In light of the increasing life expectancy of Europe's population and the rising significance of active and healthy ageing relating thereto, an integrated approach of nutritional care within primary health care is gaining importance. The aim of the review was to summarize evidence on the effectiveness of nutritional interventions in primary health care. The scoping review is based upon a comprehensive literature search of relevant literature published between January 2010 and August 2021 in PubMed, CINAHL, Cochrane Database of Systematic Reviews, Embase and Medline databases. Overall, 15 studies were included for evidence synthesis and interventions were basically clustered according to their type, into 1) eHealth and tele-medical interventions; 2) targeted single interventions; and 3) comprehensive, multi-faceted interventions. The review presents diverging evidence regarding the efficacy and effectiveness of interventions for nutritional care in primary health care, however, demonstrates encouraging outcomes. eHealth and tele-medical interventions partly show a careful positive tendency. Likewise, manifold single interventions on patient level present significant improvements in patient health outcomes. Multifaceted and comprehensive interventions found in the literature also partly demonstrate significant changes in intervention groups. Primary health care represents a critical setting for the care of older citizens and patients with complex health needs. This scoping review provides an overview of current nutrition care practices in primary health care and results reinforce the need to strengthen implementation of multi-faceted interventions carried out by the inter-disciplinary primary care team for advanced nutritional care.
BackgroundIrritable bowel syndrome (IBS) is a common multifactorial condition that affects the large intestine and is characterized by chronic and relapsing abdominal pain and altered bowel habit. IBS is due to a combination of genetic, environmental and dietary factors. It's usually a lifelong problem very frustrating to live with and can have a big impact on quality of life, as single-agent therapy ra.ObjectiveTo analyze the approaches and solutions that address the social and health unmet needs of patients with IBS.DesignA quantitative-qualitative approach was adopted in the current study to identify and specify key digital solution and high impact user scenarios applied to IBS patients, through an adaptation of the “Blueprint on Digital Transformation in Health and Care in an Ageing Society” persona methodology.SettingsDigital health solutions bring the potential of supporting health interventions through mobile apps, wearable devices, telemedicine.PatientsA Survey was administered to a group of patients in an anonymous form, and no need for Medical Ethical Committee approval was identified.InterventionsThe theoretical elaboration IBS personas was developed through an interdisciplinary Focus Group, which also mapped the pathway for the patient's management.Main outcomeThree main needs were identified to be met to improve IBS patient's lifestyle: access to psychological support, mHealth solutions supporting diet and adapted physical activity, and home-based digital health support. mHealth intervention has been identified for diet adherence, physical exercise and psychological well-being. The process has been mapped and adapted to integrate the new solutions into the care pathway.LimitationFurther research is needed to evaluate how mHealth services enable IBS patients to manage their conditions and improve their quality of life.ConclusionThe person-centered approach was implemented through a multidisciplinary Focus group that enabled the identification of the need for a mHealth intervention.
People in need of care, chronic or acute, often present problematic food intake and special nutritional needs. Integrated, person-centred and pro-active food and nutritional care delivery has been proven effective for people in health care. However, skills mismatches have been reported in different professions involved, which also applies to the role of chefs in healthcare. The EU funded project NECTAR aims at closing this gap by creating a new job profile, called Chef Gastro-Engineering (CGE). The current publication summarizes the status quo in hospitals and gives a perspective on the future role of chefs in integrated healthcare delivery.
Introduction: As the world population ages, health and social care professionals are increasingly confronted with patients with chronic long-term conditions and multimorbidity, requiring an extensive assessment and integrated care management strategy. The aim of this paper was to systematically collect and assess evidence of interprofessional education and training strategies for Comprehensive Geriatric Assessment (CGA) to build a competent health workforce. Methods: A systematic review was conducted according to PRISMA guidelines and the databases Medline, CINAHL, Cochrane and Embase were searched for studies illustrating effectiveness of educational interventions for teaching and training CGA in an interprofessional context. Results: Based on 21 identified studies, a great variability and heterogeneity in duration, setting and design of the interventions was identified. Promising results were found in the domains analysed, ranging from knowledge and skills; practices and behaviour; patient health outcomes; attitudes and perceptions to collaboration and quality of care. Discussion: Education and training of transversal skills within a continuous learning approach is key to equip the health care workforce for successful CGA performance in an interprofessional environment. Conclusion: Further research in this field is recommended to strengthen the evidence-base towards development of a resilient and integrated health care workforce for an ageing population. KURZFASSUNG Hintergrund: Aufgrund der zunehmenden Alterung der Weltbevölkerung sehen sich Fachkräfte des Gesundheits- und Sozialwesens immer häufiger mit Patient*innen mit chronischen Erkrankungen (bzw. Langzeiterkrankungen) und Multimorbidität, welche eine umfassende Beurteilung und eine integrierte Versorgungsmanagementstrategie erfordern, konfrontiert. Ziel der vorliegenden Arbeit war es, systematisch Evidenz für interprofessionelle Aus- und Weiterbildungsstrategien für ein Comprehensive Geriatric Assessment (CGA) zu sammeln und zu bewerten, um Kompetenz im Gesundheits- und Sozialwesen zu generieren. Methodik: Es wurde eine systematische Übersichtsarbeit gemäß den PRISMA-Richtlinien durchgeführt und die Datenbanken Medline, CINAHL, Cochrane und Embase im Zuge dessen nach Studien durchsucht, welche die Wirksamkeit von Bildungsmaßnahmen zur Vermittlung und Ausbildung von CGA in einem interprofessionellen Kontext belegen. Ergebnisse: Basierend auf 21 identifizierten Studien wurde eine große Variabilität und Heterogenität in Bezug auf Dauer, Setting und Design der Interventionen festgestellt. Vielversprechende Ergebnisse wurden in den analysierten Bereichen gefunden, welche von Wissen und Fähigkeiten, Praktiken und Verhalten, gesundheitlichen Ergebnissen für Patient*innen, Einstellungen und Wahrnehmungen bis hin zu Zusammenarbeit und Qualität der Versorgung reichen. Diskussion: Die Aus- und Weiterbildung von transversalen Fähigkeiten im Rahmen eines kontinuierlichen Lernansatzes ist der Schlüssel dazu, Angehörige der Gesundheits- und Sozialprofessionen mit entsprechendem Werkzeug auszustatten, um geriatrische Assessments (CGA) erfolgreich im interprofessionellen Umfeld durchführen zu können. Schlussfolgerung: Es besteht der Bedarf für weitere Forschungsvorhaben in diesem Bereich, um die Evidenzbasis für die Entwicklung eines zuverlässigen, integrierten Gesundheitspersonals für eine alternde Bevölkerung zu stärken. Schlüsselwörter: Integrierte Versorgung; Comprehensive Geriatric Assessment; Ausund Weiterbildung; interprofessionelle Bildung; Alterung
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