Aim and objectives. To improve (eye)care in nursing homes by reporting and assessing visual functioning to enhance professional caregivers' awareness of visual problems. Background. Older adults experience visual problems owing to biological ageing or eye disease. In the Netherlands, the prevalence of visual impairments is the highest in the subgroup of nursing home residents (41AE3%). These impairments influence quality of life in terms of limiting daily activities and participation in social activities. Furthermore, 63% of visual problems are defined as 'avoidable blindness'. For this reason, screening of visual functioning in the nursing home is of major importance. Moreover, visual functioning should also be taken into account to prevent the incidence of falls. Design. A field study on recorded information of visual functioning and visual assessment in nursing homes. Methods. Assessment of visual functioning of 259 residents in nursing homes. Subsequently, recorded information in client files is related to the assessment outcome. Results. Only in 101 (39%) of the 259 client records was some information on visual functioning found in client files. Whether a prescription for new glasses was dispensed made no difference in reporting on visual functioning in the client record. In more than half of the cases assessed as 'low vision or blindness', no information about visual functioning was found. Furthermore, no information was found in 31% (80/259) cases of suspected visual problems (referrals). A significant proportion of client records (p < 0AE05) showed no recorded information in cases of referral for further checkup. Conclusions. In this study, one-third of nursing homes residents have visual problems, needing examination by an ophthal-mologist. Problems with visual functioning should be assessed and captured in client records. Awareness of residents' visual functioning is a prerequisite for adapting basic daily care to the residents' needs.
Individuals with mild intellectual disabilities or borderline intellectual functioning are at increased risk to develop a substance use disorder—however, effective treatment programs adapted to this target group are scarce. This study evaluated the effectiveness of Take it Personal!+ in individuals with mild intellectual disabilities or borderline intellectual functioning and substance use disorder. Take it Personal!+ is a personalized treatment based on motivational interviewing and cognitive-behavioral therapy supported by an mHealth application. Data were collected in a nonconcurrent multiple baseline single-case experimental design across individuals with four phases (i.e., baseline, treatment, posttreatment, and follow-up). Twelve participants were randomly allocated to baseline lengths varying between 7 and 11 days. Substance use quantity was assessed during baseline, treatment, and posttreatment with a daily survey using a mobile application. Visual analysis was supported with statistical analysis of the daily surveys by calculating three effect size measures in 10 participants (two participants were excluded from this analysis due to a compliance rate below 50%). Secondary, substance use severity was assessed with standardized questionnaires at baseline, posttreatment, and follow-up and analyzed by calculating the Reliable Change Index. Based on visual analysis of the daily surveys, 10 out of 12 participants showed a decrease in mean substance use quantity from baseline to treatment and, if posttreatment data were available, to posttreatment. Statistical analysis showed an effect of Take it Personal!+ in terms of a decrease in daily substance use in 8 of 10 participants from baseline to treatment and if posttreatment data were available, also to posttreatment. In addition, data of the standardized questionnaires showed a decrease in substance use severity in 8 of 12 participants. These results support the effectiveness of Take it Personal!+ in decreasing substance use in individuals with mild intellectual disabilities or borderline intellectual functioning.
Background: Both the Short Physical Performance Battery (SPPB) and daily life gait quality and quantity obtained from wearable sensors are used to measure functional status in older adults. It is generally assumed that they are interrelated and exchangeable, but this has not yet been established. Interchangeability of these measures would pave the way for remote monitoring of functional status.Research Question: Are the SPPB and daily life gait quality and quantity measures correlated in community-dwelling older adults?Methods: The SPPB and gait quality and quantity data of 229 community-dwelling adults of 65 years or older were collected. The SPPB is a combined score of the Three Stage Balance test, Four Meter Walk test, and Five Times Sit to Stand test and ranges from 0 to 12. Participants wore a tri-axial inertial sensor for one week to assess gait quality (e.g. gait stability and smoothness) and quantity (e.g. number of strides). Correlation coefficients between SPPB scores and gait quality and quantity measures were assessed using Spearman's correlation.Results: The median age of the study population was 76.2 years (IQR 72.6-81.0), and 76 % were women (n=175). The median SPPB score was 10 (IQR 8-11). Spearman's correlation coefficients between the SPPB and gait quality and quantity measures were all below 0.3.Significance: A possible explanation for the observed weak correlations is that the SPPB reflects one's maximal capacity, while gait quality and quantity reflect the submaximal performance in daily life. The SPPB and gait quality and quantity seem therefore distinct constructs with complementary value, rather than interchangeable. A more comprehensive understanding of functional status might be achieved by combining the SPPB assessment of standardized activities with the evaluation of inertial sensor measurements obtained during daily life activities.
