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Comparison of nurses' and physicians' documentation of functional abilities of older patients in acute care--patient records compared with standardized assessment.

https://arctichealth.org/en/permalink/ahliterature154847
Source
Scand J Caring Sci. 2008 Sep;22(3):341-7
Publication Type
Article
Date
Sep-2008
Author
Anna-Birna Jensdóttir
Pálmi Jónsson
Anja Noro
Elisabeth Jonsén
Gunnar Ljunggren
Harriet Finne-Soveri
Marianne Schroll
Else Grue
Jan Björnsson
Author Affiliation
Sóltún Nursing Home, Reykjavík, Iceland. annabirna@soltun.is
Source
Scand J Caring Sci. 2008 Sep;22(3):341-7
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Critical Care
Data Collection - methods
Documentation - standards - utilization
Female
Finland
Frail Elderly
Humans
Iceland
Male
Medical Records
Medical Staff, Hospital
Nursing Process
Physicians
Questionnaires
Abstract
To compare nurses' and physicians' documentation of geriatric issues and explore double documentation and undocumented areas of importance in an acute care setting in two Nordic countries.
158 participants, aged 75+, of whom the Minimum Data Set for Acute Care (MDS-AC) instrument was conducted at admission and from which 56 variables were taken in comparison with notes from patient records documented by nurses and/or physicians in two acute care hospitals, in Finland and Iceland.
Documentation of the impairment of personal Activities of Daily Living (ADL) was missing in 40-60% of the nurses' reports and 80-97% of the physician's reports. Even poorer was the documentation of the impairment of Instrumental Activities of Daily Living (IADL), of which 75% was not reported by the nurses and 85-96% by the physicians. Cognitive function was recorded in only 30-40% of the cases.
The traditional patient record in acute care setting lacks several variables of functional abilities of the older patients. Nurses took more responsibility in the documentation of functional abilities, compared with physicians, but they could improve. Using a standardized instrument such as the MDS-AC can improve documentation and make a basis for a clearer delineation in responsibilities for documentation between nurses and physicians and thereby improve outcome of care.
PubMed ID
18840217 View in PubMed
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[Geriatric rehabilitation potential--who has it?].

https://arctichealth.org/en/permalink/ahliterature184282
Source
Ugeskr Laeger. 2003 Jun 30;165(27):2729
Publication Type
Article
Date
Jun-30-2003
Author
Marianne Schroll
Source
Ugeskr Laeger. 2003 Jun 30;165(27):2729
Date
Jun-30-2003
Language
Danish
Publication Type
Article
Keywords
Aged
Denmark
Disabled Persons - rehabilitation
Frail Elderly
Geriatric Assessment - methods
Geriatrics - trends
Health Services for the Aged
Humans
Mass Screening
Notes
Comment On: Ugeskr Laeger. 2003 Jun 30;165(27):2731-312886562
PubMed ID
12886561 View in PubMed
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Muscle strength after resistance training is inversely correlated with baseline levels of soluble tumor necrosis factor receptors in the oldest old.

https://arctichealth.org/en/permalink/ahliterature49695
Source
J Am Geriatr Soc. 2004 Feb;52(2):237-41
Publication Type
Article
Date
Feb-2004
Author
Helle Bruunsgaard
Eva Bjerregaard
Marianne Schroll
Bente Klarlund Pedersen
Author Affiliation
Department of Infectious Diseases, Hovedstadens Sygehusfclleskab, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. hellebkemp@os.dk
Source
J Am Geriatr Soc. 2004 Feb;52(2):237-41
Date
Feb-2004
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Analysis of Variance
Exercise - physiology
Female
Frail Elderly
Humans
Inflammation - prevention & control
Interleukin-6 - blood
Male
Muscle, Skeletal - physiology
Receptors, Tumor Necrosis Factor - blood
Research Support, Non-U.S. Gov't
Tumor Necrosis Factor-alpha - metabolism
Abstract
OBJECTIVES: To test the hypothesis that physical exercise induces an antiinflammatory response that is associated with reduced chronic activation of the tumor necrosis factor (TNF)-alpha system in frail elders and that the increase in muscle strength after resistance training is limited by systemic low-grade inflammation. DESIGN: A 12-week controlled resistance-training study. SETTING: Nursing homes in Copenhagen, Denmark. PARTICIPANTS: Twenty-one frail nursing home residents aged 86 to 95 completed the study. INTERVENTION: Ten participants were randomized to a program of resistance training of knee extensors and flexors three times a week for 12 weeks; the remaining 11 participants served as a control group who joined social activities supervised by an occupation therapist. MEASUREMENTS: Muscle strength, plasma levels of TNF-alpha, soluble TNF receptor (sTNFR)-1, and interleukin (IL)-6 were measured before and at the end of the intervention period. RESULTS: The training program improved muscle strength but did not affect plasma levels of TNF-alpha and sTNFR-I or IL-6. However, plasma levels of sTNFR-I at baseline were inversely correlated with the increase in muscle strength. CONCLUSION: Low-grade activation of the TNF system could limit the increase in muscle strength after resistance training in the oldest old. Furthermore, data suggest that the antiinflammatory response induced by 12 weeks of resistance training is not sufficient to reduce chronic activation of the TNF system, but the small sample size limited this interpretation.
PubMed ID
14728633 View in PubMed
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