Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors
Background Older general hospital patients, particularly those with cognitive impairment, frequently experience adverse events and other care complications during their stay. As these findings have so far been based on small and selected patient samples, the aim of the present study was to provide r...
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| Veröffentlicht in: | Zeitschrift für Gerontologie und Geriatrie 2019-11, Vol.52 (Suppl 4), p.212-221 |
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| container_title | Zeitschrift für Gerontologie und Geriatrie |
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| creator | Hendlmeier, Ingrid Bickel, Horst Heßler-Kaufmann, Johannes Baltasar Schäufele, Martina |
| description | Background
Older general hospital patients, particularly those with cognitive impairment, frequently experience adverse events and other care complications during their stay. As these findings have so far been based on small and selected patient samples, the aim of the present study was to provide reliable data on a) the prevalence of adverse care issues (summarized under the term care challenges) in older general hospital patients and on b) associated patient-related risk factors (e.g. cognitive impairment).
Methods
A cross-sectional representative study comprising 1469 patients aged ≥65 years from 33 randomly selected general hospitals in southern Germany (GHoSt). Data collection included the use of different data sources, e.g. structured interviews with responsible nursing staff concerning care challenges and procedures for determining the patients’ cognitive status.
Results
Care challenges were statistically significantly (
p
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| doi_str_mv | 10.1007/s00391-019-01628-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6821661</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2307155784</sourcerecordid><originalsourceid>FETCH-LOGICAL-c353t-ca828b923a07963313eed2e7614335ba96152ac4e37a55ef9a7f38f7d739e2f73</originalsourceid><addsrcrecordid>eNp9kD9PwzAQxS0EoqXwBRhQRpaA7YvteEFCFf8kJBaYLTe5tKnSONgpKt8el5QKFoaTT7p3755_hJwzesUoVdeBUtAspUzHkjxPNwdkzDIQKeNSH5Ix1VmeSkWzETkJYUkpU0qyYzKCrVwyGBM-tR6TYmGbBts5hqRuE9eU6JM5tuhtkyxc6Oo-Np3ta2z7cEqOKtsEPNu9E_J2f_c6fUyfXx6eprfPaQEC-rSwOc9nmoOlSksABoglxxggAxAzqyUT3BYZgrJCYKWtqiCvVKlAI68UTMjN4NutZyssi3g75jGdr1fWfxpna_N30tYLM3cfRuacyfi7CbncGXj3vsbQm1UdCmwa26JbB8OBKiaEyrMo5YO08C4Ej9X-DKNmC9sMsE2Ebb5hm01cuvgdcL_yQzcKYBCEOIp0vVm6tW8jtP9svwAltIsV</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2307155784</pqid></control><display><type>article</type><title>Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Hendlmeier, Ingrid ; Bickel, Horst ; Heßler-Kaufmann, Johannes Baltasar ; Schäufele, Martina</creator><creatorcontrib>Hendlmeier, Ingrid ; Bickel, Horst ; Heßler-Kaufmann, Johannes Baltasar ; Schäufele, Martina</creatorcontrib><description>Background
Older general hospital patients, particularly those with cognitive impairment, frequently experience adverse events and other care complications during their stay. As these findings have so far been based on small and selected patient samples, the aim of the present study was to provide reliable data on a) the prevalence of adverse care issues (summarized under the term care challenges) in older general hospital patients and on b) associated patient-related risk factors (e.g. cognitive impairment).
Methods
A cross-sectional representative study comprising 1469 patients aged ≥65 years from 33 randomly selected general hospitals in southern Germany (GHoSt). Data collection included the use of different data sources, e.g. structured interviews with responsible nursing staff concerning care challenges and procedures for determining the patients’ cognitive status.
Results
Care challenges were statistically significantly (
p
< 0.001) more often reported for patients with dementia and/or delirium (87.5%) and mild cognitive impairment (47.9%) compared to cognitively unimpaired patients (24.6%). Adjusted odds ratios suggested cognitive impairment, impaired activities of daily living, receiving long-term care and unplanned admission as significant patient-related risk factors for care challenges. Furthermore, the occurrence of such issues was associated with the application of physical restraints, support from relatives, prescription of psycholeptics and specialist consultations.
Conclusion
The findings suggest a strong impact of different degrees of cognitive impairment on challenges in care. The results might help to design appropriate training programs for hospital staff and other interventions to prevent or reduce critical situations.</description><identifier>ISSN: 0948-6704</identifier><identifier>EISSN: 1435-1269</identifier><identifier>DOI: 10.1007/s00391-019-01628-x</identifier><identifier>PMID: 31628613</identifier><language>eng</language><publisher>Heidelberg: Springer Medizin</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; Aging ; Cognitive Dysfunction - epidemiology ; Cognitive Dysfunction - therapy ; Critical Care ; Cross-Sectional Studies ; Female ; Geriatrics/Gerontology ; Germany - epidemiology ; Health Services for the Aged - organization & administration ; Hospitals, General - statistics & numerical data ; Humans ; Internal Medicine ; Long-Term Care ; Male ; Medicine ; Medicine & Public Health ; Social Sciences ; Themenschwerpunkt</subject><ispartof>Zeitschrift für Gerontologie und Geriatrie, 2019-11, Vol.52 (Suppl 4), p.212-221</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c353t-ca828b923a07963313eed2e7614335ba96152ac4e37a55ef9a7f38f7d739e2f73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00391-019-01628-x$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00391-019-01628-x$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31628613$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hendlmeier, Ingrid</creatorcontrib><creatorcontrib>Bickel, Horst</creatorcontrib><creatorcontrib>Heßler-Kaufmann, Johannes Baltasar</creatorcontrib><creatorcontrib>Schäufele, Martina</creatorcontrib><title>Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors</title><title>Zeitschrift für Gerontologie und Geriatrie</title><addtitle>Z Gerontol Geriat</addtitle><addtitle>Z Gerontol Geriatr</addtitle><description>Background
Older general hospital patients, particularly those with cognitive impairment, frequently experience adverse events and other care complications during their stay. As these findings have so far been based on small and selected patient samples, the aim of the present study was to provide reliable data on a) the prevalence of adverse care issues (summarized under the term care challenges) in older general hospital patients and on b) associated patient-related risk factors (e.g. cognitive impairment).
Methods
A cross-sectional representative study comprising 1469 patients aged ≥65 years from 33 randomly selected general hospitals in southern Germany (GHoSt). Data collection included the use of different data sources, e.g. structured interviews with responsible nursing staff concerning care challenges and procedures for determining the patients’ cognitive status.
Results
Care challenges were statistically significantly (
p
< 0.001) more often reported for patients with dementia and/or delirium (87.5%) and mild cognitive impairment (47.9%) compared to cognitively unimpaired patients (24.6%). Adjusted odds ratios suggested cognitive impairment, impaired activities of daily living, receiving long-term care and unplanned admission as significant patient-related risk factors for care challenges. Furthermore, the occurrence of such issues was associated with the application of physical restraints, support from relatives, prescription of psycholeptics and specialist consultations.
Conclusion
The findings suggest a strong impact of different degrees of cognitive impairment on challenges in care. The results might help to design appropriate training programs for hospital staff and other interventions to prevent or reduce critical situations.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging</subject><subject>Cognitive Dysfunction - epidemiology</subject><subject>Cognitive Dysfunction - therapy</subject><subject>Critical Care</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Geriatrics/Gerontology</subject><subject>Germany - epidemiology</subject><subject>Health Services for the Aged - organization & administration</subject><subject>Hospitals, General - statistics & numerical data</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Long-Term Care</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Social Sciences</subject><subject>Themenschwerpunkt</subject><issn>0948-6704</issn><issn>1435-1269</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kD9PwzAQxS0EoqXwBRhQRpaA7YvteEFCFf8kJBaYLTe5tKnSONgpKt8el5QKFoaTT7p3755_hJwzesUoVdeBUtAspUzHkjxPNwdkzDIQKeNSH5Ix1VmeSkWzETkJYUkpU0qyYzKCrVwyGBM-tR6TYmGbBts5hqRuE9eU6JM5tuhtkyxc6Oo-Np3ta2z7cEqOKtsEPNu9E_J2f_c6fUyfXx6eprfPaQEC-rSwOc9nmoOlSksABoglxxggAxAzqyUT3BYZgrJCYKWtqiCvVKlAI68UTMjN4NutZyssi3g75jGdr1fWfxpna_N30tYLM3cfRuacyfi7CbncGXj3vsbQm1UdCmwa26JbB8OBKiaEyrMo5YO08C4Ej9X-DKNmC9sMsE2Ebb5hm01cuvgdcL_yQzcKYBCEOIp0vVm6tW8jtP9svwAltIsV</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Hendlmeier, Ingrid</creator><creator>Bickel, Horst</creator><creator>Heßler-Kaufmann, Johannes Baltasar</creator><creator>Schäufele, Martina</creator><general>Springer Medizin</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20191101</creationdate><title>Care challenges in older general hospital patients</title><author>Hendlmeier, Ingrid ; Bickel, Horst ; Heßler-Kaufmann, Johannes Baltasar ; Schäufele, Martina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-ca828b923a07963313eed2e7614335ba96152ac4e37a55ef9a7f38f7d739e2f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging</topic><topic>Cognitive Dysfunction - epidemiology</topic><topic>Cognitive Dysfunction - therapy</topic><topic>Critical Care</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Geriatrics/Gerontology</topic><topic>Germany - epidemiology</topic><topic>Health Services for the Aged - organization & administration</topic><topic>Hospitals, General - statistics & numerical data</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Long-Term Care</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Social Sciences</topic><topic>Themenschwerpunkt</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hendlmeier, Ingrid</creatorcontrib><creatorcontrib>Bickel, Horst</creatorcontrib><creatorcontrib>Heßler-Kaufmann, Johannes Baltasar</creatorcontrib><creatorcontrib>Schäufele, Martina</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Zeitschrift für Gerontologie und Geriatrie</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hendlmeier, Ingrid</au><au>Bickel, Horst</au><au>Heßler-Kaufmann, Johannes Baltasar</au><au>Schäufele, Martina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors</atitle><jtitle>Zeitschrift für Gerontologie und Geriatrie</jtitle><stitle>Z Gerontol Geriat</stitle><addtitle>Z Gerontol Geriatr</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>52</volume><issue>Suppl 4</issue><spage>212</spage><epage>221</epage><pages>212-221</pages><issn>0948-6704</issn><eissn>1435-1269</eissn><abstract>Background
Older general hospital patients, particularly those with cognitive impairment, frequently experience adverse events and other care complications during their stay. As these findings have so far been based on small and selected patient samples, the aim of the present study was to provide reliable data on a) the prevalence of adverse care issues (summarized under the term care challenges) in older general hospital patients and on b) associated patient-related risk factors (e.g. cognitive impairment).
Methods
A cross-sectional representative study comprising 1469 patients aged ≥65 years from 33 randomly selected general hospitals in southern Germany (GHoSt). Data collection included the use of different data sources, e.g. structured interviews with responsible nursing staff concerning care challenges and procedures for determining the patients’ cognitive status.
Results
Care challenges were statistically significantly (
p
< 0.001) more often reported for patients with dementia and/or delirium (87.5%) and mild cognitive impairment (47.9%) compared to cognitively unimpaired patients (24.6%). Adjusted odds ratios suggested cognitive impairment, impaired activities of daily living, receiving long-term care and unplanned admission as significant patient-related risk factors for care challenges. Furthermore, the occurrence of such issues was associated with the application of physical restraints, support from relatives, prescription of psycholeptics and specialist consultations.
Conclusion
The findings suggest a strong impact of different degrees of cognitive impairment on challenges in care. The results might help to design appropriate training programs for hospital staff and other interventions to prevent or reduce critical situations.</abstract><cop>Heidelberg</cop><pub>Springer Medizin</pub><pmid>31628613</pmid><doi>10.1007/s00391-019-01628-x</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Activities of Daily Living Aged Aged, 80 and over Aging Cognitive Dysfunction - epidemiology Cognitive Dysfunction - therapy Critical Care Cross-Sectional Studies Female Geriatrics/Gerontology Germany - epidemiology Health Services for the Aged - organization & administration Hospitals, General - statistics & numerical data Humans Internal Medicine Long-Term Care Male Medicine Medicine & Public Health Social Sciences Themenschwerpunkt |
| title | Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors |
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