Search results for "Older patient"
showing 10 items of 81 documents
Ethical challenges in care for older patients who resist help
2014
Background: Situations where patients resist necessary help can be professionally and ethically challenging for health professionals, and the risk of paternalism, abuse and coercion are present. Research question: The purpose of this study was to examine ethical challenges in situations where the patient resists healthcare. Research design: The method used was clinical application research. Academic staff and clinical co-researchers collaborated in a hermeneutical process to shed light on situations and create a basis for new action. Participants and research context: Four research groups were established. Each group consisted of six to eight clinical co-researchers, all employees with diff…
A successful way for performing nutritional nursing assessment in older patients
2008
Aim. The aim of this study was to obtain increased knowledge and understanding about what can be promoting and facilitating for nurses to perform nutritional nursing assessment in older patients. Background. The frequency of older patients at nutritional risk or suffering from undernutrition is high in hospitals. Studies have shown frequent lack of awareness about signs of undernutrition as all patients are, for example, not weighed. Nurses’ descriptions about nutritional problems have also been found to be often vague and unspecific. Design. A qualitative design was used. Methods. Ten conveniently chosen registered nurses, working with older patients in two hospitals in western Sweden …
Antihypertensive treatment changes and related clinical outcomes in older hospitalized patients
2023
Background: Hypertension management in older patients represents a challenge, particularly when hospitalized. Objective: The objective of this study is to investigate the determinants and related outcomes of antihypertensive drug prescription in a cohort of older hospitalized patients. Methods: A total of 5671 patients from REPOSI (a prospective multicentre observational register of older Italian in-patients from internal medicine or geriatric wards) were considered; 4377 (77.2%) were hypertensive. Minimum treatment (MT) for hypertension was defined according to the 2018 ESC guidelines [an angiotensin-converting-enzyme-inhibitor (ACE-I) or an angiotensin-receptor-blocker (ARB) with a calciu…
Exploring nursing competence to care for older patients in municipal in‐patient acute care: A qualitative study
2019
Aim To identify critical aspects of nursing competence to care for older patients in the context of municipal in-patient acute care. Background An increasingly complex and advanced primary healthcare system requires attention to the extent of nursing competence in municipal services. However, competence in complex and advanced care settings must be explored using perspectives which acknowledge the complexity of nurses' performance. Design A phenomenological hermeneutic, qualitative approach with individual in-depth interviews was used. COREQ reporting guidelines have been applied. Methods A sample of eight nurses and two physicians employed in municipal in-patient acute care units (MAUs) we…
Acute Coronary Syndrome in the Older Patient
2021
Coronary artery disease is one of the leading causes of morbidity and mortality, and its prevalence increases with age. The growing number of older patients and their differential characteristics make its management a challenge in clinical practice. The aim of this review is to summarize the state-of-the-art in diagnosis and treatment of acute coronary syndromes in this subgroup of patients. This comprises peculiarities of ST-segment elevation myocardial infarction (STEMI) management, updated evidence of non-STEMI therapeutic strategies, individualization of antiplatelet treatment (weighting ischemic and hemorrhagic risks), as well as assessment of geriatric conditions and ethical issues in…
Atrial fibrillation: a geriatric perspective on the 2020 ESC guidelines
2021
Key Summary Points Aim To provide a geriatric perspective on the 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio–Thoracic Surgery (EACTS). Findings While the large majority of AF patients in real life are older, frail and cognitively impaired, these are mostly excluded from clinical trials, and physicians’ attitudes often prevail over standardized algorithms. On the basis of existing evidence, we suggest that (1) opportunistic AF screening by pulse palpation or ECG rhythm strip is cost-effective, and (2) whereas advanced chronological age by itself is not a contraindication to AF treatment, a Comp…
Treatment guidelines of metastatic colorectal cancer in older patients from the French Society of Geriatric Oncology (SoFOG)
2020
International audience; Background: Several guidelines dedicated to metastatic colorectal cancer (mCRC) are available. Since 2013 no recent guidelines are specifically dedicated to older patients and based on a systematic review. Materials and methods: A multidisciplinary Task Force with digestive oncologists, geriatricians and methodologists from the SoFOG was formed in 2016 to update recommendations on medical treatment of mCRC based on a systematic review of publications from 2000 to 2018. Search strategy has followed a standardized protocol from the formulation of clinical questions and definition of a search algorithm to the selection of complete articles for recommendations. Results: …
Extraperitoneal ileal conduit
2011
Today incontinent urinary diversion continues to be the most widely used diversion technique. A current Medicare evaluation showed that 80% of patients undergoing urinary diversion in the USA are subject to reconstruction by means of an ileal conduit [1]. In particular, older patients, patients with comorbidities, and women more frequently receive an incontinent urinary diversion [2,3]. Even with improved perioperative clinicalcare pathways, urinary diversion remains a morbid procedure. Complications are still common after urinary diversion with ≈ 27% patients re-admitted in the first 90 days after BJUI
Effects of a Rehabilitation Program on Perceived Environmental Barriers in Older Patients Recovering from Hip Fracture: A Randomized Controlled Trial
2013
Objectives. To study effects of a one-year multicomponent intervention on perceived environmental barriers in hip fracture patients.Design. Randomized controlled trial of a 12-month home-based rehabilitation aiming to improve mobility and function (ISRCTN53680197); secondary analyses.Subjects. Community-dwelling hip fracture patients on average 70 days after trauma (n=81).Methods. Assessments at baseline, 3, 6, and 12 months later included perceived entrance-related barriers (e.g., indoor/outdoor stairs, lighting, floor surfaces, and storage for mobility devices) and perceived barriers in the outdoor environment (poor street condition, hilly terrain, long-distances, and lack of resting plac…
Perioperative care of the elderly oncology patient: A report from the SIOG task force on the perioperative care of older patients with cancer
2012
Abstract The increasing number of older cancer patients seen in daily practice demands reflection on how to optimize their care during the perioperative period. Optimally tailored surgical management, at present the most successful cancer treatment, firmly rests on an accurate and careful anesthesiological management. The unique peculiarities of anesthesia in older cancer patients prompted the International Society of Geriatric Oncology (SIOG) to put together a panel of international experts with the aim of reviewing the literature and drafting a consensus document. This article summarizes their views.