Relevant bibliographies by topics / Geriatría

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Geriatría'

Author: Grafiati
Published: 4 June 2021
Last updated: 21 February 2023

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Journal articles on the topic "Geriatría"

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Residentes, Residentes. "Geriatría." Acta Médica Colombiana 43, no. 2S (June 24, 2019): 96–97. http://dx.doi.org/10.36104/amc.2018.1397.

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GE-1 COMPARACION DE TRES FORMULAS PARA CALCULAR LA FUNCION RENAL EN EL ANCIANO (LÓPEZ RAMÍREZ JORGE HERNÁN, SIMANCA CASTRO ELKIN LEONARDO) GE-2 POLIANGEITIS MICROSCOPICA EN EL ADULTO MAYOR: UNA PRESENTACIÓN TRAICIONERA (TOSCANO ANDRÉS, ZAPATA CARLOS, RAMOS DANIEL, QUINTERO NICOLÁS)
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Asensio Fraile, A., and M. A. Benítez-Rosario. "Geriatría." FMC - Formación Médica Continuada en Atención Primaria 12, no. 5 (May 2005): 310. http://dx.doi.org/10.1016/s1134-2072(05)71227-5.

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Gutiérrez Barreto, Samuel Eloy, Verónica Daniela Durán Pérez, Arturo Avila Avila, Eduardo Sosa Tinoco, Jonny Pacheco Pacheco, and Luis Miguel Gutiérrez Robledo. "Propuesta de Actividades Profesionales Confiables para la especialidad de Geriatría." Investigación en Educación Médica, no. 40 (October 12, 2021): 70–78. http://dx.doi.org/10.22201/fm.20075057e.2021.40.21362.

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Introducción: La educación basada en competencias ha sido considerada como una propuesta pedagógica en medicina, en las últimas décadas. En los contextos clínicos se han utilizado las Actividades Profesionales a Confiar (APC) para la aplicación de las competencias. El desarrollo de esta estrategia ha sido implementado en diversas especialidades para mejorar la calidad de la formación médica de posgrado. Objetivo: describir el proceso de construcción de APROC para la especialidad de Geriatría. Método: Este estudio utilizó el método mixto secuencial con una fase cualitativa seguida de una fase cuantitativa de validación. En la primera fase, se realizaron entrevistas a profundidad a médicos geriatras. Posteriormente, se realizó una triangulación con otras fuentes para construir las APROC. En la segunda fase, por medio de la técnica Delphi modificada se realizó consenso de expertos con profesores de la especialidad de geriatría. Resultados: Se realizó la propuesta de construcción de una APC y se construyeron diez APC para la formación de médicos geriatras, divididas en cuatro años de formación. Conclusiones: Este es el inicio de una propuesta educativa para profesores y estudiantes de la especialidad de Geriatría en Latinoamérica. Consideramos que es necesaria una adaptación al contexto, una vez que se utilice en la práctica clínica. Se ha de continuar el estudio de su implementación para demostrar los efectos de esta propuesta.
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Espaulella Panicot, Joan, and Jordi Roca Casas. "Geriatría del presente." Revista Española de Geriatría y Gerontología 47, no. 5 (September 2012): 189–90. http://dx.doi.org/10.1016/j.regg.2012.04.010.

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Gil Gregorio, Pedro. "Geriatría y gerontología." Revista Española de Geriatría y Gerontología 42, no. 6 (November 2007): 317–18. http://dx.doi.org/10.1016/s0211-139x(07)73569-2.

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Martínez Galán, I., and H. Romay Barrero. "Balneoterapia en geriatría." Fisioterapia 30, no. 3 (June 2008): 152–61. http://dx.doi.org/10.1016/s0211-5638(08)72973-0.

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Mourey, F. "Reeducación en geriatría." EMC - Kinesiterapia - Medicina Física 30, no. 2 (January 2009): 1–11. http://dx.doi.org/10.1016/s1293-2965(09)70734-0.

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Zambrano Monzón, Martín Adrián, Fernando M. Runzer-Colmenares, and Sebastián Ibarra Ervin. "Competencias sobre geriatría, modalidad de enseñanza y ageísmo en estudiantes de medicina en el contexto de la pandemia por COVID-19." Anales de la Facultad de Medicina 83, no. 4 (November 15, 2022): 307–12. http://dx.doi.org/10.15381/anales.v83i4.23403.

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Introducción. La pandemia por COVID-19 forzó a cambiar la educación médica a una modalidad virtual. Esta puede influenciar sobre la calidad de la enseñanza y la percepción que tienen los alumnos sobre los adultos mayores. Objetivo. Evaluar la percepción del auto reporte de cumplimiento de las competencias sobre geriatría (ACCG) y ageísmo, en estudiantes de medicina de universidades de Lima que llevaron el curso de geriatría en modalidad presencial y virtual. Métodos. Estudio transversal en estudiantes de 3 universidades de Lima, Perú que llevaron el curso de geriatría de forma presencial o virtual. El auto reporte de cumplimiento de competencias en geriatría fue medido mediante un puntaje y el ageísmo fue medido con la escala UCLA-GAS. Se realizó el análisis bivariado entre ACCG y el resto de las variables, finalmente se construyó un modelo de regresión lineal. Resultados. Se encontraron las medias del puntaje para ACCG fue de 0,72 (DE = 0,22) para la modalidad presencial y 0,75 (DE = 0,23) para la enseñanza virtual. No encontramos asociación estadística entre las variables de estudio (p = 0,39). La regresión lineal de auto reporte de cumplimiento de competencias en geriatría y ageísmo, fue ajustado por año de la carrera en que cursó geriatría y existencia de otro curso que aborde temas de geriatría, y se encontró que a mayor ACCG, mayor ageísmo. Conclusiones. Hasta el momento, no se puede afirmar que la educación virtual sea inferior a la presencial en lo que respecta generar al cumplimiento auto reportado de competencias en geriatría.
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OSCANOA, TEODORO. "Interacción medicamentosa en Geriatría." Anales de la Facultad de Medicina 65, no. 2 (March 11, 2013): 119. http://dx.doi.org/10.15381/anales.v65i2.1403.

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Los pacientes adultos mayores tienen tres características principales que lo diferencian de otros grupos etáreos: polipatología, polifarmacia y cambios fisiológicos relacionados con el envejecimiento que alteran la farmacocinética y farmacodinámica de los medicamentos. Estos tres factores hacen que la interacción medicamentosa (interacción fármaco-fármaco) se manifieste con mayor frecuencia y severidad en este grupo etáreo, actualmente forma parte de los problemas relacionados con medicamentos (PRM) en el adulto mayor, que necesitan ser estudiados en su epidemiología así como en las estrategias adecuadas para combatirla. El uso adecuado de los fármacos y la monitorización estrecha de éstos son esenciales en la prevención de las reacciones adversas medicamentosas producidas por las interacciones farmacológicas.
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Vilches Moraga, Arturo, and Carlos Rodríguez Pascual. "Insuficiencia cardíaca y geriatría." Revista Española de Geriatría y Gerontología 44, no. 2 (March 2009): 57–60. http://dx.doi.org/10.1016/j.regg.2008.12.005.

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Dissertations / Theses on the topic "Geriatría"

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Aguayo, Barbachan Jorge Santiago, Noriega Madalengoitia Jimena De, Villegas Gregory Mishell Diaz, and Vigil Jenny Aylin Fernandez. "Geriatría - ME88 201601." Universidad Peruana de Ciencias Aplicadas (UPC), 2016. http://hdl.handle.net/10757/626859.

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Geriatría es un curso de la especialidad de la carrera de Medicina de carácter teórico-práctico, dirigido a los alumnos del ciclo 9 que busca desarrollar las competencias Específicas de práctica clínica (diagnóstico). El aumento en la expectativa de vida de las personas conlleva al incremento de patologias no degenerativas propias de la edad a las que el médico general debe enfrentarse, además estas mismas patologias condicionan la necesidad de una evaluación integral que incluya no solo los aspectos físicos sino también a las esferas funcionales, mentales (emocional y cognitiva) y sociales que encierra la evalaucion geriátrica; este Curso de geriatría le permitirá al alumno reconocer las características especiales del adulto mayor, tales como la presentación atípica de la enfermedad, la presencia de fragilidad y de síndromes geriátricos ; competencias que le servirán a nuestro futuro médico formar parte del trabajo multi y transdisciplinario con otros profesionales de la salud en la evaluación y el manejo del paciente geriátrico y su familia.
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Ávila, Velásquez Jack Juan, Barbachan Jorge Santiago Aguayo, Vigil Jenny Aylin Fernandez, and Vilca Julia Yeny Fernández. "Geriatría - ME88 201301." Universidad Peruana de Ciencias Aplicadas (UPC), 2013. http://hdl.handle.net/10757/626955.

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Las últimas décadas han traído consigo cambios epidemiológicos, demográficos y científicos que han condicionado a su vez un incremento progresivo de la población adulta mayor. Este fenómeno se ha visto íntimamente relacionado a una mayor frecuencia de patologías crónicas y degenerativas, las cuales a su vez condicionan mayor riesgo de dependencia funcional, deterioro cognitivo, problemas psicosociales, morbimortalidad e institucionalización, generándose de este modo un mayor uso de los recursos sanitarios. Características especificas del adulto mayor, tales como la presentación atípica de la enfermedad, la presencia de fragilidad y de síndromes geriátricos, condicionan la necesidad de una evaluación integral que incluya no solo los aspectos físicos sino también a las esferas funcionales, mentales (emocional y cognitiva) y sociales; para lo cual es fundamental el trabajo multi y transdisciplinario, donde otros profesionales (psicólogos, terapistas, asistentes sociales, entre otros) de la salud a parte del geriatra participan de manera activa en la evaluación y el manejo del paciente y su familia. La adecuada prevención, así como la detección y el manejo oportuno de las diversas patologías y síndromes que aquejan a este grupo poblacional, favorecerán por un lado la mejor calidad de vida del adulto mayor y su familia y por otro lado disminuirá los gastos en salud.
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Aguayo, Barbachan Jorge Santiago, Vigil Jenny Aylin Fernandez, Cruz Roberto Esteban Giron, and Ramirez Lilian Roxana Hidalgo. "Geriatría - ME88 201401." Universidad Peruana de Ciencias Aplicadas (UPC), 2014. http://hdl.handle.net/10757/626956.

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Las últimas décadas han traído consigo cambios epidemiológicos, demográficos y científicos que han condicionado a su vez un incremento progresivo de la población adulta mayor. Este fenómeno se ha visto íntimamente relacionado a una mayor frecuencia de patologías crónicas y degenerativas, las cuales a su vez condicionan mayor riesgo de dependencia funcional, deterioro cognitivo, problemas psicosociales, morbimortalidad e institucionalización, generándose de este modo un mayor uso de los recursos sanitarios. Características específicas del adulto mayor, tales como la presentación atípica de la enfermedad, la presencia de fragilidad y de síndromes geriátricos, condicionan la necesidad de una evaluación integral que incluya no solo los aspectos físicos sino también a las esferas funcionales, mentales (emocional y cognitiva) y sociales; para lo cual es fundamental el trabajo multi y transdisciplinario, donde otros profesionales (psicólogos, terapistas, asistentes sociales, entre otros) de la salud a parte del geriatra participan de manera activa en la evaluación y el manejo del paciente y su familia. La adecuada prevención, así como la detección y el manejo oportuno de las diversas patologías y síndromes que aquejan a este grupo poblacional, favorecerán por un lado la mejor calidad de vida del adulto mayor y su familia y por otro lado disminuirá los gastos en salud.
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Castro, Viacava Guida Alicia, Noriega Madalengoitia Jimena De, Villegas Gregory Mishell Diaz, and Vigil Jenny Aylin Fernandez. "Geriatría - ME88 201901." Universidad Peruana de Ciencias Aplicadas (UPC), 2019. http://hdl.handle.net/10757/627355.

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Geriatría es un curso de la especialidad de la carrera de Medicina de carácter teórico-práctico, dirigido a los alumnos del ciclo 9 que busca desarrollar las competencias generales de Ciudadanía (nivel 3) y las específicas de Práctica Clínica: Diagnóstico (nivel 3), y Profesionalismo Sentido Ético y Responsabilidad profesional (nivel 3). El aumento en la expectativa de vida de las personas conlleva al incremento de patologias no degenerativas propias de la edad a las que el médico general debe enfrentarse, además estas mismas patologias condicionan la necesidad de una evaluación integral que incluya no solo los aspectos físicos sino también a las esferas funcionales, mentales (emocional y cognitiva) y sociales que encierra la evalaucion geriátrica; este Curso de geriatría le permitirá al alumno reconocer las características especiales del adulto mayor, tales como la presentación atípica de la enfermedad, la presencia de fragilidad y de síndromes geriátricos ; competencias que le servirán a nuestro futuro médico formar parte del trabajo multidisciplinario y transdisciplinario con otros profesionales de la salud en la evaluación y el manejo del paciente geriátrico y su familia.
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De, Noriega Madalengoitia Jimena, Villegas Gregory Mishell Diaz, Vigil Jenny Aylin Fernandez, and Sialer Jose Felipe Fonseca. "Geriatría - ME88 201801." Universidad Peruana de Ciencias Aplicadas (UPC), 2018. http://hdl.handle.net/10757/627370.

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Geriatría es un curso de la especialidad de la carrera de Medicina de carácter teórico-práctico, dirigido a los alumnos del ciclo 9 que busca desarrollar las competencias generales de Ciudadanía (nivel 3) y las específicas de Práctica Clínica: Diagnóstico (nivel 3), y Profesionalismo Sentido Ético y Responsabilidad profesional (nivel 3). El aumento en la expectativa de vida de las personas conlleva al incremento de patologias no degenerativas propias de la edad a las que el médico general debe enfrentarse, además estas mismas patologias condicionan la necesidad de una evaluación integral que incluya no solo los aspectos físicos sino también a las esferas funcionales, mentales (emocional y cognitiva) y sociales que encierra la evalaucion geriátrica; este Curso de geriatría le permitirá al alumno reconocer las características especiales del adulto mayor, tales como la presentación atípica de la enfermedad, la presencia de fragilidad y de síndromes geriátricos ; competencias que le servirán a nuestro futuro médico formar parte del trabajo multidisciplinario y transdisciplinario con otros profesionales de la salud en la evaluación y el manejo del paciente geriátrico y su familia.
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(UPC), Universidad Peruana de Ciencias Aplicadas. "Fisioterapia en Geriatría - TF17 201801." Universidad Peruana de Ciencias Aplicadas (UPC), 2018. http://hdl.handle.net/10757/623143.

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El Curso de Terapia Física en Geriatría de naturaleza teórico-práctico está dirigido a los estudiantes del séptimo ciclo desarrollando en el nivel dos, la competencia específica de práctica clínica abarcando las dimensiones de diagnóstico, promoción, prevención y tratamiento fisioterapéutico. Inter-relacionando el aspecto funcional familiar y social, proporcionando herramientas para la atención del paciente adulto mayor en etapas agudas, subagudas y crónicas de manera integral donde el estudiante ejercita y refuerza los conocimientos teóricos y prácticos de los diversos métodos fisioterapéuticos que pueden aplicarse en las patologías de mayor incidencia en el paciente adulto mayor y, trabajar de manera integral participando con el equipo de salud, motivar y reforzar el enfoque humanístico que requiere la atención del paciente geriátrico. Así mismo el estudiante se verá inmerso en el trabajo interdisciplinario con el objetivo de reinsertar al paciente adulto mayor a su entorno socio-familiar con la mejora y/o mantenimiento de la capacidad funcional y, con el plus de la participación del familiar acompañante y/o cuidador a quien debe capacitar y sensibilizar sobre los cuidados, apoyo adecuado y mantenimiento funcional durante su tratamiento y al alta.
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Jiménez, Villafuerte María Victoria. "Perfil epidemiológico del cuidador en el Servicio de Atención Domiciliaria Geriátrica de la Clínica Geriátrica "San José" PNP." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2003. https://hdl.handle.net/20.500.12672/2064.

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Diseño: Estudio descriptivo, observacional, transversal Objetivo: Determinar el perfil epidemiológico del cuidador de los pacientes del servicio de ADOGE de la Clínica Geriátrica "Sán José" PNP. Población: Se incluyeron 120 cuidadores de los pacientes del Servicio de Atención Domiciliaria Geriátrica de la Clínica Geriátrica San José PNP, se excluyeron aquellos cuidadores con fichas de evaluación del cuidador incompletas, cuidadores que se negaron a participar del estudio, aquellos cuidadores con demencia u otras enfermedades mentales, alcohólicos o con dependencia a drogas; que no puedan brindar información requerida para el estudio. Materiales y métodos: Se entrevistó a los cuidadores para la obtención de los datos de la Ficha de Evaluación del Cuidador, luego se aplicó la entrevista de sobrecarga del cuidador de Zarit Se revisaron las historias clínicas de los pacientes así como las fichas de seguimiento para confirmar y completar datos que no se obtuvieron durante la entrevista. Se elaboró una base de datos usando el paquete estadístico EPI﷓ INFO 2000. La información fue analizada utilizando el paquete estadístico SPSS VERSIÓN 11. Para el análisis descriptivo se calculó la frecuencia de las características sociodemográficas del cuidador en términos de porcentaje de prevalencia, se calcularon los intervalos de confianza al 95% en base a la distribución binomial. Así mismo, se calcularon los promedios, media y desviación estándar de las variables numéricas. Los resultados se presentan en tablas de doble entrada y gráficos. Resultados: En 67.5% de los 120 cuidadores registrados, el tipo de cuidado fue informal, exclusivamente proporcionado por familiares. El cuidador generalmente era una mujer (85.8%), con una media edad de 45.4 años, ama de casa. En nuestro estudio los beneficiarios de cuidado, tenían una media edad de 84.9 años, un alto nivel de dependencia en las actividades de la vida diaria, y diagnóstico de ingreso a ADOGE Accidente cerebrovascular 35.8%, demencia 25% y enfermedad de Parkinson 11.7%. El impacto del cuidado en la actividad laboral del cuidador fue moderada (25%), mientras que el impacto sobre la salud física y mental fueron considerables 36.7% y 86.6% respectivamente. La sobrecarga del cuidador valorada mediante la entrevista de Zarit revela un 48.4% de sobrecarga. Conclusiones: La demanda de cuidado de los adultos mayores atendidos por el servicio de ADOGE de la Clínica Geriátrica San José PNP es cubierta principalmente por cuidadores informales. En la mayoría de los casos el cuidador presenta niveles altos de sobrecarga que afecta su salud física y metal; y que además pone en grave riesgo de abuso y maltrato a los pacientes receptores de sus cuidados.
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García, Tenorio Miguel Germán. "Adherencia en el adulto mayor en consulta externa de Geriatría del Hospital Regional de Ica : 2004." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2005. https://hdl.handle.net/20.500.12672/1768.

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Establecimiento donde se realizará la investigación: HOSPITAL REGIONAL DE ICA Departamento, Servicio o Unidad donde se realizará la investigación: Encuesta a los adultos mayores atendidos en el consultorio externo de. Geriatría del Hospital Regional de Ica. Objetivos: Determinar que variables se relacionan significativamente con la adherencia al tratamiento en el adulto mayor que acude por primera vez a la consulta externa de Geriatría del Hospital regional de ICA. Evaluar por medio de la Valoración Geriátrica Integral las características del adulto mayor en la consulta externa de Geriatría del Hospital Regional de ICA Métodos: El estudio es longitudinal, descriptivo en pacientes mayores de 60 años a los que se le aplicó una encuesta de valoración geriátrica integral en aquellos que acuden por primer vez al consultorio externo de geriatría del Hospital Regional de Ica. Y se pondrá énfasis en la historia farmacológica con una encuesta que valora la adherencia a este. Resultados: Para conocer el perfil de los síndromes y problemas geriátricos así como la situación funcional, mental y social de los adultos mayores que acudieron al consultorio externo de Geriatría del hospital Regional de Ica, se incluyeron 420 pacientes de 60 años o mas durante el periodo de 1 de enero al 31 de diciembre de 2004, a quienes se les aplicó la ficha de valoración geriátrica Integral y la escala de autoreporte de medicamentos de Morinsky. La edad promedio fue de 77.9 años, predominando el sexo femenino con un 57.6%, el número de síndromes fue de 2,9.(d.s. = +/1-1.1).Siendo los principales: deprivación sensorial, 87.9.5%; incontinencias urinaria 36,4 y caídas 28,8%. El número de diagnósticos es de 6.2 y la principal patología fue la cardiovascular seguido de procesos osteodegenerativos. En el estado mental se encontró deterioro cognitivo en 18% y depresión en 7%. De la evaluación del estado funcional se encontró 78% de autonomía funcional En la situación socio familiar el 88% se encuentra en riesgo o con problema social. La adherencia global total fue de 54% y 40% de ellos presentaban problemas de subadherencia y sobreadherencia. Los fármacos más usados fueron cardiovasculares seguido de los sistema nervioso y en tercer lugar los del sistema digestivo. El gran uso de medicamentos se asocia con la edad, mayor de 5 consultas en el último año y mayor de 5 diagnósticos y este también es un factor para adherencia Conclusiones: La valoración geriátrica Integral es una herramienta metodológica imprescindible en la atención al paciente geriátrico, tanto en el ámbito de la atención primaria como en el de la especializada. Debido que mejora el diagnostico multidimensional la adherencia deviene en un problema real dado que afecta directamente el éxito del tratamiento y el pronostico de la enfermedad Se identificaron 2 factores asociados con subadherencia deterioro cognitivo y gran numero de medicamento y la sobreadherencia se asociaba con deterioro cognitivo y baja escolaridad Palabras Claves : Valoración geriátrica Integral, Adherencia
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Pizarro, Francisco. "Reposición Instituto Nacional de Geriatría Presidente Eduardo Frei Montalva." Tesis, Universidad de Chile, 2011. http://repositorio.uchile.cl/tesis/uchile/2010/aq-pizarro_f/html/index-frames.html.

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El proyecto tiene su origen en la conjunción de tres situaciones : La primera es la obsolecencia que presentan algunas infraestructuras hospitalarias del servicio público originada en la gran cantidad de años de servicio con que cargan y el crecimiento desorganizado y caótico producto de la adecuación a las nuevas demandas y estandares. La segunda es el deterioro producido por el terremoto el pasado 27 de febrero, que dejó daños estructurales severos obligando a clausurar el establecimiento lo que claramente repercute en un déficit de atención para el adulto mayor. Por último la tercera situación o fenomeno es el acelerado envejecimiento de la población por el cual atraviesa nuestro País lo que da pie para pensar en los desafios que plantea la construcción de una sociedad para todas las edades, en este caso desde el punto de vista sanitario. La necesidad de una nueva infraestructura es evidente, hace algunos años que el Instituto viene estudiando la reposición de la institución dentro de un proyecto en conjunto con el Hospital Salvador que contemplaba construir un edificio donde funcionarán ambos recintos. Sin embargo el proyecto no ha prosperado principalmente por temas burocráticos y económicos.
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González, Gómez Hugo, and Navarro Miguel Ángel Rivero. "Prevalencia de Depresión en los pacientes que acuden por primera vez a la consulta externa del Servicio de Geriatría del Centro Médico Lic. Adolfo López Mateos del Insituto de Salud del Estado de México en el periodo del 01 de enero al 30 de junio del 2010." Tesis de Licenciatura, Medicina-Quimica, 2013. http://ri.uaemex.mx/handle/20.500.11799/13909.

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Books on the topic "Geriatría"

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Llegar bien a la vejez: Gericultura, gerontología y geriatría. México: Editorial Trillas, 2014.

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Olguín, Fernando Quintanar. Atención psicológica de las personas mayores: Investigación y experiencias en psicología del envejecimiento. México, D.F: Editorial Pax México, 2011.

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Corral, Francisco Sánchez del, María Teresa Sancho Castiello, Sandra García Armesto, and Guadalupe Pajares Carbajal. Vejez, negligencia, abuso y maltrato: La perspectiva de los mayores y de los profesionales : investigación cualitativa de la Sociedad Española de Geriatría y Gerontología. Madrid: Ministerio de Trabajo y Asuntos Sociales, Secretaría de Estado de Servicios Sociales, Familias y Discapacidad, IMSERSO, 2004.

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Enfermedad en la vejez: Cómo afrontarla en familia. México: Editorial Trillas, 2015.

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Nursing care of older adults: Theory and practice. 2nd ed. Philadelphia: Lippincott, 1995.

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Miller, Carol A. Nursing care of older adults: Theory and practice. 2nd ed. Glenview, IL: Scott, Foresman/Little, Brown Higher Education, 1995.

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Nursing care of older adults: Theory and practice. 3rd ed. Philadelphia: Lippincott, 1999.

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Nursing care of older adults: Theory and practice. Glenview, Ill: Scott, Foresman/Little, Brown Higher Education, 1990.

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Christ, Mary Ann. Gerontologic nursing. 2nd ed. Springhouse, Pa: Springhouse Corporation, 1993.

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Christ, Mary Ann. Gerontologic nursing. Springhouse, Pa: Springhouse Pub. Co., 1988.

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Book chapters on the topic "Geriatría"

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Meier-Baumgartner, H. P. "Geriatrie." In Präventivmedizin, 475–507. Berlin, Heidelberg: Springer Berlin Heidelberg, 1995. http://dx.doi.org/10.1007/978-3-662-12762-9_6.

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Platt, D. "Geriatrica." In Pharmakotherapie und Alter, 339–46. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-662-00437-1_16.

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Schim van der Loeff-van Veen, Rolinka. "Geriatrie." In Geriatrie, 1–17. Houten: Bohn Stafleu van Loghum, 2017. http://dx.doi.org/10.1007/978-90-368-1660-1_1.

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Rooij, S. E. J. A. de. "Geriatrie." In Leerboek interne geneeskunde, 957–76. Houten: Bohn Stafleu van Loghum, 2017. http://dx.doi.org/10.1007/978-90-368-1841-4_23.

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Zwerschke, W., M. C. Mitterberger, G. Zürcher, and E. Fassl-Garbani. "Geriatrie." In Klinische Ernährungsmedizin, 937–60. Vienna: Springer Vienna, 2010. http://dx.doi.org/10.1007/978-3-211-88900-8_26.

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Lanzendörfer, Christoph, Resi Lanzendörfer, Harald Schardelmann, and Christian Subbe. "Geriatrie." In Innere Medizin, 671–93. Berlin, Heidelberg: Springer Berlin Heidelberg, 1998. http://dx.doi.org/10.1007/978-3-642-87097-2_16.

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Platt, D. "Geriatrica." In Pharmakotherapie und Alter, 497–506. Berlin, Heidelberg: Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77483-6_19.

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Kruse, Andreas, and H. P. Meier-Baumgartner. "Geriatrie." In Präventivmedizin, 961–1020. Berlin, Heidelberg: Springer Berlin Heidelberg, 1997. http://dx.doi.org/10.1007/978-3-662-22318-5_6.

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Jansen, P. A. F., and J. M. G. A. Schols. "Geriatrie." In Het Geriatrie Formularium, 23–30. Houten: Bohn Stafleu van Loghum, 2007. http://dx.doi.org/10.1007/978-90-313-6431-2_2.

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Ligthart, G. J. "Geriatrie." In Interne geneeskunde, 819–33. Houten: Bohn Stafleu van Loghum, 2007. http://dx.doi.org/10.1007/978-90-313-6432-9_23.

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Conference papers on the topic "Geriatría"

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Jimenez Arbás, Estíbaliz, Marta María Sánchez Menéndez, and Luisa Ruiz Fernández. "Transversalidad educativa: casos clínicos para el estudio de Geriatría y Patologías Osteoarticulares y su intervención en Autonomía e Independencia Funcional en el Adulto." In IN-RED 2019: V Congreso de Innovación Educativa y Docencia en Red. València: Editorial Universitat Politècnica de València, 2019. http://dx.doi.org/10.4995/inred2019.2019.10444.

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El objetivo de este proyecto es introducir al alumnado en el conocimiento de la discapacidad a través de casos clínicos en dos asignaturas, Geriatría y Patologías Osteoarticulares (POA) y Autonomía e Independencia Funcional en el Adulto (AIF), para ello dispusieron de material y tutorización para la resolución de los casos durante las clases de POA, por otro lado en AIF desarrollan estrategias de intervención desde la Terapia Ocupacional. Se prepararon cinco casos clínicos en reumatología (artritis reumatoide, colagenosis, espondiloartropatías, artritis cristalinas e infecciosas) y cuatro en traumatología (tendinopatías, artrosis, fracturas y amputaciones). En AIF se eligieron dos casos, mano reumatoide más específicamente un caso clínico de artritis reumatoide y otro caso clínico, una amputación de mano. La innovación metodológica de este poyecto es la transversalidad educativa. Se diseño finalmente una gamificación para la evaluación de conocimientos realizando un scape room.
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"Geriatria." In XX Congresso Brasileiro de Geriatria e Gerontologia. Geriatrics, Gerontology and Aging, 2016. http://dx.doi.org/10.5327/z2447-21152016v10suppl10001.

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"Gerontologia." In XX Congresso Brasileiro de Geriatria e Gerontologia. Geriatrics, Gerontology and Aging, 2016. http://dx.doi.org/10.5327/z2447-21152016v10suppl10002.

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"Melhores temas livres CBGG 2016." In XX Congresso Brasileiro de Geriatria e Gerontologia. Geriatrics, Gerontology and Aging, 2016. http://dx.doi.org/10.5327/z2447-21152016v10suppl1ed.

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de Carvalho, Natália Reis, Ana Luiza Carvalho Costa, Andréa Carvalho Araújo Moreira, Samir Gabriel Vasconcelos Azevedo, Naiara Teixeira Fernandes, and Francisco Eduardo Silva Oliveira. "THE FAMILY HEALTH STRATEGY AND HOSPITALIZATIONS IN OLDER ADULTS IN THE NORTHEAST OF BRAZIL." In XXII Congresso Brasileiro de Geriatria e Gerontologia. Zeppelini Publishers, 2021. http://dx.doi.org/10.5327/z2447-21232021res01.

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OBJECTIVE: To analyze the association between the expansion of the Family Health Strategy and hospitalizations for ambulatory care-sensitive conditions in older adults. METHODS: This ecological study was conducted from June to October 2019. The units of analysis were all states in the Northeast of Brazil, and the historical outline included the period from 2008 to 2018. Data on the coverage of the Family Health Strategy and hospitalizations were extracted from the Primary Care Information and Management System and the Hospital Information System. For the association analysis, Spearman coefficients (r) were calculated at a 95% confidence interval (p < 0.05) using STATA, version 13.0. An absolute r value above 0.5 was considered satisfactory. RESULTS: From 2008 to 2018, the Northeast Region recorded a 13.33% increase in the Family Health Strategy coverage and a 27.44% decrease in hospitalization rates. Coverage did not expand in the states of Paraíba, Rio Grande do Norte, and Sergipe; in the latter, there was also no significant reduction in hospitalization rates. There was a correlation between the expansion of the Family Health Strategy and a reduction in hospitalizations for ambulatory care-sensitive conditions in the states of Alagoas (r = −0.9636), Bahia (r = −0.9545), Ceará (r = −0.8884), and Piauí (r = −0.7000). CONCLUSIONS: The results indicate that increased coverage of the Family Health Strategy is associated with greater effectiveness of primary care. However, other intervening factors in hospitalization rates for ambulatory care-sensitive conditions should be considered, such as the health care model and socioeconomic context.
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Passos, Valeria Maria de Azeredo, Luísa Campos Caldeira Brant, Paulo Roberto Lopes Corrêa, Pedro Cisalpino Pinheiro, Maria de Fátima Marinho de Souza, and Deborah Carvalho Malta. "SOCIAL INEQUALITY IN COVID-19 MORTALITY AMONG OLDER ADULTS IN BELO HORIZONTE: VACCINATION PRIORITY." In XXII Congresso Brasileiro de Geriatria e Gerontologia. Zeppelini Publishers, 2021. http://dx.doi.org/10.5327/z2447-21232021res02.

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OBJECTIVE: To test the hypothesis that older adults (aged 60+ years) living in areas of greater social vulnerability were most affected by the COVID-19 pandemic in the city of Belo Horizonte between February and October 2020. METHODS: We conducted an ecological study with analysis of mortality rates by census tracts, classified as areas of low vulnerability (1330 tracts), medium vulnerability (1460 tracts), and high/very high vulnerability (1040 tracts) according to the health vulnerability index (consisting of indicators of sanitation, garbage collection, water supply, literacy level, and race). The number of deaths from COVID-19 was obtained from the Mortality Information System from 10th to 43rd epidemiological week. The rates were age-standardized for populations of the three areas of vulnerability, based on population estimates from the Brazilian Institute of Geography and Statistics. RESULTS: In Belo Horizonte, the mortality rate was 62.9 deaths per 100,000 population, ranging from 36.1 in areas of low social vulnerability to 76.6 and 101.9 in areas of medium and high/very high vulnerability, respectively. The mortality rate was 292.3 per 100,000 older persons, increasing from 179.2 in areas of low vulnerability to 353.6 and 472.6 in areas of medium and high/very high vulnerability, respectively. CONCLUSIONS: In this moment of organizing vaccination sessions for the population, social inequalities in mortality, even in the age group at highest risk, reinforce the principle of starting vaccination by prioritizing the most socially vulnerable areas. It is necessary to prioritize the most exposed older persons, as they usually live with on-site workers, have greater difficulty in complying with social distancing orders and with the hygiene preventive measures due to poor housing and transportation conditions, and experience limited access to health care services.
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Garcez, Flávia Barreto, Wilson Jacob-Filho, and Thiago Junqueira Avelino-Silva. "EFFECT OF AMBIENT TEMPERATURE ON MORTALITY IN ACUTELY ILL HOSPITALIZED OLDER PATIENTS." In XXII Congresso Brasileiro de Geriatria e Gerontologia. Zeppelini Publishers, 2021. http://dx.doi.org/10.5327/z2447-21232021res03.

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OBJECTIVE: To investigate the association between extremes of temperature and increased hospital mortality in acutely ill older patients. METHODS: A prospective cohort study of acutely ill patients aged 60 years or older, admitted to the geriatric ward of Hospital das Clinicas at the University of Sao Paulo Medical School, from 2009 to 2015. Meteorological data were obtained through the System of Information on Air Quality of the state of Sao Paulo. The average daily temperatures were categorized according to percentiles (p). Temperatures at p95 and p90 were defined as extreme heat and those below p10 and p5 as extreme cold. We collected sociodemographic, clinical, functional, and laboratory data on admission using a standardized comprehensive geriatric assessment. The primary outcome was hospital mortality. We performed multivariate analyses using Cox proportional hazards model adjusted for confounders. RESULTS: We included 1403 patients, with a mean age of 80 years; 61% were women. The overall mortality was 19%. Temperature cutoffs by percentile were 15, 16, 25, and 26°C. The adjusted hazard ratio for all-cause mortality in the ≥ 26°C temperature group compared to the 16.1–25.0°C group was 1.89 (27 vs 18%; 95%CI 1.14–3.12; p = 0.013). There was no significant association between the other temperature groups and mortality. CONCLUSIONS: A daily temperature > 26°C was independently associated with increased hospital mortality. Health administrators and clinicians should be aware of the potential negative effects of high ambient temperatures on hospitalized older patients.
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Giassi, Karina, Renato Gorga Bandeira de Mello, Bruna Cambrussi de Lima, Gabriela Stahl, Raquel Almeida de Oliveira, and Marina Siqueira Flores. "RANDOMIZED CONTROLLED TRIAL COMPARING MORNING VERSUS NIGHT ADMINISTRATION OF LEVOTHYROXINE IN OLDER PERSONS." In XXII Congresso Brasileiro de Geriatria e Gerontologia. Zeppelini Publishers, 2021. http://dx.doi.org/10.5327/z2447-21232021res04.

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OBJECTIVE: To evaluate the effectiveness of levothyroxine administration strategies in the treatment of hypothyroidism in older persons in a tertiary outpatient clinic. METHODS: A randomized controlled trial of older persons with a diagnosis of primary hypothyroidism who had been receiving levothyroxine for at least 6 months with a stable dose in the last 3 months. Patients were randomly assigned to one of two administration strategies: morning (1 hour before breakfast) or night (1 hour after the last meal). In a period ≥ 12 weeks, patients were instructed to cross over between strategies. Laboratory tests for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were performed at visit 0 (baseline), visit 1 (period ≥ 12 weeks), and visit 2 (completion — period ≥ 24 weeks); a standardized questionnaire was also applied. Preliminary analyses of the period before crossover are presented. RESULTS: The preliminary sample consisted of 98 patients, with a mean age of 71.26 (SD 7.12) years; 83.67% were women. Fifty-three patients started with the morning strategy and 45 with the night strategy, and one patient did not return for reassessment. Median TSH levels ranged from 2.74 (IQR 1.06–4.19) at baseline to 2.77 (IQR 0.75–4.41) after a 12-week follow-up in the morning group, and from 2.36 (IQR 1.48–4.85) to 2.28 (IQR 1.69–3.56) in the night group. Mean FT4 levels ranged from 1.44 (SD 0.39) to 1.42 (SD 0.36) in the morning group, and from 1.35 (SD 0.27) to 1.37 (SD 0.32) in the night group. CONCLUSIONS: The administration of levothyroxine at night was as effective as morning administration at controlling primary hypothyroidism in older persons. Therefore, this can be considered an alternative dosage strategy for the treatment of this condition.
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Pereira, Elaine Valias Sodré, Carolina Pessoni Garcia, and Maria José D’Elboux. "CASP-19 AND THE HEALTH AND SOCIODEMOGRAPHIC VARIABLES OF OLDER ADULTS PARTICIPATING IN FIBRA 80+." In XXII Congresso Brasileiro de Geriatria e Gerontologia. Zeppelini Publishers, 2021. http://dx.doi.org/10.5327/z2447-21232021res06.

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INTRODUCTION: Assessing quality of life in older adults is relevant due to the significant increase in this population. Based on Maslow’s need hierarchy model, CASP-19 is a broad measure of quality of life that focuses on positive aspects of older adults’ lives, regardless of health conditions or other factors. OBJECTIVE: To compare sociodemographic and health variables with quality of life according to CASP-19 scores. METHODOLOGY: Using data from the Frailty in Brazilian Older People (FIBRA 80+) follow-up study, this study included 233 adults aged ≥ 80 years who resided near the University of Campinas (Campinas, SP, Brazil). Sociodemographic variables (gender, age, and perceived social support), health variables (perceived health status and depressive symptoms) and quality of life were evaluated. RESULTS: The participants were predominantly women (69.09%) with a mean age of 83.46 ± 3.7 years. A total of 77.25% rated their health as fair or good, and 79% showed no signs of depression. The mean CASP-19 score was 41.8 ± 2.62 points, which corresponds to better well-being (total scores range from 0 to 57). Among the instrument’s domains, autonomy and pleasure obtained the highest mean scores (11.15 and 11.64 respectively). When comparing these variables with quality of life, social support (p = 0.001), depressive symptoms (p <0.001), and perceived health status (p <0.001) were statistically significant. CONCLUSIONS: Older adults who were satisfied with their social support, presented no depressive symptoms, and who rated their health as good or very good had higher overall quality of life scores.
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Kirkwood, Renata Noce, Natália Cristina Lisboa Batista, Larissa Bragança Falcão Marques, Juliana de Melo Ocarino, Lucas Lobo Alcântara Neves, and Bruno de Souza Moreira. "CROSS-CULTURAL ADAPTATION AND RELIABILITY OF THE FUNCTIONAL GAIT ASSESSMENT FOR OLDER BRAZILIANS." In XXII Congresso Brasileiro de Geriatria e Gerontologia. Zeppelini Publishers, 2021. http://dx.doi.org/10.5327/z2447-21232021res07.

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INTRODUCTION: Many instruments have been used to identify older adults at risk of falling, including performance-oriented mobility assessment, timed up and go test, Berg balance scale, and dynamic gait index. However, there have been reports of these clinical tests having a ceiling effect on community-dwelling older adults. To address this issue, the functional gait assessment was developed based on the dynamic gait index. Therefore, the functional gait assessment is an instrument that assesses postural stability during tasks that cause changes in gait patterns. OBJECTIVES: To translate and cross-culturally adapt the functional gait assessment to the Brazilian Portuguese language and to assess its psychometric properties in older Brazilians living in the community. METHODS: The process of translation and cross-cultural adaptation followed the recommendations of international guidelines. The pre-final version was administered to a sample of 30 older adults, both male and female, living independently in the community. To examine the psychometric properties (reliability, standard error of measurement, and internal consistency), 70 older adults aged 60 to 87 years were evaluated. RESULTS: The original and the translated versions were considered conceptually equivalent. All functional gait assessment items whose numbers were measured in inches and feet were converted to centimeters and rounded off to comply with the unit of measurement used in Brazil. The functional gait assessment-Brazil showed excellent inter- and intraexaminer reliability (intraclass correlation coefficient > 0.90), low standard error of measurement (range = 1.03 to 1.52), and good internal consistency (Cronbach alpha = 0.858). CONCLUSIONS: The functional gait assessment-Brazil is a semantically, linguistically, and psychometrically appropriate instrument for assessing balance during walking in community-dwelling older adults.
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Reports on the topic "Geriatría"

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Gilham, Donna. Assessment of hearing sensitivity by use of the acoustic reflex in the geriatric population. Portland State University Library, January 2000. http://dx.doi.org/10.15760/etd.2281.

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Muller, R. P. Feasibility Study for Life Enhancement of Military Aircraft Through Re-Squeezing Joints with Geriatric Aircraft. Fort Belvoir, VA: Defense Technical Information Center, November 2001. http://dx.doi.org/10.21236/ada399037.

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Lassell, Marie. Audiological in-service regarding hearing impairment and its impact on communication in the geriatric population. Portland State University Library, January 2000. http://dx.doi.org/10.15760/etd.5953.

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Boyes, Allison, Jamie Bryant, Alix Hall, and Elise Mansfield. Barriers and enablers for older people at risk of and/or living with cancer to accessing timely cancer screening, diagnosis and treatment. The Sax Institute, July 2022. http://dx.doi.org/10.57022/ieoy3254.

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• Older adults have complex and unique needs that can influence how and when cancer is diagnosed, the types of treatment that are offered, how well treatment is tolerated and treatment outcomes. • This Evidence Check review identified 41 studies that specifically addressed barriers and enablers to cancer screening, diagnosis and treatment among adults aged 65 years and older. • Question 1: The main barriers for older people at risk of and/or living with cancer to access and participate in timely cancer screening relate to lack of knowledge, fear of cancer, negative beliefs about the consequences of cancer, and hygiene concerns in completing testing. The main enablers to participation in timely cancer screening include positive/helpful beliefs about screening, social influences that encourage participation and knowledge. • Question 2: The main barriers for older people at risk of and/or living with cancer to access and/or seek timely cancer diagnosis relate to lack of knowledge of the signs and symptoms of cancer that are distinct from existing conditions and ageing, healthcare accessibility difficulties, perceived inadequate clinical response from healthcare providers, and harmful patient beliefs about risk factors and signs of cancer. The main enablers to accessing and/or seeking a timely cancer diagnosis include knowledge of the signs and symptoms of cancer, and support from family and friends that encourage help-seeking for symptoms. • Question 3: The main barriers for older people at risk of and/or living with cancer in accessing and completing cancer treatment include discrimination against patients in the form of ageism, lack of knowledge, patient concern about the adverse effects of treatment, predominantly on their independence, healthcare accessibility difficulties including travel and financial burden, and patients’ caring responsibilities. The main enablers to accessing and completing cancer treatment are social support from peers in a similar situation, family and friends, the influence of healthcare providers, and involving patients in treatment decision making. • Implications. The development of strategies to address the inequity of cancer outcomes in people aged 65 years and older in NSW should consider: ­ Increasing community members’ and patients’ knowledge and awareness by providing written information and decision support tools from a trusted source ­ Reducing travel and financial burden by widely disseminating information about existing support schemes and expanding remote patient monitoring and telehealth ­ Improving social support by promoting peer support, and building the support capacity of family carers ­ Addressing ageism by supporting patients in decision making, and disseminating education initiatives about geriatric oncology to healthcare providers ­ Providing interdisciplinary geriatric oncology care by including a geriatrician as part of multidisciplinary teams and/or expanding geriatric oncology clinics.
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Hauer, Klaus, Ilona Dutzi, Christian Werner, Jürgen M. Bauer, and Phoebe Ullrich. Implementation of intervention programs specifically tailored for patients with CI in early rehabilitation during acute hospitalization: a scoping review protocol. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, October 2022. http://dx.doi.org/10.37766/inplasy2022.10.0067.

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Review question / Objective: What is the current status of implementation of interventional programs on early functional rehabilitation during acute, hospital-based medical care, specifically tailored for older patients with CI and what are the most appropriate programs or program components to support early rehab in this specific population? This study combines a systematic umbrella review with a scoping review. While an umbrella review synthesizes knowledge by summarizing existing review papers, a scoping review aims to provide an overview of an emerging area, extracting concepts and identify the gaps in knowledge. The study focuses on older hospitalized adults (>65 yrs.) receiving ward based early rehabilitation. The focus within this review is on study participants with cognitive impairment or dementia. The study targets at controlled trials independent of their randomization procedure reporting on an early functional rehabilitation during hospitalization. Trials that were conducted in different or mixed settings (e.g. inpatient and aftercare intervention) without a clear focus on hospital based rehabilitation were excluded. The study aim is to identify the presence of CI specific features for early rehabilitation including: CI/dementia assessment, sub-analysis of results according to cognitive status, sample description defined by cognitive impairment, program modules specific for geriatric patients CI.
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Tipton, Kelley, Brian F. Leas, Nikhil K. Mull, Shazia M. Siddique, S. Ryan Greysen, Meghan B. Lane-Fall, and Amy Y. Tsou. Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (AHRQ), September 2021. http://dx.doi.org/10.23970/ahrqepctb40.

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Background. Timely discharge of hospitalized patients can prevent patient harm, improve patient satisfaction and quality of life, and reduce costs. Numerous strategies have been tested to improve the efficiency and safety of patient recovery and discharge, but hospitals continue to face challenges. Purpose. This Technical Brief aimed to identify and synthesize current knowledge and emerging concepts regarding systematic strategies that hospitals and health systems can implement to reduce length of stay (LOS), with emphasis on medically complex or vulnerable patients at high risk for prolonged LOS due to clinical, social, or economic barriers to timely discharge. Methods. We conducted a structured search for published and unpublished studies and conducted interviews with Key Informants representing vulnerable patients, hospitals, health systems, and clinicians. The interviews provided guidance on our research protocol, search strategy, and analysis. Due to the large and diverse evidence base, we limited our evaluation to systematic reviews of interventions to decrease hospital LOS for patients at potentially higher risk for delayed discharge; primary research studies were not included, and searches were restricted to reviews published since 2010. We cataloged the characteristics of relevant interventions and assessed evidence of their effectiveness. Findings. Our searches yielded 4,364 potential studies. After screening, we included 19 systematic reviews reported in 20 articles. The reviews described eight strategies for reducing LOS: discharge planning; geriatric assessment or consultation; medication management; clinical pathways; inter- or multidisciplinary care; case management; hospitalist services; and telehealth. All reviews included adult patients, and two reviews also included children. Interventions were frequently designed for older (often frail) patients or patients with chronic illness. One review included pregnant women at high risk for premature delivery. No reviews focused on factors linking patient vulnerability with social determinants of health. The reviews reported few details about hospital setting, context, or resources associated with the interventions studied. Evidence for effectiveness of interventions was generally not robust and often inconsistent—for example, we identified six reviews of discharge planning; three found no effect on LOS, two found LOS decreased, and one reported an increase. Many reviews also reported patient readmission rates and mortality but with similarly inconsistent results. Conclusions. A broad range of strategies have been employed to reduce LOS, but rigorous systematic reviews have not consistently demonstrated effectiveness within medically complex, high-risk, and vulnerable populations. Health system leaders, researchers, and policymakers must collaborate to address these needs.
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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, July 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.

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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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