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Specyficzne potrzeby lecznicze osób starszych a kształcenie geriatrów. Dlaczego geriatria jest specjalizacją ważną i dlaczego ciągle brakuje geriatrów?

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Dubiel M., Klich-Rączka A.

Zdrowie Publiczne i Zarządzanie

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2011

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vol. 9

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issue 1

101-109

EN

While population is aging we are facing raising number of geriatric problems. It is obvious nowadays that if we do not start creating certain plans considering medical and social care of elderly people, the situation may get out of control. The natural course of diseases in elderly is different to middle aged and young people. These individuals show different symptoms and social background, different prognosis and complications of the disease and of diagnostic and therapeutic medical procedures themselves. The major feature that distinguishes geriatric medicine from others is comprehensive geriatric assessment which is holistic and considers not only medical condition but also social, psychological background together with identifying aspects of functional status, nutrition, transportation and others. It seems that the need for professionals with experience in geriatrics is growing. The most important in this area are general practitioners and geriatricians. There is also a constant need for educational effort to create society whose members are responsible for their own health.

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Comorbidities in patients over 60 years of age treated at the rehabilitation clinic

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Pietrzyńska M., Stawińska-Witoszyńska B., Krzyżaniak A., Łańczak-Trzaskowska M., Nowak K.

Anthropological Review

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2015

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vol. 78

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issue 3

309-316

EN

Patients aged above 60 represent a very diversified population group with respect to their health condition. This may result from multimorbidity. In the rehabilitation process of elderly patients it is especially crucial to identify not only the underlying diseases which constituted the grounds for referral to the rehabilitation clinic, but also the comorbidities that have to be taken into consideration while planning their rehabilitation. The aim of the present paper is the assessment of comorbidities in patients of the rehabilitation clinic. The study population included 1616 patients (447 man and 1169 women) treated at the rehabilitation clinic. The factors put through analysis were the age and gender of the patient, the main diagnosed (underlying) illness subject to rehabilitation treatment, as well as comorbidities. All diseases, both the underlying conditions and the comorbidities have been classified according to the International Statistical Classification of Diseases and Related Health Problems (10th revised edition). The main reasons for the treatment at the rehabilitation outpatient clinic were arthrosis of the spine, knee and hip joints, polyarthritis, osteoporosis, diseases of the central nervous system diseases and paralytic syndromes as consequences of strokes, hypertension or atherosclerosis, as well as post-traumatic conditions. The most frequent comorbidities occurring in patients of the rehabilitation clinic were cardiovascular diseases (irrespective of the age group and the underlying disease). In the age group of 60-64, the subsequent comorbidities were gastrointestinal and cancers, and in the age of 65-74, neoplasms were the most frequently occurring comorbidities. The performed analysis resulted in the following conclusions: The majority of patients diagnosed and treated at the rehabilitation centre suffered from irregularities in the muscular, articular and skeletal system or the connective tissue (those were mainly the arthrosis of the spine, hip and knee joints as well as osteoporosis). The most frequently observed comorbidities in patients of the rehabilitation clinic were cardiovascular and gastrointestinal diseases, as well as neoplasms.

3

Arterial hypertension as a factor in the choice of conflict resolution strategies by elderly persons

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Tikhonova N., Demina N., Klimatckaia L., Osipov A., Kudryavtsev M., Zhavner T., Shpakou A.

Family Medicine & Primary Care Review

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2018

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issue 4

368-372

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Impact of loneliness in the elderly in health care: a cross-sectional study in an urban region of Portugal

88%

Rocha-Vieira C., Oliveira G., Couto L., Santos P.

Family Medicine & Primary Care Review

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2019

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issue 2

138-143

EN

Background. Loneliness is a subjective, complex and multi-dimensional feeling, having a significant impact on mental health. It is related to intrinsic and extrinsic factors. Objectives. The aim of this study is to evaluate the impact of loneliness in elderly patients in medical care. Material and methods. We conducted a cross-sectional study of a sample of 150 participants, aged ≥ 65 years, interviewed by a structured questionnaire, including the University of California Los Angeles Loneliness Scale (UCLA -LS ), for assessment of loneliness. Other variables included socio-demographic characterisation and family dysfunction. Total medication prescription and polymedication were used to assess the medical care assistance profile. Logistic regression was used for multivariate analysis. Results. The prevalence of moderate to severe loneliness was 36% (95% CI: 28.3–44.2%), higher with ageing, without differences between gender. The greatest impact in loneliness occurred in the presence of family dysfunction, income dissatisfaction, living alone and ageing. Being married/in a non-marital partnership and maintaining professional activity appeared as protective factors. The perception of loneliness was related with polymedication, with higher levels of loneliness matching with higher polymedication. Conclusions. Loneliness is common in the geriatric population and interferes significantly with health care; thus, it can be considered a determinant of health. Incorporating this factor into clinical decision reasoning is crucial for better health care.

5

Prevalence of insomnia and use of hypnotics in seniors from the Łodz Province, Poland

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Bielec F., Kamińska E., Dudek R., Koziarska-Rościszewska M., Rysz J.

Family Medicine & Primary Care Review

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2019

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issue 1

17-22

EN

maintaining sleep and/or waking up too early. As a result, patients may complain about physical and mental fatigue and general malaise during the day. Hence, people suffering from insomnia often look for treatment options. Objectives. To assess the frequency of insomnia in seniors; to establish the main predisposing factors and to evaluate the pharmacotherapy. Material and methods. The study was conducted in the group of 298 aged 60+ residents of Lodz region, Poland. An anonymous questionnaire concerning lifestyle, sleep disorders, and hypnotics use was conducted by each patient. The Athens Insomnia Scale – a standardized questionnaire to diagnose insomnia was also performed. Patients were allocated into 2 groups: with and without insomnia. Collected data were statistically analyzed with the use of the t-student and chi-square tests. Results. 25.8% of all patients were diagnosed with insomnia, and greater age, female sex, and mental or neurological disorders were found to be associated with insomnia in the elderly. Moreover, 22.8% of all patients took hypnotics despite the fact that 41.2% of them did not fulfill the criteria of insomnia. H1-blockers (32.4%) were the most often used. Conclusions. While H1-blockers are not recommended as the first choice insomnia drugs, they are the most frequently used hypnotics. A significant group of patients take these without medical recommendation. The implementation of a simple tool for diagnosing insomnia in everyday practice would be useful.

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Systemic aspects of securing the health safety of the elderly

88%

Paplicki M., Susło R., Dopierała K., Drobnik J.

Family Medicine & Primary Care Review

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2018

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issue 3

267-270

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Perswazja w dyskursie gerontologicznym – przeszkody i strategie w komunikacji z pacjentem geriatrycznym

38%

Ozga K., Ozga A.

Acta Universitatis Lodziensis. Folia Litteraria Polonica

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2018

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vol. 48

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issue 2

275-302

EN

The article analyses obstacles and strategies in gerontological discourse. The authors provide a brief account of the ways in which various academic fields look at the elderly and propose their own definition of gerontological discourse against this background, defining it as the set of utterances issued by the elderly and to the elderly together with the communicative situation in which they are uttered and the factors that determine their thematic range. Subsequently, basic impediments in communication with senior citizens are presented, followed by a short discussion of non-verbal and multimodal communicative strategies in gerontological discourse. The core of the article is the analysis of verbal persuasive strategies in communication geriatrician – patient. It is presented with reference to the frame of appointment with a geriatrician in the following thematic order: slowness of movement, sight and hearing disorders, repetitiveness and a tendency to depart from the subject of the conversation, pain, non-bona fide communication and the principle of small steps. In this part of the article the authors also put forward a modification of the IADL scale from the perspective of its persuasive value. The last section of the article is devoted to the issue of persuasion in communication with patients suffering from memory and cognitive impairment – discussed in terms of spaced retrieval. The analysis shows that the persuasive value of gerontological discourse is gained through strategies defined at the following levels: communicative situation, text/discourse organization, vocabulary, grammar and syntax, and interactional arrangement.

PL

Prezentowany artykuł stanowi analizę przeszkód i strategii w dyskursie gerontologicznym. Autorzy dokonują krótkiego przeglądu spojrzenia na osobę starszą w świetle różnych dziedzin nauki i na tym tle proponują własną definicję dyskursu gerontologicznego jako całokształtu wypowiedzi osób starszych oraz wypowiedzi kierowanych do osób starszych wraz z sytuacją komunikacyjną, w której są one wypowiadane, oraz czynnikami determinującymi ich zakres tematyczny. Następnie przedstawione są podstawowe przeszkody w komunikacji z osobą starszą oraz strategie niewerbalne i multimodalne w komunikacji z seniorem. Zasadniczą część artykułu stanowią perswazyjne strategie werbalne w komunikacji: lekarz geriatra – pacjent, które omawiane są w porządku tematycznym w odniesieniu do ramy wizyty geriatrycznej – wolne tempo pacjenta, zaburzenia wzroku i słuchu, repetytywność i tendencja do odbiegania od tematu rozmowy, ból, komunikacja non-bona fide oraz zasada małych kroków. W tej części artykułu autorzy proponują także modyfikację skali IADL z perspektywy jej wartości perswazyjnej. Ostatnia sekcja artykułu poświęcona jest zagadnieniu perswazji w komunikacji z pacjentem z zaburzeniami pamięci i funkcji poznawczych, omawiana w świetle metody rehabilitacji poznawczej spaced retrieval. Analiza pokazuje, że perswazyjna wartość dyskursu gerontologicznego uzyskiwana jest dzięki strategiom wyodrębnionym na następujących jego poziomach: na poziomie sytuacji komunikacyjnej, na poziomie organizacji tekstu/dyskursu, w obrębie słownictwa, gramatyki i składni oraz na poziomie układu interakcyjnego.

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Specyficzne potrzeby lecznicze osób starszych a kształcenie geriatrów. Dlaczego geriatria jest specjalizacją ważną i dlaczego ciągle brakuje geriatrów?

Comorbidities in patients over 60 years of age treated at the rehabilitation clinic

Arterial hypertension as a factor in the choice of conflict resolution strategies by elderly persons

Impact of loneliness in the elderly in health care: a cross-sectional study in an urban region of Portugal

Prevalence of insomnia and use of hypnotics in seniors from the Łodz Province, Poland

Systemic aspects of securing the health safety of the elderly

Perswazja w dyskursie gerontologicznym – przeszkody i strategie w komunikacji z pacjentem geriatrycznym