Background The prevalent rate of incontinence-associated dermatitis (IAD) trends upward in older populations. Skin breakdown from IAD impacts the quality of life of older adults and reflects the quality of care in hospitals and long-term care facilities. Specific and appropriate interventions for prevention and care are needed. This systematic review aims to review optimal strategies for prevention and care for older adults with IAD. Methods PubMed, CINAHL, SCOPUS, Medline, ProQuest, ThaiLIS, ThaiJo, and E-Thesis were searched for articles published between January 2010 and December 2020. Only articles focusing on older adults were included for the review. Results Eleven articles met the inclusion/exclusion criteria. Interventions for the prevention and care of IAD among older adults were categorized as assessment, incontinence management/causative factors management, cleansing, application of medical products for both skin moisturizing and skin barrier, body positioning, nutrition promotion, health education and training, and outcome evaluation. Specific prevention and care strategies for older adults with IAD included using specific assessment tools, applying skin cleansing pH from 4.0 to 6.8, body positioning, and promoting food with high protein. Other strategies were similar to those reported for adult patients. Conclusion The systematic review extracted current and specific prevention and care strategies for IAD in older adults. The prevention and care strategies from this systematic review should be applied in clinical practice. However, more rigorous research methodology is recommended in future studies, especially in examining intervention outcomes. Nurses and other health professionals should be educated and trained to understand the causes of IAD in older adults and the specific prevention and care strategies for this population. Because older adults are prone to skin damage, and this type of skin breakdown differs from pressure ulcers, the tools for assessment and evaluation, and the strategies for prevention and care require special attention. Prospero Registration Number CRD42021251711.
AimThe aim was to study medication use, effects of medication and perspective of participants involved in medication use among hospitalized older Buddhist monks.DesignAn embedded mixed‐method study.MethodsThis study included 71 hospitalized older Buddhist monks and 23 participants involved in medication use. Quantitative data were collected from medical and medication records. Meanwhile, qualitative data were collected by using in‐depth interviews. Data were analysed using descriptive statistics and content analysis. The study lasted from February to July 2021.ResultsOver 77% of the monks had chronic diseases. The median of medicine use was seven medicines/person and 6 days of use. Effects of the medication were as expected (52.04%), not as expected (2.22%) and unmeasurable results (45.74%). Unexpected results were hypo‐hyperglycaemia, nausea/vomiting, high blood pressure and confusion. From the interview, participants perceived and did not perceive unique practices and medication use in Buddhist monks. In addition, the Buddhist monks received medication following standards and Buddhist doctrine. Finally, recommendations for medication use were adhering to the standard, following Buddhist doctrine and being flexible as deemed necessary.ConclusionThe results revealed medication use problems and medication effects among hospitalized older Buddhist monks.ImpactOlder adults and Buddhist monks have specific needs and practices related to culture and religion, affecting typical treatment, especially medication use. Cultural diversity and sensitivity should be a concern for healthcare staff. The results can be utilized to promote an understanding of cultural diversity and increase the safety of medication administration for hospitalized older Buddhist monks.Patient and Public ContributionPatient and public contributions were involved in this study. Participants involved in medication use were interviewed to answer the research objective. Moreover, a senior Buddhist monk at Wat Thai Washington D.C. reviewed content related to the Pali Canon for the final draft of the manuscript.Clinical Trial Registration Number https://osf.io/b6p3e
Background: Postoperative cardiac surgery patients often experience appetite loss. Although nutritional status is known to be associated with time of recovery, functional status, and length of stay, less is known about factors related to patient’s loss of appetite after cardiac surgery. This review aimed to identify and understand factors related to loss of appetite in postoperative cardiac surgery patients, systematic review with narrative summary design was applied. Data sources including CINAHL, SCOPUS, PubMed, ProQuest, ScienceDirect, ThaiLIS, ThaiJo, and E-Thesis were searched without restriction on publication year through August 2020. Methods: We conducted the review following the Joanna Briggs Institute methodology, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist to categorize methodological quality and the PRISMA flow diagram to record the studies’ factors. Results: Six studies reported one or more of 16 factors related to loss of appetite: older age, sex (female), illiteracy, history of chronic disease, not knowing someone in health field, pain score ≥ 7, pain medications containing codeine, constipation, depression, heart-lung machine ≥ 120 minutes, preoperative serum creatinine levels ≥ 179 µmol/L, emergency surgery, perfusion pressure ≤ 40 mmHg, low cardiac output syndrome, mechanical ventilation ≥ 96 hours, and a New York Heart Association class III and IV. Conclusion: The small number of publications restrict our conclusions. Future research should focus on multiple factors related to appetite loss in postoperative cardiac surgery patients. Additional research will provide a foundation for evidence-based interventions to reduce appetite loss and improve patient nutritional status after cardiac surgery. Nurses and other health professionals should assess postoperative cardiac surgery patients for the presence of the 16 significant factors. To promote patients’ nutritional status, there should be evidence-based practice guidelines on the management of postoperative symptoms such as pain management, treatment of constipation, and reduction of emotional stress and depression.
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