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

Designing motivating interactive balance and walking training for stroke survivors

In the ActivAbles and STARR projects we are developing interactive training tools for stroke survivors. Our initial user studies pointed to balance being a key ability, therefore one of the developed tools is an interactive balance pad. Equipment exists for persons with good balance (eg. Wii), but most consumer games and exercises are less suited for many stroke survivors. The development process has been done in close collaboration with stroke survivors, and we have currently a prototype system that has been tested by 10 stroke survivors for a longer period in the home during a feasibility study. The system includes an interactive balance foam pad, feedback lamps and a step counting game app which all connect to a central server. The feedback is designed to be inclusive - designs are multimodal (visual and auditory), and the setup is flexible and can easily be adapted. In this paper we report and discuss the design of the system, pilot test results and the results from a feasibility study in the home

Fragilidade no idoso: o que vem sendo produzido pela enfermagem Fragilidad en el anciano: lo que se produce por la enfermería Fragility in the elderly: what has being produced by nursing

Este trabalho visa identificar a produção científica desenvolvida pela enfermagem frente à fragilidade no idoso, a partir de uma revisão integrativa da literatura, realizada nas bases Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scopus. Foram incluídos no estudo 16 artigos, sendo dois publicados em periódicos brasileiros e 14 em periódicos estrangeiros. Constata-se que, dos artigos analisados, 37,5% (6) enfocam a mudança de paradigma quanto ao modelo assistencial e 26,7% (4) destacam a família como cuidadora no contexto do idoso frágil. Pontua-se que o enfermeiro desempenha um papel impar no contexto da fragilidade, no desenvolvimento do cuidado individual e no suporte aos familiares e aos cuidadores dos idosos frágeis.<br>Este trabajo tiene como objetivo identificar la producción científica desarrollada por la enfermería para hacer frente a la fragilidad en los ancianos a partir de una revisión integradora de la literatura, realizado en las bases Scientific Electronic Library Online (SciELO), Literatura Latino-Americana y Caribe em Ciências da Saúde (LILACS) y Scopus. El estudio incluyó 16 artículos, dos publicados en revistas brasileiras y 14 en revistas extranjeras. Se constata que, en los artículos analizados, el 37,5% (6) se centran en cambiar el paradigma del modelo de asistencia y el 26,7% (4) destacan la familia como cuidadora en el contexto de los ancianos frágiles. El enfermero desempeña un papel sin precedentes en el contexto de fragilidad, en el desarrollo de la atención individual y apoyo a familiares y cuidadores de los ancianos frágiles.<br>This work aims to identify the scientific production generated by nursing considering the fragility in the elderly from an integrative literature review using the Scientific Electronic Library Online (SciELO), Literatura Latino-Americana and Caribe em Ciências da Saúde (LILACS) and Scopus. The study included 16 articles where two were published in Brazilian periodicals and 14 in foreign periodicals. The review in the analyzed articles shows that 37.5% (6) focus on a paradigm shift regarding the assistance model and 26.7% (4) highlight the family as the primary care unit in the context of a fragile elderly. The nurse plays a key role in the context of fragility, in the development of individual care, in the support to family members and other caregivers for the fragile elderly