Informed citizen and empowered citizen in health: results from an European survey

Background: The knowledge about the relationship between health-related activities on the Internet (i.e. informed citizens) and individuals? control over their own experiences of health or illness (i.e. empowered citizens) is valuable but scarce. In this paper, we investigate the correlation between four ways of using the Internet for information on health or illness and citizens attitudes and behaviours toward health professionals and health systems and establish the profile of empowered eHealth citizens in Europe. Methods: Data was collected during April and May 2007 (N = 7022), through computer-assisted telephone interviews (CATI). Respondents from Denmark, Germany, Greece, Latvia, Norway, Poland and Portugal participated in the survey. The profiles were generated using logistic regressions and are based on: a) socio-demographic and health information, b) the level of use of health-related online services, c) the level of use of the Internet to get health information to decide whether to consult a health professional, prepare for a medical appointment and assess its outcome, and d) the impact of online health information on citizens? attitudes and behavior towards health professionals and health systems. Results: Citizens using the Internet to decide whether to consult a health professional or to get a second opinion are likely to be frequent visitors of health sites, active participants of online health forums and recurrent buyers of medicines and other health related products online, while only infrequent epatients, visiting doctors they have never met face-to-face. Participation in online health communities seems to be related with more inquisitive and autonomous patients. Conclusions: The profiles of empowered eHealth citizens in Europe are situational and country dependent. The number of Europeans using the Internet to get health information to help them deal with a consultation is raising and having access to online health information seems to be associated with growing number of inquisitive and self-reliant patients. Doctors are increasingly likely to experience consultations with knowledgeable and empowered patients, who will challenge them in various ways

Stakeholders' views and experiences of care and interventions for addressing frailty and pre-frailty: A meta-synthesis of qualitative evidence

Frailty is a common condition in older age and is a public health concern which requires integrated care and involves different stakeholders. This meta-synthesis focuses on experiences, understanding, and attitudes towards screening, care, intervention and prevention for frailty across frail and healthy older persons, caregivers, health and social care practitioners. Studies published since 2001 were identified through search of electronic databases; 81 eligible papers were identified and read in full, and 45 papers were finally included and synthesized. The synthesis was conducted with a meta-ethnographic approach. We identified four key themes: Uncertainty about malleability of frailty; Strategies to prevent or to respond to frailty; Capacity to care and person and family-centred service provision; Power and choice. A bottom-up approach which emphasises and works in synchrony with frail older people's and their families' values, goals, resources and optimisation strategies is necessary. A greater employment of psychological skills, enhancing communication abilities and tools to overcome disempowering attitudes should inform care organisation, resulting in more efficient and satisfactory use of services. Public health communication about prevention and management of frailty should be founded on a paradigm of resilience, balanced acceptance, and coping. Addressing stakeholders' views about the preventability of frailty was seen as a salient need

Correction:Stakeholders' views and experiences of care and interventions for addressing frailty and pre-frailty: A meta-synthesis of qualitative evidence

[This corrects the article DOI: 10.1371/journal.pone.0180127.]

Comprehensive Geriatric Assessment VS . medical care for an elderly person

Prognozy demograficzne wskazują, że najszybciej rosnącą grupą wiekową pacjentów na świecie są osoby powyżej 65. roku życia. Szacuje się, że ich odsetek w 2050 r. osiągnie ok. 31,3% populacji Polski. Oznacza to, że ludzie w wieku podeszłym będą dominować wśród pacjentów zgłaszających się do lekarzy wszystkich specjalności. Opieka medyczna w okresie starości powinna być ukierunkowana na indywidualne potrzeby pacjenta. Prawidłowe zdiagnozowanie objawów, określenie potrzeb zdrowotnych seniora we wszystkich wymiarach determinuje dalsze postępowanie medyczne. Narzędziem ułatwiającym to zadanie jest całościowa ocena geriatryczna (COG). To wielodyscyplinarne narzędzie, a zarazem złożony proces diagnostyczny, składający się z szeregu skal, którego celem jest określenie zakresu zaburzeń zdrowia seniora, jego zdolności do samodzielnego funkcjonowania, potrzeb i problemów na płaszczyźnie fizycznej, psychicznej, socjoekonomicznej oraz środowiskowej. Główne skale znajdujące zastosowanie w COG to: ADL, IADL, Barthel i inne służące do oceny stanu funkcjonalnego seniora. W ramach COG ocenia się także stan psychiczny chorego, stosując skalę MMSE , skrócony test sprawności umysłowej Hodgkinsona, test rysowania zegara, skalę Yesavage’a i inne. Z kolei ocena socjalno-środowiskowa ma na celu zdefiniowanie potrzeb osoby w wieku podeszłym w zakresie opieki doraźnej oraz długoterminowej.Demographic projections show that the fastest growing age group of patients in the world are people over 65 years of age. For instance, it is estimated that in 2050 their share will reach approximately 31.3% of the Polish population. This means that the elderly will certainly dominate among patients visiting doctors of all specializations. Health care at old age should be focused on individual needs of the patient. A right diagnosis of symptoms, identifying the health needs of seniors in all dimensions, determines application of further medical procedures. A tool that facilitates this task is Comprehensive Geriatric Assessment (CGAGA). CGAGA is a multidisciplinary tool and also a complex diagnostic process, consisting of a series of scales, the aim of which is to determine the scope of seniors’ health disorders, their ability to operate independently, their needs and problems encountered in the physical, psychological, socio-economic and environmental spheres. The main scales which apply in the CGAGA are: ADL, IADL, Barthel and others which serve to assess the functional capacity of the senior. As part of the CGAGA one can also evaluate the psychological state, using MMSE , Hodgkinson test, CDT, scale of Yesavage and others. In turn, the social-environmental assessment is meant to define the needs of elderly patients, which are connected with emergency interventions and long-term care.Natalia Pta