Health status and functional profile at admission to nursing homes : A population based study over the years 2003-2014: comparison between people with and without diabetes

Background & Aims. Prevalence of diabetes in adults has been increasing in the last decades. Diabetes increases demand for nursing homes admission which is expensive for public and private finances. The aims of the study were to examine the prevalence of diabetes at admission to nursing homes in Iceland over 12 years, and to compare overall health, functioning, medication and medical diagnosis of residents with diabetes to those without diabetes.  Methods. A retrospective study of data obtained from the Minimum Data Set records at admission to nursing homes in Iceland during the years 2003-2014. Statistical analysis was carried out using a Chi-square-test, unpaired Student´s t-test, linear regression and logistic regression. Results. In total 5242 residents were assessed within 180 days from admission, 730 had diabetes (13.9%). Prevalence of diabetes increased from 9.4% in 2003 to 15% in 2014, with a peak of 19.1% in 2013. Mean age was 81.0 (SD 8.2) and 82.7 (SD 8.7) years for residents with and without diabetes, respectively (p < 0.001). Comorbidities like hypertension, congestive heart-failure, kidney-failure, arthritis, ulcers and amputations were more common among residents with diabetes, whereas cognitive diseases were more common in the other group.  Conclusions. The prevalence of diabetes in Icelandic nursing homes is increasing. Residents with diabetes are younger and have better cognitive performance, but suffer more physical disability and serious comorbidities than others. Nursing homes’ staff need to be current in diabetes management to provide quality care

Health status and functional profile at admission to nursing homes : A population based study over the years 2003-2014: comparison between people with and without diabetes

Background & Aims. Prevalence of diabetes in adults has been increasing in the last decades. Diabetes increases demand for nursing homes admission which is expensive for public and private finances. The aims of the study were to examine the prevalence of diabetes at admission to nursing homes in Iceland over 12 years, and to compare overall health, functioning, medication and medical diagnosis of residents with diabetes to those without diabetes.  Methods. A retrospective study of data obtained from the Minimum Data Set records at admission to nursing homes in Iceland during the years 2003-2014. Statistical analysis was carried out using a Chi-square-test, unpaired Student´s t-test, linear regression and logistic regression. Results. In total 5242 residents were assessed within 180 days from admission, 730 had diabetes (13.9%). Prevalence of diabetes increased from 9.4% in 2003 to 15% in 2014, with a peak of 19.1% in 2013. Mean age was 81.0 (SD 8.2) and 82.7 (SD 8.7) years for residents with and without diabetes, respectively (p < 0.001). Comorbidities like hypertension, congestive heart-failure, kidney-failure, arthritis, ulcers and amputations were more common among residents with diabetes, whereas cognitive diseases were more common in the other group.  Conclusions. The prevalence of diabetes in Icelandic nursing homes is increasing. Residents with diabetes are younger and have better cognitive performance, but suffer more physical disability and serious comorbidities than others. Nursing homes’ staff need to be current in diabetes management to provide quality care

COPD patients' experiences, self-reported needs, and needs-driven strategies to cope with self-management

Background: COPD is a common cause of morbidity and mortality. The aim of this study was to explore patients' experiences, self-reported needs, and needs-driven strategies to cope with self-management of COPD. Patients and methods: In this phenomenological study, 10 participants with mild to severe COPD were interviewed 1-2 times, until data saturation was reached. In total, 15 in-depth interviews were conducted, recorded, transcribed, and analyzed. Results: COPD negatively affected participants' physical and psychosocial well-being, their family relationships, and social life. They described their experiences of COPD like fighting a war without weapons in an ever-shrinking world with a loss of freedom at most levels, always fearing possible breathlessness. Fourteen needs were identified and eight clusters of needs-driven strategies that participants used to cope with self-management of COPD. Coping with the reality of COPD, a life-threatening disease, meant coping with dyspnea, feelings of suffocation, indescribable smoking addiction, anxiety, and lack of knowledge about the disease. Reduced participation in family and social life meant loss of ability to perform usual and treasured activities. Having a positive mindset, accepting help and assuming healthy lifestyle was important, as well as receiving continuous professional health care services. The participants' needs-driven strategies comprised conducting financial arrangements, maintaining hope, and fighting their smoking addiction, seeking knowledge about COPD, thinking differently, facing the broken chain of health care, and struggling with accepting support. Procrastination and avoidance were also evident. Finally, the study also found that participants experienced a perpetuating cycle of dyspnea, anxiety, and fear of breathlessness due to COPD which could lead to more severe dyspnea and even panic attacks. Conclusion: COPD negatively affects patients' physical and psychosocial well-being, family relationships and, social life. Identifying patients' self-reported needs and needs-driven strategies can enable clinicians to empower patients by educating them to improve their self-management