Background: Dependency in activities of daily living (ADL) might be caused by multidimensional frailty. Prevention is important as ADL dependency might threaten the ability to age in place. Therefore, this study aimed to assess whether protective factors, derived from a systematic literature review, moderate the relationship between multidimensional frailty and ADL dependency, and whether this differs across age groups. Methods: A longitudinal study with a follow–up after 24 months was conducted among 1027 communitydwelling people aged ≥65 years. Multidimensional frailty was measured with the Tilburg Frailty Indicator, and ADL dependency with the ADL subscale from the Groningen Activity Restriction Scale. Other measures included socio-demographic characteristics and seven protective factors against ADL dependency, such as physical activity and non-smoking. Logistic regression analyses with interaction terms were conducted. Results: Frail older people had a twofold risk of developing ADL dependency after 24 months in comparison to non-frail older people (OR=2.12, 95% CI=1.45–3.00). The selected protective factors against ADL dependency did not significantly moderate this relationship. Nonetheless, higher levels of physical activity decreased the risk of becoming ADL dependent (OR=0.67, 95% CI=0.46–0.98), as well as having sufficient financial resources (OR=0.49, 95% CI=0.35–0.71). Conclusion: Multidimensional frail older people have a higher risk of developing ADL dependency. The studied protective factors against ADL dependency did not significantly moderate this relationship.
Background: As the world population ages, the number of people with diminished performance on the Activities of Daily Living (ADL) increases. A reliable and valid measure needs to be developed to determine the effects of interventions focused at increasing self-care abilities. We developed the Performance ADL Test (PAT) for this purpose. Objective: The aim of this study was to investigate the reliability and validity of the PAT in older people living in residential homes. Methods: The PAT contains 16 test items, covering the entire range of Basic ADL and Instrumental ADL performance in elderly people. For this assessment, 40 older people (mean age of 85 ± 7.5 years) participated. All 40 subjects lived in residential institutions in the Netherlands, were able to walk at least 10 m, could understand instructions spoken in Dutch, and had no cognitive impairment. During the first test session, subjects completed the PAT, the Groningen Activity Restriction Scale (GARS), and performance-based physical fitness tests. Two weeks later, subjects were retested on the PAT. Results: Factor analysis revealed three subscales: Organization of Performance, Gross Motor Function, and Fine Motor Function. Internal consistency (Cronbach's α) of all scales and subscales ranged from 0.731 to 0.881. Test-retest reliability (intraclass correlation) ranged from 0.316 to 0.950. Paired sample t-tests revealed no significant differences between subject performance obtained during the two test periods. Pearson's correlations between the PAT and the GARS ranged from 0.490 to 0.831, and between the PAT and the fitness tests from 0.317 to 0.781. Conclusion: Although the number of participants was limited (n = 40), the PAT seems to be a useful instrument for assessing ADL performance in older people living in residential homes. In general, internal consistency, test-retest reliability, and validity were satisfactory. Copyright © 2010 S. Karger AG, Basel.
ObjectivesTo establish the prevalence and course of geriatric syndromes from hospital admission up to 3 months postdischarge and to determine the probability to retain geriatric syndromes over the period from discharge until 3 months postdischarge, once they are present at admission.DesignProspective multicenter cohort study conducted between October 2015 and June 2017.Setting and participantsAcutely hospitalized patients aged 70 years and older recruited from internal, cardiology, and geriatric wards of 6 Dutch hospitals.MeasuresCognitive impairment, depressive symptoms, apathy, pain, malnutrition, incontinence, dizziness, fatigue, mobility impairment, functional impairment, fall risk, and fear of falling were assessed at admission, discharge, and 1, 2, and 3 months postdischarge. Generalized estimating equations analysis were performed to analyze the course of syndromes and to determine the probability to retain syndromes.ResultsA total of 401 participants [mean age (standard deviation) 79.7 (6.7)] were included. At admission, a median of 5 geriatric syndromes were present. Most prevalent were fatigue (77.2%), functional impairment (62.3%), apathy (57.5%), mobility impairment (54.6%), and fear of falling (40.6%). At 3 months postdischarge, an average of 3 syndromes were present, of which mobility impairment (52.7%), fatigue (48.1%), and functional impairment (42.5%) were most prevalent. Tracking analysis showed that geriatric syndromes that were present at admission were likely to be retained. The following 6 geriatric syndromes were most likely to stay present postdischarge: mobility impairment, incontinence, cognitive impairment, depressive symptoms, functional impairment, and fear of falling.ImplicationsAcutely hospitalized older adults exhibit a broad spectrum of highly prevalent geriatric syndromes. Moreover, patients are likely to retain symptoms that are present at admission postdischarge. Our study underscores the need to address a wide range of syndromes at admission, the importance of communication on syndromes to the next care provider, and the need for adequate follow-up care and syndrome management postdischarge.
Veel ouderen ervaren tijdens en na ziekenhuisopname functieverlies. ‘Function Focused Care in Hospital’, ook wel bekend als bewegingsgerichte zorg, is een interventie gericht op het voorkomen en verminderen van functieverlies bij ouderen tijdens een ziekenhuisopname. Verpleegkundigen moedigen patiënten aan tot actieve betrokkenheid in de dagelijkse zorgmomenten.Doel Doel van dit project is de effectiviteit bepalen van Function Focused Care in Hospital op het fysiek functioneren van patiënten die opgenomen zijn in de Nederlandse ziekenhuizen. Resultaten Nederlandstalig scholingsprogramma en handboek van de Function Focused Care in Hospital-benadering voor de ziekenhuissetting; Een evaluatie van het proces en de uitkomsten van de Function Focused Care-benadering. Looptijd 01 november 2020 - 31 oktober 2025 Aanpak Er is een haalbaarheidsstudie uitgevoerd, die uitwees dat de interventie geschikt is voor de Nederlandse praktijk. Op de neurologische en geriatrische afdelingen van drie ziekenhuizen is Function Focused Care in Hospital in de dagelijkse zorg geïmplementeerd en geëvalueerd op effectiviteit. Over de interventie Function Focused Care (FFC) is een zorgbenadering waarin verpleegkundigen patiënten actief betrekken bij alle zorgmomenten om hun fysiek functioneren te optimaliseren. Eerder onderzoek heeft laten zien dat FFC een positief effect heeft op fysieke activiteit, mobiliteit en ADL bij ouderen in de wijk en de langdurige zorg. Ook laten studies in de acute zorg belovende resultaten zien van FFC op fysieke activiteit en mobiliteit bij ouderen opgenomen in het ziekenhuis. Voorbeelden van zorg volgens de FFC-benadering zijn met de patiënt naar de badkamer lopen in plaats van wassen op bed, of de maaltijd aan tafel nuttigen in plaats van zittend in bed eten. De essentie van FFC is het behouden of, indien mogelijk, verbeteren van het fysieke functioneren. Tijdens de hele ziekenhuisopname wordt de patiënt aangemoedigd meer tijd te laten besteden aan fysieke activiteit op een op de patiënt aangepast niveau. Co-financiering Het project wordt mede gefinancierd door ZonMW, projectnummer 520002003.
In recent years, ArtEZ has worked on a broadly supported strategic research agenda on the themes New Ecologies of Matter (ecological challenges), Social Equity (social-societal issues), (Un)Learning Practices (educational innovations) and (Non)CybernEtic Fabric (technological developments). Building on these strategic themes, the ArtEZ Research Collective as developed an international research strategy to become a valuable partner in the relevant Horizon Europe (HEU) areas of Environment, Industry and Social science and humanities. With its specific knowledge position and approach from arts and creativity, ArtEZ is convinced that it can play a distinctive role in European consortia to tackle various challenges in these areas, in particular from the perspective and research topics of the professorships Fashion and Tactical Design. To achieve its ambitions and goals in its targeted research topics, ArtEZ is convinced that a combination of international connections and local applications is key for successful impact. Building upon existing relations and extending the international research position requires extra efforts, e.g., by developing a strong international framework of state-of-the-art research results, impacts and ambitions. Therefore ArtEZ needs to (further) build on both its international network and its supportive infrastructure. With this proposal ArtEZ is presenting its goals and efforts to work on its international recognition as a valuable research partner, and to broaden its international network in cutting-edge research and other stakeholders. With regards to its supporting infrastructure, ArtEZ has the ambition to expand the impact of the Subsidy Desk to become a professional partner to the professorships. This approach requires a further professionalization and extension of both the Subsidy Desk organization and its services, and developing and complementing skills, expertise and competences to comply to the European requirements.
In de schoonmaakbranche is de werkdruk hoog . Hierdoor worden gebouwen dagelijks niet goed genoeg schoongemaakt. Er heerst krapte op de arbeidsmarkt. Schoonmaakwerk is vooral handmatig werk en is ook zwaar werk. De schoonmaakbranche is dringend op zoek naar technologische oplossingen die het werk in de toekomst kunnen verlichten. Eén van die technologische oplossingen is de introductie van schoonmaakrobots , die op dit moment mondjesmaat op de markt worden gebracht. Schoonmaakorganisaties weten nog niet goed hoe deze robots efficiënt in te zetten, het vergt nog veel tijd om ze te kunnen gebruiken en schoonmaakmedewerkers zijn terughoudend om ermee te werken. Het project Assisted Cleaning Robots (ACR) richt zich op de volgende onderzoeksvraag: “hoe integreer je robottechnologie in het werkproces in de schoonmaakbranche, zodat een robot enerzijds zo optimaal mogelijk het werkproces ondersteunt, en anderzijds zo optimaal mogelijk met de mens samenwerkt.” Wat hierin optimaal is en hoe dit gemeten kan worden, is onderdeel van het onderzoek en is afhankelijk van de technologische mogelijkheden, de mensen die er mee werken, en de werkomgeving. In dit project werken Fontys Hogeschool Engineering, Fontys Hogeschool Techniek & Logistiek en de Haagse Hogeschool samen met schoonmaakorganisaties CSU en Hectas en andere bedrijven (toeleveranciers van schoonmaakrobots als ontwikkelaars), nationaal samenwerkingsverband Holland Robotics en brancheorganisatie Schoonmakend Nederland. Dit project kent een looptijd van twee jaar en gaat van start op 1 november 2021. In dit project worden nieuwe schoonmaakprocessen gedefinieerd en wordt op basis van deze processen technologie ontwikkeld (waar doorgaans eerst een nieuw product wordt ontwikkeld en daarna pas gekeken naar hoe dit product in te zetten). In dit project staat de mens die met de technologie in het proces moet gaan werken centraal. De technologie en het proces worden gevalideerd middels praktijktests met de betrokken schoonmaakorganisaties, op representatieve locaties. Hieruit worden lessen getrokken voor verbeteringen.
