Hasil untuk "Geriatrics"

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This new edition includes more than 107,000 terms and definitions, more than 5,000 new to this edition. More than 45 consultants from all the major medical and health science specialties have reviewed each word for accuracy and clarity, including new consultants for the specialties of endocrinology, gastroenterology, geriatrics, and rheumatology. The art program has also been extensively enhanced and now includes approximately 1,500 images and illustrations.

Mehdi Rostami, Sefa Bulut, Nadereh Saadati et al.

Objectives This study aims to investigate the relationship of the sense of coherence and e-health literacy with health anxiety in older women. Methods & Materials This is a cross-sectional study on 350 older women from Richmond Hill, Ontario, Canada, who were selected using a convenience sampling method. The health anxiety inventory (HAI), the sense of coherence scale (SOCS), and the eHEALS were employed to collect data. Data analysis was done using the Pearson correlation test (to evaluate the relationships between variables) and multiple linear regression (to identify predictors of health anxiety), conducted in SPSS software, version 27. Results The participants’ mean age was 71.43±5.62 years. The sense of coherence (r=-0.35, P<0.001) and e-health literacy (r=-0.42, P<0.001) had a significant negative correlation with health anxiety. Regression analysis showed that both sense of coherence and e-health literacy significantly predicted the health anxiety, with e-health literacy having a stronger impact (β=-0.42, t=-7.89, P<0.001) compared to the sense of coherence (β=-0.43, t=-7.00, P<0.001). The model explained 22% of the variance in health anxiety (R²=0.20, F=4.89, P=0.003).  Conclusion The sense of coherence and e-health literacy are significantly associated with health anxiety in older women. Enhancing the sense of coherence and e-health literacy may be effective in mitigating the health-related anxiety in older women.

Shahmir H Ali

David A. Raichlen, Madeline Ally, Daniel H. Aslan et al.

Abstract INTRODUCTION We examined the relationship between sedentary behavior (SB), moderate‐to‐vigorous physical activity (MVPA), and white matter hyperintensity (WMH) volumes, a common magnetic resonance imaging (MRI) marker associated with risk of neurodegenerative disease in middle‐aged to older adults. METHODS We used data from the UK Biobank (n = 14,415; 45 to 81 years) that included accelerometer‐derived measures of SB and MVPA, and WMH volumes from MRI. RESULTS Both MVPA and SB were associated with WMH volumes (βMVPA = −0.03 [−0.04, −0.01], p < 0.001; βSB = 0.02 [0.01, 0.03], p = 0.007). There was a significant interaction between SB and MVPA on WMH volumes (βSB×MVPA = −0.015 [−0.028, −0.001], pSB×MVPA = 0.03) where SB was positively associated with WMHs at low MVPA, and MVPA was negatively associated with WMHs at high SB. DISCUSSION While this study cannot establish causality, the results highlight the potential importance of considering both MVPA and SB in strategies aimed at reducing the accumulation of WMH volumes in middle‐aged to older adults. Highlights SB is associated with greater WMH volumes and MVPA is associated with lower WMH volumes. Relationships between SB and WMH are strongest at low levels of MVPA. Associations between MVPA and WMH are strongest at high levels of SB. Considering both SB and MVPA may be effective strategies for reducing WMHs

Monique Maira Maciel, Annelita Almeida Oliveira Reiners, Carla Rafaela Teixeira Cunha et al.

Resumo Objetivo analisar o Conhecimento, Atitudes e Práticas (CAP) dos profissionais de saúde, durante a assistência às pessoas idosas vivendo com demência em relação às situações de cuidado vivenciadas pelos cuidadores informais e a associação com fatores sociodemográficos e profissionais. Método estudo transversal e analítico, do tipo CAP, realizado no município de Tangará da Serra, Mato Grosso, Brasil, com 20 enfermeiros e 20 médicos das Unidades de Saúde da Família. Os dados foram coletados por meio de entrevista utilizando-se um instrumento desenvolvido a partir da literatura disponível sobre estudos CAP. Realizou-se análise descritiva e análise bivariada da associação entre as variáveis conhecimento, atitudes e práticas dos profissionais de saúde e as variáveis sociodemográficas e profissionais, utilizando o teste exato de Fisher, com nível de significância de 5%. Resultados os profissionais de saúde apresentaram conhecimento satisfatório e atitude favorável sobre as situações de cuidado vivenciadas pelos cuidadores informais de pessoas idosas vivendo com demência. Dos profissionais, 65% possuem práticas insuficientes direcionadas aos cuidadores, incluindo orientações, grupos de apoio e educação em saúde. Não houve associação significativa entre as variáveis conhecimento, atitudes e práticas e as variáveis sociodemográficas e profissionais. Conclusão embora os profissionais de saúde tenham conhecimento satisfatório sobre a situação de cuidado vivenciada pelos cuidadores e atitudes positivas em relação a eles, suas práticas se mostram insuficientes para atender suas necessidades, de forma a não contribuir para que os cuidadores possam lidar com as várias situações que o decorrer da doença ocasiona para a pessoa idosa e a eles.

Diana Marian, Giuseppe Toro, Giovanbattista D’Amico et al.

This review explores the recent advancements and ongoing challenges in regenerating alveolar bone, which is essential for dental implants and periodontal health. It examines traditional techniques like guided bone regeneration and bone grafting, alongside newer methods such as stem cell therapy, gene therapy, and 3D bioprinting. Each approach is considered for its strengths in supporting bone growth and integration, especially in cases where complex bone defects make regeneration difficult. This review also looks at different biomaterials, from bioactive scaffolds to nanomaterials, assessing how well they encourage cell growth and healing. Personalized treatments, like customized 3D-printed scaffolds, show promise in enhancing bone formation and tissue compatibility. Additionally, signaling molecules, like bone morphogenetic proteins, play a crucial role in guiding the process of bone formation and remodeling. Despite these advances, challenges remain—particularly with severe bone loss and with refining biomaterials for more reliable, long-term outcomes. This review proposes combining advanced materials, regenerative technologies, and personalized approaches to achieve more effective and consistent outcomes in oral and maxillofacial surgery.

Rinaldi I, Mauludi R, Jusman SW et al.

Ikhwan Rinaldi,1,2 Radinal Mauludi,2 Sri Widia Jusman,3 Robert Sinto,4 Kuntjoro Harimurti5,6 1Division of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 2Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 3Department of Biochemistry and Molecular Biology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 4Division of Tropical and Infectious Diseases, Department of Internal Medicine, Cipto Mangunkusumo National General hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 5Clinical Epidemiology Unit, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia; 6Division of Geriatrics, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaCorrespondence: Ikhwan Rinaldi, Email ikhwanrinaldi@gmail.comIntroduction: Currently, Imatinib (IM) which is a Tyrosine Kinase Inhibitor (TKI), is the main treatment for patients with chronic myeloid leukemia (CML). Major molecular response (MMR) is used as therapeutic response. Resistance to IM may be caused by hypoxia which is regulated by hypoxia inducible factor (HIF) 2-α. The role of HIF2-α is currently not researched extensively. This study aimed to analyse the differences in HIF-2α expression between chronic phase CML patients that achieved MMR and those that did not achieve MMR.Methods: This study used a cross-sectional method which analysed secondary data from whole blood samples in chronic phase CML patients aged 18– 60 years that received hydroxyurea (HU) before IM, aged 18– 60 years, received IM therapy for more than 12 months, and were willing to participate in the study. The exclusion criteria for this study were patients who were receiving IM at a dose of more than 400 mg/day. HIF-2α protein expression was examined using the enzyme-linked immunosorbent assay (ELISA) method. Differences between HIF-2α protein expression in groups that achieved MMR versus not achieving MMR was analysed using the Mann–Whitney test.Results: A total of 79 subjects were obtained. The median HIF-2α was 90.56 pg/mg protein (3.01– 4628.74). There was no statistically significant difference in expression of HIF-2α in the group that reached MMR and did not reach MMR, namely 123.45 pg/mg protein and 89.25 pg/mg protein respectively (p 0.718).Conclusion: This study found no statistically significant difference between HIF-2α expression level and MMR achievement of chronic phase CML patients who received HU before IM therapy.Keywords: CML, leukemia, imatinib, resistance, chronic myeloid leukemia, IM

Fu M, Aihemaiti D, Fu H et al.

Mingyue Fu,1,2,&ast; Diliaremu Aihemaiti,1,2,&ast; Haowen Fu,1,2,&ast; Na Li,1,2 Yifan Yuan,3 Mei Ye1,2 1Department of Gastroenterology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Hubei Clinical Centre and Key Laboratory of Intestinal and Colorectal Diseases, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, People’s Republic of China; 3Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yifan Yuan; Mei Ye, Email yifanyuan95@163.com; wumeiye08@163.comBackground: Crohn’s disease (CD) is a persistent inflammatory condition that impacts the gastrointestinal system and is characterized by a multifaceted pathogenesis involving genetic, immune, and environmental components. This study primarily investigates the relationship between gene expression and immune cell infiltration in CD, focusing on disulfidptosis—a novel form of cell death caused by abnormal disulfide accumulation—and its impact on various immune cell populations. By identifying key disulfidptosis-related genes (DRGs) and exploring their association with distinct gene expression subtypes, this research aims to enhance our understanding of CD and potentially other autoimmune diseases.Methods: Gene expression data from intestinal biopsy samples were collected from both individuals with CD and healthy controls, and these data were retrieved from the GEO database. Through gene expression level comparisons, various differentially expressed genes (DEGs) were identified. Subsequently, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed to reveal the biological processes and pathways linked to these DEGs. Later, immune cell infiltration was evaluated. Hub candidate DRGs were identified using machine learning algorithms. Validation of the expression of hub DRGs was carried out using quantitative real-time polymerase chain reaction. The hub DRGs were subjected to unsupervised hierarchical clustering to classify CD patients into subtypes. The characteristics of each subtype were then analyzed.Results: Two hub DRGs (NDUFA11 and LRPPRC) were identified. NDUFA11 showed a significantly positive association with the abundance of Th17 cells. Conversely, higher expression levels of LRPPRC were associated with a reduced abundance of various immune cells, particularly monocytes. CD patients were classified into two disulfidptosis-related subtypes. Cluster B patients exhibited lower immune infiltration and milder clinical presentation.Conclusion: LRPPRC and NDUFA11 are identified as hub DRGs in CD, with potential roles in disulfidptosis and immune regulation. The disulfidptosis subtypes provide new insights into disease progression.Keywords: Crohn’s disease, disulfidptosis, machine learning, expression pattern, immune cell infiltration

Justyna Kosydar-Bochenek, Dorota Religa, Małgorzata Knap et al.

IntroductionImproving patient safety is one of the most critical components of modern healthcare. Emergency medical services (EMS) are, by nature, a challenging environment for ensuring patient safety. It is fast-paced, physically dangerous, and highly stressful, requiring rapid decision-making and action. This can create risks not only for patients but also for employees. We assessed variations in perceptions of safety culture in prehospital emergency care among an international sample of paramedics and nurses.MethodsThe Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) was used for the study. The instrument measures six domains of safety culture in the workplace: teamwork climate, job satisfaction, safety climate, working conditions, stress recognition, and perceptions of management. A total of 1,128 EMS from 9 countries participated in this study.ResultsSafety Climate was 81.32/100 (SD 6.90), Teamwork Climate 84.14/100 (SD 8.74), Perceptions of Management 76.30/100 (SD 10.54), Stress Recognition 89.86/100 (SD 5.70), Working Conditions 81.07/100 (SD 9.75), and Job Satisfaction 70.71/100 (SD 7.21). There was significant variation in safety culture scores across countries for teamwork climate (TWC), working conditions (WC), and job satisfaction (JS). Among the individual variables (age, gender, level of education, and work experience), variations in safety culture scores were unaffected by age, gender, or work experience. Organizational characteristics: employment status and position type were linked to significant variations in safety culture domain scores.ConclusionParticipants’ perceptions of the patient safety climate were not particularly satisfactory, confirming that there is still a need to develop a culture of patient safety in prehospital emergency care.

Lingfei Gao, Jiali Xie, Haiqin Zhang et al.

Abstract Background Neuron Specific Enolase (NSE), a neuro-biochemical protein marker, may correlate with the prognosis of stroke patients. Moreover, hypertension is the most common comorbidities in patients with acute ischemic stroke (AIS), and the relationship between NSE levels and long-term functional outcomes in such an increasingly large population is unclear. The aim of the study was to investigate the relationships mentioned above and optimize the prediction models. Methods From 2018 to 2020, 1086 admissions for AIS were grouped as hypertension and non-hypertension, while hypertension group was randomly divided into development and validation cohorts for internal validation. The severity of the stroke was staged by National Institutes of Health Stroke Scale (NIHSS) score. Stroke prognosis after 1 year of follow up was documented by modified Rankin Scale (mRS) score. Results Analysis revealed the following findings:(i) Serum NSE levels increased greatly in hypertension subjects with poor functional outcomes(p = 0.046). However, there was no association in non-hypertension individuals(p = 0.386). (ii) In addition to the conventional factors (age and NIHSS score), NSE (OR:1.241, 95% CI: 1.025–1.502) and prothrombin time were significantly related to the incidence of unfavorable outcomes. (iii)Based on the above four indicators, a novel nomogram was established to predict the prognosis of stoke in hypertension patients with the c-index values of 0.8851. Conclusions Overall, high baseline NSE is associated with poor 1-year AIS outcomes in hypertension patients, suggesting NSE may be a potential prognostic and therapeutic target for stroke in hypertension patients.

Misa Takahashi, H. Hagiya, T. Koyama et al.

Sexually transmitted infections remain a neglected area of research in geriatrics. However, in the global aging societies, sexual health among the middle‐aged and older adults is an emerging public concern. High‐income countries are facing a resurgence of syphilis cases among young generations, but little is known about its prevalence in older populations. We aimed to investigate the national trend of syphilis cases in Japan.

P. Coll, J. Batsis, S. M. Friedman et al.

Medicare annual wellness visits (AWV) were initiated 10 years ago. Though AWVs emphasize on disease prevention and health promotion for older adults was a huge step forward, the current “one size fits all” approach does not adequately meet the wellness needs of a diverse population of older adults. Current AWVs do not sufficiently take into consideration the medical, psychological, functional, racial, cultural and socio‐economic diversity of older adults. Updated AWVs should be tailored to meet the needs and priorities of older adults receiving them. Several geriatrics approaches to care, including geriatrics Glidepaths and the 4Ms of an Age‐Friendly Health System, could help develop and guide a more patient‐specific geriatrics focused approach to AWVs. Medicare's IPPE is an ideal time to advise new Medicare beneficiaries regarding what they should and should not do to maximize their ability to be healthy and functionally independent into their 80s, 90s, and 100s.

Min Chen, Li Peng, Ping Gong et al.

Parkinson's disease (PD) is a prevailing neurodegenerative disorder. Baicalein has neuroprotective effects on PD animals, but its mechanism is not clarified. We explored baicalein effects on PD rats. PD rat models were established by injecting 6-hydroxydopamine into the striatum of substantia nigra on the left side of the rat brain and treated with baicalein. Dopamine (DA) content, neuronal apoptosis, neuronal injury, neuronal mitochondria, and autophagy were assessed. Baicalein-treated PD rats were treated with autophagy inhibitor 3-methyladenine to identify the role of autophagy in PD. PD rats were injected with AgomiR-30b-5p or sh-SIRT1 plasmids and treated with baicalein. PD rats elicited decreased neurological score and DA secretion of the striatum, increased neuronal apoptosis, and injury, and reduced number of mitochondria and autophagy, whereas baicalein alleviated neuronal injury and partly recovered mitochondrial dysfunction, 3-methyladenine inhibited the protection of baicalein. miR-30b-5p was elevated and SIRT1 was diminished in PD rats and inhibited by baicalein. miR-30b-5p targeted SIRT1. miR-30b-5p overexpression or SIRT1 silencing annulled the protection of baicalein. The phosphorylation level of AMPK in the substantia nigra of PD rats was decreased and mTOR was increased, whereas baicalein annulled these trends. Briefly, baicalein activated mitochondrial autophagy via miR-30b-5p and the SIRT1/AMPK/mTOR pathway, thus protecting PD rats.

S. C. E. Balvert, M. V. Milders, J. E. Bosmans et al.

Abstract Background Because of the expected increase in the number of people with dementia, and the associated social and economic costs, there is an urgent need to develop effective and cost-effective care for people with dementia and their caregivers. The intervention proposed here combines two approaches to caregiver support that have shown to be effective in empowering caregivers, i.e., multiple components for caregiver support and actively engaging caregivers to involve the person with dementia in activities at home. The aim is to investigate whether the intervention is effective in improving quality of life in the caregiver and the person with dementia. A further aim will be to investigate whether this intervention can improve caregivers’ feeling of competence, experience of caregiving, and mood. Methods The study design is a pragmatic, cluster randomised controlled trial with cost-effectiveness analysis. The study participants are informal caregivers and home-living persons with dementia for whom they care, recruited in various regions in the Netherlands. The trial will compare outcomes in two groups of participants: 85 dyads who receive the intervention, and 85 dyads who receive care as usual. The intervention is a caregiver support training that is manual based and consists of 6 group sessions over 2 months. Training takes place in small groups of caregivers led by a health care professional presented at dementia day care centres. Randomisation occurs at the level of the day care centre. Participants are assessed on the outcome measures at baseline, prior to the intervention, and at 3 and 6 months after baseline. Discussion The study will provide insight into effectiveness and cost-effectiveness of an intervention that has not previously been evaluated or implemented in the Netherlands. The intervention potentially adds to the effective support options for informal caregivers of people with dementia without greatly increasing the workload for health- or social care professionals. Trial registration The trial is registered at the Dutch Trial Register at NTR6643 ; August 22nd, 2017.

N. Lundebjerg, A. Medina-Walpole

The American Geriatrics Society is committed to taking purposeful steps to address racism in health care, given its impact on older adults, their families, and our communities. In fall 2020, AGS added a statement to our vision for the future, which reflects that our commitment is central to mission: “We all are supported by and able to contribute to communities where ageism, ableism, classism, homophobia, racism, sexism, xenophobia, and other forms of bias and discrimination no longer impact healthcare access, quality, and outcomes for older adults and their caregivers.” In 2021, we will be working to flesh out a multi‐year, multi‐pronged initiative that addresses the intersection of structural racism and ageism in health care. This will include engaging members in identifying strategies and with the goal of increasing member engagement around the idea that it will take all of us working together to achieve our vision for a collective future that is free of discrimination and bias. The Society has set as the first objective that by 2031, 100% of research presented at the AGS Annual Scientific Meeting and published in the Journal of the American Geriatrics Society (JAGS) will reflect the diversity of the population being studied. Other immediate efforts include undertaking a complete update of the Geriatrics Cultural Navigator, development of corresponding public education materials, and a webinar series focused on helping us all understand our own implicit bias, recognize implicit and explicit bias, and consider actions that we each might take to address bias when we observe it.

G. Bahat, B. Ilhan, Tuğba Erdoğan et al.

Aim To meet the current need in different European countries for improving prescribing in older adults, we aimed to create an update screening tool getting origin from the two user friendly criterion sets: the STOPP/STARTv2 criteria and CRIME criteria. Findings Based on thorough literature review, 55 criteria were added, 17 criteria were removed, and 60 criteria were modified. As a result, 153 TIME criteria composed of 112 TIME-to-STOP and 41 TIME-to-START criteria were introduced. Message TIME criterion set is an update screening tool reported from Eastern Europe that included experts from geriatrics and other specialties frequently giving care to older adults and some additional practical explanations for clinical use. Purpose To improve prescribing in older adults, criterion sets have been introduced from different countries. While current criterion sets are useful to some extent, they do not meet the need in some European countries. Turkish inappropriate medication use in the elderly (TIME) criteria was planned to meet this need. Methods In phase 1, the user friendly sets: STOPP/START version2 and CRIME criteria were combined. National experts composed of geriatricians and non-geriatricians were invited to review and comment. In phase 2, thorough literature review was performed and reference-based revisions, omissions, and additions were made. Explanatory additions were added to some criteria to improve application in practice. In phase 3, all working group members reviewed the criteria/explanations and agreed on the final content. Results Phase 1 was performed by 49 expert academicians between May and October 2016. Phase 2 was performed by 23 working group academicians between October 2016 and November 2018 and included face-to-face interviews between at least two geriatrician members and one criterion-related specialist. Phase 3 was completed between November 2018–March 2019 with review and approval of all criteria by working group academicians. As a result, 55 criteria were added, 17 criteria were removed, and 60 criteria were modified from the first draft. A total of 153 TIME criteria composed of 112 TIME-to-STOP and 41 TIME-to-START criteria were introduced. Conclusion TIME criteria is an update screening tool that differs from the current useful tools by the interactive study of experts from geriatrics and non-geriatrics, inclusion of practical explanations for some criteria and by its eastern European origin. TIME study respectfully acknowledges its roots from STOPP/START and CRIME criteria. Studies are needed whether it would lead improvements in older adults’ health.

Megan Surkan, N. Rajabali, S. Bagshaw et al.

Background The Clinical Frailty Scale (CFS) is a commonly used frailty measure in intensive care unit (ICU) settings. We are interested in the test characteristics, especially interrater reliability, of the CFS in ICU by comparing the scores of intensivists to geriatricians. Methods We conducted a prospective cohort study on a convenience sample of newly admitted patients to an ICU in Edmonton, Canada. An intensivist and a resident in Geriatric Medicine (GM) independently assigned a CFS score on 158 adults within 72 hours of admission. A specialist in Geriatric Medicine assigned a CFS score independently of 20 of the 158 patients to assess agreement between the two raters trained in geriatrics. Predictive validity was captured using mortality and length of stay. Results Agreement on CFS score was fair for intensivists vs. GM resident (kappa 0.32) and for intensivists vs. GM specialist (0.29), but substantial for GM resident vs. staff (0.79). Despite this, the CFS remained prognostically relevant, regardless of rater background. Frailty (CFS ≥ 5) as assessed by either intensivist or GM resident was a strong predictor of in-hospital mortality (odds ratio [OR] 3.6; 95% CI, 1.6–8.4, p = .003 and OR 3.0; 95% CI 1.3–6.9; p = .01, respectively). Frailty was also positively correlated with age, illness severity measured by APACHE II score, and length of hospital stay. Conclusions The interrater reliability of the CFS in ICU settings is fair for intensivists vs. geriatricians.

D. Leme, E. V. Alves, Vinicius de Araujo Oliveira Alysson Feliciano Lemos et al.

multiple variables. There are still few theoretical studies on this method, especially in the areas of geriatrics and gerontology research, which cover the study of different social, clinical, or physical and mental health variables. The objectives of this study were to present the main theoretical aspects of network analysis and demonstrate its applicability by analyzing studies that used this technique, offering an accessible language for all levels of knowledge in statistics. The main characteristics of the graphs, basic theoretical concepts, and scientific articles that used networks were demonstrated. This methodological study can help the reader to understand this analytical method, which is still little explored in national research. There is a scarcity of research on this subject in the areas of geriatrics and gerontology; however, technological advances, the availability of statistical programs with new data analysis resources, and the dissemination of information are relevant factors for the expansion of knowledge and the use of network analysis in this context.

A. Torres, Ewa Domańska-Glonek, Wojciech Dzikowski et al.

In March 2020, Polish universities had to suspend all on-site activities due to the SARS-CoV-2 pandemic. As a result, we were faced with the problem of how to convert a simulation-based course in geriatrics into distance-learning. The main focus of the original course (30 academic hours) is to expose fourth-year medical students, working in teams of three, to eight simulated cases including acute dyspnea (pneumonia), behavior change (somatic delirium), and cardio-pulmonary deterioration.

C. Avgerinou, M. Kotsani, M. Gavana et al.

To explore the perceptions and attitudes of primary health care (PHC) professionals towards frailty in a country where geriatrics is not recognised as a specialty, and to explore their training needs in the identification and management of frailty. The main barriers towards identifying and managing frailty are associated with the healthcare system, with the most important ones identified to be a gap in geriatric education and training of professionals, as well as problems with staffing of allied health professionals (AHPs) in community settings. However, PHC professionals are motivated and receptive to training in frailty, and they particularly value interactive learning with a focus on practical skills. There is an imperative need for education and training of PHC professionals, recruitment and training of AHPs and interdisciplinary collaboration for the delivery of person-centred care for people with frailty living in the community. Although frailty can be delayed or prevented by appropriate interventions, these are often not available in countries lacking formal education and infrastructure in geriatrics. The aim of this study was to: (a) explore ideas, perceptions and attitudes of primary health care (PHC) professionals towards frailty in a country where geriatrics is not recognised as a specialty; (b) explore PHC professionals’ training needs in frailty; and (c) define components of a frailty educational programme in PHC. Qualitative design, using two focus groups with PHC professionals conducted in Thessaloniki, Greece. Focus groups were audio recorded and transcribed. Data were analysed with thematic analysis. In total 31 PHC professionals (mean age: 46 years; gender distribution: 27 females, 4 males) participated in the study (physicians n = 17; nurses n = 12; health visitors n = 2). Four main themes were identified: (1) Perceptions and understanding of frailty; (2) Facilitators and barriers to frailty identification and management; (3) Motivation to participate in a frailty training programme; (4) Education and training. The main barriers for the identification and management of frailty were associated with the healthcare system, including duration of appointments, a focus on prescribing, and problems with staffing of allied health professionals, but also a lack of education. Training opportunities were scarce and entirely based on personal incentive. Professionals were receptive to training either face-to-face or online. A focus on learning practical skills was key. Education and training of professionals and interdisciplinary collaboration are essential and much needed for the delivery of person-centred care for people with frailty living in the community.