五十嵐 歩

Body mass index (BMI) is an inexpensive, easy-to-calculate, and noninvasive marker of malnutrition. Few studies have examined the longitudinal effects of BMI on the incidence of unfavorable physical health outcomes (UPHOs) among older adults receiving homecare nursing. Therefore, this prospective cohort study examined the longitudinal effects of low BMI on the occurrence of UPHOs at multiple time points (i.e., 1-, 3-, and 6-months) among older adults (≥ 75 years) receiving homecare nursing across Japan. Using an online questionnaire, homecare nurses reported clients' height and weight, as well as socio-demographic characteristics (e.g., age and gender) and health conditions (e.g., diagnosis and dependency level). The occurrence of seven UPHOs (urinary tract infection, respiratory infection, pressure ulcer or skin tear, dehydration, poor dyspnea control, poor pain control, and traumatic fall) was also reported. The longitudinal effects of low BMI on the total number of UPHOs at 1-, 3-, and 6-months follow-ups were examined using a Restricted Moment Model (RMM) with a log link function. Among 660 participants included in the analysis, 42.12% were males, 36.96% had dementia, and 44.09% had low BMI. Adjusting for client's characteristics and the number of UPHOs at the baseline, low BMI at the baseline could increase the incidence of UPHOs at 1-, 3- and 6-month follow-ups (incidence rate ratio [95% confidence interval]:1.59 [1.21, 2.07], 1.57 [1.18, 2.07], 1.35 [1.02, 1.79], respectively). Adequate management of low BMI among older adults receiving homecare nursing would have a favorable effect on reducing the occurrence of UPHOs, thereby reducing the deterioration of overall physical conditions.

This prospective cohort study examined the association between home-visit nursing use and the occurrence of unfavorable health outcomes (UHOs) among community-dwelling older adults (≥75 years) across Japan. An online survey collected data about older people's characteristics (household composition, diagnosis, etc.) and the occurrence of 21 UHOs (e.g., hospitalization, respiratory infection, sleeping disorders, lack of serenity) twice a year apart. The analysis included 835 older adults (58.2% were female, and 39.4% had dementia). Controlling for participants' characteristics and the occurrence of UHOs at the baseline, regression analyses revealed that home-visit nursing use was associated with statistically significant lower occurrence rates of lack of social interaction, social isolation, neglecting the client's desired care, urinary tract infection, and poor family well-being, as well as lower incidence rate of the total number of UHOs. The results demonstrate the favorable contribution of home-visit nursing in minimizing the occurrence of UHOs among older people.

Proxy rated quality of life (QoL) might mislead the interpretation of QoL of older people. This cross-sectional survey evaluated the reliability and feasibility of using newly developed self-reported QoL items for older adults (≥75 years) receiving home care services. Of the distributed questionnaires, 60.34 % (875/1450) were returned with valid responses in at least one of the QoL items. The largest number of missing data was five cases per question, and the intraclass correlation ranged from 0.47 to 0.77. Furthermore, 66.0 % of those aged 85-94 years, 76.4 % of those with heart failure, and 50 % of those with a terminal medical condition responded to the QoL items. The newly developed items capture the essential aspects of older people's lives and were found to be reliable and feasible for use by older people, including those with terminal conditions, dementia, and a high degree of dependency.

Aim This study examined the home care nurses' implementation of comprehensive assessment of their clients, their education and the association betwwen the two. Staff education in home care nursing agencies has the potential to improve nurses' comprehensive client assessment, contributing to the provision of high‐quality home care nursing services. Methods A cross‐sectional questionnaire survey was conducted to investigate educational approaches provided by agencies and comprehensive assessment by home care nurses. Multilevel regression analyses were performed to examine the association between education and comprehensive assessment. Results We analyzed data from 105 clients, based on 78 nurses' assessments, across 11 agencies with respect to their respective staff education systems. Various educational programs for novices and all staff were provided. In the multilevel regression analysis, having a designated individual in charge of staff education and regular case reviews for all staff were significantly associated with more comprehensive assessments. Conclusions Ensuring specific educational opportunities for all home care nurses, rather than solely for novices, might improve their comprehensive assessment in home care nursing agencies. Designating educators and introducing regular case reviews as part of agencies' educational systems may improve comprehensive assessment. Geriatr Gerontol Int 2025; ••: ••–••.