Objectives: In recent years, the harm of smoking has attracted more and more public attention. Creating a healthy smoke-free environment has been widely favored and supported by the public. Smokeless environment has a certain positive effect on the rehabilitation of dementia patients. Sustained smoking cessation is associated with significantly decreased the future prevalence of dementia. Therefore, hospitals often establish a special organizational structure and management model for tobacco control, and carry out training and assessment for all staff. The nursing group also took it as the basic nursing standard. The 2019 disease pandemic has posed unique health threats to people living with dementia (PLWD). Therefore, a strict smoke-free environment is more necessary for the nursing group. One of the key challenges is scaling up long-term care services to meet the needs of the rapidly growing population of PLWD in developing countries. The aim of the study is to explore the care service needs, utilization and build an essential care service package (ECSP) for PLWD under the disease pandemic in China. Methods: From July 2018 to October 2019, a total of 1255 elderly with dementia in six cities in China by a cluster sampling were investigated with the self-designed questionnaire. Care service needs and utilization for PLWD with different levels of cognitive impairment were summarized. Results: The ECSP for PLWD was composed of 30 service items (7 for core care) in order to guarantee that all PLWD enjoy equal care services, basing on public financing and implementing strategies and taking China's situations into account. The selection plan for ECSP at different levels is designed as 'General Care Services + Selective Care Services ', in which respective service items for low, mid, and high-level care for PLWD are 7+3, 7+6, and 7+10, and requires 151.41 hours, 201.88 hours, and 252.35 hours per month, respectively. Conclusion: The present study provides the first large-scale data on care service needs and utilization for PLWD in mainland China. The ECSP for PLWD based on the needs advanced in the paper was a practicable and effective quantitative management means that deserves a large-scale application. Some safeguard mechanisms and operational implementing pathways of ECSP for PLWD during and after the disease pandemic in China are proposed.
Background It is hypothesized that education and marriage are resilience factors protective against senile dementia.Methods We investigated the resilience of elderly persons from dementia by considering the interactions between educational levels and marriage status. Four sociodemographic variables (age, sex, educational level, and marital status) were collected from 1177 elderly Chinese participants, for whom the mini-mental state examination score (MMSE score) was measured and severe cognitive impairment (MMSE score = 0) was identified.Results Lower educational level coupled with being widowed caused a greater risk of severe cognitive impairment (relative risk [RR] 1.48; 95% confidence interval [CI] 1.20-1.82; p < 0.001) for high-age elderly participants (age range: ≥80) than those low-age counterparts (age range: ≥60 and <80). By contrast, higher educational level coupled with being married leveled this age-related risk of cognitive loss (RR 0.91; 95% CI 0.65-1.27; p = 0.62). Further findings suggest that synergistically cognitive protection effect for education and marriage was only observed among high-age elderly persons, instead of among low-age ones.Conclusions Being well-educated and being married synergistically protected delayed cognitive function for elderly people. However, longevity is a prerequisite for realizing this benefit.
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Background: Dementia special care unit (D-SCU) is a main care mode for the elderly with dementia, and has increased steadily internationally. However, little is known about the D-SCUs of China. The present study aimed to analyze and summarize the types and standards of D-SCUs in China, and evaluate the care efficiency of the D-SCU care model.Methods: A cross-sectional survey was conducted between June 2018 and July 2019 in 6 cities of China. Quantitative data about the basic information and the care satisfaction were collected from 25 care facilities in the 6 cities. Qualitative data about the care status of the elderly with dementia, the standards, the management and the operation of the D-SCUs were collected among the 25 care facilities and the 3 cities that had issued standards for setting D-SCUs. Grounded theory method was used to analyze the qualitative data, and data envelopment analysis (DEA) method was applied to evaluate the care efficiency of the D-SCU care model.Results: The technical efficiency, pure technical efficiency and scale efficiency of care facilities with D-SCUs were higher than those of care facilities without D-SCUs (P=0.016, P=0.022, and P=0.021, respectively). The types of D-SCUs could be divided into independent, semi- independent, semi-dependent and dependent according to the architecture, physical space, and management mode. The standards for the area, environment, beds, service items of the D-SCUs were various among the 3 cities that had issued standards for setting D-SCUs.Conclusions: The care model of D-SCUs is effective and professional, and can be further promoted in China. The exploration and standard research on the D-SCUs should be strengthened in future.
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