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Prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls: a register study among older persons receiving municipal health care in southern Sweden
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0002-8169-853X
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0002-1437-5060
Malmö Stad.
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2021 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 21, no 1, article id 265Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Although pressure ulcers, malnutrition, poor oral health and falls are common among older persons, causing deteriorated health status, they have not been studied altogether among older persons receiving different types of municipal health care. The aim of this study was to determine the prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls among older persons aged ≥65 years receiving municipal health care in southern Sweden.

METHODS: A retrospective cross-sectional study (n = 12,518 persons aged ≥65 years) using data from the national quality registry Senior Alert was conducted. The prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls was calculated based on categorical data from the instruments available in Senior Alert. T-tests, chi-square test, the Mantel- Haenszel test and logistic regression models were performed.

RESULTS: The prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls was 27.9, 56.3, 34.2 and 74.5% respectively. Almost 90% of the older persons had at least one health risk. The prevalence of risk for pressure ulcers, poor oral health and falls was significantly higher in dementia care units compared to short term nursing care, home health care and nursing homes. The prevalence of risk for malnutrition was significantly higher among older persons staying in short term nursing care compared to other types of housing. The odds of having a risk for malnutrition were higher in short term nursing care compared to other types of housing. The oldest age group of 95-106 years had the highest odds of having a risk for falls. The presence of multiple health risks in one subject were more common in dementia homes compared to nursing homes and home health care but not compared to short term nursing care.

CONCLUSION: The prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls was high, implying that these health risks are a great concern for older persons receiving municipal health care. A comprehensive supporting preventive process to prevent all the investigated health risks among older persons receiving municipal health care is recommended.

Place, publisher, year, edition, pages
BioMed Central, 2021. Vol. 21, no 1, article id 265
Keywords [en]
Falls, Malnutrition, Municipal health care, Older persons, Poor oral health, Pressure ulcers, Prevention, Register study, Risk assessment, Senior alert
National Category
Nursing
Identifiers
URN: urn:nbn:se:mau:diva-42192DOI: 10.1186/s12877-021-02205-xISI: 000642627800003PubMedID: 33882869Scopus ID: 2-s2.0-85104596413OAI: oai:DiVA.org:mau-42192DiVA, id: diva2:1554194
Available from: 2021-05-12 Created: 2021-05-12 Last updated: 2024-05-24Bibliographically approved
In thesis
1. The stair of knowledge – prevention of pressure ulcers, malnutrition, poor oral healthand falls among older persons in nursing homes: development and evaluation of the feasibility of an educational intervention
Open this publication in new window or tab >>The stair of knowledge – prevention of pressure ulcers, malnutrition, poor oral healthand falls among older persons in nursing homes: development and evaluation of the feasibility of an educational intervention
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Evidence exists on how to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes, but these health risks still occur frequently, causing suffering. Aim: The overall aim of the thesis was to develop and evaluate the feasibility of an educational intervention to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. Methods: By combining methods, four studies were conducted to develop and evaluate the feasibility of an educational intervention. The educational intervention was developed in studies I-III, and its feasibility was evaluated in study IV. In study I, a quantitative study was conducted to determine the prevalence of the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons receiving municipal healthcare. In study II, a qualitative study was conducted to explore nurse aides’, registered nurses’ and managers’ experiences of preventive work regarding pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. In study III, a qualitativ estudy was conducted to co-design the educational intervention together with nurse aides, registered nurses and managers to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. Additionally, key persons in the municipality participated in co-designing the educational intervention. The development process and the educational intervention itself was also described in study III. In study IV, a mixed methods study was conducted to evaluate the feasibility of the educational intervention. Results: The risks of pressure ulcers, malnutrition, poor oral health and falls was approximately 28%, 56%, 34% and 74%, respectively, and approximately 90% had at least one health risk (study I). Nurse aides, registered nurses and managers experienced prevention of pressure ulcers, malnutrition, poor oral health and falls as important but challenging (study II). The lack of knowledge among them was reported as a major challenge (studies II and III). The educational intervention, the STAIR OF KNOWLEDGE, was co-designed with nurse aides, registered nurses and managers in nursing homes, and stakeholders in the municipality, to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The content, format and delivery of the STAIR OF KNOWLEDGE intervention was co-designed to fit the need for knowledge to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in a local context (study III), and was proven as feasible but with some refinements required for a perfect fit (study IV). Conclusion: The educational intervention, the STAIR OF KNOWLEDGE, was developed together with and for nurse aides, registered nurses and managers to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The STAIR OF KNOWLEDGE intervention is therefore likely to provide end users with the knowledge needed to accomplish preventive work in nursing homes. The STAIR OF KNOWLEDGE intervention was proven to be feasible but with some amendments necessary before continuing to a definitive trial.

Place, publisher, year, edition, pages
Malmö: Malmö University Press, 2024. p. 106
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383, E-ISSN 2004-9277
Keywords
prevention, pressure ulcers, malnutrition, poor oral helath, falls, older persons, nursing homes, educational intervention
National Category
Nursing
Research subject
Care science
Identifiers
urn:nbn:se:mau:diva-67403 (URN)10.24834/isbn.9789178774043 (DOI)978-91-7877-403-6 (ISBN)978-91-7877-404-3 (ISBN)
Public defence
2024-05-17, Hälsa och samhälle aulan, Jan Walderströmsgata 25, Malmö, 09:00 (Swedish)
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Note

Paper IV in dissertation as manuscript

Paper IV is not included in the fulltext online 

Available from: 2024-05-24 Created: 2024-05-24 Last updated: 2024-05-24Bibliographically approved

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Neziraj, MeritaHellman, PeterKumlien, ChristineAxelsson, Malin

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