Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Undetected falls among older adults attending medical clinics in four tertiary care centres in Sri Lanka; the need of a comprehensive geriatric assessment(BioMed Central, 2024-10) De Zoysa, W.; Rathnayake, N.; Palangasinghe, D.; Silva, S.; Jayasekera, P.; Mettananda, C.; Abeygunasekara, T.; Lekamwasam. S.OBJECTIVE Falls take a high priority among the prevalent medical conditions in old age. Despite this, a history of falls or the risk of future falls is not routinely assessed or properly managed in medical clinics in Sri Lanka. This study was done to evaluate the prevalence and factors associated with falls and recurrent falls among older adults attending medical clinics in four selected tertiary care centres in the country.METHODS A cross-sectional study was carried out at four centres (Teaching Hospital Karapitiya, Colombo South Teaching Hospital, Colombo North Teaching Hospital and University Hospital-Kotelawala Defence University) with 704 older adults, aged 65 years and above, attending medical clinics for more than six consecutive months. Information related to falls and possible associated factors (socio-demographic, behavioural, environmental and biological) were collected using an interviewer-administered questionnaire.Results: The Mean (SD) age of the participants was 72.5(5.5) years and 58.7% were females. Of the 704 total sample, 220 (31.3%, 95% CI 28-35%) participants experienced at least one fall after the age of 65, and 12.8% (95% CI 10-15%) (n = 90) experienced recurrent falls (two or more falls within the last 12 months). Falls were associated with gender, level of education, marital status, and physical dependence (p < 0.01). For those who had at least one fall, multiple logistic regression (MLR) revealed being single (p = 0.03, OR = 2.12, 95% CI; 1.052-4.304), being widowed/divorced/separated (p = 0.03, OR = 1.47, 95% CI; 1.039-2.093) compared to living with a spouse, presence of moderate (p = 0.007, OR = 1.72, 95% CI; 1.160-2.577) and severe (p = 0.001, OR = 2.98, 95% CI; 1.563-5.688) physical dependency compared to mild physical dependency as risk factors for falls. Having secondary education (p = 0.01, OR = 0.55, 0.350-0.876) was a protective factor for falls. For those with recurrent falls, MLR showed moderate physical dependency (p = 0.001, OR = 2.34, 95% CI; 1.442-3.821) compared to slight physical dependency as a risk factor.CONCLUSIONS Approximately one-third of the older adults attending medical clinics had experienced at least a single fall, and one-eighth have had recurrent falls, which were mostly unrecorded and not clinically assessed. Physical dependency was the major contributing factor to falls and recurrent falls. Falls assessment should be included in the routine clinical assessment of older adults attending outdoor medical clinics. Health professionals should be educated to detect and assess those at risk of falling and take appropriate measures to prevent or minimize falls.Item Translation, cross-cultural adaptation, and validation of the Rastreamento de Alteracoes Vocais em Idosos-RAVI (Screening for voice disorders in older adults) tool into Sri Lankan Tamil(University of Kelaniya, Sri Lanka, 2022) Moganapriya,T.; Siriwardhana,D.D.Objective: The objectives of the study was to translate, cross-culturally adapt and validate the Rastreamento de Alteracoes Vocais em Idosos-RAVI (Screening for voice disorders in older adults) instrument from English into Sri Lankan Tamil.Methods: The study was carried out as a tool adaptation and validation study. The study was conducted in three phases. Phase one involved the translation and cross-cultural adaptation of Rastreamento de Alteracoes Vocais em Idosos-RAVI (Screening for voice disorders in older adults), conducted under four phases. Stage 1 was forward translation; stage 2 was synthesis (T1 and T2) of the forward translated tools, stage 3 was backward translation of the synthesized version (T12) of the questionnaire totally blind to the original version. Stage 4 was the review of the translated questionnaires by the expert committee. The phase two involved a Delphi study to achieve content validity of the translated instrument, and a psychometric evaluation of the instrument. The psychometric evaluation was not able to be carried out due to time restrictions. Results: The RAVI tool was successfully translated and cross-culturally adapted to Sri Lankan Tamil. I-CVI (Item-level content validity index) values for all the items were acceptable (>_0.83) for all domains except for one item each in culturally appropriateness and sufficiency domains. S-CVI/Ave (scale-level content validity index based on the average method) values for all domains were satisfactory and above 0.90. Five older adults aged 60 years and above participated in the pre-test, and they understood all the items mentioned in the RAVI tool without any issues.Conclusion: The Rastreamento de Alteracoes Vocais em Idosos-RAVI (Screening for voice disorders in older adults) was successfully translated, cross-culturally adapted and content validated into Sri Lankan Tamil language. Overall, Sri Lankan Tamil translation of the RAVI instrument showed a satisfactory content validity.Item Prevalence and associated factors of voice disorders among older adults: an updated systematic review(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Herath, S.Introduction: Ageing is a continuing decrease in an organism’s age-specific health components caused by internal physical degradation. No systematic review is available on both prevalence and associated factors of voice disorders among older adults. Objectives: To systematically review the research conducted on prevalence and associated factors of voice disorders among older adults. Methods: This review was registered in the PROSPERO: International prospective register of systematic reviews under the registration number CRD-42020209022 and was adhered to Preferred Reporting Items for Systematic Reviews and Protocols on Meta-Analysis (PRISMA). Electronic databases were PubMed, EBSCO, Scopus, CINAHL, Web of Science, LILACS. Additionally, reference lists of the selected articles were scanned and citation searches were performed. Two concepts ‘voice disorders’ and ‘older adults’ were used to develop the electronic search strategy. Findings were narratively synthesized: including a summary of the prevalence of voice disorders and associated factors of voice disorders among older adults. Results: Seventeen articles met the eligibility criteria. Two articles were excluded after the study quality assessment and 15 satisfied the inclusion criteria. Prevalence of voice disorders among older adults ranged from 1.8% to 55.2%. Respiratory diseases, vocal fold lesion, hearing loss, thyroid disease, hypo salivation, stroke, temporal mandibular disorders, smoking, phonotrumatic behaviours, age, gender, not seeking physician/ physician type, geographic location, weight gain, income, anxiety, and depression associated with older adults’ voice disorders. Conclusions: The prevalence of voice disorders among older adults ranged from low to moderate. Factors associated with voice disorders among the older adults included both physical, psychosocial and behavioural aspects.