Papers by Katarzyna Szczerbińska
European Geriatric Medicine, 2013
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Przegla̧d lekarski
Knowledge of the most frequent circumstances of falls is crucial from a doctor's, nurse's... more Knowledge of the most frequent circumstances of falls is crucial from a doctor's, nurse's or caregiver's point of view, as it allows them to anticipate the threat of a fall and to take appropriate precautionary measures. It is for this reason that a fall registration system has been developed within the EUNESE (EUropean NEtwork for Safety among Elderly) international project, and then introduced in 4 nursing homes (NH) for older and chronically ill people and for chronic psychiatric patients. The article presents the results of a year's registration of falls in these facilities, also describing the typical features of the falls, considering the type of NH. The study revealed that the falls occured most frequently in a resident's room, while walking or getting up from a bed, chair, wheelchair or toilet seat, as a result of tripping or slipping on slippery, wet or insufficiently illuminated floor, in connection with gait or balance disorder, dizziness, agitation or...
Ortopedia, traumatologia, rehabilitacja
To determine the respective efficacy of two different instruction programmes designed to aid the ... more To determine the respective efficacy of two different instruction programmes designed to aid the elderly in rising unassisted after an incidental fall. The 12-week study covered 120 recent fallers (age range: 80-90 years) randomly split into two study groups: Group I (61 subjects; 41F, 20M), Group II (59 subjects 37F, 22M). Group I followed a programme combining safe postural shifts and the backward-chaining method, whereas Group II (controls) took part in conventional training to rise unassisted after a fall. The duration of the instructional programmes was 12 weeks. The Timed "Up & Go" and Tinetti tests were applied at baseline and on completion of the programmes to assess individual ability to rise unassisted after an incidental fall. The results in both groups were assessed with the t-Student test and the Wilcoxon test. Statistically significant improvements were only noted in Group I (p<0.05) in the Timed "Up & Go" test score (27 vs. 20 sec.), Tinetti sco...
European Geriatric Medicine, 2013
European Geriatric Medicine, 2013
Journal of the American Medical Directors Association, 2015
The objectives of this study were to describe the prevalence of diabetes mellitus (DM) in Europea... more The objectives of this study were to describe the prevalence of diabetes mellitus (DM) in European nursing homes (NHs), and the health and functional characteristics of diabetic residents (DMR) aged 60 years and older. Between 2009 and 2011, the Services and Health for Elderly in Long TERm care (SHELTER) project, a 12-month prospective cohort study, was conducted to assess NH residents across different health care systems in 7 European countries and Israel. The study included 59 NHs in 8 countries with a total of 4037 residents living in or admitted to a NH during the 3-month enrollment period. The multidimensional InterRAI instrument for Long-Term Care Facilities (InterRAI-LTCF) was used to assess health and functional status among residents. Descriptive statistics and linear, ordinal, and logistic regression were used to perform the analyses. We found a 21.8% prevalence of DM among NH residents. Residents with DM (DMRs) were significantly younger compared with non-DMRs (82.3, SD ±...
Przegla̧d lekarski, 2011
In the frame of the international CHANGE Project a training course for nurses has been elaborated... more In the frame of the international CHANGE Project a training course for nurses has been elaborated in order to improve their interpersonal communication skills in motivating older patients to change their health behaviours. Family nurses, caring for community-dwelling older patients applied their newly-developed competences to promote healthy nutrition and regular physical activity among their patients. To assess the effectiveness of the nurse training. Changes in physical activity and nutritional habits of older patients resulting from nurses' performance were evaluated as well as patients' intentions to change those behaviours. During the 2 weeks following the training 108 older patients at age avg. 69.6 (SD 60-87) in Krakow city, were initially interviewed by nurses with a questionnaire assessing health behaviours (frequency of intake of particular food products, frequency of different types of physical activity) and motivation to change those behaviours. The nurses provid...
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2012
Examination of prevalence of depressive symptoms among older persons in home care (HC) and comple... more Examination of prevalence of depressive symptoms among older persons in home care (HC) and complex continuing care (CCC) hospitals/units, factors associated with depressive symptoms in those settings, and rate of antidepressant use among older persons with depressive symptoms. Observational study using data from interRAI assessments used in normal clinical practice. Logistic regression models were used to identify factors associated with depressive symptoms in the frail elderly and treatment approaches were described. Fourteen HC agencies and 134 CCC hospitals/units in Ontario, Canada. Older persons (N = 191,9871) aged 65 years and older, including 114,497 persons from HC and 77,490 persons from CCC. Data were collected using Resident Assessment Instrument 2.0 (RAI 2.0) (1996-2004) in CCC and Resident Assessment Instrument for Home Care (RAI-HC) (2003-2004) in HC. Prevalence of depressive symptoms among older HC enrollees was lower (12.0%) than in CCC (23.6%). It decreased significa...
European Geriatric Medicine, 2010
ABSTRACT Background. - Stroke is one of the most disabling conditions in old age. Good quality of... more ABSTRACT Background. - Stroke is one of the most disabling conditions in old age. Good quality of care may prevent subsequent disability. Yet, recommendations for stroke care focus mainly on acute phase. Much less consistency exists in later phases when care is delivered by a wide spectrum of providers. The aim of the study was to map current trajectories of stroke patients through different health care settings in three European countries: Czech Republic, Lithuania, and Poland. Methods. - The research was conducted within the CLESA project (&quot;Cross-National Determinants of Quality of Life and Health Services for the Elderly&quot;) in 2003. It combined qualitative methods of case study questionnaire and expert consensus group. Existing standards of care, accessibility of health and social care services were compared cross-nationally focusing on time factor, professionals involved, administrative and financial components of services. Results. - Application of international recommendations for acute care for stroke patients positively affected accessibility of acute care services in all the countries considered in the study. Differences between countries occurred mainly in the post-acute care in the type of institution, professionals involved, eligibility criteria for rehabilitation and financial resources for care. Home care was the most diverse and fragmented service in terms of provider type, organisation and payment system. Conclusions. - The evidence-based medicine shaped medical care during early stroke in the Eastern European countries into rather uniform performance resulting in development of acute stroke units. However, higher heterogeneity in the rehabilitation and home care services may come out of inaccuracies in the recommendations and standards of care in later stage after stroke.
European Geriatric Medicine, 2012
ABSTRACT Objectives To establish association of specific central nervous system (CNS) drugs with ... more ABSTRACT Objectives To establish association of specific central nervous system (CNS) drugs with recurrent falling.Patients and methodsObservational cohort study conducted in seven nursing homes (NH) for 822 residents in city of Krakow, Poland. Prospective calendar-recorded registration of all falls during the study period (18 months) was performed by nurses in one hour after each fall. Among other data, age, gender and drugs taken in the day of fall were collected. Poisson regression model was used to establish drugs enhancing the rate of falling.ResultsDuring the study period, 289 falls were registered in 162 nursing home residents: 61 falls in 29 residents of NH for psychiatric patients and 228 falls in 133 residents of NHs for older and chronically ill people. According to univariate analysis, the rate of falling increased with use of antiepileptics (cIRR = 1.60; P &lt; 0.001), number of CNS drugs (crude incident rate ratio [cIRR] = 1.16; P &lt; 0.001), and for residents of NH for psychiatric patients (cIRR = 1.37; P &lt; 0.03)–despite their lower average age (61.9 vs. 78.4; P &lt; 0.001). After adjusting for age, gender, number of other than CNS drugs, type of NH and CNS drugs only antiepileptics (IRR = 1.65; P &lt; 0.003) significantly increased the rate of falling. Anti-Parkinson drugs were near to influence it (IRR = 1.41; 95% confidence interval = 0.989–2.007; P = 0.058).ConclusionNH residents taking antiepileptic drugs, and especially those taking more than one CNS drug or stay in NHs for persons with psychiatric illness, need more professionals’ attention due to a higher risk of recurrent falling.
European Geriatric Medicine, 2012
European Geriatric Medicine, 2013
Revista Española de Geriatría y Gerontología, 2009
El anciano en situación crítica: nuevos retos en la asistencia geriátrica del futuro A. López-Sot... more El anciano en situación crítica: nuevos retos en la asistencia geriátrica del futuro A. López-Soto y E. Sacanella
Pain, 2007
The relationship between pain and increasing age was investigated using data from two different c... more The relationship between pain and increasing age was investigated using data from two different care settings collected on a province-wide basis in Ontario. Home care clients (HC) and complex continuing care patients (CCC) are assessed using the Resident Assessment Instrument-Home Care and Resident Assessment Instrument 2.0 instruments, respectively, as part of normal clinical practice. For this study, the sample was restricted to those aged 65 years and older and totaled 193,158 individuals. Centenarians (those 100 years of age or older) made up 0.41% (n=788) of the sample. Pain was assessed according to a previously validated pain scale embedded in both assessments that uses items on frequency and intensity. Based on 5-year age groups beginning at 65, the mean reported pain score was lower with each increment in age for men and women. Multiple logistic regression models were constructed and the odds ratios for pain in both HC and CCC groups decreased consistently in higher age groups after adjusting for disease diagnoses, cognition, functional status and health indicators. A model that included categories of analgesic medications coded based on the WHO pain ladder showed the relationship persisted after controlling for analgesia. In clinical settings, the oldest old appear to have lower levels of pain compared with the young old after adjusting for a variety of potential confounding variables.
Nurse Education Today, 2012
s u m m a r y Background: The main goal of the study, conducted within the multicenter ComPro pro... more s u m m a r y Background: The main goal of the study, conducted within the multicenter ComPro project (Competence Profiles for Learning Supporters in Elderly Care) and funded by the Leonardo da Vinci Programme in 2006-2008, was to define the competences profile of a person responsible for the inhouse education of professionals caring for the elderly persons in social care institutions. Methods: The qualitative (3 focus group interviews) and quantitative (the KODE®X questionnaire) approach was used to study opinions of 106 care professionals and 39 managers in social care institutions, and 35 teachers in vocational schools for workers in social care about desired competences of an in-house educator. Results: The factor analysis with Varimax rotation performed separately for each group of surveyed professionals showed 4 factors in each, which had different components with the highest correlation rates. In the managers groupfactor 1 correlated most with communication and organisational competences; among care professionalswith professional knowledge and their job specific skills; among teacherswith social and didactical competences. Conclusions: The most expected competences were different in each position, what may reflect the need of creation of a job description and a post of an in-house educator in social care institutions.
Drugs & Aging, 2011
There has been concern about under-representation of older people in clinical trials. The PREDICT... more There has been concern about under-representation of older people in clinical trials. The PREDICT study reported that older people and those with co-morbidity continue to be excluded unjustifiably from clinical trials. However, there is no information about differences of opinion on these issues between EU countries. The results of a survey of health-related professionals from nine EU countries that participated in the PREDICT study are presented in this study. The aim of the study was to identify and examine any differences of opinion between EU countries on the inclusion of older patients in clinical trials. A questionnaire using a Likert scale and free text was completed by 521 general practitioners, geriatricians, clinical researchers, ethicists, nurses and industry pharmacologists/pharmacists. The questions explored the impact of the present situation, possible reasons for under-representation and potential methods of improving participation. Countries participating were the Czech Republic, Israel, Italy, Lithuania, the Netherlands, Poland, Romania, Spain and the UK. There was agreement that exclusion from clinical trials on age grounds alone was unjustified (87%) and that under-representation of older people in trials caused difficulties for prescribers (79%) and patients (73%). There were national differences between professionals. All but the Lithuanians believed that older people were disadvantaged because of under-representation. The Czech, Lithuanian and Romanian professionals felt that it was justified to have age limits based on co-morbidity (61-83%) and polypharmacy (63-85%). Romanians also thought that having age limits on trial participation was justified because of reduced life expectancy (62%) and physical disability (58%) in older people. All but the Romanian professionals felt that the present arrangements for clinical trials were satisfactory (62%). All but the Israelis (56%) and Lithuanians (70%) agreed that regulation of clinical trials needed alteration. Although respondent selection bias cannot be excluded, the differences that emerged between countries may be the result of the political and healthcare-system differences between older and newer members of the EU. These differences may influence decision making about clinical trial regulations and practice in older people.
Archives of Internal Medicine, 2011
Background: Much clinical research of relevance to elderly patients examines individuals who are ... more Background: Much clinical research of relevance to elderly patients examines individuals who are younger than those who have the disease in question. A good example is heart failure. Therefore, we investigated the extent of exclusion of older individuals in ongoing clinical trials regarding heart failure.
Aging Clinical and Experimental Research, 2009
The current article is a statement of the meeting with international and multidisciplinary partic... more The current article is a statement of the meeting with international and multidisciplinary participation, held in Wrocław, Poland on September 11-13, 2008. The meeting was devoted to working out a position focusing on the challenge for individuals, health care systems, biological, psychosocial, epidemiological, medical, and public health sciences in the ageing populations of the twenty-first century. The statement is presented as an overview, in tabular format, of the current European situation regarding basic biological research on ageing, health promotion and preventive action, clinical care for older people, and recommendations for future actions. (Pol J Endocrinol 2009; 60 (5): 408-414)
Aging Clinical and Experimental Research, 2010
This study was conducted within the European Network for Safety among the Elderly (funded by the ... more This study was conducted within the European Network for Safety among the Elderly (funded by the EC in European Public Health Programme 2003-2008). The main aim was to assess the effectiveness of two types of implementation of multi-factorial intervention to reduce the incidence of falls in three nursing homes (NHs): one based on the involvement of the entire nursing staff in assessing the risk of falls (in NH A and B) and the other with one well-qualified professional (physiotherapist) to conduct assessment (in NH C). The intervention included: registration of falls throughout the study period (18 months), training of staff in months 5-6, supervised implementation of falls prevention in months 7-12, and a follow-up in the last 6 months. The median values of falls incidence adjusted to 100 mobile residents per month were compared between NHs A, B and C in the three consecutive phases of the observation: pre-intervention, implementation and follow-up, by means of the non-parametrical ANOVA Kruskal-Wallis test. A statistically significant drop in falls incidence medians was observed during the phases in NH A (5.05 vs 2.52 vs 0.50 respectively; H=8.84, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) and NH B (4.58 vs 0.38 vs 1.90 respectively; H=8.52, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). The change was not significant in NH C (3.26 vs 5.43 vs 1.08 respectively; H=3.94, ns). Broad NH staff involvement in performing risk of falls assessment is more efficient in reducing the frequency of falls than hiring a single professional (specialized in falls prevention).
Journal of geriatric psychiatry and neurology, Jan 6, 2015
This study presents the first update of the Cognitive Performance Scale (CPS) in 20 years. Its go... more This study presents the first update of the Cognitive Performance Scale (CPS) in 20 years. Its goals are 3-fold: extend category options; characterize how the new scale variant tracks with the Mini-Mental State Examination; and present a series of associative findings. Secondary analysis of data from 3733 older adults from 8 countries was completed. Examination of scale dimensions using older and new items was completed using a forward-entry stepwise regression. The revised scale was validated by examining the scale's distribution with a self-reported dementia diagnosis, functional problems, living status, and distress measures. Cognitive Performance Scale 2 extends the measurement metric from a range of 0 to 6 for the original CPS, to 0 to 8. Relating CPS2 to other measures of function, living status, and distress showed that changes in these external measures correspond with increased challenges in cognitive performance. Cognitive Performance Scale 2 enables repeated assessmen...
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Papers by Katarzyna Szczerbińska