Gerontology Research Project

Project 2 Annotation

Zein, J. G., Dweik, R. A., Comhair, S. A., Bleecker, E. R., Moore, W. C., Peters, S. P., & … null, n. (2015). Asthma is more severe in older adults. PLoS ONE, 10(7), 1-13. doi:10.1371/journal.pone.0133490

This article focuses on the factors that increase severe asthma symptoms in older individuals and the ways to improve the quality of health care for such patients. The aim of the research was to hypothesize the fact that aging as well as asthma duration contributes to severe asthma symptoms. The study used cross-sectional method and collected data from adults participants that were enrolled in the Severe Asthma Research program during the period from 2002 to 2011.The results indicated that the probability of severe asthma among the patients increased yearly until the age of 45, after which it proceeded at a slower rate. Asthma patients above 45 years maintained the higher probability of severe asthma than young adult asthmatic patients, where both minor and major criteria of the illness severity were often observed among the older asthmatics. The research also indicated that asthmatic men above 45 years face severe symptoms as compared to women.

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The article concludes that duration of the related illness is a risk factor for severe asthma in young asthmatics than in older ones; however, the research was able to define that age is the primary contributor to severe asthma. In general, the study hypothesized that age is the primary factor that leads to severe symptoms of the illness. The study can be helpful in age-related care for older patients with asthma providing possible steps and measures in order to help more elderly asthmatics. The main limitation of the research was the external validity since most recruited patients were referred to, and their baseline features may be differed from that of the general population.

Gournellis, R., Oulis, P., & Howard, R. (2014). Psychotic major depression in older people: A systematic review. International Journal of Geriatric Psychiatry, 29(8), 784-796. doi:10.1002/gps.4065

The study was conducted with the aim to hypothesize the following claims. First, the research sought to determine whether major psychotic depression among the older people is different from non-psychotic one. Second, the study aimed to identify whether significant psychotic depression has unique clinical characteristics from the non-psychotic one. Finally, the research determined if the given type of depression in older people differs from that of younger individuals.

The study began studying psychotic major depression features in older people using a computerized MEDLINE in 2013. In compliance with the research, it was possible to conclud that significant psychotic depression in older people showed more severe depressive symptoms than the non-psychotic one. Psychotic major depression among older people showed more psychomotor disturbance and guilty feelings as compared to non-psychotic illness. When compared to major psychotic depression in young adult patients, major psychotic depression in older patients has more somatic complaints, low comorbidity with anxiety and more delusions of hypochondriac land. In general, the research concluded that major psychotic depression in older patients is linked to higher severity in most clinically significant key features than those observed in patients with non-psychotic major depression. Reviewing the difference between major psychotic depression in older and young adults patients, the study defined that the difference results from biological and psychological changes that occur when one becomes older.

Rimland, J. M., Abraha, I., Dell’Aquila, G., Cruz-Jentoft, A., Soiza, R., Gudmusson, A., & … Cherubini, A. (2016). The effectiveness of non-pharmacological interventions to prevent falls in older people: A systematic overview. The SENATOR Project ONTOP Series. PLoS ONE, 11(8), 1-29. doi:10.1371/journal.pone.0161579

The main aim of this study was identify and consider meta-analyses and reviews that assessed nonpharmacological techniques in order to prevent falls among older adults in the community and health care facilities. The researchers conducted their study seeking various related electronic database, such as PubMed, that began in March 2009 and ended in March 2015.The study provided reviews and presented one comparative research assessing any non-pharmacological technique to prevent older adults from falls. The researchers used  ProFaNE and AMSTAR taxonomy to organize the interventions.

The study identified fifty-nine reviews categorized into multiple, single and multifactorial non-pharmacological interventions in order to prevent fall among older people. In addition, they  identified and exercised the first intervention, which can be used alone or incorporated with other interventions. The second type is environment or technology interventions that consist of environmental modifications, protective and assistive aids, staff correction and education  or assessment of vision. The third intervention was the knowledge that involves educating the patients. According to the study, exercise intervention was the most efficient method to prevent falls in older people, but it was not relevant to all the settings and subjects. The research was able to help the clinicians and healthcare workers in making decision regarding ideas of non-pharmacological interventions in order to prevent fall in older people.

McKay, R. G. & Draper, B. M. (2012). Is it too late to prevent a decline in mental health care for older Australians? Medical Journal Association MJA 179(2) retrieved from

In their article, McKay and Draper analyze the decline of health care service among the old patients in Australia. In their cases, convalescent or nursing homes are safe places for the elderly parents. There have been cases of accidents and other misconduct activities within these facilities. Most care homes face problems such as untreated bedsore, malnutrition, inadequate sanitation and Medicare as well as the most common preventable accidents such as falling or tripping of old people. There is a necessity for a nurse in the home care facilities to aid in preventing or reducing the level of fall accidents within the convalescent places. The safety of the nursing home is imperative and for this reason the nurses must be more vigilant in reducing the level of fall among the elderly within the care homes.

The old patients are facing numerous challenges that need to be addressed by the medical staffs. According to the article, the authors address high rates of depression to be reported in order to affect patients aged sixty and over. Mental disorder is rampant among the old age patients in Australia. However, the Australian government has a major influence on enhancing patient care to such victims. They must commit to valuing the condition of old aged patients providing support and appropriate care. The article addresses the issue of obstacles removal by improving support and primary health care for old people and introducing multidisciplinary mental care.

Snape, E., and Redman, T. (2003). Too old or too young? The impact of perceived age discrimination. Human Resource Management Journal, 13(1), 78-89.

The article addresses the issue of old age people in the society, how their families and medical practitioners relate to this cohort. It assesses quality of the service provided to this group of people, their attitude and measures taken to improve the situation or ensure necessary care. The population is concerned with issue of the old people, with the attitude of nurses to the elders as well as their treatment in the health care facilities and the kind of medical service they receive.

In the article, Snape and Tom describe the atmosphere experienced in healthcare in Australia and the attitude of clinicians to old people. According to them,  aged individuals receive poor health service and are exposed to various medical challenges. This has created the need to improve medical service among most medical practitioners concerning their relations in the care facilities. The elderly citizens in Australia are already undergoing many challenges in receiving health care services. The article indicates the perception of old people and the behavior of the medical staff towards such patients. It indicated issues such as negligence, poor communication and lack of proper relationship between them and nurses. It offers meaningful measures that nurses can adopt to improve the health service provided to their patients.

Mark, C. (2016). Calls for CCTV in aged care homes after shocking case of elder abuse. PM ABC News.

The article provides different views related to the relationship of old age patients in the medical facilities in Australia. It presents different surveillance documentation concerning the treatment of old people in the hospitals. The staff members can use video surveillance to help improve the quality of care among the old patients. Since there is a concern about the kind of service the aged people receive in the healthcare, medical staff members are encouraged to increase their surveillance in order to improve the quality of service. Providing sufficient care to this cohort will help prevent the issues such as patient fall or any form of accidents within any medical facility.

This article describes response of the South Australian Government concerning the medical care service to the old people. There is a lack of proper care as the accidents for old patients are increasing. This is as a result of vulnerability among the elderly patients. When old people visit the health care facilities, they are inherently vulnerable, and one cannot expect that they will not be subjected to abuse. The cases of such abuses are dominant in the health care services. People who bring their elderly to the health care homes are feeling guilty of their services, and this is a result of a poor working condition in such institution.

Quigley, P., & White, S., (2013) Hospital-based quality care program measurement and improvement in high-reliability organizations. OJIN: The Online Journal of Issues in Nursing 18(2). Retrieved from ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Fall-Program-Measurement.html

According to Quigley and White (2013), the TJC provided hospital leadership with a guide to evaluate programs, which help improve the quality of health care among the old age people. The medical staffs learn various measures aimed to improve quality of the healthcare. The article evaluates and analyzes the structures and processes introduced for the purpose of improving quality health care service provided to the old patients.

According to the article, nurses and medical staff members must understand the importance of improving their relationship. They must address factors that boost their patient care such as regular checkup among the old people. They asserted that a good evaluation of nurses’ performance would help boost medical service provided to the old patients. In the article, assessing nurse performance helps depict a high-reliability and responsible staff members, thus improving the quality of services towards their patients.

Duque, G., & Kiel, D. P. 2009. Osteoporosis in older persons: Pathophysiology and therapeutic approach. Springer Science & Business Media. Medical.

Duque and Kiel (2009) describe a skeletal disorder that reduces the strength of bones known as osteoporosis. This condition is a complex trait that represents various genes and their interactions (gene-gene), as well as gene and environment interactions. This condition increases the risk of fractures in the event of a fall. The group studied twins and families. Their result indicated around eighty percent of osteoporosis traits as inheritable. However, they noted that complete knowledge of the genes underlying the phenotypic characteristics was limited. The quantity value used in diagnosing osteoporosis has been the mineral density of the bones. In the book, they review the genomics of osteoporosis focusing on new discoveries and insights on the numerous questions concerning the relevant field. The Human Genome Project greatly inspired the studies about the pathophysiology of the bone condition in past years. The approaches ranged from family studies to genome scans of animals and humans alike. The studies showed some genes of bone mass that could be inherited. The bone mineral density is the most common assessment for diagnosing osteoporosis, being the most frequently used quantitative value for genetic designs. The studies ranged from family to animals and humans alike. The studies aimed to combat the disease remain currently implemented.

Project 3

Nursing Theory and Quality Service Towards Old Patients

The age people usually face many challenges, among which is the poor health. The need to adjust and provide quality medical care to the aged patients is imperative, and, consequently, various theories have been developed to provide quality health care to these people in the medical facilities. Medical conditions are being addressed in more sophisticated approach over the years. The nurses are developing more models and theories that help in containing their old patient’s condition and improving their medical condition. The aim of this research is to examine and evaluate two conceptualized theories and how they resist to the time.

According to the study conducted by Zein, et al. (2015) addresses the need for quality health care among the old patients who suffer from asthma. This can only be practiced through applying relevant nursing theories that assist in improving the medical conditions of the aged people. The application of middle range nursing theory and Nightingale environmental theory help address the issues of medical care quality among the old patients. Applying these theories, the people receive medical care that prevents them from old age risk either in the nursing home care or at their residents. Nursing practice is formulated through the environmental and middle range nursing theory that helps define the way, in which the nurses relate to their old patients in the medical facilities.  The nightingale environmental theory is therefore defined as the act of providing patients with standardized medical care by utilizing the policy to help them recover in a good environment free from any form of risk. It involves configuring the environmental setting to help restore patients’ health.

The major concept of environmental theory in nursing practice focuses on the patients’ surrounding, their biological, physical, physiological and economic conditions impacting their state of health. The nightingale environmental theory stresses on the proper use of light, air, warmth, quietness, cleanliness among others to dispense quality service to the patients.  Nurses have a role to ensure that the old patients are well provided with conducive environment. They should prevent and protect the patient against accidents such as increase of falls that is prevalent among the old patient in the health care.

The application of nightingale environmental theory helps address challenges patients are exposed to in the health care facilities. Over the years, chronicle pain has continued to indicate medical distress among the old people. Accompanied by different discomforts, such as daily stress and back pain, the environmental and middle range theories are developed to help analyze this medical discomfort. They offer a reliable process through which the nurses can address and handle their patients in a sustainable health facility. It focuses on the external factor that contributes to such health discomfort. The theory was developed to address medical problems. Moreover, it helps to understand how to relate to old patient and ensure that the medical practitioners do not mishandle them. Its concepts exist in a mental and physical conception presenting things or events with the notion of providing concrete evidence for the real issues. The nightingale environmental theory reveals a qualitative approach to knowledge and skills of various medical conditions and nursing practices. Due to its practical nature, one can apply this theory to a large population. While recording its testability, Beck confirms the framework of the theory and its ability to be involved in different conditions.

The article was chosen for the annotation to define how medical facilities and nurses can continuously maintain and provide quality medical care to the old patients despite their medical conditions. The main purpose of the nursing care theory is to identify various difficulties and apply human relations in solving such issues. In the middle range theory, the issue of nursing staff is addressed to assist in determining its contribution to quality health service towards the old patients. Nurse staffing is considered a critical issue when discussing old patient health care. These cohorts of people are fragile and need more support and surveillance in the hospital. The performance of nurses to tackle different health concerns is determined by the staff behavior within the institution. Understanding the value and importance of staff performance, the health leaders are capable of solving problems such as patient fall or enhance coordination among the nurses and the patients. Further, quality of nursing care theory assists in identifying the things that influence nurses’ performance such as the general communication level within the hospital. It ensures the standard of staff motivation towards increasing their attitude and performance. Besides, it defines how their surroundings influence the behavior. An administrator is capable of understanding the variables that affect the performance of the nurses and find effective solutions.

The given case study defines how RN performance of the registered nurses within a healthcare institution affects the provision of their services. It is evident that the introduction of improved form of medical registration, staff motivation, and improved working condition enhanced the performance of nurses. Due to quality of nursing care theory, it is possible to address the small issues affecting nurses and staff within the healthcare administration and dispense quality health administration.

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