SEARCH · PubMed Health

Results for “Institutionalization”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources

PubMed1997

Predictors of time to institutionalization of patients with Alzheimer's disease: the CERAD experience, part XVII.

We studied the time to institutionalization (or death as the first event) in 727 white patients with Alzheimer's disease (AD) enrolled in the Consortium to Establish a Registry for Alzheimer's disease (CERAD). At the time of analysis, 417 patients had been admitted to nursing homes and 32 others had died without previous institutionalization. The major predictors of time to first event were sex, age, marital status (men only), and severity of dementia at entry into the study, as measured by activities of daily living, the Mini-Mental State Examination, and the Clinical Dementia Rating scale. The overall median time from enrollment in the study to first event was 3.1 years. For unmarried men, the median time was significantly less (2.1 years) than for either married men or for married or unmarried women, all of whom had medians greater than 3 years. In an analysis of survival time following institutionalization, we found that men survived a median of 2.1 years, compared with 4.5 years for women. This nationwide study of AD largely confirms earlier studies that reported on smaller numbers of cases from local catchment areas and included patients with various types of dementia.

Aged↗

PubMed2001

[The experience of institutionalized children].

The aim of this study was to know the experience of the institutionalized child and was guided by the theoretical referential of the "Symbolic Interactionism" and by the methodological referential of the "Grounded Theory". The data had been collected in two stages: the first one understood group activities and second stage consisted of personal interviews. The results had shown that the institutionalization occurred for abandonment and reject of the parents or for legal decision as a measure of child protection, having as context the poverty of its family. The child's experience is conflicting in relation to being institutionalized, because while he/she perceives the necessity of material gain, they miss their family, their home, their friends, and simply life outside.

Adolescent↗

PubMed1998

Implications of oral infections on systemic diseases in the institutionalized elderly with a special focus on pneumonia.

Systemic infection in the elderly patient living in a chronic care setting presents a significant burden to the health care system. The extent to which oral organisms cause systemic infections through hematogenous dissemination in the institutionalized elderly is still unknown. A more likely and common route of systemic infection by oral microorganisms is through aspiration of oropharyngeal fluids containing oral pathogenic microorganisms, which colonize the lower respiratory tract and cause pneumonia. Respiratory pathogens emerge in the dental plaque of elderly patients with very poor oral hygiene and severe periodontal disease. In the chronic care setting, aspiration of oropharyngeal fluids contaminated with these bacteria occurs in patients with diminished host defenses, resulting in bacterial pneumonia. This is also a problem in intensive care units in the hospital setting. In one study, pre-rinsing with a 0.12% chlorhexidine gluconate mouthwash significantly lowered the mortality rate from postsurgical pneumonia in patients undergoing open heart surgery. Selective digestive decontamination, a technique involving the topical application of antimicrobials to reduce the risk of colonization of the respiratory tract, has been used to reduce the incidence of nosocomial pneumonia in the acute care setting of hospitals. This technique has not been employed in the nursing home setting. Whether improving oral hygiene would also lower the risk in either of these settings has not been studied. A number of obstacles must be overcome in designing studies to investigate the relationship between oral infections and lung infections in the institutionalized elderly. Ethical issues must be addressed, and full collaboration of the medical team is required. Future studies should establish whether reducing the risk for pneumonia in the institutionalized elderly is possible through improved oral health.

Aged↗

PubMed1997

US trends in disability and institutionalization among older Blacks and Whites.

OBJECTIVES: This study estimated and compared the prevalence of disability and institutionalization in 1982, 1984, and 1989 among the older Black and White populations of the United States. METHODS: Data on over 1100 Blacks and 14,000 Whites in each of a series of three National Long Term Care Surveys were used. RESULTS: Diverging trends for Blacks and Whites led to statistically significant increases in the age- and sex-adjusted odds of disability (19%) and institutionalization (31%) for Blacks relative to Whites. CONCLUSIONS: Black and White disparities in disability appear to have widened, while disparities in institutionalization appear to have narrowed during the decade of the 1980s.

Activities of Daily Living↗

PubMed2000

Phases of the qualitative research interview with institutionalized elderly individuals.

The in-depth, open-ended formal interview is a mainstay of qualitative nursing research. However, difficulties with this method of data collection are common with institutionalized elderly individuals. During a qualitative study of urinary incontinence among nursing home residents, six distinct phases of the formal interview were identified: introducing, personalizing, reminiscing, contextualizing, closing, and reciprocating. These phases were discovered in the course of analyzing field notes and verbatim transcripts from open-ended formal interviews with 10 respondents. Allowing qualitative research interviews with institutionalized elderly individuals to unfold in this fashion may help researchers studying this group overcome problems with recruitment, retention, and "thin" data. In turn, more institutionalized elderly individuals would reap benefits associated with participation in research interviews and staff would ultimately have the opportunity to understand and appreciate life in an institution from the resident's perspective.

Activities of Daily Living↗

PubMed2005

[Scale development on health conservation of the institutionalized elderly].

PURPOSE: The purpose of this study was to develop a health conservation scale with high validity and reliability for institutionalized elderly. METHOD: The process of development of this scale was as follows. A conceptual framework composed of 4 phases of health conservation of institutionalized elderly was identified based on the literature review with elderlies and discussions with experts in health conservation. A total of 75 items, on a 4-point scale were developed. Through reliability testing and factor analysis, 57 preliminary items were selected. By means of internal consistency of the 57 items, 18 items whose inner-items correlation coefficient was below .40 were deleted. Through factor analysis, 2 items whose factor loading was below .40 were deleted. Finally 37 items remained. To verify the 37 items, factor analysis, reliability testing, and correlation was done. Data were collected from 207 institutionalized elderly subjects in Daegu, Kyungpook, Busan, and KyungNam Province from August. 2003 to February. 2004. RESULT: In the result of factor analysis of the 37 items, 4 factors were extracted. These factors were labeled as 'personal integrity', 'conservation of energy', 'structural integrity', and 'social integrity'. These factors included 4 phases of health conservation. Cronbach's Alpha of 37 the items was .9424 and the correlation coefficient of HPLP was .723. CONCLUSION: The researchers recommend the following: An explorative study on the variables related to health conservation is needed for criterion validity of this scale. Studies on health conservation of different age groups, and subjects are needed for verification.

Aged↗

PubMed2000

[Prevention of loss of functional independence and institutionalization].

LOSS OF FUNCTIONAL INDEPENDENCE: This is a serious problem in the management of older subjects. Prevention is necessary in order to assure better quality of life and avoid definitive institutionalization in a medical or social center. RELATED FACTORS: An analysis of the literature on the risk of loss of functional independence points out several medical (comorbidity, falls, cognitive capacity, sensorial deficiencies, nutrition, drugs), psychological (depression), and physical activity and social factors related to functional independence. RISK OF INSTITUTIONALIZATION: The risk is related to functional limitations and especially declining cognition, as well as social factors and the role of the primary care giver. PREVENTION: Systematic screening for risk factors is needed. The impact of measures to remedy certain medical risk factors has been clearly demonstrated. Specific programs can improve functional status, avoid institutionalization, and perhaps prolong survival.

Activities of Daily Living↗

PubMed2000

Why are antibiotics prescribed for asymptomatic bacteriuria in institutionalized elderly people? A qualitative study of physicians' and nurses' perceptions.

BACKGROUND: Antibiotic therapy for asymptomatic bacteriuria in institutionalized elderly people has not been shown to be of benefit and may in fact be harmful; however, antibiotics are still frequently used to treat asymptomatic bacteriuria in this population. The aim of this study was to explore the perceptions, attitudes and opinions of physicians and nurses involved in the process of prescribing antibiotics for asymptomatic bacteriuria in institutionalized elderly people. METHODS: Focus groups were conducted among physicians and nurses who provide care to residents of long-term care facilities in Hamilton, Ont. A total of 22 physicians and 16 nurses participated. The focus group discussions were tape-recorded, and the transcripts of each session were analysed for issues and themes emerging from the text. Content analysis using an open analytic approach was used to explore and understand the experience of the focus group participants. The data from the text were then coded according to the relevant and emergent themes and issues. RESULTS: We observed that the ordering of urine cultures and the prescribing of antibiotics for residents with asymptomatic bacteriuria were influenced by a wide range of nonspecific symptoms or signs in residents. The physicians felt that the presence of these signs justified a decision to order antibiotics. Nurses played a central role in both the ordering of urine cultures and the decision to prescribe antibiotics through their awareness of changes in residents' status and communication of this to physicians. Education about asymptomatic bacteriuria was viewed as an important priority for both physicians and nurses. INTERPRETATION: The presence of non-urinary symptoms and signs is an important factor in the prescription of antibiotics for asymptomatic bacteriuria in institutionalized elderly people. However, no evidence exists to support this reason for antibiotic treatment. Health care providers at long-term care facilities need more education about antibiotic use and asymptomatic bacteriuria.

Aged↗

PubMed2000

[The institutionalized elderly. How do we perceive old age?].

It is a commonly-held belief to associate old age with physical deterioration, loss of mental capacity and a downhill slide toward death. Although one cannot deny some aspects of truth in this belief, what is certain is that the perception which each person holds about old age, as well as each person's real life situation, will make each individual live this stage of life in very diverse manners. We may affirm that quality of life is a criteria set and evaluated by each human being, and in order to evaluate it, one's personal opinion and satisfaction are indispensable. What does quality of life mean for an elderly person who is institutionalized? What do the business administrators, managers and caretaking personnel understand quality of life to be for an elderly person who is institutionalized? Are there differences perceiving quality of life between personnel and elderly? The authors carry out this study in order to answer these kinds of questions by means of a descriptive and transversal method; one objective is to evaluate the perception of quality of life for institutionalized elderly held by each of the aforementioned groups. The study group for this research project was composed of elderly people living as permanent residents in an institution and the business administrators, managers and caretaking personnel in three geriatric centers in Navarra; there was a total of 90 people in the sample group.

Aged↗

PubMed1976

Sexual knowledge and attitudes of institutionalized and noninstitutionalized retarded adolescents.

Sixty-one noninstitutionalized and 60 institutionalized mentally retarded adolescents were psychometrically assessed on three measures: sexual knowledge, sexual attitudes, and self-concept. The two groups differed on total score on sex knowledge only, with the non institutionalized group being more knowledgeable. With regard to sexual attitudes and self-concept, the two groups did not differ in terms of total correct statements. Internal consistency demonstrated on all the measures ranged from .50 to .90. Intercorrelations of relevant variables for each group (10 for the noninstitutionalized, 13 for the institutionalized) produced several significant correlations. Results were discussed with reference to the development of a standardized instrument for assessing sex-education programs for mentally retarded persons.

Age Factors↗

PubMed2005

[Perception of their social environment and their future in institutionalized school-age children].

Family home and institutions for children without parental care represent the rearing-environments where, from the early years, whole human development goes on. It's known today that despite the recognized importance of inborn traits, the influence of child-rearing environments dominates current models of development. The aim of the study was to investigate the satisfaction with the rearing-environment of school-aged institutionalized children, their dominating feeling and if institutionalization affects life optimism for now and for the future. The study was conducted in two institutions in Bosnia and Herzegovina who share the same care model imitating the traditional Bosnian families where the older children care for the younger siblings. We took as a sample 30 institutionalized children aged 8-12, and for the control group 60 children matched by age and sex. Parents, children and teachers who gave their informed consent answered the questionnaires. It was confirmed that children without parental care are vulnerable group and in a great risk who need urgent help of professional multidisciplinary team of their close and broad environment. Lack of social support cause the withdrawing and suffering and can lead soon or later to problematic behaviour.

Bosnia and Herzegovina↗

PubMed2003

Oral health status and treatment needs of institutionalized elderly and disadvantaged population in Fiji (1997).

Information on the oral health of institutionalized elderly populations in a number of countries is available but, no data is available nor published on the elderly population of Fiji. A pilot survey was carried out at the nursing homes in the Suva area. The aim of this study was to investigate the dental status and treatment needs of institutionalized elderly people. Examiner was calibrated and consent approved from the relevant institutions. This study found that residents were institutionalized, because family members could not care for them; did not receive any form of financial assistance and therefore totally relied on the institution; generally had medical problems such as neurological disorders, cardiovascular disease and diabetes. Generally had poor oral health status such as root stumps, many missing teeth, calculus and shallow pockets were common, oral hygiene practices were poor, high demand for dentures/or the dentures were not clean, some cases of leukoplakia were found and there was an urgent need for the dental profession to deliver dental care. Recommendations include issues in developing a supporting environment, provision of adequate and appropriate access, community education and skill development, workforce development and research in geriatric dentistry in Fiji.

Adult↗

PubMed1990

Vitamin C and nutritional status of institutionalized and noninstitutionalized elderly women in Rome.

A cross-sectional study on 64 institutionalized and 65 noninstitutionalized elderly women has been undertaken. The age range was 60 through 90 years. Vitamin C status was assessed by serum ascorbic acid measurement and the nutritional status was evaluated by a three-day dietary record and main anthropometric measurements. Mean concentration of ascorbic acid was 1.03 mg/dl in the noninstitutionalized and 0.67 mg/dl in the institutionalized group (p less than 0.001). A serum ascorbic acid level less than 0.2 mg/dl was found in one (1.5%) and seven (10.9%) subjects respectively (p less than 0.03). Mean intake of vitamin C was 104.1 mg/d in the former and 87.3 mg/d in the latter group (p = NS), being less than 45 mg/d in 16 living at home and 11 institutionalized women. Serum ascorbic acid level did not correlate significantly to dietary nutrient intake but correlated to activity of daily living level (r = 0.29), vitamin C intake (r = 0.23), ideal body weight (r = -0.15), relative body weight (r = 0.15) and body mass index (r = 0.14). Suggestions are made concerning a higher intake of vitamin C and a more careful catering to improve the health status of the elderly people living in large institutions. The authors also suggest to include the serum ascorbic level determination in the assessment of the general health status of the elderly.

Aged↗

PubMed1990

Hypotensive responses to common daily activities in institutionalized elderly. A potential risk for recurrent falls.

Transient hypotension may be one of many factors contributing to the high prevalence of falls among elderly people. To determine the frequency and magnitude of hypotensive responses to common daily activities, and their potential relationship to falls in the elderly, we examined blood pressure (BP) and heart rate during a standardized series of activities in 38 institutionalized recurrent fallers (age, 87 +/- 6 years), 20 institutionalized nonfallers (age, 85 +/- 5 years), and 10 healthy young control subjects (age, 24 +/- 3 years). The coefficient of variation for systolic BP during all activities was higher in elderly subjects (fallers, 14% +/- 5%; nonfallers, 12% +/- 3%) than in young control subjects (8% +/- 1%). In contrast, the coefficient of variation for heart rate during all activities was higher in young subjects than in the elderly subjects. Elderly subjects had marked BP reduction following meals and nitroglycerin, which was significantly greater in fallers than in nonfallers, independent of the cause of the fall. Thus, institutionalized elderly have marked BP variability and hypotensive responses to meals and nitroglycerin. A decline in BP during common preload-reducing stresses may predispose some elderly people to falls.

Accidental Falls↗

PubMed1990

Lactose maldigestion: increased age-related prevalence in institutionalized children.

A study was performed to determine whether the age-related prevalence of lactose maldigestion is increased in healthy institutionalized children. Previous malnutrition did not exclude children from study. The control children had no prior history of malnutrition or hospital admissions for diarrhea. The anthropometric comparison showed the institutionalized children to be shorter and lighter than the controls, but they were of normal weight by stature, suggesting a normal recent nutritional state. Fasting breath hydrogen tests were performed following an oral dose of lactose 1 g/kg, given as a 10% solution. A rise of breath hydrogen of greater than or equal to 20 ppm was considered to indicate lactose maldigestion. Twenty-two of 44 controls and 39 of 49 study children were lactose maldigesters (p less than 0.01). The control children showed an age-related increase in the prevalence of lactose maldigestion, from 31.6% at age less than 5 years to 75% at age greater than 9 years. The institutionalized children, by comparison had an increased prevalence of 78.8% in the group under 5 years of age (p = 0.002). Equally high prevalence rates were found at all ages tested. At follow-up, lactose maldigestion was persistent in the majority of the study children. This had no nutritional impact despite a regular milk intake. The distinction between acquired and primary lactose maldigestion is of no practical significance in these children.

Adolescent↗

PubMed1993

Family caregivers of institutionalized and noninstitutionalized elderly individuals.

This article provides an overview of the literature that has examined the issues of institutionalization and community care of elderly persons. Specifically, those studies are discussed that report on the family's decision to institutionalize the elderly person and those that report on the effect of institutionalization of the family. Studies about community caregiving that report on caregiver characteristics, the stress of caregiving, and interventions to manage care issues and caregiver stress also are detailed. Implications for nursing research and practice can be derived from the article.

Adaptation, Psychological↗

PubMed1995

Comparison of two levels of vitamin C supplementation on antioxidant vitamin status in elderly institutionalized subjects.

The concentrations of antioxidant vitamins, particularly vitamin C, are often low in the plasma of institutionalized elderly subjects, and could explain their susceptibility to oxidative stress. However, as such low levels were not always found in home-living healthy elderly persons, the antioxidant vitamin depletion in the formers could result from environmental conditions better than aging itself. The objective of this study was therefore to verify the antioxidant vitamin status in institutionalized elderly persons and to evaluate if a low vit C supplement could be sufficient to improve the plasma vit C concentration in those subjects. This study confirms that plasma vitamin C levels are in the scurvy range in 20 elderly institutionalized subjects and significantly lower than in healthy home-living elderly persons. Beta-carotene concentrations were found marginally low but alpha-tocopherol levels were in the normal range. All three vitamins were correlated. Fifteen days on a physiological vitamin C (150 mg/day) supplementation was sufficient to restore normal vit C levels (50 mumol/l). A further pharmacological vit C administration (750 mg/day) during 30 days only allowed a marginal increase in the plasma vit C concentrations.

Aged↗

PubMed2006

Nutritional status and clinical outcomes among institutionalized elderly Chinese in Taiwan.

Nutrition is an important issue in institutional care, and is related to clinical outcomes in many aspects. Although Taiwan is marching to an aged society, related studies were lacking. Elderly residents in two long-term care facilities (LTCF) were enrolled for study. Nutritional status including anthropometric measurements and laboratory examinations was assessed every 3 months for 12 months. Age, sex-matched community-dwelling elderly participating in the annual health check-up was randomly selected as the control subjects. In total, 66 subjects in LTCF and 870 age, sex-matched community-dwelling elderly were enrolled. Body mass index, serum levels of albumin, and total cholesterol were significantly poorer in LTCF residents than the community-dwelling elderly. Triceps skinfold thickness, hemoglobin, serum albumin, and total cholesterol were progressively deteriorated among the institutionalized elderly during the 6-month follow-up. Thirteen subjects of the study group had been hospitalized during the follow-up. Body mass index, triceps skinfold thickness, mid-arm circumference, serum albumin at screening were significantly poorer and unintentional weight loss within 6 months was significantly greater in subjects who had been hospitalized. By using multivariate logistic regression model, only weight loss >5% within 6-month follow-up was the significant independent predictive factors to hospitalization. In conclusion, nutritional status of institutionalized elderly Chinese was significantly poorer than the community-dwelling elderly. Nutritional markers were progressively deteriorated in LTCF residents during the follow-up period. Unintentional weight loss >5% within 6 months was the only significantly independent predictive factor for hospitalization among the institutionalized elderly Chinese.

Aged↗