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Results for 'outcomes'

Results 11 - 20 of 93

Interventions for preventing falls in older people living in the community (review)

GILLESPIE Lesley D., et al
2012

Background: Approximately 30 per cent of people over 65 years of age living in the community fall each year. This is an update of a Cochrane review first published in 2009.Objective: To assess the effects of interventions designed to reduce the incidence of falls in older people living in the community. Search methods: this review searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (February 2012), CENTRAL (The Cochrane Library2012, Issue 3), MEDLINE (1946 to March 2012), EMBASE (1947 to March 2012), CINAHL (1982 to February 2012), and online trial registers. Selection criteria: Randomised trials of interventions to reduce falls in community-dwelling older people. Main results: this review included 159 trials with 79,193 participants. Most trials compared a fall prevention intervention with no intervention or an intervention not expected to reduce falls. The most common interventions tested were exercise as a single intervention (59 trials) and multifactorial programmes (40 trials). Findings: Group and home‐based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures. Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow‐up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined. Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti‐slip shoe device worn in icy conditions can also reduce falls. Taking vitamin D supplements does not appear to reduce falls in most community‐dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment. Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls. Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure. In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling. The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.

Nostalgia as a psychological resource for people with dementia: a systematic review and meta-analysis of evidence of effectiveness from experimental studies

ISMAIL Sanda Umar, et al
2020

Objective: This review systematically examines evidence relating to the effect of nostalgia on psychological well-being through a meta-analysis of measures of social connectedness, self-esteem, meaning in life, self-continuity, optimism and positive and negative affect. Rationale: If nostalgia is to be used as a clinical intervention to boost well-being in dementia by reducing threat, then it is important to assess its therapeutic potential. Results: Searches carried out in July 2014 and updated in February 2018 identified 47 eligible experimental studies comparing nostalgic reminiscence and non-nostalgic reminiscence to be included in the meta-analysis. Nostalgic reminiscence had moderate effects on positive affect (0.51 (0.37, 0.65), p= 0.001), social connectedness (0.72 (0.57, 0.87), p= 0.001), self-esteem (0.50 (0.30, 0.70), p= 0.001), meaning in life (0.77 (0.47, 1.08), p= 0.001) and optimism (0.38 (0.28, 0.47), p= 0.001) and a large effect on self-continuity (0.81 (0.55, 1.07), p= 0.001). There was, however, no difference between the effect of nostalgic reminiscence and non-nostalgic reminiscence for negative affect (−0.06 (−0.20, 0.09), p= 0.443). Conclusion: This systematic review and meta-analysis provides an overview of the evidence base for nostalgia. This is an important stage in developing nostalgia as a clinical intervention for people with dementia which might be achieved, for instance, by adapting current reminiscence and life review techniques. This meta-analysis will therefore also serve as a valuable reference point for the continued exploration of nostalgia as an intervention.

Day centres for older people: a systematically conducted scoping review of literature about their benefits, purposes and how they are perceived

ORELLANA Katharine, MANTHORPE Jill, TINKER Anthea
2020

With a policy shift towards personalisation of adult social care in England, much attention has focused on individualised support for older people with care needs. This article reports the findings of a scoping review of United Kingdom (UK) and non-UK literature, published in English from 2005 to 2017, about day centres for older people without dementia and highlights the gaps in evidence. This review, undertaken to inform new empirical research, covered the perceptions, benefits and purposes of day centres. Searches, undertaken in October/November 2014 and updated in August 2017, of electronic databases, libraries, websites, research repositories and journals, identified 77 relevant papers, mostly non-UK. Day centres were found to play a variety of roles for individuals and in care systems. The largest body of evidence concerned social and preventive outcomes. Centre attendance and participation in interventions within them impacted positively on older people's mental health, social contacts, physical function and quality of life. Evidence about outcomes is mainly non-UK. Day centres for older people without dementia are under-researched generally, particularly in the UK. In addition to not being studied as whole services, there are considerable evidence gaps about how day centres are perceived, their outcomes, what they offer, to whom and their wider stakeholders, including family carers, volunteers, staff and professionals who are funding, recommending or referring older people to them.

The impact of social prescribing services on service users: a systematic review of the evidence

PESCHENY Julia Vera, RANDHAWA Gurch, PAPPAS Yannis
2019

Background: Social prescribing initiatives are widely implemented in the UK National Health Service to integrate health and social care. Social prescribing is a service in primary care that links patients with non-medical needs to sources of support provided by the community and voluntary sector to help improve their health and wellbeing. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. This systematic review aimed to assess the evidence of service user outcomes of social prescribing programmes based on primary care and involving navigators. Methods: 11 databases, the grey literature, and the reference lists of relevant studies were searched to identify the available evidence on the impact of social prescribing on service users. Searches were limited to literature written in English. No date restrictions were applied, and searches were conducted to June 2018. Findings were synthesised narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. Results: Sixteen studies met the inclusion criteria. The evidence base is mixed, some studies found improvements in health and wellbeing, health-related behaviours, self-concepts, feelings, social contacts and day-to-day functioning post-social prescribing, whereas others have not. The review also shows that the evaluation methodologies utilised were variable in quality. Conclusion: In order to assess the success of social prescribing services, more high quality and comparable evaluations need to be conducted in the future.

Prevention: developing a framework for conceptualising and evaluating outcomes of preventive services for older people

GODFREY Mary
2001

Focusing on older people, this article seeks a way to locate prevention within a theoretical model of successful ageing. This conceptualises ageing as involving adaptation to the changing balance between gains and losses over the life course. Successful ageing is perceived as the attainment of valued goals, the minimisation of losses and maximisation of gains through the linked processes of selective compensation and optimisation. Preventive services may be conceived as resources to be drawn upon to support compensatory strategies. Outcomes and effectiveness of services may be evaluated in terms of whether they facilitate/ allow older people to achieve valued goals. In developing and evaluating preventive services in social care the question is what contribution do specific services make in optimising gains and compensating for the losses that accompany ageing? This framework is explored in respect of two areas ripe for secondary prevention services and strategies - bereavement and instrumental support in the home.

SCIE research briefing 36: reablement: a cost-effective route to better outcomes

FRANCIS Jennifer, FISHER Mike, RUTER Deborah
2011

One in a series of research briefings about preventive care and support for adults. This briefing focuses on reablement services. It summarises the findings from existing research evidence and covers: the outcomes of reablement; people's views about reablement; funding and organisational implications; costs and cost-effectiveness of reablement. The briefing also looks at whether reducing the need for home care and improving people's independence will improve their overall wellbeing. The briefing reports that good research evidence exists to suggest that reablement improves service outcomes, removing or reducing the need for standard home care. Although studies report a higher cost than traditional home care, they also indicate a strong possibility of longer-term savings. Gaps in the research evidence are also discussed.

Public mental health: evidence, practice and commissioning

CAMPION Jonathan
2019

Based on a review of recent literature, this report summarises evidence around public mental health practice. Public mental health practice takes a population approach to mental health which includes three levels of mental disorder prevention and mental wellbeing promotion. The review covers: the impact of mental health problems and of mental wellbeing; risk factors for mental disorder and protective factors for mental wellbeing; groups at higher risk of poor mental health; effective interventions to treat mental disorder and to prevent associated impacts, preventing mental disorder from arising and promoting mental wellbeing; and economic savings of different public mental health interventions. It finds that despite the existence of cost-effective public mental health interventions, only a minority of people with a mental condition in England receive any treatment, receive interventions to prevent associated impacts or receive intervention to prevent mental conditions or promote mental wellbeing. It sets out a number of actions to improve coverage of evidence based interventions to reduce the population impact of mental disorder and promote population mental wellbeing. The report has been endorsed by the Association of Directors of Public Health, Faculty of Public Health, Health Education England, Local Government Association, Royal College of General Practitioners, Royal College of Psychiatrists and RSPH (Royal Society of Public Health).

The intergenerational evaluation toolkit

JARROTT Shannon
2019

Intergenerational shared sites and intergenerational programmes that bring younger and older generations together can have many positive benefits. This Toolkit provides three resources to support programme providers and researchers to demonstrate the impact of intergenerational programming and the practices which achieve outcomes. The toolkit includes an Intergenerational Practice Evaluation tool to evaluate single intergenerational activities and the impact of programmes over time; a guide to planning an intergenerational evaluation; and a list of reliable outcome measures. The toolkit has been developed following 15 years of collaborative innovative practice and evaluation research.

Indoor nature interventions for health and wellbeing of older adults in residential settings: a systematic review

YEO Nicola L., et al
2019

Background and Objectives: Having contact with nature can be beneficial for health and wellbeing, but many older adults face barriers with getting outdoors. This study conducted a systematic review of quantitative studies on health and wellbeing impacts of indoor forms of nature (both real and simulated/artificial), for older adults in residential settings. Research Design and Methods: Search terms relating to older adults and indoor nature were run in 13 scientific databases (MEDLINE, CINAHL, AgeLine, Environment Complete, AMED, PsychINFO, EMBASE, HMIC, PsychARTICLES, Global Health, Web of Knowledge, Dissertations and Theses Global, and ASSIA). This study also pursued grey literature, global clinical trials registries, and a range of supplementary methods. Results: Of 6,131 articles screened against eligibility criteria, 26 studies were accepted into the review, and were quality-appraised using the Effective Public Health Practice Project (EPHPP) tool. The participants were 930 adults aged over 60. Nature interventions and health/wellbeing outcomes were heterogeneous, which necessitated a narrative synthesis. The evidence base was generally weak, with 18 of 26 studies having a high risk of bias. However, several higher-quality studies found indoor gardening and horticulture programs were effective for cognition, psychological wellbeing, social outcomes, and life satisfaction. Discussion and Implications: There is inconsistent evidence that indoor nature exposures are beneficial for older care residents. This study suggests that successful interventions were, at least partly, facilitating social interaction, supporting feelings of autonomy/control, and promoting skill development, that is, factors not necessarily associated with nature per se. Higher-quality studies with improved reporting standards are needed to further elucidate these mechanisms.

Active ingredients: the Aesop planning and evaluation model for arts with a social purpose

AESOP, BOP Consulting
2018

This short paper outlines a logic model developed for the planning and evaluation of the Dance to Health project, with suggestions of how it can be used in practice. The project aimed to develop a better understanding of the ways in which arts interventions in health and social contexts actually work, and to improve the ways these are designed and their impacts measured. The Active Ingredients logic model, includes: Inputs - such as the specific arts practice, venues and health or social care setting; and Outputs - volume of arts sessions and number of beneficiaries. It also summarises a set of ‘Active Ingredients’ in participatory arts work, which are summarised under the headings of ‘Engaging and Imagining’. The model will be useful for those involved in the evaluation and planning of arts interventions, as well as policymakers interested in arts as interventions.

Results 11 - 20 of 93

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News

Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation

KOMP

KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families

LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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