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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: closed (6 July 2023) | Viewed by 20176

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Special Issue Editors

Prof. Dr. Maria Adriana Henriques

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Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Community Nurse Department, Nursing School of Lisbon, 1900-160 Lisbon, Portugal
Interests: healthy aging; complex interventions; falls; community health interventions; public health interventions; fundamental care; chronic disease
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Andreia Costa

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Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Community Nurse Department, Nursing School of Lisbon, 1900-160 Lisbon, Portugal
Interests: social prescribing; health literacy; healthy aging; complex interventions; falls
Special Issues, Collections and Topics in MDPI journals

Dr. Cristina Lavareda Baixinho

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Guest Editor

Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Community Nurse Department, Nursing School of Lisbon, 1900-160 Lisbon, Portugal
Interests: falls; transitional care; knowledge transfer; home security; musculoskeletal disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The increase in life expectancy, in chronic diseases, the number of older people with disabilities, functional decline, and dementias have changed the morbidity profile and contributed to the emergence of new healthcare needs that promote health literacy and increase autonomy and independence so that the person can age within the community and at home.

This challenges and weaknesses in research and healthcare to this population, especially the most vulnerable and those with lower levels of health literacy, became clear during the COVID-19 pandemic, which contributed to isolation and difficulties in accessing care and aggravated some situations of chronicity, hindering the pooling of efforts to meet the emerging needs of individuals, families, and the community, conditioning support to elderly people and hindering transition to the role of informal caregivers.

In this Special Volume dedicated to “Primary Care and Geriatric Nursing”, we challenge nurses and other professionals to disseminate studies, systematic reviews, and experience reports focused on new models of care delivery to community-dwelling older people and caregivers—interventions that promote active aging in the context of people's lives, ensuring and enhancing community resources, for example, through social prescription, chronic disease management in the community, and accident prevention in the community and safety in this care practice environment.

Prof. Dr. Maria Adriana Henriques
Prof. Dr. Andreia Costa
Prof. Dr. Cristina Lavareda Baixinho
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

social prescribing
health literacy
healthy ageing
complex interventions
falls
community health interventions
public health interventions
transitional care
fundamental care
home security

Published Papers (9 papers)

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10 pages, 645 KiB

Open AccessArticle

Older People Living Alone: A Predictive Model of Fall Risk

by Isabel Lage, Fátima Braga, Manuela Almendra, Filipe Meneses, Laetitia Teixeira and Odete Araújo

Int. J. Environ. Res. Public Health 2023, 20(13), 6284; https://doi.org/10.3390/ijerph20136284 - 03 Jul 2023

Cited by 1 | Viewed by 1357

Abstract

Falls in older people are a result of a combination of multiple risk factors. There are few studies involving predictive models in a community context. The aim of this study was to determine the validation of a new model for predicting fall risk in older adults (65+) living alone in community dwellings (n = 186; n = 117) with a test–retest reliability study. We consider in the predictive model the significant factors emerged from the bivariate analysis: age, zone, social community resources, physical exercise, self-perception of health, difficulty to keep standing, difficulty to sit and get up from a chair, strain to see, use of technical devices, hypertension and number of medications. The final model explained 28.5% of the risk of falling in older adults living alone in community dwellings. The AUC = 0.660 (se = 0.065, IC 95% 0.533–0.787, p = 0.017). The predictive model developed revealed a satisfactory discriminatory performance of the model and can contribute to clinical practice, with respect to the evaluation of risk of falling in this frailty group and preventing falls. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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10 pages, 377 KiB

Open AccessArticle

Prevalence of Polypharmacy of Older People in a Large Brazilian Urban Center and its Associated Factors

by Luciano Magalhães Vitorino, Jorge Henrique Lopes Mendes, Gerson de Souza Santos, Cláudia Oliveira, Helena José and Luís Sousa

Int. J. Environ. Res. Public Health 2023, 20(9), 5730; https://doi.org/10.3390/ijerph20095730 - 05 May 2023

Viewed by 1555

Abstract

Background: With the aging population comes greater risks associated with polypharmacy, a significant public health problem. Objective: This study aimed to identify the prevalence of polypharmacy and its associated factors through Comprehensive Geriatric Assessment (CGA) among older adults treated in primary health care (PHC) in a large Brazilian urban center. Methods: We conducted a cross-sectional study with a random sampling of 400 older adults using primary health care. Polypharmacy was defined as the cumulative use of five or more daily medications. An assessment of a sociodemographic and health survey, fear of falling, and physical disabilities affecting activities of daily living and instrumental activities of daily living was conducted. Results: The mean age was 75.23 (SD: 8.53) years. The prevalence of polypharmacy and hyperpolypharmacy was 37% (n = 148) and 1% (n = 4), respectively. The adjusted logistic regression showed that participants with chronic non-communicable diseases (CNCDs) (OR = 9.24; p = 0.003), diabetes (OR = 1.93; p = 0.003), and obesity (OR = 2.15; p = 0.005) were associated with a greater propensity to use polypharmacy. Conclusion: Our results show that older adults with CNCDs, diabetes, and obesity were more likely to use polypharmacy. The results reinforce the importance of using CGA in clinical practice in PHC. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

18 pages, 391 KiB

Open AccessArticle

Relationship between Burden, Quality of Life and Difficulties of Informal Primary Caregivers in the Context of the COVID-19 Pandemic: Analysis of the Contributions of Public Policies

by Tania Gaspar, Marta Raimundo, Sofia Borges de Sousa, Marta Barata and Tulia Cabrita

Int. J. Environ. Res. Public Health 2023, 20(6), 5205; https://doi.org/10.3390/ijerph20065205 - 15 Mar 2023

Cited by 1 | Viewed by 2400

Abstract

The study aimed to characterize and understand the difficulties experienced by informal caregivers from a bio-psychosocial and environmental perspective, taking into account the socio-demographic and health characteristics of the informal caregiver and the person cared for, quality of life, perceived burden, social support, and the impact of the COVID-19 pandemic on the informal caregiver and the person cared for. The participants were 371 informal primary caregivers, 80.9% female, aged between 25 and 85 years, mean 53.17 (SD = 11.45) years. Only 16.4% of the informal caregivers benefited from monitoring and training for informal caregiver skills; 34.8% received information on the rights of the person being cared for; 7.8% received advice or guidance on the rights and duties of the informal caregiver; 11.9% of the caregivers benefited from psychological support; and 5.7% participated in self-help groups. A convenience sample was used, and data were collected via an online questionnaire. The main findings show that the major difficulties experienced by caregivers are related to social constraints, the demands of caring, and the reactions of the person cared for. The results reveal that the burden of the main informal caregivers is explained by the level of education, quality of life, level of dependence of the person cared for, level of difficulties, and social support. The COVID-19 pandemic impacted caregiving by increasing the perceived difficulty of accessing support services, such as consultations, services, and support; causing distress feelings in the caregiver, such as, anxiety and worry; increasing the needs and symptoms of the person cared for; and increasing the degree of isolation, for both, the informal caregiver and the person cared for. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

20 pages, 1837 KiB

Open AccessArticle

Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health

by Guangbo Ma and Kun Xu

Int. J. Environ. Res. Public Health 2023, 20(1), 192; https://doi.org/10.3390/ijerph20010192 - 23 Dec 2022

Viewed by 2290

Abstract

Long-term care insurance (LTCI) is a significant approach in the effort to actively manage aging and the currently unmet need for aged care in China. Based on data from the 2011, 2013, 2015, and 2018 phases of the China Health and Retirement Longitudinal Study, we used the propensity score matching-difference in difference (PSM-DID) approach to explore the impact of LTCI on out-of-pocket medical expenses and self-rated health. Results showed that LTCI can significantly reduce out-of-pocket medical expenses by 37.16% (p < 0.01) per year and improve self-rated health by 5.73% (p < 0.01), which conforms to the spirit of “value-based health care”. The results were found to be stable in the robustness tests conducted. Currently, China is at the intersection of “low-value-based health care” and “value-based health care”. Improving the health level of aged individuals while keeping medical costs under reasonable control is crucial for formulating and implementing a new round of healthcare reform in China. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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19 pages, 1103 KiB

Open AccessArticle

Emotional Universe of Nurse Case Managers Regarding Care for Elderly at Risk in Spain: A Hermeneutical Study

by Ángeles Pastor-López, Pedro E. Ventura-Puertos, José Hernández-Ascanio, Vanesa Cantón-Habas, Pablo Martínez-Angulo and Manuel Rich-Ruiz

Int. J. Environ. Res. Public Health 2022, 19(24), 16445; https://doi.org/10.3390/ijerph192416445 - 08 Dec 2022

Viewed by 1475

Abstract

The role of nurse case managers (NCM) involves a rarely visible emotional labor, even more when their role focuses on the care of elders at risk (EAR). Motivated by the lack of qualitative research on the emotional universe of NCM, this study explores the emotional universe (EU) of NCM regarding the care they provide to EAR in primary health care as well as the reasons that generate these emotions. An interpretative–phenomenological approach was implemented in southern Spain, with a purposive sampling that included nurses playing the NCM role for at least three years. Data collection was conducted in two periods (between September 2019 and July 2022). The primary collection tool was the semi-structured individual interview, with starting categories based on Bisquerra’s EU taxonomy. The analysis followed Ricoeur’s considerations, using the Nvivo software. In the NCM’s EU, the recognition of the social phenomena stands out, with an open feeling of empathy regarding the desire of the EAR to continue living at home. However, there was also helplessness, resignation, disappointment, and frustration when EAR rejected their proposals. Furthermore, the system’s limitations aroused compassion in the NCM and made them go beyond the limits of their role. This EU requires that their role be valued more, and higher responsiveness must be enforced to improve EAR care. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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10 pages, 381 KiB

Open AccessArticle

Mental Health Patient-Reported Outcomes and Experiences Assessment in Portugal

by Anabela Coelho, Katherine de Bienassis, Niek Klazinga, Susan Santo, Patrícia Frade, Andreia Costa and Tânia Gaspar

Int. J. Environ. Res. Public Health 2022, 19(18), 11153; https://doi.org/10.3390/ijerph191811153 - 06 Sep 2022

Cited by 8 | Viewed by 2447

Abstract

Mental ill-health is increasingly recognized by policymakers for its significant human and economic toll. The main objective of this study is to capture patient-reported outcomes and experiences on mental health care in Portugal using methods developed for international benchmarking purposes, such as the OECD Patient-reported Indicators Surveys. The study included 397 participants, 247 (62.2%) women, divided into four age groups: ages 16–24 years, ages 25–44 years, ages 45–65 years, and ages 66 years or older. The data collection procedure and analysis followed the OECD PaRIS Mental Health Working Group 2021 protocol allowing subsequent comparability with data from other OECD member countries. Findings on the WHO-5 Well-Being Index showed that women manifest a lower score in well-being following mental health care services use. This finding may be, at least in part, explained by the study population (mental health services users), including individuals with clinical depression which is more frequently observed in women. In terms of the level of satisfaction with treatment (provided by nurses, doctors, phycologists, etc.) the response “Yes, definitely” varied from 67% of answers regarding “time spent by care providers”, 76.3% “involvement in decisions” to 79.7% regarding “clarity of explanations” and 84.4% regarding the item courtesy and respect. This study shows the feasibility of implementing and using patient-reported metrics (PROM and PREM) in mental health services in Portugal. The study results generate useful clinical information to help meet the expectations and needs of patients, contributing to a continuous improvement of mental health community services. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

20 pages, 6149 KiB

Open AccessArticle

Ageing and Long-Term Informal Care: The Reality of Two Countries in Europe: Denmark and Portugal

by Ana Catarina Maia, Paulo Nogueira, Maria Adriana Henriques, Carla Farinha and Andreia Costa

Int. J. Environ. Res. Public Health 2022, 19(17), 10859; https://doi.org/10.3390/ijerph191710859 - 31 Aug 2022

Cited by 1 | Viewed by 1693

Abstract

The knowledge of long-term informal care is particularly interesting for social and health measures related to ageing. This study aims to analyze how Portugal differs from Denmark regarding long-term informal care, specifically referring to personal care received by older people. A cross-sectional study was developed in Portugal and Denmark through the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2015, with a total of 2891 participants. Descriptive statistics and logistic regressions were performed. The findings suggest a significant association for older people from Portugal who receive long-term informal care from non-household caregivers and household caregivers. Moreover, as they age and are from Portugal, their availability to receive long-term informal care from non-household caregivers increases. Furthermore, older people in Portugal are more likely to receive long-term informal care from a household caregiver. It is important to take a closer look at long-term informal care in both countries and think about healthy ageing policies in the current context of the ageing population. This study provides knowledge about disaggregated health data on ageing in the European region, helping to fill research gaps related to older people. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

14 pages, 645 KiB

Open AccessArticle

Perceptions and Representations of Senior Nursing Students about the Transition to Professional Life during the COVID-19 Pandemic

by Cidália Castro, Ricardo Antunes, Júlio Belo Fernandes, João Reisinho, Rita Rodrigues, João Sardinha, Célia Vaz, Luís Miranda and Aida Simões

Int. J. Environ. Res. Public Health 2022, 19(8), 4466; https://doi.org/10.3390/ijerph19084466 - 07 Apr 2022

Cited by 2 | Viewed by 2042

Abstract

The COVID-19 pandemic caused disruptions in education systems worldwide. The suspension of face-to-face lectures and clinical placements directly impacted nursing students’ learning. This study aimed to identify the perceptions and representations of senior nursing students about the transition to professional life during the COVID-19 pandemic. This descriptive, observational, cross-sectional study used a web-based survey from a convenience sample of 162 senior nursing students, from nine different nursing schools. Data collection was carried out in the second quarter of 2020. Male students have more negative representations related to training (p = 0.048); working students have a better perspective of professional integration (p = 0.038); students who are in a relationship have a more positive perception of interaction with patients (p = 0.047); those who have already defined a service of choice have less insecurity and less fear of making mistakes (p = 0.043). Those who report anxiety about their first place of work have more negative representations about the future in other professional dimensions. The COVID-19 pandemic represents a frequent concern among students. However, it is a dimension that does not negatively contaminate other representations about the professional future. Overall, students showed concerns regarding their performance in providing direct care to the patient and lived up to their fellow nurses’ expectations. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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12 pages, 613 KiB

Open AccessStudy Protocol

Effectiveness of Music Therapy in People Living with Dementia: An Umbrella Review Protocol

by Luís Sousa, Cláudia Oliveira, Margarida Tomás, Maria do Céu Pires, António Almeida, Helga Oliveira, E. Begoña García-Navarro and Helena José

Int. J. Environ. Res. Public Health 2023, 20(4), 3200; https://doi.org/10.3390/ijerph20043200 - 11 Feb 2023

Cited by 1 | Viewed by 2975

Abstract

Background: Dementia stands out as a neurological disorder which constitutes a progressive decline in cognitive, behavioral, emotional, and social functioning. However, non-pharmacotherapy, such as music therapy, can be combined with pharmacological treatment as a possible strategy to improve functionality regarding the cognitive and non-cognitive dimensions of people diagnosed with dementia. Objectives: To analyze and synthesize published evidence regarding the effectiveness of music therapy in people diagnosed with dementia, concerning cognitive and non-cognitive outcomes. Design: Descriptive study protocol of an umbrella review. Methods and analysis: An umbrella review method will guide this study, focusing on an extensive search of published systematic reviews and meta-analyses reviews that include randomized controlled trials and other types of trials. Databases for the article search include ISI Web of Knowledge, Scopus, and Joanna Briggs Institute (JBI) EBP database, and EBSCO Host platform (Cochrane Database of Systematic Reviews, MEDLINE, and CINAHL). Two reviewers will independently review all titles and abstracts and identify articles considering the inclusion criteria. Afterward, two reviewers will independently extract relevant information from each article for the characterization table, and evaluate the quality of selected articles using the Measurement Tool for Evaluating Systematic Reviews (AMSTAR) 2 guideline. Relevance to clinical practice: Data from this study will aid in designing healthcare workers’ training courses, clinical intervention guidelines, and specific intervention protocols that support pharmacological interventions in treating dementia. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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