Effects of proactive healthcare on pain, physical and activities of daily living functioning in vulnerable older adults with chronic pain: a pragmatic clinical trial with one- and two-year follow-up

Dong, Huan-Ji; Peolsson, Anneli; Johansson, Maria M.

doi:10.1007/s41999-024-00952-9

Cited by 3 publications

(1 citation statement)

References 41 publications

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“…Suggested changes to the current model of care for older persons with functional dependence are supported by the evidence observed in this study that there is room for improvement, there is no age limit for improvement, and this improvement influences long-term survival. Other studies also observe positive changes in long-term functional dependence through proactive actions in these persons ( 50 ).…”

Section: Discussionmentioning

confidence: 79%

The influence of nationwide COVID-19 lockdown on the functional impairment and long-term survival of dependent people for carrying out basic activities of daily living in a neighborhood of the city of Madrid, Spain: Orcasitas Cohort Longitudinal Study

Martín Moreno,

Martínez Sanz,

Fernández Gallardo

et al. 2024

Front. Public Health

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BackgroundProlonged confinement can lead to personal deterioration at various levels. We studied this phenomenon during the nationwide COVID-19 lockdown in a functionally dependent population of the Orcasitas neighborhood of Madrid, Spain, by measuring their ability to perform basic activities of daily living and their mortality rate.MethodsA total of 127 patients were included in the Orcasitas cohort. Of this cohort, 78.7% were female, 21.3% were male, and their mean age was 86 years. All participants had a Barthel index of ≤ 60. Changes from pre- to post-confinement and 3 years afterward were analyzed, and the effect of these changes on survival was assessed (2020–2023).ResultsThe post-confinement functional assessment showed significant improvement in independence over pre-confinement for both the Barthel score (t = −5.823; p < 0.001) and the classification level (z = −2.988; p < 0.003). This improvement progressively disappeared in the following 3 years, and 40.9% of the patients in this cohort died during this period. These outcomes were associated with the Barthel index (z = −3.646; p < 0.001) and the level of dependence (hazard ratio 2.227; CI 1.514–3.276). Higher mortality was observed among men (HR 1.745; CI 1.045–2.915) and those with severe dependence (HR 2.169; CI 1.469–3.201). Setting the cutoff point of the Barthel index at 40 provided the best detection of the risk of death associated with dependence.ConclusionsHome confinement and the risk of death due to the COVID-19 pandemic awakened a form of resilience in the face of adversity among the population of functionally dependent adults. The Barthel index is a good predictor of medium- and long-term mortality and is a useful method for detecting populations at risk in health planning. A cutoff score of 40 is useful for this purpose. To a certain extent, the non-institutionalized dependent population is an invisible population. Future studies should analyze the causes of the high mortality observed.

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Section: Discussionmentioning

confidence: 79%

The influence of nationwide COVID-19 lockdown on the functional impairment and long-term survival of dependent people for carrying out basic activities of daily living in a neighborhood of the city of Madrid, Spain: Orcasitas Cohort Longitudinal Study

Martín Moreno,

Martínez Sanz,

Fernández Gallardo

et al. 2024

Front. Public Health

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The perceptions of nurses and physicians in primary care of rehabilitation for frail older adults

Törnudd,

Peolsson,

Johansson

2024

Clin Rehabil

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Objectives To investigate the perceptions of primary care nurses and physicians of the potential contributions of physiotherapists (PTs) and occupational therapists (OTs) in the treatment of frail older persons, as well as the obstacles to, and opportunities for, collaboration. Design A qualitative study. Participants and setting Nurses (n = 9) and physicians (n = 8) in primary care in the county council [14 women (82%)] with experience working with older people. Method Interview study conducted with a semi-structured interview guide. Analyses were carried out with content analysis with an inductive approach. Results The analysis resulted in six categories: knowledge of physiotherapy and occupational therapy interventions; what triggers the need for physiotherapy and occupational therapy?; the availability of rehabilitation interventions; teamwork opportunities and difficulties; motivating the patient; the site of the rehabilitation. Conclusions Close and clear collaboration between nurses and physicians and PTs and OTs is an important factor in ensuring that rehabilitation interventions provide the greatest possible benefit to the patient. Improving communication between different healthcare providers and clarifying the contact routes is a prerequisite for patients to be able to get the rehabilitation they need. More research is needed to determine the best approach to achieving this goal.

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A Survey on Postgraduate Dental Students' Knowledge on Diagnostic Adjuncts for Oral Cancer

Güneri,

Bolukbasi,

Özer

et al. 2024

Preprint

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Background To assess the knowledge levels of postgraduate students in the departments of oral and maxillofacial radiology (OMFR) and oral surgery (OS) regarding diagnostic adjuncts for oral mucosal lesions. Methods Postgraduate students enrolled in OMFR and OS programs across dental faculties nationwide between 2019 and 2021 were included. A total of 434 participants were selected based on specific criteria. A 40-question questionnaire with items formulated by specialists with at least 15 years of experience covered basic information, principles/mechanisms, application techniques, and result interpretation. The survey was distributed online, and responses were collected anonymously. Statistical analysis was performed using SPSS 25.0, including descriptive statistics and significance testing. Results A total of 131 postgraduate students participated. Demographic characteristics of the participants were largely comparable. The questionnaire revealed that participants exhibited accurate responses to questions related to basic information and staining methods. However, questions related to optical methods received significantly more inaccurate responses, indicating a lack of knowledge in this area. No significant impact of age, gender, or postgraduate education program was observed on the accuracy of responses. Conclusions Despite a general awareness of basic information and staining methods for oral mucosal lesions, postgraduate students showed a notable lack of knowledge regarding optical diagnostic methods. Enhancements in theoretical curricula and hands-on clinical training are recommended to bridge this knowledge gap and improve diagnostic capabilities in detecting oral cancer. These findings highlight the need for continued education and training on diagnostic adjuncts for oral cancer among dental professionals.

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Effects of proactive healthcare on pain, physical and activities of daily living functioning in vulnerable older adults with chronic pain: a pragmatic clinical trial with one- and two-year follow-up

Cited by 3 publications

References 41 publications

The influence of nationwide COVID-19 lockdown on the functional impairment and long-term survival of dependent people for carrying out basic activities of daily living in a neighborhood of the city of Madrid, Spain: Orcasitas Cohort Longitudinal Study

The influence of nationwide COVID-19 lockdown on the functional impairment and long-term survival of dependent people for carrying out basic activities of daily living in a neighborhood of the city of Madrid, Spain: Orcasitas Cohort Longitudinal Study

The perceptions of nurses and physicians in primary care of rehabilitation for frail older adults

A Survey on Postgraduate Dental Students' Knowledge on Diagnostic Adjuncts for Oral Cancer

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