Climate change effects in older people's health: Ascoping review

Background: Climate change has serious consequences for the morbidity and mortal-ity of older adults.Objective: To identify the effects of climate change on older people's health.Methods: A scoping review was conducted following the Joanna Briggs Instituteguidelines and the PRISMA-ScR checklist. Quantitative research and reports from or-ganizations describing the effects of climate change on older people were selected.Results: Sixty-three full-text documents were selected. Heat and air pollution werethe two factors that had the most negative effects on cardiovascular and respiratorymorbidity and mortality in older people. Mental health and cognitive function werealso affected.Conclusions: Climate change affects several health problems in older individuals,especially high temperatures and air pollution. Nursing professionals must have thenecessary skills to respond to the climate risks in older adults. More instruments arerequired to determine nursing competencies on climate change and the health of thispopulation group

Measuring knowledge of Alzheimer's: Development and psychometric testing of the UJA Alzheimer's Care Scale

Background: Care for people with Alzheimer’s disease or other dementias should be based on up-to-date clinical practice guidelines. The education and training of nurses and other healthcare staff in dementia is a key factor in providing quality care. Knowledge of Alzheimer’s disease can be measured through questionnaires. The aim of this study was to develop and validate a scale to measure Alzheimer’s disease knowledge among both nursing staff and students. Methods: This was a cross-sectional survey study undertaken in three stages: 1) development of the questionnaire and item wording; 2) content validation by an expert panel; 3) questionnaire testing with two samples to establish psychometric properties. Sample 1 comprised 361 Registered Nurses, Assistant Nurses and eldercare workers from 24 nursing homes in Jaén (southern Spain). Sample 2 comprised 297 nursing students. The data were analysed through item analysis and a Rasch model. Convergent and construct validity and internal consistency were also examined. Results: The 23-item UJA Alzheimer’s Care Scale shows good outfit and infit values based on the Rasch model. One item presented differential functioning between Registered Nurses and Assistant Nurses. The intraclass correlation coefficient between the UJA Alzheimer’s Care Scale and the Spanish version of the Dementia Knowledge Assessment Tool 2 showed strong agreement among nursing staff (0.63) and students (0.79). The scale is able to distinguish between professionals with low or high knowledge of Alzheimer’s care. The overall Cronbach’s alphas were 0.70 (nursing staff) and 0.82 (nursing students). The intraclass correlation coefficient between the first test and the retest was good (0.84). Conclusions: The UJA Alzheimer’s Care Scale is a useful tool for measuring knowledge of Alzheimer’s disease and dementia care among nursing professionals or nursing students. The initial validation study obtained good psychometric properties concerning validity and reliability

Knowledge about the care of people with Alzheimer’s disease of the nursing staff of nursing homes in Spain

Abstract: People with Alzheimer’s disease often live in nursing homes. Updated knowledge among the nursing staff has led to better quality of care. The aim of this study was to measure the knowledge about the care of people with Alzheimer’s disease of the nursing staff of nursing homes in Spain. A cross-sectional study was conducted in 24 nursing homes in the province of Jaén (Spain) with a sample of 361 members of staff, i.e., registered nurses (RNs), assistant nurses (ANs), and eldercare workers (EWs). The University of Jaén UJA-Alzheimer’s Care Scale was used to measure the knowledge. The knowledge was higher among the RNs (83.3% of the maximum) than among the ANs and EWs (71.6%). Work experience and updated training were associated with the knowledge score in RNs, but only the updated training in ANs and EWs. Nursing homes with less experienced nursing staff and with a small proportion of staff receiving training on dementia have a low knowledge score. The nursing staff of nursing homes in Jaén have medium to high knowledge about Alzheimer’s care. There is a wide range of variation in the knowledge score among the nursing homes. Up-to-date staff training in dementia care is the factor with the strongest association with knowledge

Effectiveness of scenario‑based learning and augmented reality for nursing students’ attitudes and awareness toward climate change and sustainability

Background: Mainstreaming sustainable healthcare into the curricula of health professions is a key action to raise awareness and change attitudes. Therefore, the present study aimed to assess the contribution of scenario-based learning and augmented reality to the environmental awareness and attitudes toward climate change and sustainability among undergraduate nursing students. Methods: This study was designed as a time-series analysis. Undergraduate nursing students in their 3 years were introduced to sustainability and climate change in the context of healthcare through scenario-based learning sessions. Questionnaires were used to collect data on participants’ attitudes towards sustainability and climate change, the usefulness of the educational sessions and the extent to which students changed their clinical practice. A data summary, related sample Friedman and Wilcoxon signed-rank tests were used to test for differences in survey scores. Results: Attitudes and environmental awareness toward climate change and sustainability increased significantly as students received the learning sessions over the 3 years. After their first clinical training period, students already showed a high awareness of unsustainable practices in their working environment; however, they still struggled to apply sustainability and address unsustainable practices in healthcare settings. Most students felt that the scenarios helped them to make links between climate change, resources, and health. Conclusions: The scenario-based learning and augmented reality increase environmental awareness and attitudes toward climate change and sustainability among nursing students. Students are very aware of unsustainable practices in their work environment, but more work needs to be done on the application of sustainability principles to nursing practice

The Effectiveness of Advanced Practice Nurses with Respect to Complex Chronic Wounds in the Management of Venous Ulcers

This study aims to evaluate the effectiveness of advanced practice nurses with respect to complex chronic wounds (APN-CCWs) in the care of patients with venous ulcers. A multicentric, quasi-experimental pre-post study was conducted without a control group in the sanitary management areas where the APN-CCW program is being piloted. The intervention consisted of a mass training of clinical nurses from the participating districts on the proper management of injuries and the use of compression therapy. The data were collected through a specifically constructed questionnaire with questions regarding descriptive variables of injuries and their treatment. A total of 643 professionals responded (response rate of 89.1%), attending to a total population of 707,814 inhabitants. An increase in multilayer bandage use by 15.67%, an increase in elastic bandage use by 13.24%, and a significant decrease in the referral of patients to consultation with hospital specialists was achieved, from 21.08% to 12.34%. The number of patients referred to the APNs was 13.25%, which implied a resolution rate of 94.08% of their injuries. In conclusion, the coordination by the APN-CCWs in patients with venous ulcers was effective in improving the continuity of care, in the optimization of resources, and in their care role

Obligation and negative consequences in primary caregivers of dependent older relatives

The purpose of this study was to analyse the multidimensional nature of obligation and the relations between each dimension of obligation and both anxiety and depression. A secondary analysis of data from two cross-sectional studies of primary home caregivers (N = 400; probabilistic sample) of older adult relatives in Spain was conducted. Data regarding obligation (four categories basing on beliefs of obligation and social pressure: low pressure and low beliefs, low pressure and high beliefs, high pressure and low beliefs and high pressure and high beliefs), stressors, anxiety and depression were collected by interview in 2013. The combination of high pressure and low beliefs had the highest levels of anxiety and depression, and the combination of low pressure and high beliefs had the lowest levels of anxiety and depression. When the relation of behavioural problems with anxiety and depression stratified by the previous four categories of obligation was analysed, behavioural problems were associated with anxiety and depression in the subgroups with low beliefs of obligation, whereas this association disappeared in the subgroups with high beliefs of obligation.Original studies in this secondary analysis study were supported with grants from the Spanish Government (Instituto de Salud Carlos III and FEDER founds, PI90583) and Andalusian Government (Andalusian Health Service, 2011-2013). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Perceived needs of the family caregivers of people with dementia in a mediterranean setting: A qualitative study

The purpose of this study was to identify, classify and analyze the perceived needs of caregivers of elderly people with dementia during the care process. A descriptive phenomenological qualitative study using seven focus groups was conducted in different primary health care centers in the province of Jaén (Spain) between July 2012 and February 2013. Eighty-two family caregivers who were caring for people with dementia in different stages of the disease were selected by purposeful maximum variation sampling. Data were analyzed and organized thematically, considering the semantic and pragmatic content and field notes. Two main categories of the perceived needs of caregivers were identified. The first was related to the management of caring for a relative with dementia, and the second was related to the management of the caregivers’ own care. Our findings support the provision of comprehensive interventions for the improvement of caregivers’ emotional health that encompass more than one care need. This is where psycho-educational interventions aimed at managing the various aspects of dementia and self-care in caregivers can be accommodated. In addition, proactive interventions to develop important skills to care for a relative with dementia, which are not perceived as needs by the caregivers, are needed. These include skills in family negotiation, planning and searching for resources outside the family

Sustainability education in nursing degree for climate-smart healthcare: a quasi-experimental study

Purpose– In light of the world’s accelerating march towards a sustainable future, the education for sustainable healthcare must be sufficiently acknowledged in health professions curricula. Early integration of these competences into nursing degree programme emphasizes its importance and applicability. This paper aims to investigate the effectiveness of an educational sustainability intervention in higher education to change nursing students’ attitudes towards sustainability and climate change, and environmentalawareness. Design/methodology/approach– A quasi-experimental study was performed with repeated measures between September 2019 and May 2023. Undergraduate students were introduced to sustainability and climate change in the context of healthcare using scenario-based learning and augmented reality over the courses in nursing degree. Participants’ attitudes and awareness were collected by online questionnaires. Findings– The educational intervention showed effectiveness in significantly improving attitudes towards climate change and sustainability, and the environmental awareness for changing their clinical practice (p < 0.01). However, students struggled to apply sustainability and address unsustainable practices in healthcare settings. Originality/value– This study shows an effective model of curricular sustainability that can be implemented in other universities and health disciplines. The findings highlighting the importance of sustainability education in nursing and its potential to drive positive change in healthcare practice and society at large. Embedding key topics aligned with sustainable development goals in the curriculum prepares nursing or health workforce to address planetary health and implement sustainable practices that provide climate-smart care

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

ELABORACIÓN Y VALIDACIÓN PSICOMÉTRICA DE UNA ESCALA DE CONOCIMIENTOS SOBRE LA ENFERMEDAD DE ALZHEIMER Y OTRAS DEMENCIAS. APLICACIÓN EN PROFESIONALES DE RESIDENCIAS DE MAYORES Y EN ESTUDIANTES DE ENFEMERÍA

Objetivos: Elaborar y establecer las propiedades psicométricas de una escala para medir el conocimiento sobre los cuidados a personas con enfermedad de Alzheimer (EA) y otras demencias. Metodología: Cuatro fases: 1) Identificación y evaluación de calidad de Guías de práctica clínica sobre Enfermedad de Alzheimer (EA); 2) Elaboración de una escala de conocimientos sobre cuidados a personas con EA y validación de contenido. 3) Evaluación psicométrica de la escala en 2 muestras (personal de enfermería y estudiantes). 4) Medición de conocimientos en personal de Residencias de Mayores de Jaén, y en estudiantes de Grado de Enfermería de la Universidad de Jaén Resultados: La versión 1 de la escala con 30 ítems tuvo buena validez de contenido. Tras su administración a dos muestras (Profesionales:361; y estudiantes:297) queda una versión final de 23 ítems con adecuadas propiedades psicométricas: fiabilidad y validez. Conclusión: La escala UJA Alzheimer-Care es un instrumento fiable y valido para medir conocimiento sobre cuidados de la enfermedad de Alzheimer aplicable a profesionales de las residencias de mayores y a estudiantes de enfermería.Aim: To develop and establish the psychometric properties of a scale aimed to measure knowledge on caring for people with Alzheimer disease and dementia. Methods: Four phases: 1) Identification and quality assessment of clinical guidelines about Alzheimer disease (AD). 2) Construction of a scale about knowledge on the care for people with AD and content validation. 3) Psychometric evaluation of the scale using 2 samples (nursing staff and students). 4) Measurement of the level of knowledge in Nursing homes staff in Jaén and in undergraduate nursing students at the University of Jaén. Results: The version 1 of this scale, with 30 items, showed good content validity. After the study with the 2 samples (nursing staff N= 361; Students N= 297) the 23-items final version of the scale have adequate psychometric properties, both reliability and validity. Conclusion: The UJA Alzheimer-Care scale is a reliable and valid instrument aimed to measure knowledge on Alzheimer disease care; it can be applied both to Nursing Homes staff and to nursing students.Tesis Univ. Jaén. Departamento de Enfermería. Leída el 26 de mayo de 2017