Kasama Wongprachum

Introduction: Falls are a major health concern for older adults, particularly those with cognitive impairment. Many factors contribute to the risk of falls, making it a complex issue to manage. Aim: This systematic review aimed to identify and describe the implementation strategies used for fall prevention in community-dwelling older people with cognitive impairment. Eligibility criteria: The review included studies on fall prevention interventions for community-dwelling adults aged > 50 years with cognitive impairment. Eligible studies were primary research, including experimental, quasi-experimental, qualitative, and mixed methods designs, with detailed implementation strategies. Systematic reviews, protocols, editorials, opinions, commentaries, and conference papers were excluded. Methods: This review followed the JBI methodology for systematic reviews of effectiveness and was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases were searched for studies published in English after 2000: MEDLINE (EBSCOhost), CINAHL Ultimate (EBSCOhost), PsycINFO (EBSCOhost), Scopus, and Web of Science Core Collection. Data on implementation strategies and outcomes were extracted and synthesized using the ERIC framework and Proctor's implementation taxonomy. Results: Twenty-one studies met the eligibility criteria. Twenty-four implementation strategies were identified, with 15 directly fitting the ERIC list and 9 additional strategies emerging. The most common strategies were engaging consumers (i.e., patients and family members or caregivers) (n = 13), adapting and tailoring to context (n = 9), and training and educating stakeholders (n = 8). Implementation outcomes were reported inconsistently across studies. Several implementation strategies were often used, but their combined effects on fall prevention outcomes were not clearly reported. Conclusions: This review indicates that engaging consumers, particularly family members, was the most common implementation strategy to prevent falls. The review also highlights new strategies, such as providing culturally appropriate interventions and using dementia-trained instructors. Lastly, the review identifies the need for clearer reporting of implementation strategies and outcomes in future studies. Review registration: PROSPERO CRD4202454689 Spanish http://links.lww.com/IJEBH/A380

Background: Optimal glycemic management is critical since it can predict all associated essential causes of death, even after accounting for other risk factors. Objectives: This study investigated the factors associated with glycemic control in patients with type 2 diabetes mellitus (T2DM), particularly self-care behaviors. Methods: An analytical cross-sectional study examined 385 patients with T2DM in 1 general and 17 community hospitals in Kalasin Province. The samples were collected using mixed-method sampling. Data were collected using a validated questionnaire with six parts and laboratory examination records between September 2021 and December 2022. Descriptive statistics (e.g., percentages and means ± SD) were used to analyze the data. The relationship between relevant factors and lack of glycemic control was analyzed by multivariate logistic regression using SPSS version 25. Results: Results showed that most patients were female (78.18%), and the mean age was 59.84 ± 9.05 years. Additionally, a significant proportion of the patients (79.74%) had poor glycemic control. Several factors are significantly associated with poor glycemic control in patients with T2DM. These factors included subjects under the age of 60 years (OR = 2.95, 95% CI: 1.57 to 5.54; p-value < 0.001), a diabetes duration of over 10 years (OR = 3.95, 95% CI: 1.90 to 8.22; p-value < 0.001), poor knowledge about diabetes (OR = 3.92, 95% CI: 1.59 to 9.67; p-value < 0.003), and inadequate self-care behaviors (OR = 6.12, 95% CI: 3.20 to 11.68; p-value < 0.001). Conclusions: In conclusion, proper interventions for controlling glycemic level behaviors are necessary to improve proper self-care behaviors in patients who have a low knowledge level of T2DM, have had diabetes for over ten years, and are aged < 60 years. This approach can reduce the likelihood of experiencing disabilities and economic hardship.