Belang van ondersteunende netwerken voor ouderen

__Abstract__ ‘Even Buurten’ is een Rotterdams initiatief. Hierin proberen professionals uit zorg en welzijn via een integrale wijkaanpak de sociale netwerken rondom thuiswonende ouderen te verstevigen. Doel van dit sociale netwerk is (vroeg) signalering en het bieden van concrete hulp en ondersteuning aan kwetsbare ouderen. Uit onderzoek naar het ‘Even Buurten’-initiatief komt het belang van een sterk sociaal buurtnetwerk duidelijk naar voren. Het succes van een integrale wijkaanpak hangt in sterke mate af van een integraal formeel e´n informeel ondersteunend netwerk in de buurt. Formele en informele netwerken werken echter nog niet goed samen. En ook binnen het formele netwerk (bijv. tussen zorg en welzijn) wordt nog onvoldoende samengewerkt om kwetsbare ouderen optimale ondersteuning te bieden. Deze klinische les beschrijft hoe integrale, wijkgerichte ondersteuning beter tegemoetkomt aan de behoeften en wensen van kwetsbare ouderen

Prediction of mortality by the Tilburg Frailty Indicator (TFI)

Objective: To predict mortality with the Tilburg Frailty Indicator (TFI) in a sample of community-dwelling older people, using a follow-up of 7 years. Design: Longitudinal. Setting and Participants: 479 Dutch community-dwelling people aged 75 years or older. Measurements: The TFI, a self-report questionnaire, was used to collect data about total, physical, psychological, and social frailty. The municipality of Roosendaal (a town in the Netherlands) provided the mortality dates. Results: Total, physical, and psychological frailty predicted mortality, with unadjusted hazard ratios of 1.295, 1.168, and 1.194, and areas under the receiver operating characteristic curves of 0.664, 0.671, and 0.567, respectively. After adjustment for age and gender, the areas under the curves for total, physical, and psychological frailty were 0.704, 0.702, and 0.652, respectively. Analyses using individual components of the TFI show that difficulty in walking and unexplained weight loss predict mortality. Conclusions and Implications: This study has shown the predictive validity of the TFI for mortality in community-dwelling older people. Our study demonstrated that physical and psychological frailty predicted mortality. Of the individual TFI components, difficulty in walking consistently predicted mortality. For identifying frailty, using the integral instrument is recommended because total, physical, psychological, and social frailty and its components have proven their value in predicting adverse outcomes of frailty, for example, increase in health care use and a lower quality of life

Prediction of Mortality by the Tilburg Frailty Indicator (TFI)

Objective: To predict mortality with the Tilburg Frailty Indicator (TFI) in a sample of community-dwelling older people, using a follow-up of 7 years. Design: Longitudinal. Setting and Participants: 479 Dutch community-dwelling people aged 75 years or older. Measurements: The TFI, a self-report questionnaire, was used to collect data about total, physical, psychological, and social frailty. The municipality of Roosendaal (a town in the Netherlands) provided the mortality dates. Results: Total, physical, and psychological frailty predicted mortality, with unadjusted hazard ratios of 1.295, 1.168, and 1.194, and areas under the receiver operating characteristic curves of 0.664, 0.671, and 0.567, respectively. After adjustment for age and gender, the areas under the curves for total, physical, and psychological frailty were 0.704, 0.702, and 0.652, respectively. Analyses using individual components of the TFI show that difficulty in walking and unexplained weight loss predict mortality. Conclusions and Implications: This study has shown the predictive validity of the TFI for mortality in community-dwelling older people. Our study demonstrated that physical and psychological frailty predicted mortality. Of the individual TFI components, difficulty in walking consistently predicted mortality. For identifying frailty, using the integral instrument is recommended because total, physical, psychological, and social frailty and its components have proven their value in predicting adverse outcomes of frailty, for example, increase in health care use and a lower quality of life

Effects of health care interventions on quality of life among frail elderly : a systematized review

ntroduction Many health care interventions have been developed that aim to improve or maintain the quality of life for frail elderly. A clear overview of these health care interventions for frail elderly and their effects on quality of life is missing. Purpose To provide a systematic overview of the effect of health care interventions on quality of life of frail elderly. Methods A systematic search was conducted in Embase, Medline (OvidSP), Cochrane Central, Cinahl, PsycInfo and Web of Science, up to and including November 2017. Studies describing health care interventions for frail elderly were included if the effect of the intervention on quality of life was described. The effects of the interventions on quality of life were described in an overview of the included studies. Results In total 4,853 potentially relevant articles were screened for relevance, of which 19 intervention studies met the inclusion criteria. The studies were very heterogeneous in the design: measurement of frailty, health care intervention and outcome measurement differ. Health care interventions described were: multidisciplinary treatment, exercise programs, testosterone gel, nurse home visits and acupuncture. Seven of the nineteen intervention studies, describing different health care interventions, reported a statistically significant effect on subdomains of quality of life, two studies reported a statistically significant effect of the intervention on the overall quality of life score. Ten studies reported no statistically significant difference between the intervention and control groups. Conclusion Reported effects of health care interventions on frail elderly persons’ quality of life are inconsistent, with most of the studies reporting no differences between the intervention and control groups. As the number of frail elderly persons in the population will continue to grow, it will be important to continue the search for effective health care interventions. Alignment of studies in design and outcome measurements is needed

Prediction of mortality by the Tilburg Frailty Indicator (TFI)

Objective:  To predict mortality with the Tilburg Frailty Indicator (TFI) in a sample of community-dwelling older people, using a follow-up of 7 years. Design:  Longitudinal. Setting and Participants:  479 Dutch community-dwelling people aged 75 years or older. Measurements:  The TFI, a self-report questionnaire, was used to collect data about total, physical, psychological, and social frailty. The municipality of Roosendaal (a town in the Netherlands) provided the mortality dates. Results:  Total, physical, and psychological frailty predicted mortality, with unadjusted hazard ratios of 1.295, 1.168, and 1.194, and areas under the receiver operating characteristic curves of 0.664, 0.671, and 0.567, respectively. After adjustment for age and gender, the areas under the curves for total, physical, and psychological frailty were 0.704, 0.702, and 0.652, respectively. Analyses using individual components of the TFI show that difficulty in walking and unexplained weight loss predict mortality. Conclusions and Implications:  This study has shown the predictive validity of the TFI for mortality in community-dwelling older people. Our study demonstrated that physical and psychological frailty predicted mortality. Of the individual TFI components, difficulty in walking consistently predicted mortality. For identifying frailty, using the integral instrument is recommended because total, physical, psychological, and social frailty and its components have proven their value in predicting adverse outcomes of frailty, for example, increase in health care use and a lower quality of life

Prediction of Mortality by the Tilburg Frailty Indicator (TFI)

Objective: To predict mortality with the Tilburg Frailty Indicator (TFI) in a sample of community-dwelling older people, using a follow-up of 7 years. Design: Longitudinal. Setting and Participants: 479 Dutch community-dwelling people aged 75 years or older. Measurements: The TFI, a self-report questionnaire, was used to collect data about total, physical, psychological, and social frailty. The municipality of Roosendaal (a town in the Netherlands) provided the mortality dates. Results: Total, physical, and psychological frailty predicted mortality, with unadjusted hazard ratios of 1.295, 1.168, and 1.194, and areas under the receiver operating characteristic curves of 0.664, 0.671, and 0.567, respectively. After adjustment for age and gender, the areas under the curves for total, physical, and psychological frailty were 0.704, 0.702, and 0.652, respectively. Analyses using individual components of the TFI show that difficulty in walking and unexplained weight loss predict mortality. Conclusions and Implications: This study has shown the predictive validity of the TFI for mortality in community-dwelling older people. Our study demonstrated that physical and psychological frailty predicted mortality. Of the individual TFI components, difficulty in walking consistently predicted mortality. For identifying frailty, using the integral instrument is recommended because total, physical, psychological, and social frailty and its components have proven their value in predicting adverse outcomes of frailty, for example, increase in health care use and a lower quality of life

Focus op professie: Rapport Commissie Positionering Hoger Beroepsonderwijs

De onafhankelijke commissie ‘positionering hoger beroepsonderwijs’ heeft het rapport ‘Focus op professie’ aangeboden aan het bestuur van de Vereniging Hogescholen. Het rapport vormt belangrijke input voor de standpuntbepaling van de Vereniging Hogescholen ten aanzien van de toekomst van het hoger beroepsonderwijs, mede in het licht van de toekomstverkenning van het hoger onderwijs die minister Dijkgraaf van OCW in gang heeft gezet