Search

Item does not contain fulltext

Contains fulltext : 55994.pdf (Publisher’s version ) (Closed access)

Contains fulltext : 55666.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 64133.pdf (Publisher’s version ) (Open Access)

Item does not contain fulltext Till now, no specific diagnostic instruments to detect personality disorders in the elderly are available. The aim of our study was to contribute to the construction of a reliable en valid instrument for the detection of personality disorders in older adults. Therefore, a draft version of the instrument was constructed both for the patient and the informant. Both the patient and the informant version of the instrument included 52 items with the same content. These items concerned Habitual behaviour (HAB), Biographical information (BIO) and Observation of actual behaviour (OBS). 159 clients of 60 years and older of a Dutch ambulatory mental health care organisation were assessed with the screening instrument. In 96 of the 159 outpatients one or more informants were included. The results indicate that the internal consistency of seven HAB items, nine BIO items and five OBS items was moderate to good with regard to both the patient and informant instrument. Test-retest reliability of the 21 items of the patient instrument was moderate with regard to HAB, excellent with regard to BIO and moderate with regard to OBS. Interrater reliability of OBS was also moderate. The criterion validity (criterion: DSM-IV TR Axis II classification) of HAB, BIO and OBS based on the 21 items of the patient instrument was fair and with regard to the same 21 items of the informant instrument insufficient. In conclusion, sixteen out of 52 potential items of the patient's draft version of the screening instrument can be used to detect a possible personality disorder. These sixteen items from the HAB and BIO scale are named the Gerontological Personality disorder Scale (GPS). Medical doctors, psychologists and nurses working in ambulatory mental health organisation can use the GPS as a resource during the diagnostic process. Whether the GPS can be used beyond mental health organisations, for example by general practitioners is a subject for future studies.

Item does not contain fulltext Background. Mild cobalamin (Cbl) deficiency is frequently found in older persons and is associated with cognitive and cerebral abnormalities. The effects of Cbl supplementation on these abnormalities are largely unknown. Methods. In a single-blind, placebo-controlled intervention study, 16 healthy community-dwelling elderly subjects with low plasma Cbl concentration and no cognitive impairments were studied. Subjects underwent 1 month of treatment with placebo, followed by 5 months of treatment with intramuscular injections of hydroxycobalamin. Before and after measurements of plasma cobalamin, total homocysteine (tHcy), methylmalonic acid (MMA), quantitative electroencephalograph (qEEG), and psychometric tests were taken. Results. After Cbl supplementation, plasma Cbl concentrations increased, and plasma MMA and tHcy concentrations decreased. The performance on the Verbal Word Learning Test, Verbal Fluency and Similarities improved. qEEG showed more fast activity and less slow activity. Lower plasma tHcy concentrations were related to increased fast activity on qEEG on the one hand and improved performance on the Verbal Word Learning Test and Similarities on the other. Increased fast or decreased slow activity on qEEG was associated with improved performance on the Verbal Word Learning Test, Similarities and Verbal Fluency. Conclusions. Electrographic signs of improved cerebral function and improved cognitive function were found after Cbl supplementation in older subjects with low plasma Cbl concentrations who were free of significant cognitive impairment. These improvements were related to a reduction of plasma tHcy concentration.

Contains fulltext : 55898.pdf (Publisher’s version ) (Closed access)

Item does not contain fulltext

Item does not contain fulltext

Item does not contain fulltext

Item does not contain fulltext C.H. van der Kooij Gewoon lief zijn? Het maieutisch zorgconcept en het invoeren van geïntegreerde belevingsgerichte zorg op psychogeriatrische verpleeghuisafdelingen [diss. VU] Utrecht:Lemma ,2004 90-5931-143-4

Item does not contain fulltext C.H. van der Kooij Gewoon lief zijn? Het maieutisch zorgconcept en het invoeren van geïntegreerde belevingsgerichte zorg op psychogeriatrische verpleeghuisafdelingen Utrecht:Lemma ,2004 90-5931-143-4

Contains fulltext : 21885___.PDF (Publisher’s version ) (Open Access) In deze literatuurstudie staat gedragsproblematiek bij oudere somatische verpleeghuispatiënten centraal. Voor dit onderzoek zijn vier vragen geformuleerd, die betrekking hebben op aard en prevalentie van gedragsproblematiek, patiëntkenmerken, oorzaken van gedragsproblematiek en screeningsmethoden. Het begrip 'inadequaat gedrag' wordt geïntroduceerd en gedefinieerd, in verband met de negatieve connotaties en de beperktheid van de term 'gedragsproblematiek'. De prevalentie cijfers van inadequaat gedrag in het somatisch verpleeghuis variëren, omdat in de literatuur verschillende onderzoekspopulaties en definities gehanteerd worden. Concrete patiëntkenmerken zijn niet gevonden. Wel is een aantal risicofactoren beschreven die predisponeren tot inadequaat gedrag. Deze risicofactoren liggen zowel op somatisch en psychisch als op sociaal niveau. Inadequaat gedrag kan deels veroorzaakt worden door de persoonlijkheid en levensgebeurtenissen, deels door ziekte in heden of verleden en deels door de nieuwe omgeving. De verpleeghuisopname en het verblijf kunnen inadequaat gedrag doen ontstaan, in stand houden en doen toenemen. Het model van Gurland (1987) voor multidimensionele analyse van inadequaat gedrag aan de hand van thema's wordt geïntroduceerd. Deze thema's geven richting aan het screeningsproces. Hoewel er diverse geschikte instrumenten voor screening van de doelgroep beschikbaar zijn, ontbreekt een protocol. Verdere studie is wenselijk naar concrete doelgroepkenmerken en een op de doelgroep af gestemd screenings- en interventieprotocol.

In this study the quality of care interactions was investigated using Self-Determination Theory. We explored to what extent professional caregivers support residents’needs of relatedness, autonomy and competence and how this is related to residents’ well-being. Four nursing homes in the Netherlands participated. Three video-observations (with different caregivers) of each resident (n=20) were made during morning care and questionnaires were completed. The results show that residents’ needs were, on average, moderately fulfilled during care interactions. Higher resident well-being as observed during care was related to a higher level of needs being supported by professional caregivers. Resident and caregiver characteristics were explored, with the education and job function of caregivers being related to need support. Professional caregivers demonstrated many good quality interactions, but there was also a recognised need for improvement. Suggestions are presented for improving resident-centred care by taking the three psychological needs of relatedness, autonomy and competence into account.

Contains fulltext : 87367.pdf (Publisher’s version ) (Closed access) From experimental research it appears that personality plays a role in causes and onset of aggressive behavior in adults. However, studies about the influence of premorbid personality on aggressive behavior of older persons with dementia show contradictory results. In this study we gathered data on personality and behavior of 166 residents of psychogeriatric nursing homes. Nursing staff filled out the Cohen-Mansfield Agitation Inventory (Dutch version, CMAI-D). Proxy family members completed the Hetero Anamnestic Personality questionnaire (HAP). Results showed that on the CMAI-D aggression could be distinguished from other forms of agitation. Four subscales of the HAP showed significant positive correlations with aggression as measured with the CMAI-D. These subscales were: Antagonism, Whimsical and impulsive behavior, Rigid behavior, and Being vulnerable in social interactions. Although the influence of personality decreased with increasing cognitive impairment, it was still present in stage 6 of the Reisberg Global Deterioration Scale. In depth analysis items of the HAP revealed a first profile of the aggression prone personality. 01 juni 2010

Item does not contain fulltext Handleiding en werkboek voor groepsgesprekken van jongeren en ouderen, bestemd voor beroepsopleidingen zorg en welzijn. 'Groen en grijs' is een heldere handleiding om jongeren en ouderen met elkaar in gesprek te brengen. Als zij elkaars belevingswereld beter leren kennen, zal er een minder stereotiep beeld ontstaan, waardoor het verlenen van zorg aan ouderen en het stimuleren van het welzijn van ouderen gebasseerd kunnen worden op de individuele wensen en behoeften. xxx Zo'n 15% van de Nederlandse bevolking bestaat uit mensen van 65 jaar of ouder. Dat percentage zal de komende jaren oplopen tot 20%. Toch is er maar weinig contact tussen jongeren en ouderen, zeker buiten het familieverband. Mede hierdoor ontstaan er stereotiepe beelden. xxx Jongeren die een opleiding volgen op het gebied van zorg en welzijn zullen in toenemende mate met ouderen te maken krijgen. Van professionals mag je verwachten dat zij zich in contact met ouderen niet laten leiden door stereotypen. Daarom is dit boek geschreven. 114 p.

Item does not contain fulltext

Item does not contain fulltext

Item does not contain fulltext 95 p.

Item does not contain fulltext 556 p.

Contains fulltext : 55842.pdf (Publisher’s version ) (Closed access) 1 p.

Item does not contain fulltext

Item does not contain fulltext

Item does not contain fulltext

Item does not contain fulltext

Objectives: To explore and quantify the relative contribution of guideline recommendations and other determinants in the GP's diagnostic workup of patients suspected of dementia. Study design: We prospectively studied 64 GPs in a district in the east of the Netherlands who diagnosed dementia according to the national Dutch guidelines for primary care. Their diagnoses were compared to the reference standard drawn up by the memory clinic team of the Nijmegen University Medical Centre. Population: The physicians evaluated 107 patients older than 55 years suspected of dementia. Outcome measures: The predictive value of various clinical and demographic parameters in both univariate and multivariate logistic regression analyses. Results: The positive and negative predictive value of the GPs diagnosis were 0.8 and 0.7 respectively. Activities of daily living (ADL), dependency (odds ratio (OR)=5.3, p=0.03), years since symptoms first presented (OR= 1.84, p=0.03) and the presence of somatic comorbidity (OR=0.48, p=0.02) independently contributed to the prediction of presence or absence of dementia. The area below the receiver-operating characteristic (ROC) curve for these 3 variables together was 0.79. An accurate diagnosis was further associated with a home visit (OR=4.0, p=0.03) and the availability of an informant (OR=3.3, p=0,045). The number of recommendations applied did not additionally contribute to the assessment of the final diagnosis. Conclusions: The accuracy of the diagnosis made by the GPs was reasonable. For GPs, ADL dependency is a better predictor of dementia than cognitive impairment. Family physicians should be aware of diagnostic difficulties in patients with somatic comorbidity. Paying a home visit and contacting an informant arefactors contributing to better diagnosis. We were unable to confirm the diagnostic value of many of the recommendations made in the dementia guidelines.