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Accelerating client-driven care: pilot study for a social interaction approach to knowledge translation.

https://arctichealth.org/en/permalink/ahliterature155589
Source
Can J Nurs Res. 2008 Jun;40(2):58-74
Publication Type
Article
Date
Jun-2008
Author
Carol L McWilliam
Anita Kothari
Beverly Leipert
Catherine Ward-Griffin
Dorothy Forbes
Mary Lou King
Marita Kloseck
Karen Ferguson
Abram Oudshoorn
Author Affiliation
School of Nursing, University of Western Ontario, London, Canada. cmcwill@uwo.ca
Source
Can J Nurs Res. 2008 Jun;40(2):58-74
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Adult
Consumer Participation
Diffusion of Innovation
Evidence-Based Medicine
Female
Group Processes
Health Planning Councils
Home Care Services - organization & administration
Humans
Interprofessional Relations
Middle Aged
Ontario
Pilot Projects
Abstract
This study piloted a knowledge translation (KT) intervention promoting evidence-based home care through social interaction. A total of 33 providers organized into 5 heterogeneous, geographically defined action groups participated in 5 researcher-facilitated meetings based on the participatory action model. The KT evidence reflects an empowering partnership approach to service delivery. Exploratory investigation included quantitative pre-post measurement of outcomes and qualitative description of data, presented herein. The critical reflections of the groups reveal macro-, meso-, and micro-level barriers to and facilitators of KT as well as recommendations for achieving KT. Insights gleaned from the findings have informed the evolution of the KT intervention to engage all 3 levels in addressing barriers and facilitators, with a conscious effort to transcend "push" and "pull" tendencies and enact transformative leadership. The findings suggest the merit of a more prolonged longitudinal investigation with expanded participation.
PubMed ID
18714898 View in PubMed
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An exploration of risk for recurrent falls in two geriatric care settings.

https://arctichealth.org/en/permalink/ahliterature106798
Source
BMC Geriatr. 2013;13:106
Publication Type
Article
Date
2013
Author
Humeira Tariq
Marita Kloseck
Richard G Crilly
Iris Gutmanis
Maggie Gibson
Author Affiliation
School of Health Studies, Faculty of Health Sciences, Western University, Ontario, Canada. mkloseck@uwo.ca.
Source
BMC Geriatr. 2013;13:106
Date
2013
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Aged
Aged, 80 and over
Female
Health Services for the Aged
Hospitals, Veterans
Humans
Male
Ontario - epidemiology
Pilot Projects
Recurrence - prevention & control
Rehabilitation Centers
Risk factors
Risk Management - methods
Abstract
Fall events were examined in two distinct geriatric populations to identify factors associated with repeat fallers, and to examine whether patients who use gait aids, specifically a walker, were more likely to experience repeat falls. Each unit already had a generic program for falls prevention in place.
Secondary data analysis was conducted on information collected during the pilot testing of a new quality assurance Incident Reporting Tool between October 2006 and September 2008. The study settings included an in-patient geriatric rehabilitation unit (GRU) and a long stay veterans' unit (LSVU) in a rehabilitation and long-stay hospital in Ontario. Participants were two hundred and twenty three individuals, aged 65 years or older on these two units, who experienced one or more fall incidents during the study period.
Logistic regression analyses showed that on the GRU age was significantly associated with repeat falls. On the LSVU first falls in the morning or late evening were associated with repeat falling. Walker as a gait aid listed at time of first fall was not associated with repeat falls.
This study suggests that different intervention may be necessary in different geriatric settings to identify, for secondary prevention, certain individuals for which the generic programs prove inadequate. Information collection with a specific focus on the issue of repeat falls may be necessary for greater insight.
Notes
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PubMed ID
24106879 View in PubMed
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Hip fracture types in men and women change differently with age.

https://arctichealth.org/en/permalink/ahliterature144984
Source
BMC Geriatr. 2010;10:12
Publication Type
Article
Date
2010
Author
David A Tanner
Marita Kloseck
Richard G Crilly
Bert Chesworth
Jason Gilliland
Author Affiliation
Division of Geriatric Medicine, Parkwood Hospital, 801 Commissioners Road East, London, Ontario, Canada.
Source
BMC Geriatr. 2010;10:12
Date
2010
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging - physiology
Female
Hip Fractures - epidemiology - etiology - physiopathology
Humans
Male
Middle Aged
Ontario - epidemiology
Risk factors
Sex Characteristics
Abstract
Hip fractures are expensive and a frequent cause of morbidity and mortality in the elderly. In most studies hip fractures have been viewed as a unitary fracture but recently the two main types of fracture (intertrochanteric and subcapital) have been viewed as two fractures with a different etiology and requiring a different approach to prevention. The relative proportion of intertrochanteric fractures increases with age in women. In previous studies no particular pattern in men has been noted. In this study, we explored changes in the relative proportion of the two fracture types with age in the two genders.
Patients of 50 years and older, with a diagnosis of hip fracture, discharged from two local acute care hospitals over a 5 year period (n = 2150) were analyzed as a function of age and gender to explore the relative proportions of intertrochanteric and subcapital fractures, and the change in relative proportion in the two genders with age.
Overall, for the genders combined, the proportion of intertrochanteric fractures increases with age (p = .007). In women this increase is significant (p
Notes
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PubMed ID
20214771 View in PubMed
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Involving the community elderly in the planning and provision of health services: predictors of volunteerism and leadership.

https://arctichealth.org/en/permalink/ahliterature168837
Source
Can J Aging. 2006;25(1):77-91
Publication Type
Article
Date
2006
Author
Marita Kloseck
Richard G Crilly
Roger C Mannell
Author Affiliation
Faculty of Health Sciences, The University of Western Ontario, London, ON, N6A 3K7, Canada. mkloseck@uwo.ca
Source
Can J Aging. 2006;25(1):77-91
Date
2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Health Services for the Aged - organization & administration
Housing for the Elderly
Humans
Leadership
Male
Middle Aged
Ontario
Peer Group
Volunteers
Abstract
A rapidly growing older population has led to changes in health care, including a community health movement with an emphasis on community collaboration, self-help, and capacity building. This study examined factors in the lives of older individuals that influenced their ability and willingness to participate in a health-related community-capacity-building project to help their frail, older neighbours. Using cross-sectional survey methodology, 107 volunteers who lived in a high density seniors' apartment complex known for its high health service utilization were compared with a random sample of 74 non-volunteers from the same community. Factors associated with volunteer involvement included age, activity level, functional ability, life satisfaction and certain personality characteristics. The study suggests that, within a community, the ''younger-old'' may be able to support their frail, older neighbours so that they can remain living in the community.
PubMed ID
16770750 View in PubMed
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Patient outcomes after discharge from a geriatric day hospital.

https://arctichealth.org/en/permalink/ahliterature171113
Source
Can J Aging. 2005;24(3):305-9
Publication Type
Article
Date
2005
Author
Richard G Crilly
Sonya Lytwynec
Marita Kloseck
Jan M Smith
Tyler Olsen
Bill Gold
Shelley Masse
Author Affiliation
Division of Geriatric Medicine, St. Joseph's Health Care London - Parkwood Site, 801 Commissioners Road East, London, ON, N6C 5J1, Canada. rcrilly@uwo.ca
Source
Can J Aging. 2005;24(3):305-9
Date
2005
Language
English
Publication Type
Article
Keywords
Accidental Falls
Aged
Aged, 80 and over
Ambulatory Care
Canada
Caregivers
Continuity of Patient Care
Female
Health Services for the Aged
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Patient Discharge
Questionnaires
Self-Help Devices
Abstract
Evidence suggests that frailer older patients benefit from a continuum of care rather than the admit/discharge model of our health system. This study examined patient outcomes after discharge from a geriatric day hospital (GDH) to determine what proportion continues to do well, what proportion declines, how the two groups differ, and if factors predictive of deterioration can be identified. Using telephone survey and Goal Attainment Scaling methodologies, the goals of 151 patients discharged from a GDH between 6 and 18 months previously were examined to determine whether GDH achievements were maintained or lost. All but 5 patients improved between GDH admission and discharge; after discharge, 39 per cent deteriorated. The need for more support in the community was predictive of deterioration, probably reflecting patient frailty. Number of medical diagnoses or medications were not predictive. Frailer older patients tend not to maintain goals achieved in a GDH after discharge and may benefit from ongoing maintenance.
PubMed ID
16421854 View in PubMed
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Perceiving falls within a family context: a focused ethnographic approach.

https://arctichealth.org/en/permalink/ahliterature159582
Source
Can J Aging. 2008;27(4):331-45
Publication Type
Article
Date
2008
Author
Christine Kilian
Alan Salmoni
Catherine Ward-Griffin
Marita Kloseck
Author Affiliation
School of Kinesiology, University of Western Ontario, ON N6A 3K7, Canada.
Source
Can J Aging. 2008;27(4):331-45
Date
2008
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Adult
Adult Children
Aged
Aged, 80 and over
Aging
Anthropology, Cultural - methods
Canada
Female
Geriatric Assessment
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Parents
Questionnaires
Research Design
Risk
Sampling Studies
Space Perception
Abstract
The purpose of the present research was to examine the perceptions of risk regarding falling held by older adults and their adult children. Using a focused ethnographic approach, older adults and adult children were interviewed in depth. Thematic analysis was conducted to identify themes within groups and to compare the perspectives of older adults and adult children. Findings highlighted differences in perceptions and approaches to action between older adults and their adult children. There were three approaches to action adopted by these families, which focused around whose actions were dominant: parents' actions, shared actions, and children's secret actions. The results emphasize the value placed on independence by older adults and the impact of multiple family relations taking action to prevent falls. The present study points to the importance of including multiple family perspectives in research concerning injury prevention for older adults.
PubMed ID
19416795 View in PubMed
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Underrepresentation of individuals 80 years of age and older in chronic disease clinical practice guidelines.

https://arctichealth.org/en/permalink/ahliterature132980
Source
Can Fam Physician. 2011 Jul;57(7):e263-9
Publication Type
Article
Date
Jul-2011
Author
Lizebeth Cox
Marita Kloseck
Richard Crilly
Carol McWilliam
Laura Diachun
Author Affiliation
Faculty of Health Sciences, University of Western Ontario, Arthur and Sonia Labatt Health Sciences Bldg, Room 316, London, ON N6A 5B9. lcox2@uwo.ca
Source
Can Fam Physician. 2011 Jul;57(7):e263-9
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada
Chronic Disease - epidemiology - therapy
Comorbidity
Female
Guideline Adherence - standards
Humans
Male
Practice Guidelines as Topic
Abstract
To determine whether Canadian clinical practice guidelines (CPGs), and the evidence used to create CPGs, include individuals 80 years of age and older.
Descriptive analysis of 14 CPGs for 5 dominant chronic conditions (diabetes, hypertension, heart failure, osteoporosis, stroke) and descriptive analysis of all research-based references with human participants in the 14 guidelines.
To identify recommendations for individuals 65 years of age and older or 80 years of age and older and for those with multiple chronic conditions.
Although 12 of 14 guidelines provided specific recommendations for individuals 65 years of age and older, only 5 provided recommendations for frail older individuals (= 80 years). A total of 2559 studies were used as evidence to support the recommendations in the 14 CPGs; 2272 studies provided the mean age of participants, of which only 31 (1.4%) reported a mean age of 80 years of age and older.
There is very low representation of individuals in advanced old age in CPGs and in the studies upon which these guidelines are based, calling into question the applicability of current chronic disease CPGs to older individuals. The variety of medical and functional issues occurring in the elderly raises the concern of whether or not evidence-based disease-specific CPGs are appropriate for such a diverse population.
Notes
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PubMed ID
21753085 View in PubMed
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The use of Goal Attainment Scaling in a community health promotion initiative with seniors.

https://arctichealth.org/en/permalink/ahliterature162706
Source
BMC Geriatr. 2007;7:16
Publication Type
Article
Date
2007
Author
Marita Kloseck
Author Affiliation
Faculty of Health Sciences, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, London, Ontario, Canada. mkloseck@uwo.ca
Source
BMC Geriatr. 2007;7:16
Date
2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Community Health Services - organization & administration
Feasibility Studies
Female
Geriatric Assessment - methods
Health promotion
Humans
Male
Ontario
Organizational Objectives
Outcome Assessment (Health Care)
Abstract
Evaluating collaborative community health promotion initiatives presents unique challenges, including engaging community members and other stakeholders in the evaluation process, and measuring the attainment of goals at the collective community level. Goal Attainment Scaling (GAS) is a versatile, under-utilized evaluation tool adaptable to a wide range of situations. GAS actively involves all partners in the evaluation process and has many benefits when used in community health settings.
The purpose of this paper is to describe the use of GAS as a potential means of measuring progress and outcomes in community health promotion and community development projects. GAS methodology was used in a local community of seniors (n = 2500; mean age = 76 +/- 8.06 SD; 77% female, 23% male) to a) collaboratively set health promotion and community partnership goals and b) objectively measure the degree of achievement, over- or under-achievement of the established health promotion goals. Goal attainment was measured in a variety of areas including operationalizing a health promotion centre in a local mall, developing a sustainable mechanism for recruiting and training volunteers to operate the health promotion centre, and developing and implementing community health education programs. Goal attainment was evaluated at 3 monthly intervals for one year, then re-evaluated again at year 2.
GAS was found to be a feasible and responsive method of measuring community health promotion and community development progress. All project goals were achieved at one year or sooner. The overall GAS score for the total health promotion project increased from 16.02 at baseline (sum of scale scores = -30, average scale score = -2) to 54.53 at one year (sum of scale scores = +4, average scale score = +0.27) showing project goals were achieved above the expected level. With GAS methodology an amalgamated score of 50 represents the achievement of goals at the expected level.
GAS provides a "participatory", flexible evaluation approach that involves community members, research partners and other stakeholders in the evaluation process. GAS was found to be "user-friendly" and readily understandable by seniors and other community partners not familiar with program evaluation.
Notes
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PubMed ID
17605827 View in PubMed
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Using photovoice methodology to investigate facilitators and barriers to food acquisition and preparation by rural older women.

https://arctichealth.org/en/permalink/ahliterature132124
Source
J Nutr Gerontol Geriatr. 2011;30(3):225-47
Publication Type
Article
Date
2011
Author
Carly Neill
Beverly D Leipert
Alicia C Garcia
Marita Kloseck
Author Affiliation
University of Western Ontario, London, Canada. cneill@alumni.uwo.ca
Source
J Nutr Gerontol Geriatr. 2011;30(3):225-47
Date
2011
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Commerce
Diet - standards
Diet Records
Family Characteristics
Female
Focus Groups
Food Handling
Food Labeling
Food Supply
Health Knowledge, Attitudes, Practice
Humans
Interpersonal Relations
Ontario
Photography
Rural Population
Seasons
Social Values
Socioeconomic Factors
Transportation
Weather
Abstract
This research investigates facilitators and barriers that rural women aged 65 to 75 years in Southwestern Ontario experience in acquiring and preparing food through the use of photovoice methodology. Eighteen participants in five rural communities used a camera and log book to document their experiences and perspectives relating to the acquisition and preparation of food, and they each participated in two focus groups to engage in critical dialogue and knowledge sharing regarding the meaning and significance of the pictures they took. Analysis of photographs, log books, and focus group data revealed 13 themes, 3 emerging as facilitators to food acquisition and preparation (availability of food, social networks and values, personal values and resources), 5 as barriers (adjusting to changing family size, winter weather, food labeling issues, grocery shopper resources, limited physical capacity), and 5 as both facilitators and barriers (economics, valuing a healthy diet, technology changes, transportation, location and nature of grocery stores). Data also revealed rurality, age, and gender as foundationally influential factors affecting rural older women's food acquisition and preparation.
PubMed ID
21846240 View in PubMed
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9 records – page 1 of 1.