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Chen J, Ye W, Zheng X, Wu W, Chen Y, Chen Y. Predictors of medical staff's knowledge, attitudes and behavior of dysphagia assessment: A cross-sectional study. PLoS One 2024; 19:e0301770. [PMID: 38578772 PMCID: PMC10997058 DOI: 10.1371/journal.pone.0301770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/21/2024] [Indexed: 04/07/2024] Open
Abstract
PURPOSE This study aimed to explore the predictors of medical staff's Knowledge, Attitudes and Behavior of dysphagia assessment, to provide reference suggestions for constructing the training program and improving the rate of dysphagia assessment. METHODS This study was a cross-sectional study. A total of 353 nurses and doctors from four provinces (Guangdong, Hunan, Guangxi, and Shaanxi) who were selected by convenience sampling and invited to complete the questionnaire through WeChat, DingTalk, and Tencent instant messenger from May 23 to 31, 2022. A self-reported questionnaire was used to assess participants' Knowledge, Attitude and Behavior regarding dysphagia assessment. Participants' sociodemographic, training, and nursing experience were measured using the general information sheet and analyzed as potential predictors of medical staff's Knowledge, Attitudes and Behavior of dysphagia assessment. A multiple linear regression model was used to identify the predictors. RESULTS The mean scores for Knowledge, Attitudes and Behavior of dysphagia assessments were (15.3±2.7), (35.9±4.9) and (41.4±14.4) respectively. Knowledge and Behavior of medical staff were medium, and attitude was positive. Multiple linear regression results indicated that experience in nursing patients with dysphagia, related training for dysphagia, working years in the field of dysphagia related diseases, specialized training (geriatric, swallowing and rehabilitation) and department (Neurology, Rehabilitation, Geriatrics) were significant predictors of Behavior, accounting for 31.5% of the variance. Working years in the field of dysphagia related diseases, department (Neurology, Rehabilitation, Geriatrics) and title were significant predictors of medical staff's knowledge, accounting for 7.8% of variance. Education, experience in nursing patients with dysphagia, department (Neurology, Rehabilitation, Geriatrics) and related training for dysphagia were significant predictors of medical staff's attitude, accounting for 12.9% of variance. CONCLUSIONS The study findings implied that nursing experience, training, and work for patients with swallowing disorders could have positive effects on the Knowledge, Attitudes and Behavior of medical staff regarding dysphagia assessment. Hospital administrators should provide relevant resources, such as videos of dysphagia assessment, training centers for the assessment of dysphagia, and swallowing specialist nurses.
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Affiliation(s)
- Juanhui Chen
- Department of Nursing, Longgang Central Hospital of Shenzhen, Shenzhen, Guangdong Province, China
| | - Wenqiu Ye
- Department of Neurology, Longgang Central Hospital of Shenzhen, Shenzhen, Guangdong Province, China
| | - Xingyun Zheng
- Department of Neurosurgery, Longgang Central Hospital of Shenzhen, Shenzhen, Guangdong Province, China
| | - Wenna Wu
- Department of Rehabilitation, Longgang Central Hospital of Shenzhen, Shenzhen, Guangdong Province, China
| | - Yuebao Chen
- Department of Neurology, Guangxi International Zhuang Medicine Hospital, Nanning, Guangxi Province, China
| | - Yinjuan Chen
- Department of Nursing, Shenzhen FuYong People’s Hospital, Shenzhen, Guangdong Province, China
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Sureshkumar A, Payne MW, Viana R, Hunter SW. The Effect of Advanced Age on Prosthetic Rehabilitation Functional Outcomes in People With Lower Limb Amputations: A Retrospective Chart Audit of Inpatient Admissions. Arch Phys Med Rehabil 2023; 104:1827-1832. [PMID: 37119956 DOI: 10.1016/j.apmr.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To evaluate the effect of age on functional outcomes at discharge from prosthetic rehabilitation. DESIGN Retrospective chart audit. SETTING Rehabilitation hospital. PARTICIPANTS Individuals ≥50 years with a transtibial level lower limb amputation (LLA) and above admitted to the inpatient prosthetic rehabilitation program from 2012 to 2019 (n=504). A secondary analysis included a subset of matched participants (n=156). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The L-Test of Functional Mobility (L-Test), 2-Minute Walk Test (2MWT), 6-Minute Walk Test (6MWT), and Activities-specific Balance Confidence scale. RESULTS A total of 504 participants (66.7±10.1 years) met the inclusion criteria, 63 participants (84.9±3.7 years) were part of the oldest old group. The sample was stratified into 4 age groups (50-59, 60-69, 70-79, and 80+) for data analysis. The analysis of variances were statistically significant for all outcome measures (P<.001). Post-hoc testing for the L-Test, 2MWT, and 6MWT demonstrated that the oldest old had significantly reduced performance compared with people 50-59 years old (P<.05), but there were no significant differences between the oldest old and the 60-69 [(L-Test, P=.802), (2MWT, P=.570), (6MWT, P=.772)] and 70-79 [(L-Test, P=.148), (2MWT, P=.338), (6MWT, P=.300)] age groups. The oldest old reported significantly lower balance confidence compared with all 3 age groups (P<.05). CONCLUSION The oldest old achieved similar functional mobility outcomes as people 60-79 years, the most common age group of people with an LLA. Advanced age alone should not disqualify individuals from prosthetic rehabilitation.
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Affiliation(s)
| | - Michael W Payne
- Department of Physical Medicine & Rehabilitation, Parkwood Institute London, Canada; Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Ricardo Viana
- Department of Physical Medicine & Rehabilitation, Parkwood Institute London, Canada; Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Susan W Hunter
- Faculty of Health Sciences, University of Western Ontario, London, Canada; Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada; School of Physical Therapy, University of Western Ontario, London, Canada
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3
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Vera M, Lorente L. Nurses´ Performance: The Importance of Personal Resources for Coping with Stressors. Issues Ment Health Nurs 2023; 44:844-853. [PMID: 37643368 DOI: 10.1080/01612840.2023.2239908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
The health crisis caused by the COVID-19 pandemic has negatively influenced the work of health staff, especially nurses. Stressors that affect nurses have been intensified and new stressors have also emerged, threatening their well-being and job performance. The main objective of this study is to analyze the role of nurses´ personal resources in the relationship between job stressors and job performance during the COVID-19. Sample is composed of 438 nurses from 39 Spanish cities. This is a cross-sectional study. The results confirm the full mediation of resilience in the relationship between stressors and job performance, and the moderation of self-efficacy in the relationship between resilience and job performance, and in the full mediation. This study highlight the role played by self-efficacy as the main personal resource in buffering the effect of stressors on nurses´ performance. Resilience only becomes crucial in individuals with low levels of self-efficacy beliefs. Managers of health institutions and hospitals are invited to invest resources in strengthening the personal resources of health staff, especially self-efficacy beliefs, and resilience to ensure that their performance remains adequate.
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Affiliation(s)
- María Vera
- Universidad Pablo de Olavide, Sevilla, Spain
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Moehl K, Newman D, Perera S, Toto PE, Weiner DK. Validating Goal Attainment in Veterans Undergoing Decompressive Laminectomy: A Preliminary Study. PAIN MEDICINE 2021; 22:829-835. [PMID: 33211875 DOI: 10.1093/pm/pnaa406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Although decompressive laminectomy (DL) for lumbar spinal stenosis (LSS) is a common procedure among older adults, it is unclear whether surgical definitions of success translate into patient-defined success. Using goal attainment scaling (GAS) to compare goal achievement between individuals, we investigated the relationship between surgical-defined functional recovery and achievement of personalized goals in patients who underwent DL for LSS. PARTICIPANTS Twenty-eight community-dwelling veterans scheduled to undergo DL. METHODS Participants were interviewed over the phone to set 1-year post-DL goals within 30 days before undergoing DL. Brigham Spinal Stenosis (BSS) score, comorbidities, cognitive function, and psychological factors also were assessed. GAS and BSS were repeated 1 year after DL. GAS scores were transformed into GAS-T scores (T-score transformation) to standardize achievement between patients and GAS-T change scores to compare study variables. RESULTS Seventeen of 28 participants had successful DL outcomes by BSS standards, though none of the participants achieved all of their GAS goals, with follow-up GAS-T scores averaging 44.5 ± 16.8. All three BSS scales positively correlated with GAS-T change scores: severity change r = 0.52, P = 0.005; physical function change r = 0.51, P = 0.006; and satisfaction r = 0.70, P < 0.001. Covariate analysis revealed a negative correlation between GAS-T change score and fear-avoidance beliefs: r = -0.41, P = -0.029. CONCLUSION There was congruent validity between GAS and the BSS in older veterans undergoing DL for LSS. Given the need for patient-centered care in older adults, future investigations exploring GAS in larger studies that target additional pain conditions and include participants with greater demographic diversity are warranted.
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Affiliation(s)
| | - Dave Newman
- Geriatric Research, Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Subashan Perera
- Department of Medicine (Geriatric Medicine).,Department of Biostatistics
| | | | - Debra K Weiner
- Department of Medicine (Geriatric Medicine).,Department of Psychiatry.,Department of Anesthesiology.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.,Geriatric Research, Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
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5
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Yang HJ, Chen KM, Hsu HF. Motivation theory-based physical activity programme for older adults in residential care facility: A modified Delphi and single-group pretest-posttest study. Int J Older People Nurs 2020; 16:e12355. [PMID: 33135323 DOI: 10.1111/opn.12355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/20/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Physical inactivity exposes older adults living in long-term care institutions to a high risk of health deterioration. Developing effective behaviour change interventions based on a theoretical framework is a pressing concern. AIMS This study developed an 'Easy Walking' intervention programme based on the Wheel of Motivation and aimed to: (1) develop the intervention programme for promoting self-efficacy of older adults living in long-term care facilities; and (2) examine the perceived helpfulness of the intervention programme for encouraging walking behaviours. METHODS This study consisted of two stages. In the first stage, a three-round modified Delphi process was conducted with ten experts to rate the eight motivators in the Wheel of Motivation. The Easy Walking programme was designed accordingly. In the second stage, a single-group pretest-posttest study design was employed to evaluate the Easy Walking programme. Structured questionnaires were used to collect data on the changes in self-efficacy and on the perceived helpfulness regarding the programme. RESULTS The Easy Walking intervention programme features eight factors that influence motivation. Thirty older adults participated in and evaluated the programme. The results showed a significant difference in self-efficacy (t = -7.02, p < .001) of the older adults. Regarding the perceived usefulness of the intervention, the mean scores for each item ranged from 3.73 to 4.93 points. 'Safe environment' was perceived to be the most helpful factor for encouraging walking behaviours. CONCLUSION The Easy Walking programme enhanced the self-efficacy of institutionalised older adults and was perceived as helpful in physical activity engagement. Nursing professionals in long-term care institutions could implement the Easy Walking programme to be part of daily nursing activities.
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Affiliation(s)
- Hui-Ju Yang
- School of Nursing, Tzu Hui Institute of Technology, Pingtung, Taiwan
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hui-Fen Hsu
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
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Evans E, Kosar CM, Thomas KS. Positive Beliefs and the Likelihood of Successful Community Discharge From Skilled Nursing Facilities. Arch Phys Med Rehabil 2020; 102:480-487. [PMID: 32991871 DOI: 10.1016/j.apmr.2020.09.375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/07/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To examine the association of patient and direct-care staff beliefs about patients' capability to increase independence with activities of daily living (ADL) and the probability of successful discharge to the community after a skilled nursing facility (SNF) stay. DESIGN Retrospective cohort study of SNF patients using 100% Medicare inpatient claims and Minimum Data Set resident assessment data. Linear probability models were used to estimate the probability of successful discharge based on patient and staff beliefs about the patient's ability to improve in function, as well as patient and staff beliefs together. Estimates were adjusted for demographics, health status, functional characteristics, and SNF fixed effects. PARTICIPANTS Fee-for-service Medicare beneficiaries (N=526,432) aged 66 years or older who were discharged to an SNF after hospitalization for stroke, hip fracture, or traumatic brain injury. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Successful community discharge (discharged alive within 90d of SNF admission and remaining in the community for ≥30d without dying or health care facility readmission). RESULTS Patients with positive beliefs about their capability to increase independence with ADLs had a higher adjusted probability of successful discharge than patients with negative beliefs (positive, 63.8%; negative, 57.8%; difference, 6.0%, 95% confidence interval [CI], 5.4-6.6). This remained true regardless of staff beliefs, but the difference in successful discharge probability between patients with positive and negative beliefs was larger when staff had positive beliefs. Conversely, the association between staff beliefs and successful discharge varied based on patient beliefs. If patients had positive beliefs, the difference in the probability of successful discharge between positive and negative staff beliefs was 2.5% (95% CI, 1.0-4.0). If patients had negative beliefs, the difference between positive and negative staff beliefs was -4.6% (95% CI, -6.0 to -3.2). CONCLUSIONS Patients' beliefs have a significant association with the probability of successful discharge. Understanding patients' beliefs is critical to appropriate goal-setting, discharge planning, and quality SNF care.
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Affiliation(s)
- Emily Evans
- Department of Health Services, Policy, and Practice, Center for Gerontology and Healthcare Research, Brown School of Public Health, Providence, RI.
| | - Cyrus M Kosar
- Department of Health Services, Policy, and Practice, Center for Gerontology and Healthcare Research, Brown School of Public Health, Providence, RI
| | - Kali S Thomas
- Department of Health Services, Policy, and Practice, Center for Gerontology and Healthcare Research, Brown School of Public Health, Providence, RI; Providence VA Medical Center, Providence, RI
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Chung BPH, Chiang WKH, Lau H, Lau TFO, Lai CWK, Sit CSY, Chan KY, Yeung CY, Lo TM, Hui E, Lee JSW. Pilot study on comparisons between the effectiveness of mobile video-guided and paper-based home exercise programs on improving exercise adherence, self-efficacy for exercise and functional outcomes of patients with stroke with 3-month follow-up: A single-blind randomized controlled trial. Hong Kong Physiother J 2020; 40:63-73. [PMID: 32489241 PMCID: PMC7136530 DOI: 10.1142/s1013702520500079] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/20/2020] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To compare the effectiveness of mobile video-guided home exercise program and standard paper-based home exercise program. METHODS Eligible participants were randomly assigned to either experimental group with mobile video-guided home exercise program or control group with home exercise program in a standard pamphlet for three months. The primary outcome was exercise adherence. The secondary outcomes were self-efficacy for exercise by Self-Efficacy for Exercise (SEE) Scale; and functional outcomes including mobility level by Modified Functional Ambulatory Category (MFAC) and basic activities of daily living (ADL) by Modified Barthel Index (MBI). All outcomes were captured by phone interviews at 1 day, 1 month and 3 months after the participants were discharged from the hospitals. RESULTS A total of 56 participants were allocated to the experimental group ( n = 27 ) and control group ( n = 29 ) . There were a significant between-group differences in 3-months exercise adherence (experimental group: 75.6%; control group: 55.2%); significant between-group differences in 1-month SEE (experimental group: 58.4; control group: 43.3) and 3-month SEE (experimental group: 62.2; control group: 45.6). For functional outcomes, there were significant between-group differences in 3-month MFAC gain (experimental group: 1.7; control group: 1.0). There were no between-group differences in MBI gain. CONCLUSION The use of mobile video-guided home exercise program was superior to standard paper-based home exercise program in exercise adherence, SEE and mobility gain but not basic ADL gain for patients recovering from stroke.
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Affiliation(s)
- Bryan Ping Ho Chung
- Physiotherapy Department, Tai Po Hospital, 11 Chuen On Road, Tai Po, New Territories, Hong Kong
| | - Wendy Kam Ha Chiang
- Physiotherapy Department, Shatin Hospital, 33A Kung Kok Street, Shatin, New Territories, Hong Kong
| | - Herman Lau
- Hospital Chief Executive, Shatin Hospital, 33A Kung Kok Street, Shatin, New Territories, Hong Kong
| | - Titanic Fuk On Lau
- Physiotherapy Department, Tai Po Hospital, 11 Chuen On Road, Tai Po, New Territories, Hong Kong
| | - Charles Wai Kin Lai
- Physiotherapy Department, Shatin Hospital, 33A Kung Kok Street, Shatin, New Territories, Hong Kong
| | - Claudia Sin Yi Sit
- Physiotherapy Department, Tai Po Hospital, 11 Chuen On Road, Tai Po, New Territories, Hong Kong
| | - Ka Yan Chan
- Physiotherapy Department, Shatin Hospital, 33A Kung Kok Street, Shatin, New Territories, Hong Kong
| | - Chau Yee Yeung
- Physiotherapy Department, Tai Po Hospital, 11 Chuen On Road, Tai Po, New Territories, Hong Kong
| | - Tak Man Lo
- Physiotherapy Department, Tai Po Hospital, 11 Chuen On Road, Tai Po, New Territories, Hong Kong
| | - Elsie Hui
- Department of Medicine and Geriatrics, Shatin Hospital, 33A Kung Kok Street, Shatin, New Territories, Hong Kong
| | - Jenny Shun Wah Lee
- Department of Medicine and Geriatrics, Tai Po Hospital, 11 Chuen On Road, Tai Po, New Territories, Hong Kong
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Underwood F, Latour JM, Kent B. A concept analysis of confidence related to older people living with frailty. Nurs Open 2020; 7:742-750. [PMID: 32257261 PMCID: PMC7113533 DOI: 10.1002/nop2.446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/27/2019] [Accepted: 12/19/2019] [Indexed: 11/25/2022] Open
Abstract
Aim To describe and define a concept of confidence in the context of older people living with frailty, which is important to the worldwide healthy-ageing agenda preventing decline in independence and well-being. Design Concept analysis informed by Walker and Avant's eight-stage approach. Methods Electronic databases (MEDLINE, CINAHL and PsychINFO) from 1994-2018 were searched. Published studies exploring confidence and excerpts of papers referencing older people, frailty and confidence informed the concept analysis. Extracted attributes informed model case and additional case development. Appraisal of antecedents, consequences and empirical referents informed the final concept's construction. Results Three overall defining attributes of confidence were identified in this concept analysis: physical, psychological and social. A central feature is personal control, influencing internal and external factors. These control factors can be enabling factors (positive factors) or dis-enabling factors (negative factors), affecting the frail older persons overall physical health and mental well-being.
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Affiliation(s)
- Frazer Underwood
- Royal Cornwall Hospitals NHS TrustTruroUK
- Faculty of Health: MedicineDentistry and Human ScienceUniversity of PlymouthPlymouthUK
| | - Jos M. Latour
- Faculty of Health: MedicineDentistry and Human ScienceUniversity of PlymouthPlymouthUK
| | - Bridie Kent
- Faculty of Health: MedicineDentistry and Human ScienceUniversity of PlymouthPlymouthUK
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Lee LS, Banks L, Oh PI, Brooks D, Colella TJF. Capturing the perspectives of women with coronary artery disease regarding interval training or continuous exercise in cardiac rehabilitation. Disabil Rehabil 2020; 44:68-78. [PMID: 32343623 DOI: 10.1080/09638288.2020.1756469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Motivators and barriers to exercise participation in women with coronary artery disease remain poorly understood. With evidence suggesting that women with coronary artery disease are less likely to adhere to exercise during cardiac rehabilitation and are more likely to drop out, it is important to understand these factors in order to optimize cardiac rehabilitation programs for women.Methods: We contribute to the discussion by presenting findings from a qualitative study using two focus groups with nine women with coronary artery disease sharing their experiences with attending cardiac rehabilitation and exercising in this setting, in addition to their perceived motivators and barriers to performing aerobic interval training. Focus group transcripts were analysed using a deductive thematic approach with Bandura's Social Cognitive Theory as the guiding conceptual framework.Results: Four themes were identified regarding the attitudes and experiences of attending and exercising at cardiac rehabilitation, while five themes capturing the motivators and barriers for these women to perform aerobic interval training were identified for the first time. These novel themes encompassed the daunting nature of it, the physical discomfort associated with it, and conversely, the potential sense of enjoyment and accomplishment that it could bring.Conclusion: This study demonstrates the complexity of implementation of aerobic interval training into clinical practice, and suggests that further research is warranted to explore this domain.IMPLICATIONS FOR REHABILITATIONDespite challenges in feasibility of conducting a randomised controlled trial in female patients with coronary artery disease examining the effects of aerobic interval training versus moderate-intensity continuous exercise on aerobic exercise capacity, there was a significant per protocol treatment effect of 0.95 ml·kg-1·min-1 in favour of aerobic interval training.The cardiac rehabilitation environment provides key facilitators and perceived benefits for exercising and attending cardiac rehabilitation for women, and thus emphasises the need for improving referral and enrolment processes specifically for women into cardiac rehabilitation programs.Aerobic interval training may elicit feelings of fear and physical discomfort, or may be precluded by comorbid conditions, therefore, judicious consideration must be taken in examining the suitability of implementation into clinical practice for each female patient.
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Affiliation(s)
- Leanna S Lee
- Institute of Medical Science, University of Toronto, Toronto, Canada.,Cardiovascular Prevention and Rehabilitation Program, University Health Network/Toronto Rehabilitation Institute, Toronto, Canada
| | - Laura Banks
- Cardiovascular Prevention and Rehabilitation Program, University Health Network/Toronto Rehabilitation Institute, Toronto, Canada
| | - Paul I Oh
- Cardiovascular Prevention and Rehabilitation Program, University Health Network/Toronto Rehabilitation Institute, Toronto, Canada
| | - Dina Brooks
- Institute of Medical Science, University of Toronto, Toronto, Canada.,Cardiovascular Prevention and Rehabilitation Program, University Health Network/Toronto Rehabilitation Institute, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Tracey J F Colella
- Cardiovascular Prevention and Rehabilitation Program, University Health Network/Toronto Rehabilitation Institute, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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Wiśniowska-Szurlej A, Ćwirlej-Sozańska A, Wołoszyn N, Sozański B, Wilmowska-Pietruszyńska A. Effects of Physical Exercises and Verbal Stimulation on the Functional Efficiency and Use of Free Time in an Older Population under Institutional Care: A Randomized Controlled Trial. J Clin Med 2020; 9:jcm9020477. [PMID: 32050476 PMCID: PMC7074187 DOI: 10.3390/jcm9020477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 01/08/2023] Open
Abstract
Older people in institutional care are, for the most part, physically inactive and do not interact with each other or medical staff. Therefore, reducing sedentary behaviour is a new, important, and modifiable lifestyle variable that can improve the health of elderly people. The aim of the project was to assess the degree of improvement in functional performance and the possibility of changing habitual, free time behaviour among elderly people under institutional care by applying physical training with verbal stimulation. The study covered older people, aged 65–85 years, who are living a sedentary lifestyle in care homes in Southeastern Poland. Those who met the eligibility criteria were enrolled in the study and were assigned, at random, to one of four parallel groups: basic exercises (n = 51), basic exercises combined with verbal stimulation (n = 51), functional exercise training (n = 51), and functional exercise training with verbal stimulation (n = 51). No statistically significant differences in baseline characteristics were observed across the groups. Data were collected at baseline and at 12 and 24-weeks following the completion of the intervention. In the group with functional exercise training with verbal stimulation, in comparison to the group with basic exercises, the greatest positive short-term impact of intervention was demonstrated in terms of functional fitness (increased by 1.31 points; 95% confidence interval (CI) = 0.93–1.70), gait speed (improved by 0.17 m/s, 95% CI = 0.13–0.22), hand grip strength (by over 4 kg; 95% CI = 2.51–4.95), and upper-limb flexibility (by 10 cm; 95% CI = 5.82–12.65). There was also a significant increase in the level of free-time physical activity and an improvement in the quality of life, especially as expressed in the domain of overall physical functioning. Our study showed that a functional exercise program, combined with verbal stimulation, is effective at improving physical fitness and raising the level of free-time physical activity.
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Affiliation(s)
- Agnieszka Wiśniowska-Szurlej
- Institute of Health Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland; (A.Ć.-S.); (N.W.); (B.S.)
- Correspondence: ; Tel.: +48-604181162
| | - Agnieszka Ćwirlej-Sozańska
- Institute of Health Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland; (A.Ć.-S.); (N.W.); (B.S.)
| | - Natalia Wołoszyn
- Institute of Health Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland; (A.Ć.-S.); (N.W.); (B.S.)
| | - Bernard Sozański
- Institute of Health Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland; (A.Ć.-S.); (N.W.); (B.S.)
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Harper KJ, Jacques A, Barton A. Validity and Reliability of the Daily Living Self-Efficacy Scale in Subacute Geriatric Rehabilitation. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2019.1675844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kristie J. Harper
- Occupational Therapy Department, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Angela Jacques
- Institute for Health Research, The University of Notre Dame Australia, Perth, WA, Australia
- Department of Research, Sir Charles Gairdner Hospital, Perth, Australia
| | - Annette Barton
- Occupational Therapy Department, Sir Charles Gairdner Hospital, Perth, WA, Australia
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12
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Goudie S, Dixon D, McMillan G, Ring D, McQueen M. Is Use of a Psychological Workbook Associated With Improved Disabilities of the Arm, Shoulder and Hand Scores in Patients With Distal Radius Fracture? Clin Orthop Relat Res 2018; 476:832-845. [PMID: 29406451 PMCID: PMC6260104 DOI: 10.1007/s11999.0000000000000095] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Symptom intensity and magnitude of limitations correlate with stress, distress, and less effective coping strategies. It is unclear if interventions to target these factors can be used to improve outcomes after distal radius fracture in either the short- or longer term. QUESTIONS/PURPOSES (1) Are there any factors (including the use of a workbook aimed at optimizing psychological response to injury, demographic, radiographic, medical, or psychosocial) associated with improved Disabilities of the Arm, Shoulder and Hand (DASH) and Numerical Rating Scale pain (NRS pain) scores at 6 weeks after management of distal radius fracture? (2) Are any of these factors associated with improved DASH and NRS pain scores at 6 months after management of distal radius fracture? METHODS We conducted a double-blind randomized controlled trial comparing a workbook designed to optimize rehabilitation by improving psychological response to injury using recognized psychological techniques (the LEARN technique and goal setting) versus a workbook containing details of stretching exercises in the otherwise routine management of distal radius fracture. Patients older than 18 years of age with an isolated distal radius fracture were recruited within 3 weeks of injury from a single academic teaching hospital between March and August 2016. During recruitment, 191 patients who met the inclusion criteria were approached; 52 (27%) declined participation and 139 were enrolled. Eight patients (6%) were lost to followup by 6 weeks. The remaining cohort of 129 patients was included in the analysis. DASH scores and NRS pain scores were recorded at 6 weeks and 6 months after injury. Multivariable regression analysis was used to identify factors associated with outcome scores. RESULTS At 6 weeks after distal radius fracture, when compared with an information-only workbook, use of a psychologic workbook was not associated with improved DASH (workbook DASH: 38 [range, 21-48]; control DASH: 35 [range, 21-53]; difference of medians: 3; p = 0.949) nor NRS pain scores (workbook NRS: 3 [range, 1-5]; control NRS: 2 [range, 1-4]; difference of medians: 1; p = 0.128). Improved DASH scores were associated with less radial shortening (β = 0.2, p = 0.009), less dorsal tilt (β = 0.2, p = 0.035), and nonoperative treatment (β = 0.2, p = 0.027). Improved NRS pain scores were associated with nonoperative treatment (β = 0.2, p = 0.021) and no posttraumatic stress disorder (PTSD) (β = 0.2, p = 0.046). At 6 months, use of a psychologic workbook was not associated with improved DASH (workbook DASH: 11 [range, 5-28]; control DASH: 11 [range, 3-20]; difference of medians: 0; p = 0.367) nor NRS pain scores (workbook NRS: 1 [range, 0-2]; control NRS: 1 [range, 0-2]; difference of medians: 0; p = 0.704). Improved DASH score at 6 months was associated with having fewer medical comorbidities (β = 0.3, p < 0.001) and lower enrollment PTSD (β = 0.3, p < 0.011). Lower NRS pain scores at 6 months were associated with having fewer medical comorbidities (β = 0.2, p = 0.045), lower enrollment PTSD (β = 0.3, p = 0.008), and lower enrollment Tampa Scale for Kinesiophobia (β = 0.2, p = 0.042). CONCLUSIONS Our study demonstrates that there is no benefit from the untargeted use of a psychological workbook based on the LEARN approach and goal-setting strategies in patients with distal radius fracture. Future research should investigate if there is a subgroup of patients with a negative psychological response to injury that benefits from psychological intervention and, if so, how best to identify these patients and intervene. LEVEL OF EVIDENCE Level II, therapeutic study.
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Affiliation(s)
- Stuart Goudie
- S. Goudie, M. McQueen, Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, UK D. Dixon, G. McMillan, Department of Psychology, University of Strathclyde, Glasgow, UK D. Ring, Dell Medical School, University of Texas at Austin, Austin, TX, USA
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Pikkarainen A, Vähäsantanen K, Paloniemi S, Eteläpelto A. Rehabilitation agency of older adults in group-based intervention. Scand J Occup Ther 2018; 26:411-422. [PMID: 29313394 DOI: 10.1080/11038128.2018.1424237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS This study investigated the individual rehabilitation agency of older adults in a one-year group-based gerontological rehabilitation context. Here, rehabilitation agency is understood as being manifested when older adults make choices and decisions regarding their everyday lives, including notions of themselves. METHODS The data were obtained via non-participant observation of the final individual goal evaluation sessions of 38 older adults with their personal counselor. In these sessions, older adults discussed their rehabilitation outcomes, actions, choices and decisions during the rehabilitation year, along with their future in home settings. The data were analyzed using qualitative content analysis and an agency-centred approach. FINDINGS The findings revealed that older adults made choices and decisions differently concerning their life in and beyond the rehabilitation context. Four forms of rehabilitation agency of older adults were identified: (i) renewable, (ii) widened, (iii) selective and (iv) fractured. These forms of agency were differently connected to older adults' life courses and to their peer relations in the rehabilitation context. CONCLUSIONS An agency-centred approach could produce new theoretical ideas and practical implications for developing older adults' rehabilitation to better meet their needs as well as the goals of group-based rehabilitation interventions.
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Affiliation(s)
- Aila Pikkarainen
- a School of Health and Social Studies , Jyväskylä University of Applied Sciences , Jyväskylä , Finland
| | - Katja Vähäsantanen
- b Adult Education, Faculty of Education and Psychology , University of Jyväskylä , Jyväskylä , Finland
| | - Susanna Paloniemi
- b Adult Education, Faculty of Education and Psychology , University of Jyväskylä , Jyväskylä , Finland
| | - Anneli Eteläpelto
- b Adult Education, Faculty of Education and Psychology , University of Jyväskylä , Jyväskylä , Finland
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Ghazi C, Nyland J, Whaley R, Rogers T, Wera J, Henzman C. Social cognitive or learning theory use to improve self-efficacy in musculoskeletal rehabilitation: A systematic review and meta-analysis. Physiother Theory Pract 2018; 34:495-504. [DOI: 10.1080/09593985.2017.1422204] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Cameron Ghazi
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
| | - John Nyland
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
- Athletic Training Program, Kosair Charities College of Health and Natural Sciences, Spalding University, Louisville, KY, USA
| | - Rumeal Whaley
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
| | - Thomas Rogers
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
| | - Jeff Wera
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
| | - Cameron Henzman
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
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Wiśniowska-Szurlej A, Ćwirlej-Sozańska A, Wilmowska-Pietruszyńska A, Milewska N, Sozański B. The influence of 3 months of physical exercises and verbal stimulation on functional efficiency and use of free time in an older population under institutional care: study protocol for a randomized controlled trial. Trials 2017; 18:376. [PMID: 28800755 PMCID: PMC5553734 DOI: 10.1186/s13063-017-2114-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 07/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, there has been a significant change in the demographics of developed countries, including an increase in the number of older people. This aging population and the associated need for medical care and assistance places great strain on health care systems worldwide. In older populations, improved knowledge and understanding of the relationship between moderate exercise and health might result in greater motivation to engage in such activity; thus improving the overall health of this population. The aim of the proposed project is to assess the degree of improvement in functional performance through physical training with verbal stimulation, as well as the possibility of changing habitual ways of spending free time, in older people under institutional care. METHODS Study participants aged 65-85 years, who are living a sedentary lifestyle in care homes in Southeast Poland, will be invited to participate in this randomized controlled trial. Those who meet the eligibility criteria and are enrolled in the study will be assigned at random to one of four parallel groups: (1) basic exercises combined with verbal stimulation, (2) basic exercises without verbal stimulation, (3) functional exercise training with verbal stimulation, and (4) functional exercise training without verbal stimulation. Participants will engage in 30-min workouts, twice per week, for 12 weeks. Tests will be done: (1) before exercises, (2) after 12 weeks of exercises, (3) 12 weeks after the end of the exercises, and (4) 24 weeks after the exercises. Primary outcome measures will include the Short Physical Performance Battery (SPPB). Secondary outcomes will include the Physical Activity Scale for the Elderly (PASE), the Timed Up and Go (TUG) test, the 10-Meter Walk test (10MWT), the Back Scratch (BS) test, the Chair Sit and Reach (CSR) test, the Grip Strength (GS), and the Berg Balance Scale (BBS). Other outcomes will include results regarding postural stability from the stabilometric platform and quality of life (SF-36). DISCUSSION Our study will help to determine the effectiveness of the training programs, particularly in relation to participants' motivation to exercise. TRIAL REGISTRATION The Sri Lanka Clinical Trials Registry, ID: SLCTR/2016/004 . Registered on 12 February 2016.
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Affiliation(s)
| | - Agnieszka Ćwirlej-Sozańska
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Warszawska Street, 35-205, Rzeszow, Poland
| | | | - Natalia Milewska
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Warszawska Street, 35-205, Rzeszow, Poland
| | - Bernard Sozański
- Centre for Innovative Research in Medical and Natural Sciences, Medical Faculty, University of Rzeszow, Warzywna Street, 35-959, Rzeszow, Poland
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The association between patient participation and functional gain following inpatient rehabilitation. Aging Clin Exp Res 2017; 29:729-736. [PMID: 27590904 DOI: 10.1007/s40520-016-0625-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 08/12/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate patients' participation during physical therapy sessions as assessed with the Pittsburgh rehabilitation participation scale (PRPS) as a possible predictor of functional gain after rehabilitation training. METHODS All patients aged 65 years or older consecutively admitted to a Department of Rehabilitation and Aged Care (DRAC) were evaluated on admission regarding their health, nutritional, functional and cognitive status. Functional status was assessed with the functional independence measure (FIM) on admission and at discharge. Participation during rehabilitation sessions was measured with the PRPS. Functional gain was evaluated using the Montebello rehabilitation factor score (MRFS efficacy), and patients stratified in two groups according to their level of functional gain and their sociodemographic, clinical and functional characteristics were compared. Predictors of poor functional gain were evaluated using a multivariable logistic regression model adjusted for confounding factors. RESULT A total of 556 subjects were included in this study. Patients with poor functional gain at discharge demonstrated lower participation during physical therapy sessions were significantly older, more cognitively and functionally impaired on admission, more depressed, more comorbid, and more frequently admitted for cardiac disease or immobility syndrome than their counterparts. There was a significant linear association between PRPS scores and MRFS efficacy. In a multivariable logistic regression model, participation was independently associated with functional gain at discharge (odds ratio 1.51, 95 % confidence interval 1.19-1.91). CONCLUSION This study showed that participation during physical therapy affects the extent of functional gain at discharge in a large population of older patients with multiple diseases receiving in-hospital rehabilitation.
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Underwood F, Burrows L, Gegg R, Latour JM, Kent B. The meaning of confidence for older people living with frailty: a qualitative systematic review. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:1316-1349. [PMID: 28498173 DOI: 10.11124/jbisrir-2016-002951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND In many countries, the oldest old (those aged 85 years and older) are now the fastest growing proportion of the total population. This oldest population will increasingly be living with the clinical condition of frailty. Frailty syndromes negatively impact on the person as they do the healthcare systems supporting them. Within healthcare literature "loss of confidence" is occasionally connected to older people living with frailty, but ambiguously described. Understanding the concept of confidence within the context of frailty could inform interventions to meet this growing challenge. OBJECTIVES The objective of this systematic review was to explore the meaning of confidence from the perspective of older people living with frailty through synthesis of qualitative evidence to inform healthcare practice, research and policy. INCLUSION CRITERIA TYPES OF PARTICIPANTS Studies that included frail adults, aged over 60 years, experiencing acute hospital and or post-acute care in the last 12 months. PHENOMENA OF INTEREST The concept of "confidence" and its impact on the physical health and mental well-being of older people living with frailty. CONTEXT Studies that reported on the older person's descriptions, understanding and meaning of confidence in relation to their frailty or recent healthcare experiences. TYPES OF STUDIES Studies of qualitative design and method. SEARCH STRATEGY A three step search strategy was used. The search strategy explored published studies and gray literature. Publications in English from the last 20 years were considered for inclusion. METHODOLOGICAL QUALITY All included articles were assessed by two independent reviewers using the Joanna Briggs Institute Qualitative Assessment Review Instrument (JBI-QARI). DATA EXTRACTION Data were extracted from included studies using the data extraction tools developed by the Joanna Briggs Institute. DATA SYNTHESIS Qualitative research findings were collated using a meta-aggregative approach and JBI-QARI software. RESULTS Synthesized findings of this review were drawn from just four research studies that met the inclusion criteria. Only six findings contributed to the creation of three categories. These informed a single synthesized finding: Vulnerability, described as a fragile state of well-being that is exposed to the conflicting tensions between physical, emotional and social factors. These tensions have the capability to enhance or erode this state. CONCLUSIONS Assertions that an understanding of the concept confidence has been reached cannot be made. The review data offer limited insight into the concept of confidence being described by the cohort of older people living with frailty.
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Affiliation(s)
- Frazer Underwood
- 1Royal Cornwall Hospitals NHS Trust, Truro, UK 2School of Nursing and Midwifery, Faculty of Health and Human Science, Plymouth University, Plymouth, UK 3The University of Plymouth Centre for Innovations in Health and Social Care: a Joanna Briggs Institute Centre of Excellence, UK
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Shaughnessy M, Resnick BM. Using Theory to Develop an Exercise Intervention for Patients Post Stroke. Top Stroke Rehabil 2015; 16:140-6. [DOI: 10.1310/tsr1602-140] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Marks R. Self-efficacy and arthritis disability: An updated synthesis of the evidence base and its relevance to optimal patient care. Health Psychol Open 2014; 1:2055102914564582. [PMID: 28070346 PMCID: PMC5193269 DOI: 10.1177/2055102914564582] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Self-efficacy, denoting the degree of confidence an individual has in carrying out a specific activity, was initially discussed in the 1970s as a potential correlate of disease outcomes. Drawn from 35 years of related research, this review provides an updated understanding of the concept of self-efficacy and its relevance for arthritis management. There is a consistent link between self-efficacy, arthritis pain and disability, and adherence to recommended therapeutic strategies. A wide variety of intervention strategies improve arthritis self-efficacy, as well as outcomes. Steps to assess and intervene thoughtfully to maximize self-efficacy beliefs are likely to impact arthritis disability outcomes quite favorably and significantly, regardless of disease type, duration, or sociodemographic factors.
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Affiliation(s)
- Ray Marks
- The City University of New York, USA; Columbia University, USA
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Koh WLE, Barr CJ, George S. Factors influencing post-stroke rehabilitation participation after discharge from hospital. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.6.260] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Wei Ling E Koh
- Senior Occupational Therapist at Changi General Hospital, Singapore and a Postgraduate in clinical rehabilitation at Flinders University, Australia
| | | | - Stacey George
- Senior Lecturer and Course Coordinator of postgraduate programmes in clinical rehabilitation, Flinders University, Australia
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Lucas B, Cox C, Perry L, Bridges J. Pre-operative preparation of patients for total knee replacement: An action research study. Int J Orthop Trauma Nurs 2013. [DOI: 10.1016/j.ijotn.2012.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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McMillan L, Booth J, Currie K, Howe T. ‘Balancing risk’ after fall-induced hip fracture: the older person's need for information. Int J Older People Nurs 2013; 9:249-57. [DOI: 10.1111/opn.12028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 03/06/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Laura McMillan
- School of Health, Nursing and Midwifery; University of the West of Scotland; Paisley UK
| | - Joanne Booth
- School of Health & Life Sciences; Glasgow Caledonian University; Glasgow UK
| | - Kay Currie
- School of Health & Life Sciences; Glasgow Caledonian University; Glasgow UK
| | - Tracey Howe
- School of Health & Life Sciences; Glasgow Caledonian University; Glasgow UK
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Tung YC, Cooke M, Moyle W. Sources older people draw on to nurture, strengthen and improve self-efficacy in managing home rehabilitation following orthopaedic surgery. J Clin Nurs 2012; 22:1217-25. [DOI: 10.1111/j.1365-2702.2012.04252.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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McMillan L, Booth J, Currie K, Howe T. A grounded theory of taking control after fall-induced hip fracture. Disabil Rehabil 2012; 34:2234-41. [DOI: 10.3109/09638288.2012.681006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tyrrell EF, Levack WM, Ritchie LH, Keeling SM. Nursing contribution to the rehabilitation of older patients: patient and family perspectives. J Adv Nurs 2012; 68:2466-76. [DOI: 10.1111/j.1365-2648.2012.05944.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lane AM, Hirst SP. Are Gerontological Nurses Apathetic About Apathy in Older Adults. J Gerontol Nurs 2012; 38:22-8; quiz 30-1. [DOI: 10.3928/00989134-20111207-50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 07/08/2011] [Indexed: 11/20/2022]
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Abstract
Despite its serious health consequences, apathy in older adults is often underrecognized by gerontological nurses and other health care professionals. Within this article, we discuss what apathy is and present a review of the literature and research. Two frameworks emerging from the literature search-one regarding rehabilitation and the other illness-are introduced as ways in which apathy may be conceptualized and addressed. Using these frameworks, implications for gerontological nurses are outlined.
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Affiliation(s)
- Annette M Lane
- Brenda Strafford Centre for Excellence, University of Calgary, Calgary, Canada.
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Baert V, Gorus E, Mets T, Geerts C, Bautmans I. Motivators and barriers for physical activity in the oldest old: a systematic review. Ageing Res Rev 2011; 10:464-74. [PMID: 21570493 DOI: 10.1016/j.arr.2011.04.001] [Citation(s) in RCA: 200] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 04/21/2011] [Accepted: 04/25/2011] [Indexed: 11/29/2022]
Abstract
Worldwide, people engage insufficiently in physical activity, particularly subjects aged 80 years and over. For optimal life-style campaigns, knowledge of motivators and barriers for physical activity is mandatory. Given their specific needs, it is conceivable that these would be different for the oldest old compared to younger subjects. Pubmed, Web of Science and Psychinfo were systematically screened for articles reporting motivators and barriers for physical activity. Papers were excluded if data regarding elderly aged >79 years were absent. Forty-four relevant articles were included, involving a total of 28,583 subjects. Sixty one motivators and 59 barriers for physical activity in the elderly were identified, including those who are relevant for persons aged 80 years and over. Based on the results of our literature review, we recommend that when promoting physical activity in the oldest old, special attention is paid to the health benefits of physical activity, to the subject's fears, individual preferences and social support, and to constraints related to the physical environment. However, no studies were found exclusively describing people aged 80 years and over, and future research is necessary to differentiate the barriers or motivators that are specific for the oldest old from those of younger elderly.
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Affiliation(s)
- Veerle Baert
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Belgium
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Whyte E, Skidmore E, Aizenstein H, Ricker J, Butters M. Cognitive impairment in acquired brain injury: a predictor of rehabilitation outcomes and an opportunity for novel interventions. PM R 2011; 3:S45-51. [PMID: 21703580 PMCID: PMC4492523 DOI: 10.1016/j.pmrj.2011.05.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 05/09/2011] [Indexed: 11/16/2022]
Abstract
Cognitive impairment is a common sequela in acquired brain injury and one that predicts rehabilitation outcomes. There is emerging evidence that impairments in cognitive functions can be manipulated by both pharmacologic and nonpharmacologic interventions to improve rehabilitation outcomes. By using stroke as a model for acquired brain injury, we review the evidence that links cognitive impairment to poor rehabilitation outcomes and discuss possible mechanisms to explain this association. Furthermore, we examine nascent promising research that suggests that interventions that target cognitive impairments can lead to better rehabilitation outcomes.
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Affiliation(s)
- Ellen Whyte
- Department of Psychiatry, School of Medicine, WPIC-BT 764, 3811 O'Hara St, Pittsburgh PA 15213, USA
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Resnick B, D'Adamo C. Factors associated with exercise among older adults in a continuing care retirement community. Rehabil Nurs 2011; 36:47-53, 82. [PMID: 21473560 DOI: 10.1002/j.2048-7940.2011.tb00065.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The objectives of this study were to test a model of the factors that influence exercise activities among a group of older adults living in a continuing care retirement community with a wellness center that features a pool, exercise room, and exercise classes. This was a correlational study using a one-time survey. A total of 163 residents with an average age of 86.6 years (SD = 6.1) participated in the study. Ninety (55%) of the participants exercised regularly (30 minutes daily), 88% of whom used the wellness center. Of all participating residents, 49% reported using the wellness center. Self-efficacy and negative outcome expectations directly related to exercise behavior. Marital status, resilience, health status, pain, and fear of falling were indirectly related to exercise. All of these factors explained 15% of the variance in exercise behavior. These findings support previous work and provide future direction for research regarding interventions to increase exercise among older adults. Further, access to a wellness center providing exercise opportunities may increase adherence to a regular exercise regimen among older adults.
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Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA.
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Warner LM, Schüz B, Knittle K, Ziegelmann JP, Wurm S. Sources of Perceived Self-Efficacy as Predictors of Physical Activity in Older Adults. Appl Psychol Health Well Being 2011. [DOI: 10.1111/j.1758-0854.2011.01050.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Poziom motywacji osób starszych a efekty rehabilitacji / Motivational predictors of successful rehabilitation in elderly patients. Physiotherapy 2011. [DOI: 10.2478/v10109-011-0029-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Chard SE, Stuart M. An Ecological Perspective on the Community Translation of Exercise Research for Older Adults. J Appl Gerontol 2010. [DOI: 10.1177/0733464810385814] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Regular exercise lowers the risk of disease progression for many chronic illnesses, but older adults experience relatively low rates of exercise. Although multiple intervention studies indicate that community-based programs can facilitate exercise participation, whether this research has resulted in widespread targeted exercise programs within communities is unknown. This study seeks to understand the ecological context of exercise for older adults through a cross-sectional survey of community exercise facilities within a mid-Atlantic city. The findings highlight the limited nature of the existing exercise infrastructure and reveal gaps in the community translation of research evidence regarding exercise adherence. An expansion in the availability of community exercise programs for older adults and more uniform policies to support older adult exercise are needed.
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Resnick B, Galik E, Gruber-Baldini AL, Zimmerman S. Perceptions and performance of function and physical activity in assisted living communities. J Am Med Dir Assoc 2010; 11:406-14. [PMID: 20627181 DOI: 10.1016/j.jamda.2010.02.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2010] [Accepted: 02/02/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The purpose of this study was to describe residents' self-efficacy and outcome expectations with regard to function and physical activity (PA); to measure functional performance and time in PA; to evaluate the fit between the resident and the environment; and to evaluate knowledge, beliefs, and care behaviors of nursing assistants (NAs) in 4 different assisted living (AL) communities. DESIGN This was a descriptive study using baseline data from an ongoing intervention study, Testing the Impact of a Function Focused Care Intervention, Res-Care-AL. SETTING Four assisted living communities in Maryland. PARTICIPANTS A total of 171 residents and 96 NAs consented, passed eligibility, and were included in this study. MEASUREMENTS Descriptive data were obtained from NAs and residents. Resident data also included self-efficacy and outcome expectations associated with functional tasks and exercise, social support for exercise, and subjective and objective information about function and physical activity. NA data included self-efficacy and outcome expectations, knowledge, and performance of function-focused care. RESULTS Residents were mostly female, white, and widowed; needed some assistance with activities of daily living; and engaged in very little PA based on subjective and objective reports. NAs were mostly female and black, had more than a decade of nursing experience, strong confidence but limited knowledge of function-focused care, and performed this care in 76% of observed care interactions. There were no site-specific differences among NAs with regard to beliefs, knowledge, or performance of function-focused care. There were site-specific differences in residents with regard to self-efficacy for functional ability; functional performance; social supports for exercise from experts; and from family, person-environment fit, and PA based on subjective surveys. There were no differences noted based on actigraphy. CONCLUSION Residents in AL communities engage in very limited amounts of PA and staff in these sites could benefit from ongoing education about how to increase PA among residents and help them adhere to current guidelines for PA so as to optimize overall health status.
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Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD 21201, USA.
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Skidmore ER, Whyte EM, Holm MB, Becker JT, Butters MA, Dew MA, Munin MC, Lenze EJ. Cognitive and affective predictors of rehabilitation participation after stroke. Arch Phys Med Rehabil 2010; 91:203-7. [PMID: 20159122 DOI: 10.1016/j.apmr.2009.10.026] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Revised: 10/29/2009] [Accepted: 10/30/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine associations between cognitive and affective impairments and rehabilitation participation during stroke rehabilitation. DESIGN Secondary analyses of stroke patients who received acetylcholinesterase inhibitors during inpatient rehabilitation. SETTING University-affiliated inpatient rehabilitation facilities. PARTICIPANTS Patients (N=44) admitted to inpatient stroke rehabilitation with impairment in attention, memory, or executive functions. INTERVENTIONS Secondary analysis of patients receiving inpatient stroke rehabilitation care plus random assignment to one of two acetylcholinesterase inhibitors or no drug at rehabilitation admission. MAIN OUTCOME MEASURES Correlations between measures of cognitive (Digit Span, Hopkins Verbal Learning Test, Executive Interview) and affective impairments (Hamilton Rating Scale for Depression, Apathy Evaluation Scale) and participation (Pittsburgh Rehabilitation and Participation Scale) were examined. Significant correlates of participation were examined in a linear multiple regression model. RESULTS Executive functions and depressive symptoms were significant correlates of participation. After controlling for baseline disability, executive functions predicted participation, but depressive symptoms did not (F(4,32)=9.35; R(2)=.54, P<.001). CONCLUSIONS These findings are an important first step toward understanding potentially modifiable clinical factors that contribute to rehabilitation participation and overall functional status after rehabilitation. A better understanding of cognitive impairment and rehabilitation participation may be used to develop strategies for improving functional outcomes after stroke.
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Affiliation(s)
- Elizabeth R Skidmore
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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Abstract
It is not uncommon for studies examining factors associated with functional recovery 1 year after hip fracture to be presented from the perspective of clinicians or researchers. Few studies have examined factors that facilitate functional recovery from the patient's perspective. This article discusses community-dwelling older adults age 65 and older who sustained a hip fracture and received surgical repair and postacute rehabilitation. Data were collected 1 year after postacute rehabilitation. Content analysis was used for the descriptive study. Participants reported that rehabilitation services greatly facilitated their recovery. Participants also recognized the importance of their own motivation, and noted it was essential to maintain a positive attitude and fully engage in recommended rehabilitation activities. The keys to functional recovery were active participation in rehabilitation and following instructions from care providers. In addition, self-determination, a positive attitude, and social support played significant roles in making rehabilitation work.
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Affiliation(s)
- Yuchi Young
- University of Albany, SUNY, Rensselaer, NY, USA.
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Nieuwenhuijsen ER, Zemper E, Miner KR, Epstein M. Health behavior change models and theories: contributions to rehabilitation. Disabil Rehabil 2009; 28:245-56. [PMID: 16492619 DOI: 10.1080/09638280500197743] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE This article highlights the importance of health behavior change (HBC) theory, and its relevance to rehabilitation research and practice. METHOD An extensive review of HBC-related literature pertinent to rehabilitation was conducted, focusing on the potential impact of these theories and models in enhancing long-term results of rehabilitation with regard to lifestyle change and health promotion, and outlining the benefits of incorporating HBC themes into rehabilitation practice. For our purposes, the HBC concept is based on initiation and maintenance of health behaviors, functioning, wellness, and self-management of chronic conditions or disabilities within an environmental context. While comparing and contrasting three widely known theories of HBC, the contributions of these theories to rehabilitation research and practice are discussed. RESULTS Three propositions are put forward: (1) HBC variables should regularly be used as outcome measures in evidence-based rehabilitation research; (2) there should be a better understanding of the role of the rehabilitation provider as a facilitator in eliciting healthy behaviors; and (3) there is a need to expand the HBC concept into a more comprehensive view encompassing a person's functioning within the environmental context. CONCLUSIONS A conceptual merger between HBC theories and rehabilitation practice can have major implications for individuals with disabilities, their functioning, health, and well-being.
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Affiliation(s)
- Els R Nieuwenhuijsen
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI 48108, USA.
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Resnick B, Galik E, Gruber-Baldini AL, Zimmerman S. Implementing a restorative care philosophy of care in assisted living: Pilot testing of Res-Care-AL. ACTA ACUST UNITED AC 2009; 21:123-33. [DOI: 10.1111/j.1745-7599.2008.00394.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee LL, Perng SJ, Ho CC, Hsu HM, Lau SC, Arthur A. A preliminary reliability and validity study of the Chinese version of the self-efficacy for exercise scale for older adults. Int J Nurs Stud 2008; 46:230-8. [PMID: 18950769 DOI: 10.1016/j.ijnurstu.2008.09.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Revised: 08/16/2008] [Accepted: 09/04/2008] [Indexed: 11/17/2022]
Abstract
BACKGROUND Population ageing affects most undeveloped, developing and developed countries. Less than a quarter of older people undertake a level of physical activity worldwide that is sufficient to lead to health benefits. Understanding older people's confidence regarding engaging in exercise helps to structure physical activity interventions that motivate them to initiate and adhere to regular exercise. Estimates of the reliability and validity of the English version of the self-efficacy for exercise (SEE) scale has been widely tested and shown to be valid for use in various settings and among older people. The reliability and validity of a Chinese version of the SEE for older adults has not been tested. AIM To undertake a preliminary assessment of the reliability and validity of the SEE scale when applied to the older Chinese adults. METHODS The Chinese version of the self-efficacy for exercise (SEE-C) scale was tested on a sample of 192 older people from Taiwan with a mean age of 71.2 years recruited between October and December 2003. RESULTS There was acceptable internal consistency of the SEE-C scale. The fit of the measurement model to the data for the SEE-C scale was acceptable. There was evidence of validity of the measure based on hypothesis testing: health status predicted exercise self-efficacy, and exercise self-efficacy predicted physical activity. Those who exercised regularly (n=102) had a higher mean SEE-C score (5.3) than those who did not (2.9, n=90). CONCLUSION This preliminary validation study provided evidence for the reliability and validity of the Chinese version of the SEE scale. Future testing of the SEE-C scale needs to be carried out to see whether these results are generalisable to older Chinese people living in urban areas and with different characteristics. A test of the scale among younger adults for a wider use of the instrument is also warranted.
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Affiliation(s)
- Ling-Ling Lee
- Department of Nursing, Tzu Chi College of Technology, and School of Nursing, Tzu Chi University, Hualien, Taiwan.
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Resnick B, Ory MG, Hora K, Rogers ME, Page P, Chodzko-Zajko W, Bazzarre TL. The Exercise Assessment and Screening for You (EASY) Tool: Application in the Oldest Old Population. Am J Lifestyle Med 2008. [DOI: 10.1177/1559827608320229] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The screening tool, the Exercise Assessment and Screening for You (EASY), was developed to call attention to the benefits of exercise and to assist older adults in selecting safe and effective exercise. The purpose of this study is to describe the use of the EASY in an oldest old population, consider the factors associated with EASY scores, and examine the relationship between exercise and adverse events in this population. The sample comprised 163 oldest old adults with an average age of 86.5 (SD = 5.8), the majority of whom were women (73%) and unmarried (64%). The participants responded affirmatively to approximately 2 of the 6 items on the EASY (mean = 1.9, SD = 1.3). Fear of falling, negative outcome expectations, number of comorbidities, age, and pain were all significantly associated with the total score on the EASY and accounted for 24% of the variance. Those who responded affirmatively to at least 1 item on the EASY were more likely to engage in exercise than those who did not (chi-square = 8.0, P = .01). The findings from this study help establish some baseline evidence of the applicability of the EASY when used as a screening tool to help guide oldest old adults prior to starting an exercise program.
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Affiliation(s)
| | - Marcia G. Ory
- The Texas A & M Health Science Center, College Station
| | - Kerrie Hora
- The Texas A & M Health Science Center, College Station
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Rydholm Hedman AM, Heikkilä K, Grafström M, Strömberg L. Hip fractures and cognitive state: patient outcomes and proxies’ perceptions of the rehabilitation period. Int J Older People Nurs 2008; 3:178-86. [DOI: 10.1111/j.1748-3743.2008.00131.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee LL, Arthur A, Avis M. Using self-efficacy theory to develop interventions that help older people overcome psychological barriers to physical activity: a discussion paper. Int J Nurs Stud 2008; 45:1690-9. [PMID: 18501359 DOI: 10.1016/j.ijnurstu.2008.02.012] [Citation(s) in RCA: 142] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Revised: 12/22/2007] [Accepted: 02/28/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND Only a fifth of older people undertake a level of physical activity sufficient to lead to health benefit. Misconceptions about the ageing process and beliefs about the costs and benefits of exercise in late life may result in unnecessary self-imposed activity restriction. Thus, adhering to a physical activity can be difficult particularly when the benefits of exercise are often not immediate. Many of the barriers to engaging in physical activity among older people are attitudinal. It is therefore important to take account of the non-physical aspects of physical activity intervention programmes, such as increasing confidence. Self-efficacy is a widely applied theory used to understand health behaviour and facilitate behavioural modification, such as the increase of physical activity. AIM This paper aims to examine the ways in which self-efficacy theory might be used in intervention programmes designed to overcome psychological barriers for increasing physical activity among older people. CONCLUSION A number of studies have demonstrated that exercise self-efficacy is strongly associated with the amount of physical activity undertaken. Evidence from some trials supports the view that incorporating the theory of self-efficacy into the design of a physical activity intervention is beneficial. Physical activity interventions aimed at improving the self perception of exercise self-efficacy can have positive effects on confidence and the ability to initiate and maintain physical activity behaviour. There are a number of ways for nurses to facilitate older people to draw on the four information sources of self-efficacy: performance accomplishments, vicarious learning, verbal encouragement, and physiological and affective states. Research challenges that future studies need to address include the generalisability of exercise setting, the role of age as an effect modifier, and the need for more explicit reporting of how self-efficacy is operationalised in interventions.
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Affiliation(s)
- Ling-Ling Lee
- Department of Nursing, Tzu Chi College of Technology, No. 880, Chien-Kuo Road, Section 2, Hualien 970, Taiwan.
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Resnick B, Petzer-Aboff I, Galik E, Russ K, Cayo J, Simpson M, Zimmerman S. Barriers and benefits to implementing a restorative care intervention in nursing homes. J Am Med Dir Assoc 2008; 9:102-8. [PMID: 18261702 DOI: 10.1016/j.jamda.2007.08.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Revised: 08/16/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study considered the factors that facilitated or prevented nursing assistants (NAs) from engaging in restorative care activities. DESIGN This was a qualitative study using a focus group methodology. SETTING Study participants were recruited from 6 nursing homes. PARTICIPANTS Participants were nursing assistants (NAs) from a study testing the implementation of a restorative care intervention (Res-Care) study. Of the 244 NAs recruited from the 6 treatment sites, 179 were available at 12 months and 93 (52%) participated in the study. MEASUREMENT An interview guide was used during each of the focus groups. Data analysis was done using basic content analysis. RESULTS Sixty-one codes were identified and reduced to 4 themes: facilitators of restorative care; barriers to restorative care; benefits of restorative care; and sustaining restorative care. CONCLUSION The findings provide an important NA perspective with regard to implementation of a restorative philosophy of care and provide recommendations for future work in this area.
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Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, Baltimore MD 21201, USA.
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Abstract
BACKGROUND After the cardiovascular events of myocardial infarction (MI) and coronary artery bypass surgery (CABS), unpartnered older adults are a vulnerable group that may benefit from interventions to improve health outcomes. The purpose of this analysis is to determine if a community-based collaborative peer advisor/advanced practice nurse intervention increased participation in cardiac rehabilitation programs and reduced hospital readmissions after MI and CABS and determine whether the type of cardiovascular event influenced rehospitalization. SUBJECTS AND METHODS This study was a randomized clinical trial that enrolled 247 unpartnered older adults who were single, widowed, or divorced. Subjects were randomized into 4 groups: standard of care group for MI and for CABS and standard of care plus the treatment groups for MI and for CABS, for 12 weeks after discharge. There were 163 women/84 men, with a mean age of 76.4 years, who were admitted for MI (n = 93) or CABS (n = 154) and who were enrolled from 5 academic medical centers. The treatment consisted of a community-based intervention of a home visit within 72 hours and telephone calls at 2, 6, and 10 weeks from an advanced practice nurse and 12 weekly telephone calls from a peer advisor. Participation in a cardiac rehabilitation program and rehospitalizations were collected at 6 weeks and 3, 6, and 12 months by telephone interview. RESULTS AND CONCLUSIONS There were significantly more participants in cardiac rehabilitation programs after 3 months in the treatment group, and this increase was seen up to 1 year after MI and CABS. There were no statistical differences, although there were fewer rehospitalizations between 3 and 6 months after MI and CABS in the treatment group compared with the standard of care group. Overall, the evidence from this study suggests that a community-based collaborative peer advisor/advanced practice nurse intervention can play a role in promoting active participation in cardiac rehabilitation programs and fewer rehospitalizations in unpartnered older adults after MI and CAGS.
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Affiliation(s)
- Diane L Carroll
- Yvonne L. Munn Center for Nursing Research, Institute for Patient Care, Massachusetts General Hospital, Boston, MA 02114, USA.
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Davis AHT. Exercise Adherence in Patients with Chronic Obstructive Pulmonary Disease: An Exploration of Motivation and Goals. Rehabil Nurs 2007; 32:104-10. [PMID: 17514994 DOI: 10.1002/j.2048-7940.2007.tb00161.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Adherence to an exercise regimen is challenging. Motivation is an important factor that can enhance exercise adherence. A key component of motivation is the setting and accomplishment of specified goals. Therefore, it is important to understand the relationship between patients' motivation and goals. Motivation and goal orientation in 14 participants with chronic obstructive pulmonary disease were assessed. Participants were also interviewed to explore their exercise and activity goals. Motivation was significantly associated with goal orientation. In addition, participants reported many explicit activity goals, but few participants had set specific exercise goals. The inconsistency between activity and exercise goals has not been reported previously. Findings from this preliminary study provide novel and relevant information that may help care providers understand factors that may influence exercise adherence in people with chronic obstructive pulmonary disease.
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Affiliation(s)
- Amy H T Davis
- College of Nursing, University of Arizona, Tucson 85721-0203, USA.
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Resnick B, Orwig D, Zimmerman S, Hawkes W, Golden J, Werner-Bronzert M, Magaziner J. Testing of the SEE and OEE post-hip fracture. West J Nurs Res 2006; 28:586-601. [PMID: 16829639 DOI: 10.1177/0193945906287218] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to test the reliability and validity of the Self-Efficacy for Exercise (SEE) and the Outcome Expectations for Exercise (OEE) scales in a sample of 166 older women post-hip fracture. There was some evidence of validity of the SEE and OEE based on confirmatory factor analysis and Rasch model testing, criterion based and convergent validity, and evidence of internal consistency based on alpha coefficients and separation indices and reliability based on R2 estimates. Rasch model testing demonstrated that some items had high variability. Based on these findings suggestions are made for how items could be revised and the scales improved for future use.
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Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, Baltimore, Maryland, USA
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Collis Pellatt G. Patients and professionals' views of the patient's role in spinal cord injury rehabilitation. ACTA ACUST UNITED AC 2006. [DOI: 10.12968/bjnn.2006.2.4.21516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Glynis Collis Pellatt
- University of Luton, Aylesbury Vale Education Centre, Stoke Mandeville Hospital, Aylesbury, Bucks HP21 8AL
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Greenglass ER, Marques S, deRidder M, Behl S. Positive coping and mastery in a rehabilitation setting. Int J Rehabil Res 2006; 28:331-9. [PMID: 16319558 DOI: 10.1097/00004356-200512000-00005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this study was to examine the predictive value of positive coping in relation to behavioral outcomes. Positive coping focuses on goal setting and preparative behavior in response to distress. The participants were 228 in-patients in a rehabilitation hospital following joint replacement. The average age of participants was 67.3 years old, 71% were women and two-thirds were married. Sixty percent had a hip replacement and 40% had a knee replacement. The study was designed so that at Time 1, two scales were used: the proactive coping subscale of the Proactive Coping Inventory and the Getting on with Life scale. Proactive coping measures future-oriented planning and goal-setting strategies that an individual develops when confronting stress. Getting on with Life assesses feelings about resuming activities and social relationships that give one day-to-day pleasure. At Time 2, behavioral outcomes were assessed using the 2-Minute Walk (2 MW) Test and a functional independence measure. In the 2 MW Test, participants were instructed to walk at a comfortable pace and the distance walked in 2 min was measured in meters. The functional independence measure was based on average ratings of participants' independence behavior by trained hospital personnel in different areas. Results indicated that proactive coping and Getting on with Life were significantly related to behavioral outcomes. In conclusion, the results illustrate the value of positive coping in a rehabilitation setting.
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Abstract
PURPOSE To examine the experiences of people with disabilities regarding their spirituality and its meaning for them. This study asked: What are the differences in the meaning of spirituality in the lives of individuals with childhood onset disabilities when compared to those with adult onset disabilities? METHOD This qualitative study involved semi-structured individual interviews of 12 adults, six with childhood onset and six with adult onset disabilities. Member checking of both transcribed data and open coding was done to ensure trustworthiness. Data was analyzed using open, axial, and selective coding. RESULTS Findings suggested that the two groups held different perceptions about the meaning of spirituality. For childhood onset participants, two categories of 'connecting and expressing for purpose and meaning in life', and 'disability as a vehicle to discover god's purpose' were generated. For adult onset participants, two categories of 'connecting and expressing through feelings and actions', and 'disability as a catalyst for spiritual awakening' were derived from the data. CONCLUSIONS Individuals with childhood and adult onset disabilities perceive and experience spirituality differently. Therefore, different approaches to using spirituality in practice need to be employed for the two groups. Suggestions are provided for incorporating spirituality into occupational therapy practice.
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Affiliation(s)
- Emily K Schulz
- The University of Alabama, Birmingham, Alabama 35294, USA.
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Hiltunen EF, Winder PA, Rait MA, Buselli EF, Carroll DL, Rankin SH. Implementation of efficacy enhancement nursing interventions with cardiac elders. Rehabil Nurs 2006; 30:221-9. [PMID: 16294801 DOI: 10.1002/j.2048-7940.2005.tb00116.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Intervention strategies based on social cognitive theory and encompassing the bio-psycho-behavioral domains are proposed to enhance self-efficacy in men and women 65 years and older recovering from myocardial infarction and coronary artery bypass grafting. This paper describes a study in which the theory-based development of efficacy enhancement (EE) nursing interventions and their implementation and utilization with interventions from the Nursing Interventions Classification (NIC) were used with cardiac elders in the treatment group of the community-based randomized clinical, trial, "Improving Health Outcomes in Unpartnered Cardiac Elders." Advanced practice nurses (APNs) provided the nursing intervention to 110 participants (mean age = 76.2, SD = 6.0) for the first 12 weeks after discharge to home. After an initial introductory meeting in the acute-care setting, participant contacts by the APNs were made at a home visit and telephone calls at 2, 6, and 10 weeks. Results describe the number of participants receiving interventions at all contacts over 12 weeks, at specified contact points, and the intensity (nurse time) of the interventions. Verbal encouragement and mastery were EE interventions used with the greatest number of participants. Exercise promotion, energy management and active listening were NIC interventions used with the most participants. Variations in the use of interventions over 12 weeks and their intensities, suggest patterns of recovery in the elders. During rehabilitation EE interventions can be successfully implemented with men and women 65 years and older and individualized to the recovery trajectory. Nurses can integrate specific EE interventions with more general interventions from the bio-psycho-behavioral domains to enhance the recovery process for cardiac elders.
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