Sustainable implementation of advance care planning in Asia: An interpretive-systemic framework for national development.

Objectives: A qualitative interpretive-systemic focus group study was conducted to examine the developmental and implementational underpinnings of Asia's first national Advance Care Planning (ACP) programme constituted in Singapore.

Methods: 63 physicians, nurses, medical social workers, and allied health workers who actively rendered ACP were purposively recruited across seven major public hospitals and specialist centers.

Results: Framework analysis revealed 19 themes, organized into 5 categories including Life and Death Culture, ACP Coordination, ACP Administration, ACP Outcomes, and Sustainability Shift.

Forging a Frailty-Ready Healthcare System to Meet Population Ageing.

The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization's World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered.

Changing landscape of nursing homes in Singapore: challenges in the 21st century.

The ageing population is posing new challenges to Singapore's healthcare system. The rise of dual income and the decline of extended families, as well as an increase in age-related degenerative disorders due to increased longevity render it difficult for the family to remain the primary social safety net to care for our elderly in their own homes. Consequently, nursing homes may become increasingly relevant for resource and expertise-challenged families to cope with the burden of caring for a frail and dependent elderly.

A paradigm shift in regulating and running nursing homes in Singapore.

Singapore faces a rapidly aging population. By 2030, 19% of her population will be aged 65 years and above. Other Asian countries face similar problems, with South Korea having the fastest aging population worldwide, followed by China and Thailand.

Factors affecting unplanned readmissions from community hospitals to acute hospitals: a prospective observational study.

Introduction: While the readmission rate from community hospitals is known, the factors affecting it are not. Our aim was to determine the factors predicting unplanned readmissions from community hospitals (CHs) to acute hospitals (AHs).

Materials And Methods: This was an observational prospective cohort study, involving 842 patients requiring post-acute rehabilitation in 2 CHs admitted from 3 AHs in Singapore.

Caring for dying patients and those facing death in an acute-care hospital in Singapore: a nurse's perspective.

Nurses are at the forefront of caring for dying patients in hospices, nursing homes, acute-care hospitals, and patients' homes. This study was conducted to explore the emotional and practical experience as well as attitudes of nurses caring for the dying and the deceased in an acute-care hospital in Singapore. The authors explored differences in opinion among the various ethnic groups (Malay, Chinese, Indian, Filipino) that make up the nurse population in this particular hospital.

Habitual walking and its correlation to better physical function: implications for prevention of physical disability in older persons.

Background: Our objective was to determine the association between participation in habitual physical activity (including walking, shopping, and indoor and outdoor activities) and leisure-time or sports activities on physical performance and fitness in older persons.

Methods: In an observational study, 123 predominantly ethnic Chinese participants aged 50 years and older were recruited from a health promotion program. Main outcome measures were bioelectric impedance for body fat composition, peak oxygen consumption (VO(2)max), gait speed, handgrip strength, and chair rise time.