Reliability and practical aspects of the disease impact measure on hypertensive patients

OBJECTIVE: to evaluate the feasibility, acceptability, the ceiling and floor effects and the reliability of the Instrument to Measure the Impact of Coronary Disease on Patient's Daily Life (IDCV) when applied to hypertensive patients. METHOD: one hundred and thirty seven hypertensive outpatients were interviewed, using questionnaires to collect sociodemographic and clinical data, followed by the IDCV. Reliability was assessed according to the temporal stability and internal consistency criteria. RESULTS: the IDCV was applied in 8.0 (±3.0) minutes with 100% of the items answered. A ceiling effect of 31.4% was observed in the domain Adjustment to the Disease. The stability measure was observed for the total score and for all domains. There was evidence of internal consistency of the total IDCV (α=0.83) and the domains Physical Impact of the Disease - Symptoms (α=0.78) and Social and Emotional Impact of the Disease (α=0.74). CONCLUSION: the IDCV is an instrument of easy use and its reliability among hypertensive patients is evidenced. The domain Adjustment to the Disease, however, should be reviewed in further studies

Utility of the Care Dependency Scale in predicting care needs and health risks of elderly patients admitted to a geriatric unit: a cross-sectional study of 200 consecutive patients

Halina Doroszkiewicz,1 Matylda Sierakowska,2 Marta Muszalik3 1Department of Geriatrics, Medical University of Bialystok, Bialystok, Poland; 2Department of Integrated Medical Care, Medical University of Bialystok, Bialystok, Poland; 3Department and Clinic of Geriatrics, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland Objective: The aim of the study was to evaluate the usefulness of the Polish version of the Care Dependency Scale (CDS) in predicting care needs and health risks of elderly patients admitted to a geriatric unit.Methods: This was a cross-sectional study of 200 geriatric patients aged ≥60 years, chronologically admitted to a geriatrics unit in Poland. The study was carried out using the Polish version of the CDS questionnaire to evaluate biopsychosocial needs and the level of care dependency.Results: The mean age of the participating geriatric patients was 81.8±6.6. The mean result of the sum of the CDS index for all the participants was 55.3±15.1. Detailed analysis of the results of evaluation of the respondents’ functional condition showed statistically significant differences in the levels of care dependency. Evaluation of the patients’ physical performance in terms of the ability to do basic activities of daily living (ADL) and instrumental ADL (I-ADL) showed statistically significant differences between the levels of care dependency. Patients with high dependency were more often prone to pressure ulcers – 13.1±3.3, falls (87.2%), poorer emotional state – 6.9±3.6, mental function – 5.1±2.8, and more often problems with locomotion, vision, and hearing. The results showed that locomotive disability, depression, advanced age, and problem with vision and hearing are connected with increasing care dependency.Conclusion: CDS evaluation of each admitted geriatric patient enables us to predict the care needs and health risks that need to be reduced and the disease states to be improved. CDS evaluation should be accompanied by the use of other instruments and assessments to evaluate pressure ulcer risk, fall risk, and actions toward the improvement of subjective well-being, as well as correction of vision and hearing problems where possible and assistive devices for locomotion. Keywords: Care Dependency Scale, care needs, health risks, elderl

Quality of life of women with breast cancer undergoing radiotherapy using the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire

Marta Muszalik,1 Małgorzata Kołucka-Pluta,2 Kornelia Kędziora-Kornatowska,1 Joanna Robaczewska1 1Department and Clinic of Geriatrics, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 2Centrum of Oncology in Bydgoszcz, Bydgoszcz, Poland Objective: Breast cancer is one of the most common cancers in women, particularly among older women. This illness along with its treatment has a great impact on a woman’s subjective opinion of her quality of life and functioning in everyday life. The aim of this research was to assess the quality of life in women undergoing radiotherapy for the treatment of breast cancer. Patients and methods: The research was carried out in 120 patients with breast cancer undergoing radiotherapy in the Oncological Center in Bydgoszcz, Poland. Among the 120 examined patients, there were 30 women aged between 20–50 years and the remaining were over 50 years of age, including 42 women over the age of 60. Demographic and clinical data were collected and the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire (version 4) was used to assess health-related quality of life (HRQOL) of the patients. Statistical analyses were conducted using Statistica, version 10.0. Results: Patients with breast cancer undergoing radiotherapy rated their quality of life with an average of 113.83 points. Older patients above 71 years of age also displayed significantly higher HRQOL (122.70 points). A lower level of fatigue was noticed among patients ≤50 years and ≥71 years of age. Education and marital status also had an important impact on HRQOL. Educated women with a good financial situation had a significantly higher HRQOL, compared to those with a lower education and in poor living conditions. Conclusion: HRQOL and state of fatigue in breast cancer patients treated with radiotherapy depended upon their age. Both were high among women aged 71 years and above, while younger patients (51–70 years of age) had slightly lower values. Results suggest that sociodemographic factors influence the conditions of life of women treated with radiotherapy for breast cancer in a significant way. Overall, patients tolerated this type of treatment well. Keywords: quality of life, breast cancer, elderly women, radiotherapy, HRQOL, FACIT-

Care Dependency Scale - psychometric testing of the Polish version

The importance of this study lies in the availability of psychometrically sound assessment instruments, which are of critical importance for the study of patient's care dependency and the provision of care to these patients. The aim of this study was to identify the psychometric properties of the Care Dependency Scale (CDS) by analyzing data gathered in Poland. The Polish research instrument was a translation of the original Dutch CDS. Psychometric evaluations were carried out based on a convenience sample of 216 older patients. A high alpha coefficient of 0.98 was obtained. Subsequent inter-rater and test-retest reliability revealed Kappa values between 0.82-0.97 and 0.64-0.86, respectively. Factor analysis (principal component analysis) confirmed the one-factor model reported in earlier studies. The analysis of the scale showed that the instrument is promising to be used in elderly care in Poland. The Polish version of the CDS permits comparison with results from earlier studies using this instrument

Assessment of the relationship between frailty syndrome and the nutritional status of older patients

Marta Muszalik,1 Mateusz Gurtowski,1 Halina Doroszkiewicz,2 Robbert JJ Gobbens,3–5 Kornelia Kędziora-Kornatowska11Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Toruń, Poland; 2Department of Geriatrics, Medical University of Bialystok, Białystok, Poland; 3Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands; 4Zonnehuisgroep Amstelland, Amstelveen, the Netherlands; 5Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BelgiumObjective: The aim of this study was to assess the relationship between frailty syndrome and the nutritional status of older patients.Material and methods: This cross-sectional study was conducted in a sample of 120 patients hospitalized at the Geriatric Clinic between January 2017 and May 2017. The research tools were the Frailty Instrument of the Survey of Health, Ageing and Retirement in Europe (SHARE-FI), including relevant anthropometric measurements and muscle strength measurement, and the Mini Nutritional Assessment (MNA). All the calculations were performed using the Statistica 10.0 program. The p-values lower than 0.05 were considered as statistically significant.Results: The mean age of the participants was 71 years (SD=9.03). Most participants were from urban areas. More than half of the participants (53.3%) were women. Based on the SHARE-FI, the frailty syndrome was found in 33.3% of the participants. The mean value in the MNA scale was 24.4 points (SD=3.4). The frailty syndrome was significantly correlated to gender (p<0.025), financial status (p=0.036) and MNA (p<0.01) score. A statistically significant difference was observed between gender (p=0.026), financial status (p=0.016), place of living (p=0.046) and MNA score.Conclusion: This study confirmed significant correlations between the frailty syndrome and the nutritional status of older adults. In terms of prevention and clinical application, it seems important to control the nutritional status of older people and the frailty syndrome. The above-mentioned scales should be used to evaluate patients, analyze the risk and plan the intervention for that group of patients.Keywords: frailty syndrome, nutritional status, older adults, MNA, SHARE-F

Functional assessment of geriatric patients in regard to health-related quality of life (HRQoL)

Marta Muszalik,1 Tomasz Kornatowski,2 Halina Zielińska-Więczkowska ,3 Kornelia Kędziora-Kornatowska ,1 Ate Dijkstra41Clinic of Geriatrics, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland; 2Department of Preventive Medicine and Environmental Health, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland; 3Department of Pedagogy and Nursing Didactics, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland; 4Research group iHuman, NHL University for Applied Sciences, Leeuwarden, the NetherlandsPurpose: The main aim of our research was to evaluate general health, functioning, and performance parameters, as well as care problems of Geriatric Clinic inpatients in relation to deficits in fulfilling needs. The assessment of health-related quality of life was also performed.Patients and methods: The research subjects were patients attending the Clinic of Geriatrics: 149 women and 78 men; 227 persons in total. The research was carried out using a diagnostic poll method, with the application of the Activities of Daily Living questionnaire of assessment of daily efficiency on the basis of the Katz index, the Instrumental Activities of Daily Living questionnaire, the Care Dependency Scale used to measure the level of care dependency and human needs, and the Nottingham Health Profile scale.Results: The results showed that the majority of respondents achieved high and medium levels of functional capability. The main problems associated with the fulfillment of needs were difficulties with the adoption of appropriate body posture, movement restrictions, and problems related to participating in unassisted leisure activities outside the home. The general deficit in fulfilling the needs of the patients was low. The most significant problems were related to sleep disorders, restrictions in freedom of movement, loss of vital energy, and ailments resulting in the observable presence of pain.Conclusion: Good daily functioning of elderly patients significantly depended on their intellectual and mental efficiency. Elderly patients require a comprehensive, holistic approach to a variety of problems that occur with aging.Keywords: daily activity, elderly people, human need

Health and nursing problems of elderly patients related to bio-psycho-social need deficiencies and functional assessment

Elderly population is characterized by larger need for social welfare and medical treatment than other age groups. Along with aging, there is a number of emerging health, nursing, caring, psychological and social problems. Complexity of these problems results from overlapping and advancing involutional changes, multi-illness, decreased functional efficiency and other factors. The aim of the study was the assessment of health problems in geriatric patients as well as bio-psycho-social need deficiencies in a view of selected parameters of functional efficiency. The research group consisted of the Chair and Clinic of Geriatrics, 186 women and 114 men, 300 persons in total. The research was carried out using a diagnostic poll method with the application of the Activities of Daily Living (ADL) questionnaire of assessment of daily efficiency on the basis of the Katz Scale; the Care Dependency Scale (CDS) questionnaire used to measure the level of the care dependency and human needs, Norton's bed sores risk assessment scale, the Nursing Care Category (NCC) questionnaire applied to assess the need for nursing care. In most patients the results unveiled manifestations of three or more illnesses. Functional efficiency was at low and average level. Half of the subjects were endangered by risk of bed sores as well as showed high need fulfillment deficiency. The highest level of the deficiency was observed in patients in the eldest age group as well as suffering from multi-illness. Material status, education, place of residence or gender showed no significant influence on the level of need fulfillment. (C) 2011 Elsevier Ireland Ltd. All rights reserved

Independence of elderly patients with arterial hypertension in fulfilling their needs, in the aspect of functional assessment and quality of life (QoL)

Functional efficiency is the ability to be independent in fulfilling the basic needs of everyday life. Independence in meeting these needs is important to maintain a good quality of life (QoL). Chronic diseases affecting elderly people may, to some extent, limit fulfilling numerous needs, however, the acquired ability to live with a disease enables such patients to cope well with their needs. The aim of the study was to evaluate in the examined patients the independence in meeting their bio-psycho-social needs in relation to functional efficiency and QoL. The study group was recruited among hospitalized patients in the Department and Clinic of Geriatrics, 91 women and 59 men, for a total of 150 people. The mean age of the study group was 73.4 years. The research was carried out using a diagnostic poll method with the application of The Functional Assessment of Chronic Illness Therapy questionnaire (FACIT-F version 4); Activities of Daily Living questionnaire (ADL) of assessment of daily efficiency on the basis of the Katz Scale; Care Dependency Scale questionnaire (CDS) used to measure the level of the care dependency and human needs. The results of CDS for the study group were running at high level and were dependent on the marital status and age. No impact of gender, place of residence, education, material situation and disease duration was revealed. Similarly, FACIT-F scores were higher for married patients than for widowed ones, and they were age-dependent. Most of CDS scores were at a high level, which means that the investigated patients were, to a limited extent, care-dependent in meeting their needs. In the majority of subjects, the level of daily activities was high, which proves an independent functioning. Results of CDS were dependent on FACIT-F scores in the study group. (C) 2010 Elsevier Ireland Ltd. All rights reserved