Læknablaðið - okt 2019, Qupperneq 25

LÆKNAblaðið 2019/105 441
R A N N S Ó K N
Introduction: Many factors influence the nursing needs and survival
of nursing home residents, including the admission criteria. The aim of
the study was to compare health, survival and predictors for one- and
two-year survival of people entering Icelandic nursing homes between
2003–2007 and 2008–2014.
Material and methods: Retrospective, descriptive, comparative
study. The data was obtained from a Directorate of Health database
for all interRAI assessments of Icelandic nursing homes from January
1, 2003, to December 31, 2014 (N = 8487).
Results: There was a significant difference in the health and survival
of new nursing home residents before and after December 31, 2007. In
the latter period, the mean age was 82.7 years. In the previous period,
it was 82.1 years, and the prevalence of Alzheimer‘s disease, ischemic
heart disease, heart failure, diabetes and COPD increased between
the periods. One-year survival decreased from 73.4% to 66.5%, and
two-year survival decreased from 56.9% to 49.1%. The strongest
mortality risk factors were heart failure and chronic obstructive
pulmonary disease, as well as high scores on the CHESS scale and
ADL long scale.
Conclusion: After 2007, new residents were older, in poorer health,
and their life expectancy was shorter than for those moving to nursing
homes before that. The results suggest that the aim of the regulatory
change was achieved, i.e., to prioritise those in worst health. Their
care needs may therefore be different and greater than before.
Health and survival in Icelandic nursing homes 2003 – 2014, before and after
the setting of stricter criteria for nursing home admission in December 2007
ENGLISH SUMMARY
1Faculty of Nursing, University of Iceland, 2Emergency, Geriatrics, Rehabilitation Services, National University Hospital, 3School of Humanities and Social Sciences,
University of Akureyri, 4Department of Education and Science, Akureyri Hospital, 5Department of Rehabilitation, Akureyri Hospital, 6Respiratory-, allergy- and sleep
research, Faculty of Medicine, Uppsala University, Sweden.
Key words: Geriatrics, Minimum Data Set, nursing homes, old people, elderly people, survival.
Correspondence: Ingibjörg Hjaltadóttir, ingihj@hi.is
Greinin barst til blaðsins 8. maí 2019, samþykkt til birtingar 27. ágúst 2019.
Ingibjörg Hjaltadóttir1,2
Kjartan Ólafsson3
Árún K. Sigurðardóttir4,5
Ragnheiður Harpa Arnardóttir4,6,7
12. Mor V, Intrator O, Unruh MA, Cai S. Temporal and
geographic variation in the validity and internal
consistency of the Nursing Home Resident Assessment
Minimum Data Set 2.0. BMC Health Serv Res 2011; 11: 78.
13. Fries BE, Simon SE, Morris JN, Flodstrom C, Bookstein FL.
Pain in US nursing homes: validating a pain scale for the
minimum data set. Gerontologist 2001; 41: 173­9.
14. Burrows AB, Morris JN, Simon SE, Hirdes JP, Phillips C.
Development of a minimum data set­based depression
rating scale for use in nursing homes. Age Ageing 2000; 29:
165­72.
15. Gruber­Baldini AL, Zimmerman SI, Mortimore E,
Magaziner J. The validity of the minimum data set in
measuring the cognitive impairment of persons admitted
to nursing homes. J Am Geriatr Soc 2000; 48: 1601­6.
16. Resnick HE, Fries BE, Verbrugge LM. Windows to
their world: the effect of sensory impairments on social
engagement and activity time in nursing home residents. J
Gerontol B Psychol Sci Soc Sci 1997; 52: S135­S44.
17. Hebert LE, Weuve J, Scherr PA, Evans DA. Alzheimer
disease in the United States (2010­2050) estimated using
the 2010 census. Neurology 2013; 80: 1778­83.
18. Ogarek JA, McCreedy EM, Thomas KS, Teno JM, Gozalo
PL. Minimum Data Set Changes in Health, End­Stage
Disease and Symptoms and Signs Scale: A Revised
Measure to Predict Mortality in Nursing Home Residents.
J Am Geriatr Soc 2018; 66: 976­81.
19. Foebel AD, Liperoti R, Gambassi G, Gindin J, Ben
Israel J, Bernabei R, et al. Prevalence and correlates of
cardiovascular medication use among nursing home
residents with ischemic heart disease: results from the
SHELTER study. J Am Med Dir Assoc 2014; 15: 410­5.
20. Zarowitz BJ, O’Shea T. Chronic obstructive pulmonary
disease: prevalence, characteristics, and pharmacologic
treatment in nursing home residents with cognitive impa­
irment. J Manag Care Pharm 2012; 18: 598­606.
21. Hjaltadóttir I, Sigurðardóttir Á. Algengi sykursýki og
heilsufar íbúa á íslenskum hjúkrunarheimilum 2003­2012.
Læknablaðið 2015; 101: 79­84.
22. Garcia TJ, Brown SA. Diabetes management in the nursing
home. Diabetes Educ 2011; 37: 167­87.
23. Vetrano DL, Collamati A, Magnavita N, Sowa A,
Topinkova E, Finne­Soveri H, et al. Health determinants
and survival in nursing home residents in Europe: Results
from the SHELTER study. Maturitas 2018; 107: 19­25.
24. Samefors M, Östgren CJ, Mölstad S, Lannering C, Midlöv
P, Tengblad A. Vitamin D deficiency in elderly people
in Swedish nursing homes is associated with increased
mortality. Eur J Endocrinol 2014; 170: 667­75.
25. Rawshani A, Rawshani A, Franzén S, Sattar N, Eliasson
B, Svensson AM, et al. Risk factors, mortality, and
cardiovascular outcomes in patients with type 2 diabetes.
N Engl J Med 2018; 379: 633­44.
26. Haugstvedt A, Graue M, Aarflot M, et al. Challenges in
maintaining satisfactory documentation routines and
evidence­based diabetes management in nursing homes.
Int Diabet Nurs 2016; 13: 37­42.
27. Vossius C, Selbæk G, Benth JŠ, Bergh S. Mortality in
nursing home residents: A longitudinal study over three
years. PloS one 2018; 13: e0203480.
28. Jónsson Á, Bernhöft I, Bernhardsson K, Jónsson PV.
Afturvirk rannsókn á heilsufarsbreytum heimilismanna á
Droplaugarstöðum árin 1983­2002. Læknablaðið 2005; 91:
153­60.
29. Eiríksdóttir JÓ, Bragadóttir H, Hjaltadóttir I. Samanburður
á heilsufari, færni, einkennum og meðferðarmarkmiðum
íbúa á íslenskum hjúkrunarheimilum eftir áætluðum
lífslíkum. Tímarit hjúkrunarfræðinga 2017; 93: 79­85.
30. Shin JH, Scherer Y. Advantages and disadvantages of
using MDS data in nursing research. J Gerontol Nurs 2009;
35: 7­17.
DOI: 10.17992/lbl.2019.10.251