Background: The growing care demand for frail older adults and those at risk of frailty in primary health care (PHC) requires professionals trained in the subject to promote adequate care. This study aimed to analyze the self-reported, theoretical and practical knowledge of PHC professionals about the frailty syndrome.
Methods: This is an observational cross-sectional study with a sample of 485 Brazilian health professionals (bachelor's degree) working in PHC with older adults. An electronic questionnaire was used to collect data on professional characteristics and self-reported, theoretical and practical knowledge concerning frailty phenotype. Agreement analysis between types of knowledge and multivariate logistic regression were performed to show the factors associated with knowledge about frailty.
Results: Theoretical knowledge showed the worse result, with 87.5% of the professionals describing the syndrome incorrectly. Roughly half the professionals self-reported (52.6%) very little/no knowledge concerning the syndrome and demonstrated low practical knowledge (55.1%) when identifying clinical cases. There were misconceptions about the syndrome, like it is natural from the aging process (83.3%) and is synonymous with disability and comorbidity (51.2%). The majority of the professionals were unaware of instruments for assessing frailty (77.9%) and the phenotype criteria (68.2%). No agreement was observed between the types of knowledge. Professionals specialized in or who had taken training courses in older adult health were 6.1 and 2.7-fold more likely, respectively, to self-reported some knowledge on the frailty syndrome.
Conclusions: PHC professionals presented little knowledge on the frailty syndrome. Most professionals were unaware of the frailty definition, its assessments for diagnosis and evidence for its treatment. The lack of knowledge on frailty could affect the care provided to older adults in primary care.
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http://dx.doi.org/10.1186/s12877-022-02927-6 | DOI Listing |
JAMA Cardiol
January 2025
Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.
Importance: A comprehensive lipid panel is recommended by guidelines to evaluate atherosclerotic cardiovascular disease risk, but uptake is low.
Objective: To evaluate whether direct outreach including bulk orders with and without text messaging increases lipid screening rates.
Design, Setting, And Participants: Pragmatic randomized clinical trial conducted from June 6, 2023, to September 6, 2023, at 2 primary care practices at an academic health system among patients aged 20 to 75 years with at least 1 primary care visit in the past 3 years who were overdue for lipid screening.
JAMA Cardiol
January 2025
Ifakara Health Institute, Ifakara Branch, Ifakara, United Republic of Tanzania.
Importance: Hypertension is the primary cardiovascular risk factor in Africa. Recently revised World Health Organization guidelines recommend starting antihypertensive dual therapy; clinical efficacy and tolerability of low-dose triple combination remain unclear.
Objectives: To compare the effect of 3 treatment strategies on blood pressure control among persons with untreated hypertension in Africa.
JAMA Netw Open
January 2025
Department of Medicine, University of California, San Francisco.
Importance: Multiple organ dysfunction (MOD) is a leading cause of in-hospital child mortality. For survivors, posthospitalization health care resource use and costs are unknown.
Objective: To evaluate longitudinal health care resource use and costs after hospitalization with MOD in infants (aged <1 year) and children (aged 1-18 years).
JAMA Netw Open
January 2025
Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California.
Importance: Limited research explores mental health disparities between individuals in sexual and gender minority (SGM) populations and cisgender heterosexual (non-SGM) populations using national-level data.
Objective: To explore mental health disparities between SGM and non-SGM populations across sexual orientation, sex assigned at birth, and gender identity within the All of Us Research Program.
Design, Setting, And Participants: This cross-sectional study used survey data and linked electronic health records of eligible All of Us Research Program participants from May 31, 2017, to June 30, 2022.
JAMA Netw Open
January 2025
Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota.
Importance: There is a clear benefit to body armor against firearms; however, it remains unclear how these vests may influence day-to-day patient encounters when worn by emergency medical services (EMS).
Objective: To determine the association of ballistic vests worn by EMS clinicians with workplace violence (WPV) and disparities in care among racial and/or ethnic minority patients.
Design, Setting, And Participants: Prospective cohort study of a volunteer-based sample of EMS clinicians at a large, multistate EMS agency encompassing 15 ground sites across the Midwest from April 1, 2023, to March 31, 2024.
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