Dissertations / Theses on the topic 'Hospitalized elderly patients'
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Bainbridge, Samantha. "Experiences of hospitalized patients with dementia." Honors in the Major Thesis, University of Central Florida, 2012. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/657.
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People with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff. Results showed a limited body of literature that addressed hospital experiences of people with dementia and those of family and professional caregivers. Additionally, few studies addressing this topic have been conducted in the United States. The primary finding from this study is that better communication is needed between nursing staff, patients, and their family caregivers. Nurses should carry out detailed assessments of cognition and pain in all elderly patients, and strive to provide appropriate palliative and end-of-life care. Dementia- specific training for all staff members may help to promote a better understanding of patients with dementia. Lastly, further research into the experiences of hospitalized dementia patients is needed, with a focus on acute care settings within the United States.B.S.N.
Bachelors
Nursing
Nursing
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Dallas, Mary I. "Influence of mobility impairment on outcomes in elderly patients hospitalized for an acute ischemic stroke." NSUWorks, 2006. http://nsuworks.nova.edu/hpd_pt_stuetd/26.
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Vargas, Ma Guadalupe Ojeda. "Vivência de enfermeiros no cuidado do idoso moribundo hospitalizado -a perspectiva fenomenológica." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/22/22131/tde-07012008-114028/.
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As inquietações por estudar esta temática apreendendo quais significados atribuem os enfermeiros ao cuidar do paciente idoso, hospitalizado, em fase terminal, surgiu a partir de experiências pessoais. Minha inquietação aumentou com a prática profissional, notando que, o pessoal que atendia aos idosos, em fase terminal, em sua maioria, era auxiliar de enfermagem, sem nenhuma formação específca para este cuidado. Assim, ao surgir a oportunidade de ingressar no doutorado em enfermagem, emergiu, novamente, a inquietação que há muitos anos vinha se instalando: O quê significa para a enfermeira o cuidado do idoso, em seu encontro com a morte, no mundo hospitalar? Desta forma, a proposta foi possibilitar que suas experiências, manifestadas por meio do discurso verbal e não verbal, pudessem aproximar-me do mundo que elas habitam nos hospitais e saber quais significados atribuem a esta experiência para propor um novo pensar sobre este cuidado. Tratou-se de um estudo conduzido segundo uma abordagem qualitativa, pertinente às questões muito particulares de um objeto cuja natureza não pode ser quantificada. A investigação foi desenvolvida com enfermeiros que trabalham nos hospitais públicos, na cidade de Celaya, Guanajuato, pelo fato de atenderem à maioria da população idosa. A coleta de dados foi realizada por meio de 12 entrevistas, conduzidas segundo a abordagem fenomenológica, a partir de uma questão norteadora proposta aos enfermeiros. Durante a investigação, pude apreender que, para eles, a vivência do cuidado do paciente, enquanto profissionais de enfermagem, envolve vários aspectos como as especificidades da pessoa da qual se cuida, como suas características físicas, emocionais, sociais e espirituais. Foi descrito ainda como sendo o ato de ajudar o paciente a morrer. No entanto, muitas vezes, procuram realizá-lo de forma a protelar a morte, como um impulso para conservar a vida daquele que está morrendo. Esse cuidado é proporcionado em um mundo concreto - geralmente, o hospital - e é um desafio manifestado pelos enfermeiros de forma a permitir o respeito às decisões do paciente e de sua família. Da mesma forma, as políticas das instituições de saúde pública necessitam serem revistas para que o familiar possa permanecer próximo do idoso em fase terminal, pois é seu direito morrer em companhia dos seus, de forma a ter uma morte digna. Reconhece-se, cada vez mais, que este cuidado é uma especialidade de enfermagem que requer conhecimentos e capacidades profissionais específicos e uma determinada estrutura de carreira profissional.The restlessness for studying this theme, and learn about the meanings that nurses assign to caring for dying older patients, aroused from personal experiences. My restlessness increased with professional practice, and I noticed that the majority of the staff who cared for older, terminal patients were auxiliary nurses, with no specific training for this particular health care practice. Hence, when I ran across the opportunity to enter the nursing doctorate program, this restlessness, which had been present for many years, emerged once again: What does it mean, for nurses, to care for older individuals, as they face death, in the hospital environment? Therefore, the purpose was to permit that their experiences, reported both verbally and non-verbally, could bring me closer to the world they inhabit in the hospitals, and learn about the meanings that they assign to this experience. That way, I would be able to propose a new thought concerning this care. This study used a qualitative approach, pertinent to the very specific issues of an object whose nature cannot be quantified. The research was developed with nurses working in public hospitals in the city of Celaya, Guanajuato, because they care for the majority of the elderly population. Data collection occurred through 12 interviews, conducted according to the phenomenological approach, based on a guiding question directed to nurses. During the research, I learned that, for the nurses, the experience of caring for the patients involves various aspects like the specificities of the person being cared for, as well as his or her physical, emotional, social, and spiritual characteristics. Nurses also reported that their work was the act of helping the patient to die. However, nurses often seek to, through their work, postpone death, as an impulse to preserve the life of who is dying. This care is provided in a concrete world - usually the hospital - and nurses state that it is a challenge to respect patients\' and their family\'s decisions. Similarly, public health institution policies should be reviewed so as to permit relatives to stay close to terminal patients, since it is their right to die in the company of their loved ones, as a way of having a dignified death. It has been more and more recognized that his care is a nursing specialty that requires specific professional knowledge and skills, besides a particular professional career structure.
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Gauthier, Kelly J. "Length of Hospital Stay, Delirium and Discharge Status Outcomes Associated With Anticholinergic Drug Use in Elderly Hospitalized Dementia Patients." VCU Scholars Compass, 2006. http://hdl.handle.net/10156/1704.
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Andersson, Andreas. "Ett digitalt spel för inlagda patienter." Thesis, Malmö universitet, Fakulteten för teknik och samhälle (TS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-20417.
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Digitala spel har tidigare utvecklats för att på olika sätt stödja rehabilitering av patienter både fysiskt och psykiskt. För att lyckas med dessa spel krävs specifika element för att skapa en spelupplevelse. Dessutom krävs anpassning av det grafiska gränssnittet för att patienten ska ha möjlighet att använda spelet trots sina begränsningar. Dessa spel har dock haft fokus på specifika fall eller sjukdomar, exempelvis rehabilitering efter stroke. Problemet denna studie ämnar att lösa är det faktum att sjukhuspatienter får för lite motion. Då det blir vanligare att patienterna har egna rum blir de bekväma och isolerar sig, något som resulterar i minskad social interaktion. För att adressera detta problem utvecklade studien en spelprototyp för sjukhuspatienter. Studien genomförde åtta användartester som observerades och följdes upp med intervjuer för att utvärdera den slutgiltiga prototypen. Resultatet sammanställdes till en lista med riktlinjer för hur spel kan designas för att motivera patienter till rörelseVideo games is a proven solution to your website to support patients rehabilitation, both physically and mentally. A numbered I was a great of elements are required to create a successful game for the specific audience. The game needs a combination of components to create a game experience and customization to the graphical user interface to support the user's limitations. These games are usually created for a specific kind of rehabilitation, i.e rehabilitation for stroke patients. This paper aims to study the issue with hospitalized patients not getting enough exercise during their stay. Since more and more patients receive separate rooms they also get less social interaction due to isolation. The study will develop a digital game prototype for hospitalized patients with the aim to solve this problem. The study performed eight user tests for the final prototype. The tests consisted of observations followed by interviews. The test results were then compiled into a list with design guidelines about how to create a digital, motivational, exercise game for hospitalized patients.
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Alassaad, Anna. "Improving the Quality and Safety of Drug Use in Hospitalized Elderly : Assessing the Effects of Clinical Pharmacist Interventions and Identifying Patients at Risk of Drug-related Morbidity and Mortality." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-234488.
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Older people admitted to hospital are at high risk of rehospitalization and medication errors. We have demonstrated, in a randomized controlled trial, that a clinical pharmacist intervention reduces the incidence of revisits to hospital for patients aged 80 years or older admitted to an acute internal medicine ward. The aims of this thesis were to further study the effects of the intervention and to investigate possibilities of targeting the intervention by identifying predictors of treatment response or adverse health outcomes. The effect of the pharmacist intervention on the appropriateness of prescribing was assessed, by using three validated tools. This study showed that the quality of prescribing was improved for the patients in the intervention group but not for those in the control group. However, no association between the appropriateness of prescribing at discharge and revisits to hospital was observed. Subgroup analyses explored whether the clinical pharmacist intervention was equally effective in preventing emergency department visits in patients with few or many prescribed drugs and in those with different levels of inappropriate prescribing on admission. The intervention appeared to be most effective in patients taking fewer drugs, but the treatment effect was not altered by appropriateness of prescribing. The most relevant risk factors for rehospitalization and mortality were identified for the same study population, and a score for risk-estimation was constructed and internally validated (the 80+ score). Seven variables were selected. Impaired renal function, pulmonary disease, malignant disease, living in a nursing home, being prescribed an opioid and being prescribed a drug for peptic ulcer or gastroesophageal reflux disease were associated with an increased risk, while being prescribed an antidepressant drug (tricyclic antidepressants not included) was linked with a lower risk. These variables made up the components of the 80+ score. Pending external validation, this score has potential to aid identification of high-risk patients. The last study investigated the occurrence of prescription errors when patients with multi-dose dispensed (MDD) drugs were discharged from hospital. Twenty-five percent of the MDD orders contained at least one medication prescription error. Almost half of the errors were of moderate or major severity, with potential to cause increased health-care utilization.
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Miller, E. F. Ruth. "Targeted discharge planning of hospitalised elderly patients." Thesis, Queen's University Belfast, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.314100.
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Hunt, C. "The clinical and biochemical effects of vitamin C supplementation in acutely ill, hospitalised elderly patients." Thesis, Open University, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.384613.
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Al, Shemeili Saeed Khamis. "Exploring structures and processes of medicines management in elderly hospitalised patients in the United Arab Emirates." Thesis, Robert Gordon University, 2015. http://hdl.handle.net/10059/1370.
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Given the complexity of medicines use in elderly patients, structures and processes of medicines management are key to deriving best outcomes. This research was conducted in hospitals in the United Arab Emirates (UAE) and focused on the patient journey from admission to discharge. The overall aim was to explore the structures and processes of medicines management in elderly hospitalised patients in the UAE, conducted in three phases. Phase 1. Following a review of systematic reviews of aspects of medicines management (e.g. reconciliation), this phase focused on a specific, emerging tool (the Drug Burden Index (DBI)) relating to anticholinergic/sedative agents, which are problematic in the elderly. The aim was to critically appraise, synthesize and present evidence of DBI use. The review protocol was registered with the Joanna Briggs Institute and conducted according to best accepted practice. The key finding was the lack of evidence of DBI use prospectively to identify potentially inappropriate prescribing. Phase 2. Phase 2 employed a qualitative phenomenological design to explore health professionals’ views and experiences of medicines management. Semi-structured interviews were conducted with 27 professionals and analysed using Normalization Process Theory (NPT) and the Theoretical Domains Framework (TDF). Findings revealed little evidence of coherence, cognitive participation, collective action and reflexive monitoring (NPT). TDF domains dominant were: professional role, identity; beliefs about capabilities; beliefs about consequences; environmental context, resources; and knowledge. Phase 3. The Delphi technique in phase 3 aimed to determine consensus around medicines management using an expert panel of policy makers, educators and lead health professionals. Phase 1 and 2 findings were used in construction of validated statements. A high level of consensus (≥70% strongly agree/agree) was obtained for statements other than those for targeting medicines management (rather than all elderly admissions) and tasks linked to professions (rather than trained staff). Overall, this research has generated original findings focused on the entire inpatient hospital journey, particularly the need to more clearly define, refine and agree on healthcare structures and processes across the entire patient journey from admission to discharge. The use of the NPT and TDF has highlighted those individual practitioners and organisational issues which require consideration.
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Fadayevatan, Reza. "Inpatient hospital care for older people : relationship between comprehensive geriatric assessment (CGA), frailty and outcomes in eldery hospitalized patients." Thesis, University of Sheffield, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.443880.
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Myhrberg, Ulrica, and Ana Lundberg. "Närståendes delaktighet vid vård av äldre : -bemötande, tillgänglighet och information." Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-106898.
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Studies show that older is an increased proportion patients in hospital and that it is a patient group that can be difficult to communicate with because of older patients' often multiple disease picture. Relatives to the patient can be help for caregivers in the communication and the care of the patient. The aim with the study was to examine relative's experience of participation, meeting/support, accessibility and information on a geriatrics rehabilitation care unit. The study had a descriptive design and was designed as a questionnaire study. It was implemented on one geriatrics rehabilitation care unit on the countryside in central Sweden, belong to Uppsala University hospital. The number questionnaires that were distributed out were 49 and the reply frequency was 82 %. The result showed that most relatives in the study were satisfied with participation, meeting/ support, accessibility and information. The result showed also on a significance correlation between participation and meeting/ support, accessibility and information. The study did not reveal any difference between men and women concerning the experience of participation. Likewise, no correlation was revealed on between how long time the patient where in hospital and the experience of participation. Relatives experienced to have a relative good contact with the doctor, but a part stated however that they did not have any opinion about it. Our conclusion is that the concept to participation is meeting/ support, accessibility and information.
Studier visar att äldre är en ökande andel patienter i vården och att det är en patientgrupp somkan vara svår att kommunicera med på grund av äldre patienters ofta multipla sjukdomsbild. Närstående till patienten kan vara till hjälp för vårdgivaren i kommunikationen och vården av patienten. Syftet med studien var att undersöka närståendes självskattade upplevelse av delaktighet,bemötande, tillgänglighet och information på en geriatrisk rehabiliteringsavdelning. Studien hade en deskriptiv design och var utformad som en enkätstudie. Den genomfördes på en geriatrisk rehabiliteringsavdelning på landsbygden i centrala Sverige tillhörande Akademiska sjukhuset. Antalet enkäter som delades ut var 49 stycken och svarsfrekvensen var 82 %. Resultatet visade att de flesta närstående i studien var nöjda med delaktighet, bemötande, tillgänglighet och information. Resultatet visade även på en signifikans gällande samvariation mellan delaktighet och bemötande, tillgänglighet och information. Studien visade inte på någon signifikans gällande skillnaden mellan män och kvinnor avseende upplevelsen av delaktighet. Likaså påträffades ingen signifikans mellan hur lång tid patienten var inneliggande och den närståendes upplevelse av delaktighet. Närstående upplevde sig ha en relativt bra kontakt med ansvarig läkare men en stor del uppgav dock att de inte hade någon uppfattning. Vår slutsats är att nyckeln till delaktighet är bemötande, tillgänglighet och information.
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Lim, Yen Peng. "Malnutrition and clinical outcomes in elderly patients from a Singapore acute hospital." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/44143/1/Yen_Peng_Lim_Thesis.pdf.
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Older adults, especially those acutely ill, are vulnerable to developing malnutrition due to a range of risk factors. The high prevalence and extensive consequences of malnutrition in hospitalised older adults have been reported extensively. However, there are few well-designed longitudinal studies that report the independent relationship between malnutrition and clinical outcomes after adjustment for a wide range of covariates. Acutely ill older adults are exceptionally prone to nutritional decline during hospitalisation, but few reports have studied this change and impact on clinical outcomes. In the rapidly ageing Singapore population, all this evidence is lacking, and the characteristics associated with the risk of malnutrition are also not well-documented. Despite the evidence on malnutrition prevalence, it is often under-recognised and under-treated. It is therefore crucial that validated nutrition screening and assessment tools are used for early identification of malnutrition. Although many nutrition screening and assessment tools are available, there is no universally accepted method for defining malnutrition risk and nutritional status. Most existing tools have been validated amongst Caucasians using various approaches, but they are rarely reported in the Asian elderly and none has been validated in Singapore. Due to the multiethnicity, cultural, and language differences in Singapore older adults, the results from non-Asian validation studies may not be applicable. Therefore it is important to identify validated population and setting specific nutrition screening and assessment methods to accurately detect and diagnose malnutrition in Singapore. The aims of this study are therefore to: i) characterise hospitalised elderly in a Singapore acute hospital; ii) describe the extent and impact of admission malnutrition; iii) identify and evaluate suitable methods for nutritional screening and assessment; and iv) examine changes in nutritional status during admission and their impact on clinical outcomes. A total of 281 participants, with a mean (+SD) age of 81.3 (+7.6) years, were recruited from three geriatric wards in Tan Tock Seng Hospital over a period of eight months. They were predominantly Chinese (83%) and community-dwellers (97%). They were screened within 72 hours of admission by a single dietetic technician using four nutrition screening tools [Tan Tock Seng Hospital Nutrition Screening Tool (TTSH NST), Nutritional Risk Screening 2002 (NRS 2002), Mini Nutritional Assessment-Short Form (MNA-SF), and Short Nutritional Assessment Questionnaire (SNAQ©)] that were administered in no particular order. The total scores were not computed during the screening process so that the dietetic technician was blinded to the results of all the tools. Nutritional status was assessed by a single dietitian, who was blinded to the screening results, using four malnutrition assessment methods [Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), body mass index (BMI), and corrected arm muscle area (CAMA)]. The SGA rating was completed prior to computation of the total MNA score to minimise bias. Participants were reassessed for weight, arm anthropometry (mid-arm circumference, triceps skinfold thickness), and SGA rating at discharge from the ward. The nutritional assessment tools and indices were validated against clinical outcomes (length of stay (LOS) >11days, discharge to higher level care, 3-month readmission, 6-month mortality, and 6-month Modified Barthel Index) using multivariate logistic regression. The covariates included age, gender, race, dementia (defined using DSM IV criteria), depression (defined using a single question “Do you often feel sad or depressed?”), severity of illness (defined using a modified version of the Severity of Illness Index), comorbidities (defined using Charlson Comorbidity Index, number of prescribed drugs and admission functional status (measured using Modified Barthel Index; MBI). The nutrition screening tools were validated against the SGA, which was found to be the most appropriate nutritional assessment tool from this study (refer section 5.6) Prevalence of malnutrition on admission was 35% (defined by SGA), and it was significantly associated with characteristics such as swallowing impairment (malnourished vs well-nourished: 20% vs 5%), poor appetite (77% vs 24%), dementia (44% vs 28%), depression (34% vs 22%), and poor functional status (MBI 48.3+29.8 vs 65.1+25.4). The SGA had the highest completion rate (100%) and was predictive of the highest number of clinical outcomes: LOS >11days (OR 2.11, 95% CI [1.17- 3.83]), 3-month readmission (OR 1.90, 95% CI [1.05-3.42]) and 6-month mortality (OR 3.04, 95% CI [1.28-7.18]), independent of a comprehensive range of covariates including functional status, disease severity and cognitive function. SGA is therefore the most appropriate nutritional assessment tool for defining malnutrition. The TTSH NST was identified as the most suitable nutritional screening tool with the best diagnostic performance against the SGA (AUC 0.865, sensitivity 84%, specificity 79%). Overall, 44% of participants experienced weight loss during hospitalisation, and 27% had weight loss >1% per week over median LOS 9 days (range 2-50). Wellnourished (45%) and malnourished (43%) participants were equally prone to experiencing decline in nutritional status (defined by weight loss >1% per week). Those with reduced nutritional status were more likely to be discharged to higher level care (adjusted OR 2.46, 95% CI [1.27-4.70]). This study is the first to characterise malnourished hospitalised older adults in Singapore. It is also one of the very few studies to (a) evaluate the association of admission malnutrition with clinical outcomes in a multivariate model; (b) determine the change in their nutritional status during admission; and (c) evaluate the validity of nutritional screening and assessment tools amongst hospitalised older adults in an Asian population. Results clearly highlight that admission malnutrition and deterioration in nutritional status are prevalent and are associated with adverse clinical outcomes in hospitalised older adults. With older adults being vulnerable to risks and consequences of malnutrition, it is important that they are systematically screened so timely and appropriate intervention can be provided. The findings highlighted in this thesis provide an evidence base for, and confirm the validity of the current nutrition screening and assessment tools used among hospitalised older adults in Singapore. As the older adults may have developed malnutrition prior to hospital admission, or experienced clinically significant weight loss of >1% per week of hospitalisation, screening of the elderly should be initiated in the community and continuous nutritional monitoring should extend beyond hospitalisation.
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Archimbaud, Nicolas. "Vie quotidienne et soins des personnes âgées dépendantes en milieu hospitalier : une enquête filmique à l’hôpital Bretonneau (AP-HP, Paris 18ème)." Thesis, Paris 10, 2013. http://www.theses.fr/2013PA100169.
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La thèse porte sur le quotidien des personnes âgées soignées à l’hôpital gériatrique Bretonneau, établissement spécialisé de l’AP-HP situé dans le 18ème arrondissement de Paris. Elle a pour objet d’étudier certains modes de prise en charge de ces malades en perte d’autonomie dits « dépendants » ou « déments », en privilégiant les approches non médicamenteuses novatrices (art-thérapie, socio-esthétique, psychomotricité). L’enquête de terrain, effectuée entre 2008 et 2010, s’est appuyée sur la méthode du film d’exploration, faisant de la caméra le principal instrument de la recherche. Il en résulte trois films documentaires : Hôpital de Jour (117 min.), Court Séjour (67 min.) et Long Séjour (120 min.). Tout en éclairant par petites touches le fonctionnement général de l’institution, ces films décrivent la vie quotidienne de quelques malades et font des pensionnaires de Bretonneau les personnages centraux de la représentation cinématographique. Une partie écrite analyse les stratégies et les résultats de l’enquête de terrain. Elle met l’accent sur les enjeux éthiques soulevés par la présence de l’observateur-filmeur dans un milieu particulièrement sensible et auprès de sujets très vulnérables. Les analyses détaillées portent sur les trois fils conducteurs principaux de la description filmique : les configurations de l’espace et de l’environnement matériel, les techniques corporelles appliquées à la perte d’autonomie, les rituels d’interaction soignants-soignésThis thesis deals with the daily life of the elderly who are patients at the Bretonneau Geriatric hospital, in Paris 18th arrondissement. It studies how these dependent or mentally-ill elders are cared for, focusing on innovative drug-free therapies (art therapy, esthetic therapy, psychomotricity).The field survey took place between 2008 and 2010 and used the method of exploratory filming, making the camera the main tool for the research. Three documentary films were made : Day Hospital (117 min), Short Stay (67 min) and Long Stay (120 min). While shedding some light on the way the institution works, these documentaries show the everyday life of a few patients and make them the main characters of the films. The written part analyses the strategy and the results of the field survey. It stresses the ethical issues raised by the presence of the filmmaker-observer in a highly sensitive environment and with very vulnerable subjects. The detailed analyses deal with the three main themes of the films : configuration of space and of material environment, physical techniques helping with loss of autonomy, interaction rituals between caregivers and patients
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Jiann-HorngKuo and 郭建宏. "Comprehensive geriatric pharmaceutical care among hospitalized elderly patients." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/56460540464359807936.
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碩士國立成功大學
老年學研究所
103
Summary Using method of the comprehensive geriatric pharmaceutical care group (CGPC) as the research framework, this research aimed: to compare difference of medication problems among elderly patients that were either visited directly by pharmacists using comprehensive geriatric pharmaceutical assessment or not. Our study found that medication problems in elderly, including the geriatric syndrome and recommended to the geriatric medical team for the discussion and then applied it to patients. To reduce problems and risk of medication . Introduction Because of age-related physiological changes, decline in activities of daily living, multiple comorbid diseases with polypharmacy, as well as psychological conditions and lack support from family and society, medication prolems become more complex. When geriatric syndrome occurs, the consideration of medication use must be more serious. Methods From September to December 2014, patients aged ≧65 years hospitalized to geriatric ward and general medical ward of a medical center in southern Taiwan, were recruited. By dividing into the intervention group with comprehensive pharmaceutical care in geriatric ward and the control group with routine pharmaceutical care in the general medical ward, a total of 240 patients (120 each) with informed consents will be enrolled. The process of clinic visits included: (1) To record the admission medications and comprehensive geriatric assessment; (2) To clarify STOPP and START criteria assessment; (3) To collect pharmaceutical care problem; (4) To discuss with geriatric team members. Medication problems were compared between intervention group and control group, of which conditions and medications were reviewed on the computer system in hospital. Results Among 240 enrolled individuals, their mean age was 81.5 years , 48% were male. The reasons of hospitalization were fever, dyspnea and limb pain. The most common diagnoses of diseases were hypertension, chronic kidney disease and diabetes mellitus, with an average of 5.1 diagnoses per patient. Numbers of prescribed medications among comprehensive geriatric pharmaceutical care group (CGPC) and general pharmaceutical care group (GPC) were 1547 and 1412, with averages of 12.9±5.5 and 11.8±5.4 medications, respectively. A total of 75 and 28 among the CGPC and GPC groups, respectively. Among CGPC cases, 45 medication problems were found by clinic visit. Overall, the most common types of medication problems were unnecessary medication use, non-crushed medications, dosage adjustment for renal impairment, not recommended for renal impairement, medication related laboratory data to be followed up. The 45 CGPC medication problems found by clinic visit included general dosage adjustment, delirium assessment, limited clinical benefit, inappropriate use, questionable usage of medications, previous medications needed to be continued but not prescribed after admission. Medication education for patients were poor adherence to medication use and use of medications incorrect. By STOPP criteria, 36 CGPC cases and the 21 GPC cases had been prescribed 49 and 23 inappropriate medications, respectively. Overall, most common STOPP medications were calcium channel blockers in patients with chronic constipation, aspirin, clopidogrel, dipyridamole or warfarin in patients with concurrent bleeding disorder, benzodiazepines and first generation antihistamines in patients who are prone to falls. By START criteria, 15 CGPC cases and 23 GPC cases had 20 and 32 potential medications to be suggested to initiate. Conclusion Comprehensive geriatric pharmaceutical care might be used to evaluate a variety of potential medication problems among hospitalized elderly patients with multi-comorbidities. After further discussion with physicians, such problems and risk of medication use might be reduced among hospitalized elderly patients.
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Yu, Shail Jane, and 游秀珍. "Depression and correlative factors in hospitalized elderly medical patients." Thesis, 1995. http://ndltd.ncl.edu.tw/handle/92480349055185817504.
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Hui-TzuHuang and 黃惠子. "Functional Decline, Functional Trajectory and Death among Hospitalized Elderly Patients." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/96223471632642250775.
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博士國立成功大學
健康照護科學研究所
102
Functional decline is considered to be one of the major complications among hospitalized elderly. It leads to elderly loss of independence and self-esteem and resulting in decreased lifestyle and quality of life. The aim of this study was to examine predictors of functional decline and delineate the trajectories of functional status 3 months after discharge, and to explore predictors of death after discharge. A cohort study design and convenience sampling were used at a medical center in southern Taiwan. Hospitalized patients aged 65 and over were recruited in this study. Structure questionnaire included demographic information, Geriatric syndrome, Activities of Daily Living (ADL), Instrument Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), Geriatric depression Scale and Charlson Comorbidity Index. Functional trajectory, by ADL score, was collected at 4 time points: 2 weeks before admission, admission, discharge and 3 months after discharge. After exclusion of deaths and loss of contact, researchers collected a total of 273 older patients’ ADL information. The results showed that eighty-three (30.4%) patients had a functional decline 3 months after discharge. Logistic regression revealed that the number of falls one year before admission, instrumental ADL (IADL) score 2 weeks before admission, ADL score decline between pre-admission and admission, ADL score decline during hospitalization, ADL score decline between pre-admission and discharge, and comorbidities were significant predictors of ADL score decline 3 months after discharge. The ADL score decline between pre-admission and discharge was the mediator of functional decline 3 months after discharge. Functional trajectory as shown by ADL scores indicated that all older patients dropped steeply at admission and that two thirds were gradually restored 3 months after discharge. Total mortality rate was 12% (n = 37/308) after discharge. Predictors of mortality included body mass index, IADL score two weeks before admission, and comorbidities. Clinical nurses can integrate the findings of this study and apply Comprehensive Geriatric Assessment to tailor intervention during hospitalization to prevent older patient’s functional decline and early mortality after discharge.
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Fang-WenHu and 胡芳文. "Exploring inappropriate use of urinary catheters among hospitalized elderly patients." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/64776494791337246321.
Full textAbstract:
博士國立成功大學
健康照護科學研究所
103
Background: Urinary catheterization may lead to substantial complications and is often used in hospitals without an appropriate indication. Studies of factors and clinical outcomes associated with inappropriate use of urinary catheters in the elderly population are rare. Purpose: To explore the incidence, rationales, associated factors and clinical outcomes of inappropriate urinary catheter use in hospitalized elderly patients among three phases: initial urinary catheter placement, urinary catheter remaining, and urinary catheter re-insertion. Methods: A longitudinal study enrolling patients aged 65 years and older with urinary catheters placed within 24 hours of hospitalization was conducted. Criteria for urinary catheter use were developed to identify inappropriate catheter use. Characteristics of patients and catheter use, voiding function history, health conditions, care conditions related to catheter placement, conditions for urinary catheter re-insertion, and subjective perceptions of urinary catheter use were collected through reviewing medical records and by interviewing patients or their primary caregivers. Mortality, length of hospital stay, time to first removal of catheter, catheter remaining in place at discharge, catheter-associated urinary tract infections (CAUTIs), catheter-related complications, change of activities of daily living (ADLs), and new admission to nursing home after discharge determined as clinical outcomes. Results: The incidence of initial inappropriate placement of urinary catheters (IIPC) in hospitalized elderly patients was 38.3%. The rationale most often reported for IIPC was “convenience of care.” Factors associated with IIPC were, chronic constipation, a history of urinary tract infection, medical treatment diagnosis, cognitive impairment, depressive symptoms, independence in ADLs, insertion of catheter during evening and night shifts, and lack of nursing documentation of the rationale for catheterization. Patients with IIPC showed greater decline in ADLs. Among 321 patients, a total of 1958 urinary catheter-days were observed, 67% catheter-days were inappropriate. Inappropriate use of urinary catheters occurred mostly in females and surgical patients and was associated with IIPC and lack of medical documentation. “Convenience of care” was the most common rationale for inappropriate use. Increasing inappropriate catheter-days was a significant predictor of longer hospital stay, delayed time to removal of catheters, increased rate of urinary catheterization at discharge, development of CAUTIs and catheter-related complications, and a decline in ADLs. The incidence of catheter re-insertion was 20.6%, of which 49.5% of them were improperly re-inserted. Conclusions: Older patients are at greater risk of inappropriate use of urinary catheters. Inappropriate use may lead to substantial complications in older patients. The health care professions, patients and their caregivers do not pay attention to appropriate use of urinary catheters, which induces a vicious cycle of inappropriate catheter use. To eliminate inappropriate catheter use, formulating hospital-level clinical policies related to the use of urinary catheters is extremely important and should include concrete regulations for documentation and a specific education protocol for health care professionals, patients and their caregivers.
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Pei-WenChiang and 江佩紋. "Relationship Between Fall and Functional Decline among Hospitalized Elderly Patients." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/22494848569319708994.
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Wen-KuanChou and 周玟觀. "A preliminary study of comprehensive geriatric pharmaceutical care among hospitalized elderly patients." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/77453906984563660492.
Full textAbstract:
碩士國立成功大學
老年學研究所
102
The aim of the study is to establish the assessment protocol of comprehensive geriatric pharmaceutical care. We enrolled hospitalized patients aged ≥ 65 years in a geriatric ward from a medical center in Taiwan. The drug utilization evaluation was conducted using the assessment form of comprehensive geriatric pharmaceutical care. The following contents of the evaluation were included: 1) Reasonability of drug utilization; 2) Potential association between medications and geriatric syndrome; 3) Potentially inappropriate medications based on STOPP ＆ START criteria; 4) Patient education and feedback. The application of comprehensive geriatric pharmaceutical care identified 16 types of 135 medication problems, including dosage adjustment according to renal function in 22 (16.3%), medication-related abnormal laboratory data to be followed up in 20 (14.8%), potential association of geriatric syndrome and medications in 18 (13.3%) including crushing the non-crushed medication and delirium, questionable indication in 17(12.6%), non-adherence or incorrect in 12(8.9%), inadequate dosage in 11(8.2%) and limited benefit in 6(4.4%). During the hospital stay, 29 (48.3%) patients received ≥ one inappropriate medications by STOPP criteria and 14 (23.3%) patients needed to be added by START criteria, with a total of 58 medications detected by both criteria. The application of comprehensive geriatric pharmaceutical care might detect medication problems among the hospitalized elderly patients. Further study to clarify the effects of the suggestions by pharmacists for medication problems is needed.
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Chubenko, Nicholas. "Group intervention using reminiscence with elderly hospitalized patients awaiting personal care home placement." 1992. http://hdl.handle.net/1993/22533.
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Hui-NingTu and 杜彗寧. "Post-discharge medical utilization among hospitalized elderly patients receiving comprehensive geriatric pharmaceutical care." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/36249671471624034501.
Full textAbstract:
碩士國立成功大學
老年學研究所
103
SUMMARY The aim of this study is to evaluate effect of comprehensive geriatric pharmaceutical care on medical utilization 3 months after discharge among hospitalized elderly patients. We enrolled 135 hospitalized elderly patients aged ≧65 years in a geriatric ward as the intervention group and 135 in an internal medicine ward as the control group. After 3 months by discharged, we collect data from electronic medical review system to analyze patients’ medical utilization among 3 months after discharged. Results showed that the unplanned readmission rate and unplanned re-emergency rate are lower in the intervention group, lower number of medication, and the quality indicators showed a better outcome after intervention of comprehensive geriatric pharmaceutical care. The result of this prove the effectiveness of comprehensive pharmaceutical care among hospitalized elderly patients. INTRODUCTION People aged ≧ 65 years are the most rapidly growing age groups in Taiwan. Older adults suffer from multiple medical conditions, which require multiple medications for proper treatment. Previous studies showed pharmaceutical care among older adults could reduce readmission rate, re-emergency rate, mortality rate and medication numbers. In Taiwan, studies about geriatric pharmaceutical care focused only on satisfaction of pharmaceutical care but not on clinical indicators. Study showed comprehensive geriatric pharmaceutical care can detect more drug-related problems than usual pharmaceutical care. Our study is to investigate the impact on medical utilization among hospitalized elderly patients. MATERIALS AND METHODS From September 2014 to January 2015, hospitalized elderly patients in geriatric ward of a medical center in southern Taiwan were enrolled as intervention group, in which a model of comprehensive geriatric pharmaceutical care was initiated by study pharmacists. Information of medical utilization of all patients was reviewed from electronic medical record within 3 months after discharge. In the intervention group, study pharmacists interviewed patients and caregivers to obtain complete information of patients’ medication utilization based on comprehensive geriatric assessment. The drug-related problems would be discussed in geriatric interdisciplinary team. Meanwhile, elderly patients in internal medicine ward were selected as the controlled cases by matched age, gender and admission within ± 1 week of the patients in the intervention group. RESULTS A total of 270 patients were enrolled, with 135 each in both groups. Their mean ages were 81.50±8.31 in intervention group and 81.3±7.77 in the control group, 51.85% were female in both groups. The intervention and controlled groups did not differ regarding age, gender or comorbidity. Compared to the controlled group, the intervention group had a lower rate of unplanned readmission and re-emergency rate in the first month after discharged (0.16±0.37 v.s. 0.28±0.50, p=.002; 0.21±0.42 v.s.0.37±0.64, p=0.02). In the intervention group, number of medications after discharged is significant lower than that before admission(12.35±5.54 v.s. 9.05±3.59, p=0.04). Also, the quality indicators of pharmaceutical questionnaire showed improvement by comprehensive pharmaceutical care in the intervention group. CONCLUSION Comprehensive geriatric pharmaceutical care might reduce rates of unplanned readmission and unplanned re-emergency of .hospitalized elderly patients in the first month after discharged. A lower number of medications and better quality of pharmaceutical care can be anticipated.
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Mai, Chang Sheng, and 麥昌盛. "Examination of the association between licensed caregivers and the outcome of hospitalized elderly patients." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/78859974866339577357.
Full textAbstract:
碩士長庚大學
醫務管理學研究所
97
Objective: Caregivers play an important role in the health of elderly people with long–term care needs. The aim of this study is to examine how personal characteristics of caregivers and their knowledge and skills of care relate to health care outcome of elderly inpatients. Method: A pre-post survey research design was adopted to collect self-reported and objective data of 58 elderly inpatients and their caregivers in a local hospital of northern Taiwan. Structured questionnaires included EQ-5D by inpatients and the health knowledge scale and the Care Quality Scale for the caregivers. Objective data retrieved from medical records consisted of indicators related to nutrition, physiology conditions, and health function. Results: The health care outcome of inpatients was significantly influenced by the care frequency and skills of caregivers. The results of stepwise regression suggested that the care skills of caregivers significantly contributed to the outcomes of physiology conditions （β＝0.86, R2=0.74）and health function（β＝0.62, R2=0.46）. None of the factors related to caregivers was significantly related to inpatients’ health-related Quality of Life. Conclusion: The findings suggested that care frequency and skills performed by the caregivers significantly influence the health care outcome of hospitalized elderly, especially the indicators of physiology conditions. The results imply that caregivers are able to play important roles to improve the quality of care for the elderly in needs. A long-term care policy needs to establish by including the caregivers as an important human capital.
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Chun-YinYeh and 葉俊吟. "Experience of following the protocol of urinary catheter bundle care in hospitalized elderly patients." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/xa3679.
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PAN, CHUEN-HUA, and 潘春華. "The Investigation of Sleep Quality, Depression Tendencies and Related Factors for Hospitalized Elderly Patients." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/81139563425921556878.
Full textAbstract:
碩士中臺科技大學
護理系碩士班
104
The purpose of this study was to understand the relation and influential factors between sleep quality and depr ession tendency in hospitalized elderly patients. Structured questionnaire was used to collect demographic data,sleep quality and depression tendencies.Descriptive statistics, independent sample t test, one-way ANOVA, Scheffe method (scheffe) and Pearson product correlation analysis were used to verify the relationship between variables.The results could be used as basis to improve sleep quality and quality of life for the hospitalized elderly patients. Nonparametric test methods were used because the data were not normal distribution.The results showerd that the average age of participants was 75.2 years, the majority was men (63.2%). Nearly ninety percentage ( 87.7%) of participants lived with family, 63.2% of participants had chroric disease,and more than eighty percentage of participants could do independent functional activities. The main leisure activities were walking and watching TV. The indicators of sleep quality were sleep efficiency 71.8%，2.6 waking times during sleep , sleep latency 36.6 minutes, the average sleep quality score 10.23 ± 4.35, and over one half of participants self-rated poor sleep quality (PSQI> 5) (51.9%).,The average score of melancholy tendency index was 6.60 ± 3.37. The related factors of sleep quality were education, economic status, chronic diseases, and physical activity.Eeconomic conditions, chronic diseases, physical activity were the influential factors of depression tendencies.Sleep quality in elderly hospitalized patients was positively correlated with depression tendencies. the more depression tendencies, the worse sleep quality for the hospitalized elderly patients. The results can be a reference for improving the sleep quality and depression tendencies in the hospitalized elderly patients.
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Casalou, Sally Fox. "Informal social networks of hospitalized elderly oncology patients a research report submitted in partial fulfillment ... /." 1988. http://catalog.hathitrust.org/api/volumes/oclc/68788070.html.
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Kao, Li-Ting, and 高麗婷. "Hospital variations in the implementation of pulmonary rehabilitation for hospitalized elderly obstructive pulmonary disease patients." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/d659k8.
Full textAbstract:
碩士高雄醫學大學
高齡長期照護碩士學位學程
105
Background: Chronic obstructive pulmonary disease (COPD) is one of the major diseases in older adults. Pulmonary rehabilitation (PR) is one of internationally recommended therapeutic options for COPD patients. However, little is known about the efficacy of PR for hospitalized elderly (≧65 years old) patients with COPD in Taiwan, what hospital characteristics affect PR, or how these characteristics affect PR. Objective: To explore the efficacy of PR for these patients and differences in the efficacy of PR between hospitals. Method: The claims datasets were extracted from Taiwan’s National Health Insurance Research Database (NHIRD) between January 1, 2000, and December 31, 2012. This study reviewed the NHIRD records of hospitalized elderly patients with primary a diagnosis of COPD (ICD_9_CM codes 490~496, excluding 493) from 36 hospitals, and recorded the data of Details of Inpatient Orders (DO), Inpatient Expenditure by Admissions (DD), and Registry for contracted medical facilities (HOSB) to obtain information about PR. The information about Hospital excellent plan was obtained from National Health Insurance Administration Ministry of Health and Welfare (NHIA). Telephone interview provided the information about COPD guideline. Result: The total of 36 hospitals was selected in this study. The records of 3278 elderly COPD patients were reviewed, which showed that the total of PR was used by 787, estimated mean 21.86 ± 31.47. Of the overall PR rate that the weighted average 21.11, estimated mean 19.06 ± 23.74. Twelve of the 36 hospitals had higher-than-average PR implementation rate, and twenty four had a lower-than-average PR implementation rate. In the individual PR rate analysis, only the parameter of COPD guideline with PR was shown significant different (p＝.00, t/F= 9.80). In the overall PR rate analysis, all parameters were significantly different (p < .05). Between 2000 and 2008, the median was “Zero data” the mean was 9.75- 16.96, the interquartile range (IQR) was 2.78- 27.6, coefficient of variability (CV) was 1.54-2.69. Between 2009 and 2011, the median was 10.56-16.40, the mean was 19.50-22.89, IQR was 28.57-31.33, and CV was 1.22-1.27. Between 2011 and 20112, the median was 16.40 to 6.8, the mean was 22.89 to 19.57, the IQR was 31.33 to 27.60, and the CV was 1.27 to 1.42. Regression analysis showed that a significant number of hospitalized elderly COPD patients underwent PR: > 43% in northern Taiwan’s hospital, > 41% in hospitals with excellent plan, and more 3.33 times in hospitals with COPD_PR guideline (p < .05). Hospitalized patients received PR rate, less 82% in educational hospitals and less 52% in public hospitals (p < .00). Significance was set at α =.05 (two-sided). Conclusion: The PR implementation rate varied significantly between 2000 and 2012 for hospitalized elderly COPD patients in Taiwan. The varied based upon differences in hospital location, and upon whether a hospital used the “excellent plan” or the COPD_PR guideline. Teaching hospitals and public hospitals implemented PR less frequently than did non-teaching hospitals and non-public hospitals. The variability was smaller after 2008. Taiwan government health policy and recommendation were substantial interventions that stimulated the improvement of the PR implementation rate. Key words: Pulmonary rehabilitation, hospitalization, chronic obstructive pulmonary disease, elderly
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Hu, Chu-hsuan, and 胡竹瑄. "Locations of fracture, length of stay, mortality and related factors among hospitalized elderly fracture patients." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/31710136010799925638.
Full textAbstract:
碩士國防醫學院
公共衛生學研究所
87
Abstract The proportion of elderly people in our population is increasing. In addition to the threat of the chronic disease, injury is another major cause of death for elderly people. Elderly people are at high risk of fracture during the occurrence of injuries. Research article indicated that there are differences between the urban and the rural areas on the incidence of fracture. Since Taipei City and Hualien County are good representatives of urban and rural areas in Taiwan, the study was designed to compare between Taipei and Hualien on fracture locations, fracture types, length of stay and mortality among hospitalized fracture patients at age 65 or above. Data come from National Health Insurance Data base, covering 22 months from January 1996, to October 1997. The main findings are- 1. The percentages of fractures with external causes among were 47.1 in Taipei and 76 in Hualien. Among all external causes, the percentage of falls was higher in Taipei, whereas the percentage of motor vehicle accidents was higher in Hualien. 2. Hip fractures were the most frequently seen cases both in Taipei and Hualien. However, among all kinds of fractures the percentage of hip fractures was higher in Taipei, whereas the percentage of skull fracture was higher in Hualien. 3. Less than 8% of elderly fractures were compound fractures in both areas. Patients with compound fracture were mostly male, younger and injured by motor vehicle accidents. 4. Both in Taipei and Hualien mortality cases were counted for less than 2% among elderly fracture inpatients. Factors related to mortality of fracture inpatients identified from Taipei data were male, older age, skull fracture, hip fracture and compound fractures. There was no significant risk factor of fracture death identified from Hualien data. Keywords: elderly people、fracture、hospitalization
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KO, Wen-Wen, and 柯玟玟. "Assessment of the nutritional status of hospitalized elderly patients with modified Mini Nutritional Assessment (MNA)." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/64554533275916826218.
Full textAbstract:
碩士亞洲大學
長期照護研究所
97
Abstract Background: Malnutrition is common in the elderly, especially among those who are hospitalized. Elderly in-patients often have depressed appetite, reduced food intake and nutritional imbalance. These conditions increase disease risks and even mortality. Objective: The study was aimed to (a) assess the nutritional status of hospitalized elderly patients, and (b) to validate the predictive ability of two modified versions of the Mini Nutritional Assessment (MNA) in elderly hospitalized patients. Methods: The study employed purposive sampling and recruited 109 consecutive elderly (≥65y) new patients who were hospitalized during March 2009 in an area hospital in rural Central-Western Taiwan. At approximately 24 hours after their arrival subjects were interviewed for assessing their nutritional statuses with three versions of the MNA, the original, the modified Taiwan version 1 (T-1) and Taiwan version 2 (T-2). T-1 was the same as the original version in all aspects except the anthropometric questions (Questions F, Q & R) where population specific BMI, mid-arm circumference (MAC) and calf-circumference (CC) cut-points replaced the original cut-points whereas T-2 omitted the BMI question and redistributed its scores to MAC and CC questions and adopted incremental cut-points and scoring. All versions maintained the same total scores and rating system. Results were statistically analyzed with SPSS 12.0 Software Package. Friedman Test and Wilcoxon Signed-rank Test were used to determine the significance of differences among the results graded with the three versions. Multivariate linear regression analysis was applied to determine the variables associated with the nutritional status. The study protocol was approved by the hospital IRB and all patients or their legal guardians signed an informed written concent. Results: Among the 109 patients, only 91 had complete data and those were used for further analyses. The original MNA scale rated 43 (47.3%) patients malnourished, 36 (39.6%) at risk of malnutrition and only 12 (13.2%) normal; T-1 rated 38 (41.8%), 23 (25.3%) and 30 (33.0%), respectively; and T-2 rated 49 (53.8%), 29 (31.9%) and 13 (14.3%) normal. Analyses with Friedman Test and Wilcoxon Signed-rank Test indicated that result rated with the T-1 version was different from that rated with the original and the T-2 versions whereas no difference was detected between results rated with the original and T-2 versions. Conclusion: Results indicate that malnutrition is prevalent among elderly hospitalized patients and also suggest that for frail elderly hospitalized patients, T-2 which has increased MAC and CC weightings to replace BMI weighting in the scale may better reflect the nutritional risk status. Routine assessment and timely intervention is the key to improving the nutritional status of frail elderly. T-2 is a tool particularly suitable for assessing the nutritional status of these frail patients.
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SUN, PEI-CHEN, and 孫培真. "A Study on Survival of Elderly Hospitalized Out-of-hospital Cardiac Arrest Patients in Taiwan." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/ccpve4.
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碩士國防醫學院
公共衛生學研究所
106
About 20,000 sudden Out-Of-Hospital Cardiac Arrest (OHCA) occur in Taiwan each year. The incidence of adults began to rise after the age of 30, peaked between age 45 and 75, and the incidence increased with age. At present, Taiwan’s awareness of the survival of elderly patients with OHCA remains limited. The purpose of this study was to understand the survival of OHCA elderly inpatients. This study uses the "HOSB file" and "DD file" in the National Health Insurance Research Database. Screening for primary diagnoses of ventricular fibrillation "427.41", Ventricular flutter "427.42" and Cardiac arrest "427.5", and those older than 65 years old as OHCA elderly. SPSS 21.0 was used to analyze the patient characteristics, hospital characteristics, event characteristics, and in-hospital survival of elderly patients hospitalized for OHCA from 1997 to 2013. The multivariate Logistic Regression was used to correct possible interference factors (age, gender, comorbidity), and to calculate in-hospital mortality/survival ratio and survival odds ratio. The results of the study show that between 1997 and 2013, over age 65 in Taiwan were due to OHCA hospitalization. Totally 12564 people, 54.6% of men, the proportion of the age 80-84 group accounted for 22.5%. The proportion of elderly women living with OHCA was higher (41.1%) in hospital survival rate, and the proportion of hospital survival rate was higher in diagnose type (ventricular fibrillation)(76.5%), 65-69 years old had a higher survival rate (44.6%), and the ratio of hospital survival rate fell from 56.4% in 1997 to 25.8% in 2013. This study showed factors affecting the inpatient survival rate of cardiac arrest in the elderly, including gender, age, comorbidity, hospital hierarchy, district, urbanization degree, initial heart rhythm (diagnosis type), medical department, year. It is recommended that elder caregivers should pay attention to the above relevant risk factors to increase the hospitalization survival rate.
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Chen, Yu-Chen, and 陳榆臻. "A Study of Predicting the Likelihood of Falls in Hospitalized Elderly Patients Using Data Mining Classification Techniques." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/88073625473462960335.
Full textAbstract:
碩士元智大學
資訊管理學系
97
Reduce the risk of patient harm resulting from falls is a sub goal of the Joint Commission on Accreditation of Healthcare Organizations of 2007. So prevent the elderly from falling is one of the important public health issue of countries all over the world. The sub-project coordinated fall risk factors of past literature and collected 602 fall and non-fall admission data includes age, admission type, diagnosis, muscle power, admission and fall(discharge) fall risk assessment, Barthel indexs from researching hospital of north Taiwan. The research proposed to use data mining to construct inpatient fall risk forecast model and find significant patterns and prediction factors of fall and non-fall. In addition, the research according to different surgery first, and then look over that influences its surgery''s important dangerous factor. It can provide hospital to examine patients more efficiency. Finally, the accuracy rate of training data were up to 70% ,and validation date were also achieved 70%. Therefore, the model can achieve not just accuracy, but general.
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Chuang, Yi Fei, and 莊依菲. "The Congruence of End-Of-Life Decisions between the Hospitalized Elderly Patients and Their Primary Family Caregivers." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/u63nha.
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Su, Hsiao-Wen, and 蘇筱雯. "Effects of the Individual Characteristics, Mental Health Status, Quality of Life and Depression on Suicide Ideation among Hospitalized Elderly Patients in Hualien." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/56837987362522915160.
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碩士國立臺北護理健康大學
護理研究所
103
This cross-sectional correlational study used a part of data of the research project “Project for Improving Quality of Hospitalized Elderly Suicide Prevention” in 2012 for secondary data analysis. The original study recruited elderly patients from a certain regional teaching hospital in the eastern Taiwan as the research subjects. Moreover, in the present study obtained the consent from the original subjects (N=228) to use their data for secondary data analysis. This study mainly investigated the effects of individual characteristics, mental health status, depression emotion, and quality of life on suicidal ideation of elderly patients. This study collected data by the following instruments: mental health status (Brief Symptom Rating Scale [BSRS-5]), cognitive function status (Mini-Mental State Examination [MMSE]), quality of life (WHOQOL-BREF), suicidal ideation (Beck Scale for Suicide Ideation), and depression emotions (Geriatric Depression Scale short form). In addition, this study used SPSS 18/Windows to perform statistical analyses on data. For descriptive statistics, this study used mean, standard deviation, percentage, and median to analyze data. For inferential statistics, this study used independent sample t test, one-way ANOVA, Pearson product-moment correlation, and logistic regression analysis to test the important predictors of suicidal ideation. The research results showed that: (1) Of the total subjects, 89.5% reported depressive emotion, and 26.3% reported suicide ideation; (2) The different groups of economic status and marital status had a significant differences on the suicidal ideation；(3) Age, marital status, mental health status, and overall quality of life were negatively correlated with suicidal ideation; economic status, self-perceived health status, mental health status, and depression emotion were positively correlated with suicidal ideation; (4) A logistic regression analysis showed that those with poor mental health status (OR = 1.24, p=0.006), high level of depression emotional (OR=3.23, p=0.04), low level of quality of life (OR=0.96, p=0.03) had the highest risk of suicide ideation. This study revealed that BSRS-5 have a high correlation with suicide ideation in the elderly inpatients, independent from the depression factors. This study suggests that there is an independent relationship between physical health status and suicide behavior in the case of elderly inpatients. Therefore, the results of this study suggested that the health professionals caring for elderly patients who suffering from not only physical problems, must also pay attention to mental health problems, such as depression, suicide prevention and care.
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Hung, Yen-Hui, and 洪燕慧. "Compare 2% Chlorhexidine Alcohol With 10% Povidone-Iodine Alcohol for The Risk of Developing Phlebitis Among Hospitalized Elderly Patients With Peripheral Intravenous Catheter." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/62471701977472623779.
Full textAbstract:
碩士國立臺北護理健康大學
護理研究所
101
The purpose of this study was to compare 2% chlorhexidine alcohol with 10% povidone-iodine alcohol for the risk of developing phlebitis among hospitalized elderly patients with peripheral intravenous catheter. Participants (≥65 years) with peripheral intravenous catheter of this study were recruited from geriatric units at a Taipei medical center hospital by purposive sampling. Based on the admitting time, 64 patients were first assigned to the povidone-iodine group from September to November in 2012 and then 85 patients were assigned to the chlorhexidine-alcohol group from November 2012 to January 2013. Total of patients were 149. A Likert 6-point (0~5) scale of Visual Infusion Phlebitis(VIP) was used to assess the patients’ phlebitis conditions, Score 1 and 2 are considered phlebitis, The higher the score the more severe the patient had phlebitis. Score 2 and above, indicated the catheter must be removed. The data were collected three times a day by ward nurses during the patients with an intravenous catheter. The data was analyzed with SPSS 20.0 for windows, crosstabs, percentage, Kaplan-Meier curve, Chi square test, Log rank test and Cox regression analysis were used. The results showed that the risk of 39.7% developing phlebitis among chlorhexidine-alcohol group was lower than 59.6% of that among the povidone-iodine group (χ2 : 4.939, p = 0.026). After controlling sex, age, Charlson comorbidity index, the site of injection, intravenous infusion, with or without using antibiotics, and diabetes with Cox regression, the risk of developing phlebitis of chlorhexidine-alcohol group was 0.569 times compare with povidone-iodine group (p = 0.044). The peripheral intravenous catheters dwell time (87.5 hours) among the povidone-iodine group was 10.1 hours shorter than those (97.6 hours) in chlorhexidine-alcohol group (p = 0.127). Overall, this study shows using 2% chlorhexidine alcohol solution for skin preparation could effectively reduce the risk of phlebitis and prolong catheter dwell time for hospitalized elderly patients with peripheral intravenous catheter.
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Sandine, Julie A. "Kinetic forms of acute cognitive impairment measurement of variant behaviors in elderly hospitalized patients with acute cognitive impairment : a research project sumbitted in partial fulfillment ... for the degree of Master of Science (Gerontological Nursing) ... /." 1993. http://catalog.hathitrust.org/api/volumes/oclc/68797227.html.
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Boehne, Rebecca E. "Relationships among health and demographic characteristics, latitude of choice, and elderly hospitalized patient adjustment." Thesis, 1990. http://hdl.handle.net/1957/36994.
Full textAbstract:
Adaptation to role transitions can have various
outcomes. Health and demographic characteristics as well
as environmental control have been shown to affect the
transition to the role of patient. The acutely ill
elderly's adaptation to the role of hospitalized patient
has not been measured from the elderly patient's
perspective.
This study utilized a random sample of 176
hospitalized elderly medical-surgical patients and the
patients' registered nurses to examine the relationships
among demographic and health characteristics, latitude of
choice and elderly hospitalized patient adjustment.
Patients were excluded who had been in ICU for more than 24
hours, had decreased mental status, or were judged to be
too physically ill to participate.
The study used an adaptation of the Latitude of
Choice Scale (a measure of environmental control) developed
by Hulicka and colleagues, a nurse-rated hospitalized
patient adjustment scale developed by Cicirelli, and an
adaptation of the adjustment scale for patients' self-assessment.
Results from a series of multiple regression analyses
indicate that, taken as a group, neither demographic nor
health characteristics predict environmental control, as
measured by the adapted version of the Latitude of Choice
Scale (LOC). However, one individual health
characteristic, length of time since last hospitalization,
was a negative predictor of LOC. Further, the results
indicate that taken as a group, health and demographic
characteristics, along with patient LOC scores are not
predictive of either nurse or patient-rated adaptation.
The individual health characteristic "patient acuity
rating" did negatively predict both nurse and patient-rated
adjustment scores. Nurse-rated patient adjustment
scores were also negatively predicted by the participants'
prior number of hospitalizations. A paired-t test
indicated that patients rated themselves significantly
better adjusted than did their nurses. This finding was
judged to be clinically unimportant because of the small
real difference in the mean scores. Random-effects ANOVA
found no significant variance between nurses' ratings of
patients.Graduation date: 1991
36
Ahrens-Townsend, Judith Elizabeth. "The life satisfaction of the elderly hospitalized patient waiting to move to a nursing home." 1990. http://hdl.handle.net/1993/23187.
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Wang, Han Ting. "La fragilité comme prédicteur de la durée du séjour hospitalier après les chirurgies orthopédiques majeures électives chez les patients âgés." Thèse, 2017. http://hdl.handle.net/1866/20515.
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VRZALOVÁ, Monika. "Role sestry ve screeningu deprese u seniorů." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-260905.
Full textAbstract:
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.