-Herng Sheu, and Chieh Liang Wu. "The Association between the Participation of Quality Control Circle and Patient Safety Culture." International Journal of Environmental Research and Public Health 17, no. 23 (November 29, 2020): 8872. http://dx.doi.org/10.3390/ijerph17238872.
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Promoting patient safety culture (PSC) is a critical issue for healthcare providers. Quality control circles program (QCCP) can be used as an effective tool to foster long-lasting improvements on the quality of medical institution. The effect of QCCP on PSC is still unknown. This was a retrospective study conducted with matching data. A safety attitudes questionnaire (SAQ) was used for the evaluation of PSC. The association between all scores of six subscales of SAQ and the participation QCCP were analyzed with both the Mann–Whitney and Kruskal–Wallis tests. A total of 2718 valid questionnaires were collected. Most participants of QCCP were females (78.9%), nurses (52.6%), non-supervisors (92.2%), aged <40 years old (64.8%), degree of specialist or university graduates (78%), and with work experience of <10 years (61.6%). Of all participants, the highest scores were in the dimension of safety climate (74.11 ± 17.91) and the lowest scores in the dimension of working conditions (68.90 ± 18.84). The participation of QCCP was associated with higher scores in four dimensions, namely: teamwork climate (p = 0.006), safety climate (p = 0.037), perception of management (p = 0.009), and working conditions (p = 0.015). The participation or not of QCCP had similar results in the dimension of job satisfaction and stress recognition. QCCP was associated with SAQ in subjects with the following characteristics: female, nurse, non-supervisor, aged >50 years old, higher education degrees and with longer working experiences in the hospital. In this first study on the association between each dimension of SAQ and the implementation of QCCP, we found that QCCP interventions were associated with better PSC. QCCP had no benefits in the dimensions of job satisfaction and stress recognition.
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Fox, Louis, Harriet Wylie, Fidelma Cahill, Anna Haire, Joyce Kibaru, Saran Green, Catherine Hartley, Richard Sullivan, and Mieke Van Hemelrijck. "C-CRES: COVID-19 and cancer research engagement study." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 182. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.182.
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182 Background: Emerging reports suggest that continuation of clinical trials is feasible and safe even in hospitals admitting COVID-19 patients-given the appropriate safety procedures. However, to our knowledge no studies have yet addressed how to again engage patients in cancer research. C-CRES was developed to identify factors that may be affecting participation in cancer research during the COVID-19 pandemic. We aimed to examine patient-specific concerns around research participation. This information will help inform future strategies for mitigating the impact of COVID-19 on cancer research. Methods: Between 5-13 June 2020, we advertised an anonymous survey using our research group’s Twitter account and tagged a variety of cancer patient organisations/charities. Patients aged 18 with a current cancer diagnosis were eligible to participate and asked about their diagnosis/treatment, experience in cancer research, and beliefs about future cancer research participation given the COVID-19 pandemic. We specifically asked about potential concerns relating to research engagement. Results: A total of 75 patients filled out our questionnaire, of whom 89% were UK-based. 65% of respondents were male and the majority was of a white background (89%). The median age category was 60-69 years. 47% of patients had prostate cancer, 15% breast, 12% bladder, and 9% kidney cancer–a reflection of the cancer types our research team focuses on. Interestingly, 49% of participants had never participated previously in research. We therefore set out to make comparisons of patient concerns with regards to research participation during the COVID-19 outbreak between those with and without research experience. Those who had never taken part in research before were more likely to have concerns about currently being on cancer treatment (p=0.02) and about the type of cancer they had been diagnosed with (p≤0.05), with regards to taking part in cancer research during the current COVID-19 outbreak. Conclusions: Those with no prior experience of taking part in cancer research may be more likely to have concerns related to their cancer type and current treatment, in terms of participation during COVID-19. Efforts should be made to reassure potential cancer research participants about safety of participating during the COVID-19 pandemic.
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Gallo, Joseph J., Hillary R. Bogner, Joseph B. Straton, Katherine Margo, Pat Lesho, Peter V. Rabins, and Daniel E. Ford. "Patient Characteristics Associated with Participation in a Practice-Based Study of Depression in Late Life: The Spectrum Study." International Journal of Psychiatry in Medicine 35, no. 1 (March 2005): 41–57. http://dx.doi.org/10.2190/k5b6-dd8e-th1r-8gpt.
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Objective: An important component of generalizing study results to patients is the extent to which study participants adequately represent individuals targeted for the study. The Spectrum study of depression in older primary care patients was utilized to consider patient characteristics associated with nonparticipation. Method: Interviewers utilized a validated questionnaire to screen adults aged 65 years and older for depression who presented to one of the participating primary care practices in the Baltimore, Maryland area. Screening interviews included information about sociodemographic factors, functioning, health, and attitudes about depression and its treatment in order to compare participants with persons who declined. Results: In all, 2,560 adults aged 65 years and older were screened. Comparison of the characteristics of the patients who were eligible for the study ( n = 773) with patients who participated fully in the in-home evaluation ( n = 355) found that the study sample included proportionately more persons who: 1) were less than 80 years old; 2) completed high school; and 3) reported two or more visits to the practice site within six months of the interview. Among patients who were depressed, no significant differences were found in the characteristics of those who met study eligibility criteria and those who agreed to participate. Conclusions: Persons over the age of 80 years of age or those with less than a high school education may require tailored strategies for recruitment even when approached by a trained interviewer in a primary care doctor's office.
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Severe, Jennifer, Ruiqi Tang, Faith Horbatch, Regina Onishchenko, Vidisha Naini, and Mary Carol Blazek. "Factors Influencing Patients’ Initial Decisions Regarding Telepsychiatry Participation During the COVID-19 Pandemic: Telephone-Based Survey." JMIR Formative Research 4, no. 12 (December 22, 2020): e25469. http://dx.doi.org/10.2196/25469.
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Background Telepsychiatry enables patients to establish or maintain psychiatric care during the COVID-19 pandemic. Little is known about the factors influencing patients’ initial decisions to participate in telepsychiatry in the midst of a public health crisis. Objective This paper seeks to examine factors influencing patients’ initial decisions to accept or decline telepsychiatry immediately after the stay-at-home order in Michigan, their initial choice of virtual care modality (video or telephone), and their anticipated participation in telepsychiatry once clinics reopen for in-person visits. Methods Between June and August 2020, we conducted a telephone-based survey using a questionnaire comprising 14 quantitative and two qualitative items as part of a quality improvement initiative. We targeted patients who had an in-person appointment date that fell in the first few weeks following the Michigan governor’s stay-at-home order, necessitating conversion to virtual visits or deferment of in-person care. We used descriptive statistics to report individual survey responses and assess the association between chosen visit type and patient characteristics and future participation in telepsychiatry using multivariable logistic regression. Results A total of 244 patients whose original in-person appointments were scheduled within the first 3 weeks of the stay-at-home order in Michigan completed the telephone survey. The majority of the 244 respondents (n=202, 82.8%) initially chose to receive psychiatric care through video visits, while 13.5% (n=33) chose telephone visits and 1.2% (n=3) decided to postpone care until in-person visit availability. Patient age correlated with chosen visit type (P<.001; 95% CI 0.02-0.06). Patients aged ≥44 years were more likely than patients aged 0-44 years to opt for telephone visits (relative risk reduction [RRR] 1.2; 95% CI 1.06-1.35). Patient sex (P=.99), race (P=.06), type of insurance (P=.08), and number of previous visits to the clinic (P=.63) were not statistically relevant. Approximately half of the respondents (114/244, 46.7%) stated they were likely to continue with telepsychiatry even after in-person visits were made available. Telephone visit users were less likely than video visit users to anticipate future participation in telepsychiatry (RRR 1.08; 95% CI 0.97-1.2). Overall, virtual visits met or exceeded expectations for the majority of users. Conclusions In this cohort, patient age correlates with the choice of virtual visit type, with older adults more likely to choose telephone visits over video visits. Understanding challenges to patient-facing technologies can help advance health equity and guide best practices for engaging patients and families through telehealth.
Dissertations / Theses on the topic "Aged Patient Participation"
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Shackelford, Katya A. "Complexities of Participation: Education and Authority in Primary Care Patient-Provider Interactions in the age of the Internet." Scholarship @ Claremont, 2012. http://scholarship.claremont.edu/scripps_theses/72.
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This thesis is about primary care medicine in the United States today. Specifically, I look into primary care providers’ experiences working with patients in the context of the public’s current access to extensive health and medical information online. In this thesis, I discuss and analyze my conversations with physicians, nurse practitioners, and a physicians’ assistant about their objectives in primary care, the challenges they face, and their perceptions of patients’ ability to seek out information on their own. I explore providers’ educational emphasis in primary care consultations, and argue that this focus on education informs their views of patients’ independent research and involvement in care. I further argue that regardless of my informants’ enthusiasm about patient involvement and the merits of patient-education, these providers still hold and express a strong authority over medical knowledge and decisions. Thus in looking at the influence of what could be seen as a democratization of medical knowledge through public access and the Internet, it seems that the limitations of such access are still great in U.S. medical practice.
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Fitzpatrick, Janet M. "Patient-based outcomes : older adults' perceptions of hospital and recovery experiences /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq54846.pdf.
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Ziebart, Jolene Anna. "Negotiating a code status a comparison of elderly persons' and health care providers' perspectives /." 1990. http://catalog.hathitrust.org/api/volumes/oclc/22617188.html.
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Thesis (M.S.)--University of Wisconsin--Madison, 1990.Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 157-161).
Books on the topic "Aged Patient Participation"
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Step by step: How to actively ensure the best possible care for your aging relative. New York, NY: Warner Books, 1987.
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Agich, George J. Autonomy and long-term care. New York, NY: Oxford University, 1993.
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Cicirelli, Victor G. Family caregiving: Autonomous and paternalistic decision making. Newbury Park: Sage Publications, 1992.
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Cicirelli, Victor G. Family Caregiving: Autonomous and Paternalistic Decision Making (SAGE Library of Social Research). Sage Publications, Inc, 1991.
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Cicirelli, Victor G. Family Caregiving: Autonomous and Paternalistic Decision Making (SAGE Library of Social Research). Sage Publications, Inc, 1991.
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Supply of Blood for Transfusion in Latin America and Caribbean Countries 2016-2017. Organización Panamericana de la Salud, 2020. http://dx.doi.org/10.37774/9789275121719.
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Blood transfusions are necessary to improve or save the lives of children with severe anemia, mothers in obstetric emergencies, patients with hemoglobinopathies, cancer patients, transplant patients, patients with chronic age-related diseases, such as bleeding caused by vascular problems and orthopedic surgeries, people injured in accidents, among other causes. Supply and access to safe blood for transfusions are closely related to the organization and degree of development of blood services, with the governance and participation of society through voluntary unpaid donation. Since 2004, the Pan American Health Organization (PAHO) has been collecting and publishing indicators related to blood supply in the countries of Latin America and the Caribbean. In 2014, the countries of the Region of the Americas reaffirmed their commitment to universal health through the approval of the Action Plan for Universal Access to Safe Blood 2014-2019, approved by the 53rd Directing Council held in October 2014 (CD53.6), this plan promotes universal access to safe blood for transfusion in the region, through unpaid voluntary donations, the organization of blood services, the implementation of quality and safety standards and the implementation of governance actions. The data presented here allows monitoring and reporting on progress and limitations in the implementation of the Action Plan for Universal Access to Safe Blood. Furthermore, it is hoped that these data will promote the analysis and evaluation of the indicators at the national and subregional levels, and that strategies that improve blood safety and accessibility to transfusions will be strengthened or modified. The information was provided by the authorities of the countries and corresponds to the years 2016 and 2017.
Book chapters on the topic "Aged Patient Participation"
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Oppenheimer, Catherine. "Special features of psychiatric treatment for the elderly." In New Oxford Textbook of Psychiatry, 1571–79. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199696758.003.0206.
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Three themes underlie the topics in this chapter. Physical, psychological, and social problems often occur together, linked by chance or causality in the life of the old person. Very rarely can one problem be dealt with in isolation, and many different sources of expertise may be engaged with a single individual. Therefore good coordination between different agents is essential in old age psychiatry, both for the individual patient and in the overall planning of services. Many of the pathologies characteristic of old age are gradual in onset and degenerative in nature, and more due to failures in processes of repair than to an ‘external foe’, so the distinction between disease and health is often quantitative rather than qualitative. ‘Normality’ becomes a social construct with fluid borderlines, containing the overlapping (but not identical) concepts of ‘statistically common’ and ‘functionally intact’. Thus the popular perception of normal old age includes the ‘statistically common’ facts of dependence and failing function, whereas ‘intactness’ (excellent health and vigorous social participation) is seen as remarkable rather than the norm. But the boundaries of ‘old age’ are also socially constructed—in developed countries good health at the age of 65 would nowadays be regarded as a normal middle-aged experience, whereas superb health at 95 would still be something noteworthy. Since some degree of physical dependence, forgetfulness, and vulnerability to social exclusion is expected in old age, meeting those needs is also regarded as a ‘normal’ demand on families and community agencies such as social services, rather than the responsibility of health care providers. As the severity of the needs increases, however, so also does the perceived role of health professionals, both as direct service providers and in support of other agencies. Because of the high prevalence of cognitive impairment in old age (especially among the ‘older old’), questions frequently arise as to the competence of patients to make decisions. Older people who cannot manage decisions alone may come to depend increasingly on others for help; or, resisting dependence, they become vulnerable through neglect of themselves or through the injudicious decisions they make. When an incompetent person is cared for by a spouse or family member, the danger of self-neglect or of ill-considered decisions is lessened, but instead, there are the risks of faulty decisions by the caregiver (whether through ignorance or malice), and also risks to the health of the caregiver from the burden of dependence by the incompetent person. Legal mechanisms, differing from one country to another, exist to safeguard the interests of incompetent people. These three themes will be developed further, and with them the following special topics: 1 multiple problems: including sleep disorders in old age, medication in old age psychiatry, and psychological treatments in old age psychiatry; 2 blurred boundaries of normality: including the role of specialist services and support between agencies; 3 incapacity and dependence: including balancing the needs of patients and caregivers, abuse of older people, ethical issues, and medico-legal arrangements for safeguarding decisions.
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Magnavita, Nicola. "Engagement in Health and Safety at the Workplace." In Promoting Patient Engagement and Participation for Effective Healthcare Reform, 265–89. IGI Global, 2016. http://dx.doi.org/10.4018/978-1-4666-9992-2.ch013.
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Dramatic changes in the age structure of the population have led to a rise in the age of retirement. An ageing working population may be a problem for companies and for their health and safety services that must face the long-term management of active, chronically ill workers. For sustainability reasons the discipline of occupational medicine must be replaced by occupational health, which not only combats occupational diseases, but actively works to promote the health of older workers. More in general, occupational health has a strong interest in promoting engagement in professional activities. Shifting from a reactive to a proactive logic will take time and require a big effort on the part of employers, employees and health and safety staff in order to develop participatory ergonomics and best health promotion practices in the workplace.
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Potpara, Tatjana. "Definitions, clinical presentation, symptoms, quality of life, and patient preferences." In ESC CardioMed, 2053–54. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0478.
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The term supraventricular tachycardia (SVT) refers to all tachycardias originating from supraventricular tissue (i.e. the sinus node, atria, or atrioventricular junction) or requiring it for their maintenance. Paroxysmal SVT is a clinical syndrome characterized by a tachycardia with an abrupt onset and termination. Non-paroxysmal SVTs have a gradual onset and offset sometimes characterized by the ‘warm-up’ and ‘warm-down’ phenomena. The term incessant is used to describe continuous SVTs, or repetitive SVTs recorded during 90% or more of the monitoring period. Clinical presentation of SVT is heterogeneous, depending on the SVT type, the patient’s age, and underlying comorbidities. Some SVT patients may be asymptomatic or minimally symptomatic. Symptoms related to SVTs include palpitations, lightheadedness, dizziness, diaphoresis, chest discomfort or chest pain, shortness of breath/dyspnoea, anxiety, polyuria, presyncope, and syncope, which may have different causes (cardiogenic syncope, vasovagal reflex syncope, or syncope due to sinus node dysfunction). A detailed appreciation of the SVT pattern (e.g. abrupt or gradual onset/offset), frequency of episodes, duration, symptoms (e.g. regular fast heart beating, or irregular palpitations), and possible triggers may aid the interpretation of the electrocardiogram tracings and definite diagnosis. Although SVTs are generally more common in younger, healthy individuals, a variable disease course may significantly alter the patient’s quality of life. Many SVT patients have insufficient knowledge about their disease and available treatment. Patient education can improve their understanding of the disease and facilitate active participation of patients in the informed, shared decision-making regarding treatment.
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Madhusoodanan, Subramoniam, Marina Tsoy-Podosenin, Leah R. Steinberg, and Nitin Tandan. "Drug interactions involving psychotropic drugs." In Mental Disorders in Primary Care. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198746638.003.0021.
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This chapter covers the various drug interactions of psychotropic agents with other drugs, over the counter (OTC) medications, food substances, herbals, alcohol, and smoking. The basic mechanisms of pharmacokinetics, pharmacodynamics, and other interactions are discussed. The disease states and age-related changes underlying the drug interactions in the elderly are briefly addressed. Drug interactions discussed have been classified as severe, moderate, or mild, according to the severity of their anticipated clinical consequences. Serious complications including death may occur in severe interactions involving cardiovascular drugs. A thorough understanding of the basis of drug interactions, and patient participation in the treatment are vital. It is also particularly important to compile a list of medications, including OTC and herbal drugs, currently taken by the patient.
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Beutter, Chantal N. L., Jan Ross, Patrick Werner, Dilyana Vladimirova, Uwe M. Martens, and Christian Fegeler. "Quality of Life as an Indicator for Care Delivery in Clinical Oncology Using FHIR." In German Medical Data Sciences: Bringing Data to Life. IOS Press, 2021. http://dx.doi.org/10.3233/shti210058.
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Introduction: Health-related quality of life (HR-QoL) as a parameter for patient well-being is becoming increasingly important.[1] Nevertheless, it is mainly used as an endpoint in studies rather than as an indicator for adjustments in therapy. In this paper we will present an approach to gradually integrate quality of life (QoL) as a control element into the care delivery of oncology. Concept: Acceptance, usability, interoperability and data protection were identified and integrated as key indicators for the development. As an initial approach, a questionnaire tool was developed to provide patients a simplified answering of questionnaires and physicians a clearer presentation of the results. Implementation: As communication standard HL7 FHIR was used and known security concepts like OpenID Concept were integrated. In a usability study, first results were achieved by asking patients in the waiting room to answer a questionnaire, which will be discussed with the physician in the appointment. This study was conducted in 2019 at theSLK Clinics Heilbronn and achieved 86% participation of all respondents with an average age of 67 years. Discussion: Although the evaluation study could prove positive results in usability and acceptance, it is necessary to aim for longitudinal surveys in order to include QoL as a control element in the therapy. However, a longitudinal survey through questionnaires leads to decreasing compliance and increasing response bias. [2] For this reason, the concept needs to be expanded. With sensors a continuous monitoring can be carried out and the data can be mapped to the individual, interpreted by machine learning. Conclusion: Questionnaires are a concept that has been successfully applied in studies for years. However, since care delivery poses different challenges, the integration of new concepts is inevitable. The authors are currently working on an extension of the use of questionnaires with patient generated data through sensors.
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Palumbo, Claudia, and Umberto Volpe. "Italy." In Dementia Care: International Perspectives, 189–94. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198796046.003.0025.
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Italy is among countries in the world with the highest population of older people, with Italian elderly people accounting for over 20% of the total population of the country, and ranks second in Europe in terms of the ‘ageing index’ (i.e. the number of people aged 65 and above per 100 youths under the age of 15). In Italy, over 1 million people suffer from dementia, including approximately 600,000 cases of Alzheimer’s disease. Since 2000, a specific National Dementia Plan was initiated and Alzheimer’s Evaluation Units (UVAs) were introduced in all Italian regions to coordinate systematically the complex care process for dementia. Some Italian regions have recently deemed appropriate to change the denomination of UVAs to ‘Evaluation Units of Dementia’ (UVDs) and/or ‘Centres for Cognitive Impairment’. More recently, the Italian Ministry of Health launched an initiative aimed at improving the essential levels of assistance/care (LEA). The LEA represent all activities and services deemed essential to all Italian citizens and that the Italian national health system has to ensure are available, either on a free basis or by paying a participation fee, depending on patients’ situations.
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Kostka, Joanna, Małgorzata Koziarska-Rościszewska, and Tomasz Kostka. "Special situations in the elderly: sport, physical activity, and travel." In ESC CardioMed, 2976–80. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0719.
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The number of physically active and travelling older people is gradually increasing. Regular physical activity can bring significant health benefits to people of all ages. On the other hand, due to concomitant chronic disease and age-related changes, older athletes are at higher risk of both acute adverse events and overuse injuries. Therefore, general medical and cardiovascular evaluation is recommended before initiation of a training programme. Similarly, it is necessary to perform a medical assessment of older subjects concerning fitness for travel and possible medical consequences. A pre-travel visit should allow individual physical and mental limitations for travel to be discussed and provide a patient with necessary prophylaxis, such as vaccinations or malaria prevention. Special problems in older athletes and travellers with chronic diseases should be taken into consideration (e.g. the risk of venous thromboembolism during prolonged exercise or travel in hot environment). Older adults with concomitant co-morbidities constitute a growing percentage of subjects participating in sports or undertaking travel. Although they are at higher risk of cardiovascular complications, a general recommendation to ‘avoid inactivity’ may be nowadays be put forward.
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Kostka, Joanna, Małgorzata Koziarska-Rościszewska, and Tomasz Kostka. "Special situations in the elderly: sport, physical activity, and travel." In ESC CardioMed, 2976–80. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0719_update_001.
Full textAbstract:
The number of physically active and travelling older people is gradually increasing. Regular physical activity can bring significant health benefits to people of all ages. On the other hand, due to concomitant chronic diseases and age-related changes, older athletes are at higher risk of both acute adverse events and overuse injuries. Therefore, general medical and cardiovascular evaluation is recommended before initiation of a training programme. Similarly, it is necessary to perform a medical assessment of older subjects concerning fitness for travel and possible medical consequences. A pre-travel visit should allow individual physical and mental limitations for travel to be discussed and provide a patient with necessary prophylaxis, such as vaccinations or malaria prevention. Special problems in older athletes and travellers with chronic diseases should be taken into consideration (e.g. the risk of venous thromboembolism during prolonged exercise or travel in hot environment). Older adults with concomitant co-morbidities constitute a growing percentage of subjects participating in sports or undertaking travel. Although they are at higher risk of cardiovascular complications, a general recommendation to ‘avoid inactivity’ may nowadays be put forward.
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Zeppenfeld, Katja, and Sebastiaan R. D. Piers. "Primary prevention of sudden cardiac death in arrhythmogenic right ventricular cardiomyopathy." In ESC CardioMed, edited by Gerhard Hindricks, 2354–58. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0558.
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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by progressive fibrofatty replacement of the myocardium, providing the substrate for ventricular reentrant tachycardia, typical for the overt phase of ARVC. Importantly, life-threatening ventricular arrhythmias may also occur in the concealed phase of the disease. The reported rates for sustained ventricular arrhythmias and all-cause mortality in ARVC differ substantially across cohorts. Survival free from sustained ventricular arrhythmias in patients with ARVC-related pathogenic mutations is approximately 66% and 42% at age 40 and 60 years, respectively, in tertiary referral centres. Participation in competitive sports has been associated with an increased propensity of ventricular arrhythmias/death and should therefore be avoided. Beta-blocker therapy may prevent exercise-induced ventricular arrhythmias and should be considered in all patients with ARVC. In patients with unexplained syncope and other recognized risk factors, the implantation of an implantable cardioverter defibrillator (ICD) for primary prevention may be considered. Decisions should be made carefully, weighing the risk of sudden cardiac death, the lifelong risk of complications, and the impact of an ICD on lifestyle and psychological health. ICDs are associated with significant adverse event rates, in particular in young patients who may carry an ICD for several decades.
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Pope, Chelle, Richard D. deShazo, and Monroe James King. "Asthma Over 65." In Asthma, 441–52. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199918065.003.0032.
Full textAbstract:
With the worldwide increase in the older population and the growing prevalence of asthma, it is no surprise that asthma in the elderly is also an increasing problem. Insufficient data exist to make firm conclusions on many important issues about this condition. Seniors with asthma often have coexisting and comorbid conditions, and the combination of age and illness has precluded, in general, their participation in clinical trials. Other important variables in this population include differences in perception, interpretation, and response to the symptoms of airway obstruction. Many patients mistakenly believe that wheeze and dyspnea are normal, and they commonly decrease their activity, a response that can induce further social isolation and a decreased quality of life. Coupled with the challenge of misdiagnosis or underdiagnosis are the potential problems associated with side effects from medications, drug–drug interactions, problems appropriately using medications, and compliance. This chapter identifies the prevalence of asthma, which affects decisions about therapy, and the important questions in this age group yet to be answered.
Conference papers on the topic "Aged Patient Participation"
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Gupta, Sahil, Rasmi Palassery, Santhosh K. Devadas, Vinayak Maka, and Nalini Kilara. "Epidemiology of Adolescent and Young Adult Cancers in a Tertiary Hospital in South India." In Annual Conference of Indian Society of Medical and Paediatric Oncology (ISMPO). Thieme Medical and Scientific Publishers Pvt. Ltd., 2021. http://dx.doi.org/10.1055/s-0041-1735371.
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Abstract Introduction There has been an increase in the incidence of malignancies in young Indians, and there is no data reflecting the trend and profile of adolescent and young adult (AYA) cancers. Objectives This study was aimed to ascertain the epidemiology of AYA cancers in a tertiary care center in south India and the trend of AYA cancers during the past 9 years. Materials and Methods All patients aged 15 to 39 years with the diagnosis of cancer who were registered and received treatment with M.S. Ramaiah Hospital during a 9-year period from January 2011 to December 2019 were included. Basic demographic information on age, gender was available along with address and contact information. Using cancer site and morphology codes, the cancers were grouped by the ICD-O coding system of AYA cancers and their clinical information on disease and treatment status were collected retrospectively and analyzed. Results Of the total 946 registered AYA cancer patients, majority of AYA cancer were in age group of 35 to 39 years (39%) and females (58%). When analyzing the data and dividing the AYA population into early (15–24 years) and late (25–39 years), we found that whereas the majority of the patients had hematolymphoid malignancies (48%) in the early group (15–24 years), the late group (25–39 years) had more carcinomas (68%). The percentage distribution of AYA cancers among the study population, lymphoma and leukemia contribute 11% and 15%, respectively, to the patient load and still the carcinomas formed the bulk (58%) of the population. It is interesting to know that breast, genitourinary, and gastrointestinal (GI) malignancies constituted 17.75%, 14.16%, and 14.69% individually. Conclusion AYA oncology consists of a heterogeneous population and the profile differs by geography, sex, and other factors. There has been limited improvement in the past decade but there is a lot more to be done. To assess the problem, we have to identify and characterize the problem and look at the epidemiology of this population. This will require multicenter and international studies with focus on improving outcomes as in pediatric inspired ALL protocols. The trials should be started at local levels to ensure maximum participation. We need to generate data on epidemiology and channel our resources properly to save this precious but so called lost tribe of oncology.
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Neri Semeri, G. G., F. Rovelli, G. F. Gensini, S. Pirelli, M. Carnovali, and A. Fortini. "FREVENTION OF MYOCARDIAL REINFARCTION BY LOW DOSE HEPARIN." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643597.
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The effectiveness of low dose heparin in the prevention of myocardial reinfarction was investigated in a multi centric randomized controlled study. After having given their, informed consent to undergo daily subcutaneous heparin adninistratian, 728 patients of both sex aged 50-75 years, who had suffered frcm a transmural myocardial infarction 6-18 months before the enrollment and were in the I or II NYHA class were randomized. 365 patients (control group) were an the therapy usually performed by the 21 experimental canters participating in the study and 363 (heparin group) were treated with subcutaneous calcium heparin (Calciparina®) 12,500 IU daily in addition to the usual therapy of the centers. Curing enrollment the balancement of the two grcups was periodically checked for age, sex, serum cholesterol, cigarette smoking, blood pressure, site of infarction, arrhythmias and drug regimen. The prospect!vely established end-points were: transmural reinfarctioi as primary end-point; general mortality and mortality for cardiovascular events as accessory end-points over a mean follow-up period of 24 nxnths. Statistical analysis was foreseen both on drug efficacy (EE) and intention to treat (IT) basis. Patients of both groups underwent periodical examinations during the study. Acherence to the therapy and bone mineral content (bone density by double isotope technique) were also checked. At the end of the study the balancement for the factors considered was satisfactory and the drop-outs were 7.7% in heparin group and 6.3% in control group (ns). In heparin group the re infarction rate was lcwer by 62.92% than in control group. At life table analysis the difference was statistically significant (p<0.05 DE and p=0.05 IT). Mortality rate was reduced by 47.61% (DE) in heparin group (p<0.05 at life table analysis). Cardiovascular mortality was not significantly reduced (−33.06%), but the mortality attributable to thromboembolism was reduced in heparin group (p<0.05). Sixty patients (16.5%) discontinued heparin treatment, but only in 23 patients (6.3%) suspension was due to side effects.
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Schmidt, Márcia Moura, Amanda Bittencourt Lopes da Silva, Samanta Fanfa Marques, and Cynthia Seelig. "ANXIETY AND DEPRESSION IN PATIENTS SUFFERING A MYOCARDIAL INFARCTION DURING THE COVID-19 PANDEMIC." In International Psychological Applications Conference and Trends. inScience Press, 2021. http://dx.doi.org/10.36315/2021inpact026.
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"Introduction: Acute myocardial infarction is an experience that may cause severe emotional impact to the individual who presented it. The anxiety and depression felt is caused not only by the infarction episode itself, but also by the current uncertain state of the world during and because of the COVID-19 pandemic, something which can heighten these negative feelings throughout the entire population, especially in those considered to be in high risk groups. Objective: The objective of the present study is to estimate the prevalence of anxiety and depression among patients infarcted during the current coronavirus pandemic in the state of Rio Grande do Sul. This study will compare clinical characteristics and risk factors between groups with and without anxiety and depression. Methods: Acute myocardial infarction patients who were submitted to percutaneous coronary intervention from February to June 2020 at a reference hospital in cardiology were considered eligible. The patients were interviewed via phone calls. The clinical characteristics and intra-hospital events were obtained from the hospital’s REDCap Database. The level of anxiety and depression suffered was evaluated utilizing the HADS (Hospital Anxiety and Depression Scale). Patients considered as suffering from anxiety and depression were those who obtained scores for the possible and probable presence of those mood disorders. Patients were divided into groups with and without anxiety and depression. The categorical variables were expressed through frequency and percentage and analyzed by the Chi-square test and the continuous variables were described by average and standard deviation, and analyzed by Student's t-test. Results: A total of 55 patients were interviewed. The majority of these patients were male (74,5%) and white (80%). The average age of those participating in the study was 58 ±12 years, and the female participants were older than the males. The average number of years of education was 8 ± 4 years. The prevalence of anxiety was 38,2% and of depression 30,9%. Conclusions: The prevalence of anxiety and depression was higher than those described in the literature for this population, which supports the hypothesis that the pandemic may be aggravating the patient’s emotional state. Another group will be interviewed for the control group."
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Ibrahim Ali, Alaa. "Health behavior evaluation in women with multiple pregnancies." In The 8th International Conference of Biotechnology, Environment and Engineering Sciences. SRO media, 2020. http://dx.doi.org/10.46617/icbe8004.
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Objective: The main purpose of this study is to evaluate the impact of the health behavior in pregnant Iraqi women in multiple pregnancies, and which one had characteristic influence in examined Iraqi women. Patients and Methods:The study was carried out in Al-Yermook Hospital for a period of one year from July 2019 to July 2020. It was included 40 pregnant women in multiple pregnancies, completed the 22 weeks gestational age, with taking their verbal consent for the participation in this investigation. Selected questioner used to collect data, as well as using Juczyński’s Health Behavior Inventory questionnaire to evaluate the health behaviors of recruited women involved in this study. Results:The heath behaviors rate was high particularly for Iraqi pregnant women in multiple pregnancies, as the health behaviors indicators were high among all the identified categories. Conclusion: The higher health behavior rate of pregnant women in multiple pregnancies, as the preventative behaviors had the highest rate.
Reports on the topic "Aged Patient Participation"
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Lumpkin, Shamsie, Isaac Parrish, Austin Terrell, and Dwayne Accardo. Pain Control: Opioid vs. Nonopioid Analgesia During the Immediate Postoperative Period. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0008.
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Background Opioid analgesia has become the mainstay for acute pain management in the postoperative setting. However, the use of opioid medications comes with significant risks and side effects. Due to increasing numbers of prescriptions to those with chronic pain, opioid medications have become more expensive while becoming less effective due to the buildup of patient tolerance. The idea of opioid-free analgesic techniques has rarely been breached in many hospitals. Emerging research has shown that opioid-sparing approaches have resulted in lower reported pain scores across the board, as well as significant cost reductions to hospitals and insurance agencies. In addition to providing adequate pain relief, the predicted cost burden of an opioid-free or opioid-sparing approach is significantly less than traditional methods. Methods The following groups were considered in our inclusion criteria: those who speak the English language, all races and ethnicities, male or female, home medications, those who are at least 18 years of age and able to provide written informed consent, those undergoing inpatient or same-day surgical procedures. In addition, our scoping review includes the following exclusion criteria: those who are non-English speaking, those who are less than 18 years of age, those who are not undergoing surgical procedures while admitted, those who are unable to provide numeric pain score due to clinical status, those who are unable to provide written informed consent, and those who decline participation in the study. Data was extracted by one reviewer and verified by the remaining two group members. Extraction was divided as equally as possible among the 11 listed references. Discrepancies in data extraction were discussed between the article reviewer, project editor, and group leader. Results We identified nine primary sources addressing the use of ketamine as an alternative to opioid analgesia and post-operative pain control. Our findings indicate a positive correlation between perioperative ketamine administration and postoperative pain control. While this information provides insight on opioid-free analgesia, it also revealed the limited amount of research conducted in this area of practice. The strategies for several of the clinical trials limited ketamine administration to a small niche of patients. The included studies provided evidence for lower pain scores, reductions in opioid consumption, and better patient outcomes. Implications for Nursing Practice Based on the results of the studies’ randomized controlled trials and meta-analyses, the effects of ketamine are shown as an adequate analgesic alternative to opioids postoperatively. The cited resources showed that ketamine can be used as a sole agent, or combined effectively with reduced doses of opioids for multimodal therapy. There were noted limitations in some of the research articles. Not all of the cited studies were able to include definitive evidence of proper blinding techniques or randomization methods. Small sample sizes and the inclusion of specific patient populations identified within several of the studies can skew data in one direction or another; therefore, significant clinical results cannot be generalized to patient populations across the board.