Background Due to the rapid ageing of the population, there is increasing demand for long‐term care in the people's home environment. Such care aims to allow the people to stay at home and avoid hospitalisation or other institutional care. In home health care, care must be provided at the highest possible quality, with the focus on the people's needs and experiences. Objectives This study explores the experiences and needs of frail older people receiving home health care. Design and methods An exploratory descriptive qualitative approach was chosen. Audio‐taped semi‐structured interviews were conducted with fifteen older people receiving home health care. A content analysis was used to analyse the data collected. Results The content analysis identified one main theme, three categories and seven subcategories related to frail older people's needs and experiences of home health care. The main theme was quality of care. The first category, Safe and Secure Care, consisted of three subcategories: Education and Experience of Nurses, Information, and Continuity of Care in terms of personnel continuity and regular care. The second category, Autonomy, contained two subcategories: Decision‐making and Self‐sufficiency. The last category, Relationship with Professionals, consisted of two subcategories: Personality of Nurse and Partnerships. Conclusion Older people are able to express their satisfaction or dissatisfaction with home health care. The results of this study revealed that the quality of care is crucial for frail older people. Implication for practice The provision of home health care is inherently highly specific; home care nurses should work to provide the highest possible quality of care. In particular, nurses should focus on ensuring that the care they provide is safe, effective, timely, efficient and person‐centred.
Objectives: The main aim of this meta-analysis was to compare the effects of different physical activities on cognitive functions in older adults divided according to cognitive impairment levels. Methods: We searched Web of Science, Scopus, and PubMed for randomized control trials (RCT). A standardized mean difference (SMD) of the pre-post intervention score of global cognitive function tests were calculated by the random model in the Cochrane meta-analyses for people with cognitive impairment generally and across three levels - mild, mild to moderate, and moderate to severe cognitive impairment separately. Additionally, an unstandardized coefficient beta (B) was calculated in generalized linear models to estimate the effects of exercise, cognitive impairment severity, age, female ratio, length of intervention, and time of exercise a week on the global cognitive function. Results: Data from 26 studies involving 1,137 participants from intervention groups and 1,187 participants from control groups were analyzed. Physical exercise had a positive effect on cognitive functions in people across all levels of cognitive impairments SMD (95 % confidence interval [CI]) = 1.19 (0.77 - 1.62); however, heterogeneity was considerably high I 2 = 95%. Aerobic (B = 8.881) and resistance exercise (B = 4.464) was significantly associated with better results in global cognitive functions when compared to active control. A higher number of female participants cin intervention groups had a statistically significant effect on the global cognitive function (B = 0.229). onclusions: Physical exercise was associated with cognitive function improvement in older people with cognitive impairments. Aerobic exercise was more strongly associated than resistance exercise to combat cognitive decline. Keywords: Physical activity, Dementia, Aging, Meta-analysis, Aerobic exercise, Cognitive function
Background. The main aim of this study was to estimate the effect of physical activities (PA) on cognitive functions (CF) in cognitively impaired older adults divided according to the impairment severity. Methods. We searched Web of Science, Scopus, and PubMed for randomized controlled trials (RCT). We focused on the effect of exercise on CF in intervention groups and control groups separately in people with cognitive impairment across three levels -borderline intact, mild, and moderate cognitive impairment separately. Results. Data from 40 studies involving 1,780 participants from intervention groups and 1,508 participants from control groups were analyzed. 37.0% of intervention groups presented a statistically significant beneficial effect of PA on CF, while 5% presented a statistically significant harmful effect of PA on CF. 40.0% of the control groups showed a significant decrease in CF. 54.3% interventions had a statistically significant beneficial effect (Hedges' g > 0). However, there was a great variability between the studies in terms of exercise program description and cognitive impairment of the subjects. Conclusions. Physical exercise was associated with cognitive function improvement in older people with cognitive impairment. The positive effect is stronger in people with a mild level of cognitive impairment.
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