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Rooney D, Aplin T, Bennett S, Gui DS, Scott T. Exploring occupational therapy practice in Australian residential aged care facilities: A cross-sectional survey. Aust Occup Ther J 2024; 71:578-592. [PMID: 38459851 DOI: 10.1111/1440-1630.12943] [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: 05/07/2023] [Revised: 01/14/2024] [Accepted: 02/17/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Occupational therapy in residential aged care facilities (RACFs) can enhance residents' occupational engagement and wellbeing. However, industry reports suggest that occupational therapists in Australian RACFs have mostly provided physical therapies such as pain management via massage and not addressed residents' occupations. There is limited literature on what constitutes occupational therapists' practice in RACFs to inform policy and practice. The aim of this cross-sectional survey was to explore practice patterns of occupational therapists working in Australian RACFs and influences on their practice. METHODS Occupational therapists working in Australian RACFs were invited from July 2019 to March 2020 to complete a self-report online questionnaire via email and advertisements on industry websites, newsletters, and social media. The questionnaire asked therapists about their caseload, referrals, assessments, and interventions. Data were analysed descriptively and presented as frequencies and percentages. RESULTS A total of 214 occupational therapists completed the survey. Occupational therapists' daily practice largely focussed on pain management; other areas of practice included falls prevention, pressure care, and mobility. The Aged Care Funding Instrument in place at the time of the survey was identified as the leading factor influencing therapists' choice of assessments and interventions. Organisational policies and procedures were also perceived as key factors influencing occupational therapy practice. CONCLUSION This paper highlights the influence of government funding and organisational policies in limiting occupational therapists' scope of practice and their ability to fully address the occupational needs of residents. Occupational therapists and the profession in general should be aware of factors in aged care funding models, and their application, that restrict occupational therapy practice and inhibit residents' function and advocate for change where needed. With the introduction of the Australian National Aged Care Classification funding model replacing Aged Care Funding Instrument, future research should explore potential changes to therapists practice following the implementation of the new funding model.
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Affiliation(s)
- Donna Rooney
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Dorcas Simin Gui
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Theresa Scott
- School of Psychology, The University of Queensland, St Lucia, Queensland, Australia
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2
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Jun H, Grabowski DC. Mental health in nursing homes: The role of immigration in the long-term care workforce. Soc Sci Med 2024; 351:116978. [PMID: 38761455 PMCID: PMC11180551 DOI: 10.1016/j.socscimed.2024.116978] [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: 08/08/2023] [Revised: 04/05/2024] [Accepted: 05/14/2024] [Indexed: 05/20/2024]
Abstract
One-fourth of nursing home residents are diagnosed with anxiety disorders and approximately half live with depression. Nursing homes have long struggled with staffing shortages, and the lack of care has further heightened the risk of poor mental health. A key solution to both problems could be immigration. Prior studies have documented how immigrant labor could strengthen the long-term care workforce. We add to this picture by exploring the impact of immigrant inflows on the mental health outcomes of nursing home residents. Using a nationally representative dataset and a shift-share instrumental variable approach, we find empirical evidence that immigration reduces diagnoses of depression and anxiety, the use of antidepressant and antianxiety drugs, and self-assessed symptoms of depression. The results are robust to several sensitivity tests. We further find that the effect is more substantial in facilities with lower direct care staff hours per resident and with likely more immigrants without citizenship. Language barriers tend to be a minor issue when providing essential care. The findings suggest that creating a policy framework that directs immigrant labor to the long-term care sector can mutually benefit job-seeking immigrants and nursing home residents.
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Affiliation(s)
- Hankyung Jun
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA.
| | - David C Grabowski
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
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Hou T. Depressive Symptoms, Sleep Quality, and Pain Are Associated With Frailty in Nursing Home Residents During the COVID-19 Pandemic. Pain Manag Nurs 2024; 25:241-248. [PMID: 38413256 DOI: 10.1016/j.pmn.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND The COVID-19 pandemic has caused severe effects on older adults. Depressive symptoms, poor sleep quality, and pain are common in older adults with frailty. However, it is unknown the relationship between these symptoms and frailty in nursing home residents and the difference of importance between pain intensity and pain impact on frailty during the COVID-19 Pandemic. Therefore, this study aims to explore the associations between depressive symptoms, poor sleep quality, pain intensity, and pain impact with frailty in older adults living in nursing homes. METHODS In this cross-sectional population-based study, 172 older adults living in nursing homes from Changsha in China were included. We collected data on depressive symptoms, sleep quality, pain, and frailty using the Patient Health Questionnaire, the Pittsburgh Sleep Quality, the Brief Pain Inventory-short form, and the FRAIL-NH Scale. Generalized linear regression models were used to explore the interaction association between these symptoms with frailty. RESULTS Most older adults were between 80 and 90 years old. Approximately 11.6% of older adults experienced one of the following symptoms: depressive symptoms, poor sleep quality, pain intensity, or pain impact. Moreover, 76.7% of older adults experienced at least two of these symptoms. The most common overlapping symptoms were depressive symptoms and poor sleep quality (14.5%). Among nursing home residents, the most common sites of pain were the lower limbs, followed by the back. There was a strong correlation between depressive symptoms, sleep quality, pain intensity, pain impact, and frailty. After adjusting for covariates, the interaction term between any two or three symptoms of depressive symptoms, poor sleep quality, pain intensity, and pain impact was found to be associated with a higher likelihood of frailty in older adults residing in nursing homes (p< .05). CONCLUSIONS Depressive symptoms, poor sleep quality, pain intensity, and pain impact are common among nursing home residents. Furthermore, these symptoms interacted with each other. In future studies, multidisciplinary interventions aimed at releasing these symptoms and reducing the adverse outcome of frailty are needed.
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Affiliation(s)
- Tianxue Hou
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Kong F, Yu L, Hou Y, Zhu L, Zhou J, Huang L, Lv Y, Wang L, Zhang L, Yang Y, Ying Y. Efficacy of Internet-Based Cognitive Behavioral Therapy for Subthreshold Depression Among Older Adults in Institutional Long-Term Care Settings: Pragmatic Randomized Controlled Trial. J Med Internet Res 2024; 26:e40187. [PMID: 38427424 PMCID: PMC10943436 DOI: 10.2196/40187] [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: 06/09/2022] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Subthreshold depression (sD) is prevalent in older populations in long-term care (LTC) settings, but psychological therapy in LTC settings in China is not readily available. Thus, internet-based cognitive behavioral therapy (ICBT) may be suitable for this population, but research on the efficacy of ICBT for older adults with sD, especially those living in LTC settings, is limited. OBJECTIVE This study aimed to evaluate the efficacy and acceptability of ICBT treatment for sD among LTC residents in China. We also examined whether ICBT is as effective as group-based cognitive behavioral therapy (CBT) for treating sD in this population. METHODS We conducted a pragmatic randomized controlled trial, which included 18 LTC institutions. A total of 354 participants were randomized to ICBT, group-based CBT, or a waiting list and were followed up for 12 months. The primary outcome was self-reported depressive symptoms on the Center for Epidemiological Studies Depression Scale (CES-D). Secondary outcomes were the scores of the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-Item (GAD-7), and Geriatric Depression Scale (GDS). A mixed-effects model was used to assess the efficacy of ICBT. RESULTS The ICBT group showed a significant improvement in self-reported depressive symptoms, which was maintained at the 12-month follow-up (all P<.001). The ICBT group exhibited a significantly larger reduction in the scores of the CES-D (Cohen d=0.07, 95% CI 0.04-0.09; P=.01), PHQ-9 (d=0.30, 95% CI 0.28-0.33; P<.001), GDS (d=0.10, 95% CI 0.08-0.13; P<.001), and GAD-7 (d=0.19, 95% CI 0.17-0.22; P<.001) compared with a waiting list at postintervention. ICBT had significantly stronger effects than CBT on the PHQ-9 and GAD-7 at postintervention (d=0.15, 95% CI 0.13-0.17; P<.001 and d=0.21, 95% CI 0.19-0.23; P<.001, respectively), 6-month follow-up (d=0.18, 95% CI 0.16-0.21; P<.001 and d=0.18, 95% CI 0.15-0.21; P<.001, respectively), and 12-month follow-up (d=0.15, 95% CI 0.11-0.19; P<.001 and d=0.18, 95% CI 0.14-0.21; P<.001, respectively). CONCLUSIONS ICBT is a relatively effective and acceptable intervention for reducing depressive symptoms among Chinese LTC residents with sD. These findings indicate the usefulness of ICBT application for sD in LTC settings. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000030697; https://www.chictr.org.cn/showproj.aspx?proj=50781.
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Affiliation(s)
- Fanqian Kong
- Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Libo Yu
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | | | - Lijie Zhu
- Pfizer Research and Development Co, Ltd, Shanghai, China
| | - Jing Zhou
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Lingjie Huang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yueer Lv
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Li Wang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Li Zhang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yiling Yang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yuchen Ying
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
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Miller E, Wilding R, Baker S, Caldwell GA, Neves BB, Waycott J. Transforming aged care with virtual reality: How organisational culture impacts technology adoption and sustained uptake. Australas J Ageing 2024; 43:183-190. [PMID: 37803886 DOI: 10.1111/ajag.13248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVES Virtual reality (VR) is not a common leisure activity in aged care, despite pilot studies demonstrating its value as a tool to combat inactivity and loneliness. This study investigated the organisational enablers and barriers to sustained uptake of VR among aged care staff and organisations, who may lack familiarity or confidence with the technology. METHODS Creative methods were adopted to co-design and develop a VR implementation toolkit tailored specifically for aged care staff. Three aged care homes in South-East Queensland participated, with 15 residents and seven staff engaging in up to four VR sessions facilitated by the research team. Participant observation of the VR sessions was complemented by interviews with aged care staff and residents. RESULTS Guided by Normalisation Process Theory, a reflexive thematic analysis identified four key themes: (1) Positively Appreciating the VR Experience, (2) Staff VR Champions and the Importance of Personal Use and Experimentation with VR, (3) Management Support and (4) Technical Challenges. CONCLUSIONS Our results indicate benefits and challenges of VR use in aged care, offering valuable insights into the factors that can lead to the long-term success of VR-based leisure activities for aged care. Providing time and resources for a VR champion to experiment and learn about the technology is critical. The development of an online implementation toolkit, based on our learning from this project, also provides aged care stakeholders with the evidence-based resources needed to ensure the successful implementation of VR-based leisure programs.
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Affiliation(s)
- Evonne Miller
- QUT Design Lab, School of Design, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Raelene Wilding
- Sociology, School of Humanities and Social Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Steven Baker
- School of Human Services and Social Work, Griffith University, Gold Coast Campus, Gold Coast, Queensland, Australia
| | - Glenda A Caldwell
- QUT Design Lab, Australia School of Architecture and Built Environment, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Barbara B Neves
- Sociology, School of Social Sciences, Monash University, Melbourne, Victoria, Australia
| | - Jenny Waycott
- School of Computing and Information Systems, The University of Melbourne, Melbourne, Victoria, Australia
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du Toit SHJ, Jessup GM. JAVA Memory Care program: Facilitating social and occupational engagement for older adults living with advanced dementia. Aust Occup Ther J 2024; 71:64-75. [PMID: 37842971 DOI: 10.1111/1440-1630.12911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/24/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Residents in aged care homes often report lack of life purpose and meaning and limited opportunities to contribute to their community. The JAVA Memory Care program is designed to facilitate engagement for older adults with advanced dementia. This study explored whether JAVA Memory Care engaged such adults meaningfully, on social and occupational levels, within one Australian residential care home. METHODS A mixed method design guided this exploration. Trained staff facilitated six JAVA groups over 2 months. Three sources of data were utilised. Observational data (qualitative and quantitative) were obtained using a narratively enhanced Assessment Tool for Social and Occupational Engagement (ATOSE). The other two data sources were qualitative and analysed thematically: reflections by the lead JAVA facilitator and data generated by a research discussion group. RESULTS The quantitative data comprised 564 ATOSE behaviour markers. Participants were categorised as being engaged in 93% of these markers. Two of the three qualitative themes focused on the collective and self-expressive nature of participant engagement. The third theme focused on practicalities such as time pressures, facilitator training, resident selection, and resource preparation. For residents, the groups provided a context for relating meaningfully to others. CONCLUSION The JAVA program achieved a high level of engagement. However, it was a time intensive intervention and required a person-centred philosophy, appropriate staff training, organisational support, and a suitable quiet space. The program had positive benefits, but practical issues identified needed to be considered before implementation.
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7
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Jun H, Grabowski DC. Nursing Home Staffing: Share Of Immigrant Certified Nursing Assistants Grew As US-Born Staff Numbers Fell, 2010-21. Health Aff (Millwood) 2024; 43:108-117. [PMID: 38190591 PMCID: PMC10824124 DOI: 10.1377/hlthaff.2023.00881] [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] [Indexed: 01/10/2024]
Abstract
Nursing homes have long faced a shortage of direct care workers, a problem that was magnified during the COVID-19 pandemic. Using nationally representative data from three sources, we found that much of the certified nursing assistant (CNA) workforce in US nursing homes is filled by immigrant labor. The number of native-born CNAs has been declining rapidly since the mid-2010s, whereas the number of foreign-born CNAs has remained relatively constant. During the first two years of the COVID-19 pandemic, the share of immigrant CNAs employed by nursing homes surged, which can be explained by a simultaneous drop in the share of native-born staff. Staffing shortages observed during the pandemic would have been worse if not for foreign-born CNAs remaining in the workforce. However, the share of foreign-born CNAs varied considerably across states, from less than 1 percent in West Virginia to more than 70 percent in Hawaii. In an analysis of prepandemic data, we found that nursing homes in regions with a higher share of immigrant CNAs were associated with more direct care staff hours per resident day and better nursing home quality performance. With the growing demand for long-term care, creating pathways for job-seeking immigrants to fill the gaps in direct care will be crucial to meeting future staffing needs.
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Affiliation(s)
- Hankyung Jun
- Hankyung Jun , Harvard University, Boston, Massachusetts
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8
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Tan JDL, Maneze D, Montayre J, Ramjan LM, Wang D, Salamonson Y. Family visits and depression among residential aged care residents: An integrative review. Int J Nurs Stud 2023; 146:104568. [PMID: 37597458 DOI: 10.1016/j.ijnurstu.2023.104568] [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: 01/01/2023] [Revised: 07/10/2023] [Accepted: 07/22/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Depression in older people living in residential aged care is a serious and highly prevalent health issue, with loneliness and social isolation being major contributors. The COVID-19 pandemic underscored the harm visiting restrictions have on the mental wellbeing of older people in residential aged care. However, there is a need to systematically review the relationship between family visits and depression in this population. OBJECTIVE This literature review seeks to explore the association between family visits and depression among those living in residential aged care. METHODS An integrative review was conducted in March 2022, based on a search of seven databases from inception to 2022. Papers were included if the studies were situated in a residential aged care facility and explored the impact of in-person family visits on depression of residents. Those that examined impact of family visits on community-dwelling older people and papers examining virtual family visits were excluded. The quality of the included papers was assessed using appropriate critical appraisal tools. Guided by the aim of this study, the included papers were narratively synthesised and presented thematically (PROSPERO ID CRD42022325895). RESULTS Ten papers, published between 1991 and 2022, were included in the final synthesis. Multiple categorisations of frequency of visits and different scales were used to assess depression. Depression among residents in aged care facilities varied from 20 % to 58.7 % with 40 % of studies showing a positive association between the frequency of family visits and lower rate of depression. Three themes influencing the association between family visits and depression in residential aged care were identified. These were: (i) intersection of culture, filial values, and depression; (ii) resident-related factors including whether admission was voluntary and presence of functional impairment; and (iii) non-resident-related factors such as social activities for residents and staff involvement. CONCLUSION Family visits ameliorated loneliness and depression among residents in aged care however, other factors such as culture, comorbidities and functional impairment, opportunities for socialisation and the social involvement of facility staff also influenced depression. Whilst the low number of studies reviewed limited comparison and generalisation of results, the review highlighted the broader and crucial role of healthcare staff in facilitating socialisation and promoting mental wellbeing of residents especially those who are not visited by families. TWEETABLE ABSTRACT Family visits ameliorate depression in institutionalised older people but may not be the "silver bullet" as depression is multifactorial.
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Affiliation(s)
- Josh D L Tan
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
| | - Della Maneze
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Joanna Briggs Institute, Sydney, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia; School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Lucie M Ramjan
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
| | - Donna Wang
- School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
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Kwan RYC, Ng F, Lam LCW, Yung RC, Sin OSK, Chan S. The effects of therapeutic virtual reality experience to promote mental well-being in older people living with physical disabilities in long-term care facilities. Trials 2023; 24:558. [PMID: 37633916 PMCID: PMC10464193 DOI: 10.1186/s13063-023-07592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Mental well-being is poor in long-term care facilities (LTCF) residents. Physical disabilities, impaired social engagement, and environmental stress are also common in LTCF which exacerbate the decline of the mental well-being of older people living in LTCF. Protective elements, including nature-based, reminiscence, outdoor, and group activities, are known to be effective to promote the mental well-being of older people living in LTCF. However, limited by their physical disabilities and poor social support, older people living in LTCF are not likely to benefit from these effective measures. Virtual reality has been proven to be feasible to be environmentally unrestricted to providing LTCF residents with all protective elements promoting mental well-being. However, its effects on the mental well-being of LTCF residents living with physical disabilities are unclear. METHODS This study employs a single-blinded, two-parallel-group (intervention-to-control group ratio = 1:1), non-inferiority, randomized controlled trial. Eligible participants are aged 60 years or above, LTCF residents, and living with physical disabilities. The study will be conducted in LTCF. In the intervention group, participants will receive a 6-week VR experience program. In the control group, participants will receive the usual care provided by the LTCF. The primary outcome is mental well-being, as measured by World Health Organization Five Well-being Index at the time point of baseline (i.e., week 0) and after completion of the intervention (i.e., week 7). This study aims to recruit a total of 216 participants. Generalized estimating equations (GEE) will be used to examine the effects of the intervention. TRIAL REGISTRATION The trial has been registered at ClinicalTrials.gov (Identifier: NCT05818579 ), Registered on April 5, 2023. The latest version of the protocol was published online on 19 April 2023. All items come from the World Health Organization Trial Registration Data Set. This study has been approved by the Research Ethics Committee of Tung Wah College, Hong Kong (reference number: REC2023158). The findings will be disseminated in peer-reviewed journals, presented at international and local conferences with related themes, and shared in local media.
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Affiliation(s)
| | - Fowie Ng
- School of Management, Tung Wah College, Hong Kong SAR, China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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10
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Yang ACH, Chaudhury H, Ho JCF, Lau N. Measuring the Impact of Bedroom Privacy on Social Networks in a Long-Term Care Facility for Hong Kong Older Adults: A Spatio-Social Network Analysis Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085494. [PMID: 37107776 PMCID: PMC10139142 DOI: 10.3390/ijerph20085494] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
This study aims to measure the impact of bedroom privacy on residents' social networks in a long-term care (LTC) facility for older adults. Little is known about how the architectural design of bedrooms affects residents' social networks in compact LTC facilities. Five design factors affecting privacy were examined: bedroom occupancy, visual privacy, visibility, bedroom adjacency, and transitional space. We present a spatio-social network analysis approach to analyse the social network structures of 48 residents. Results show that residents with the highest bedroom privacy had comparatively smaller yet stronger groups of network partners in their own bedrooms. Further, residents who lived along short corridors interacted frequently with non-roommates in one another's bedrooms. In contrast, residents who had the least privacy had relatively diverse network partners, however, with weak social ties. Clustering analyses also identified five distinct social clusters among residents of different bedrooms, ranging from diverse to restricted. Multiple regressions showed that these architectural factors are significantly associated with residents' network structures. The findings have methodological implications for the study of physical environment and social networks which are useful for LTC service providers. We argue that our findings could inform current policies to develop LTC facilities aimed at improving residents' well-being.
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Affiliation(s)
- Aria C. H. Yang
- School of Design, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Correspondence:
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, 8888 University Drive Burnaby, Vancouver, BC V5A 1S6, Canada
| | - Jeffrey C. F. Ho
- School of Design, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Newman Lau
- School of Design, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
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11
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Knippenberg IAH, Leontjevas R, Stoyanov S, Persoon A, Verboon P, Vermeulen H, van Lankveld JJDM, Gerritsen DL. Informal antidepressant strategies for nursing home residents: two group concept mapping studies. Aging Ment Health 2023; 27:251-262. [PMID: 35369803 DOI: 10.1080/13607863.2022.2057427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To identify and structure potential informal antidepressant strategies that can be used in daily practice for nursing home residents alongside formal treatments. METHODS In a first Group Concept Mapping study, residents, relatives, and professional caregivers (N = 124) brainstormed on strategies residents could use to prevent or alleviate depression. In a second study, the same participants (N = 110) reported strategies for use by others. Furthermore, participants rated the expected effectiveness and feasibility of the suggested strategies. Simultaneously, all strategies were sorted by experts and clustered using multidimensional scaling and hierarchical cluster analysis. RESULTS Six clusters emerged for strategies by residents themselves and five clusters for strategies by others. For residents' strategies, the clusters Being socially connected and Participating in activities were perceived as most effective, as was the cluster Offering personal attention for strategies by others. Participants perceived Creating a healthy living environment as the most feasible cluster executed by residents. Within strategies by others, the clusters Offering personal attention, Using positive treatment/approach, and Using or adapting the physical environment were perceived as the most feasible. CONCLUSION The results indicated the importance of social connectedness, a personalized and positive approach by significant others, and tailored activity programs. The results also suggest that adaptations to the physical environment within nursing homes may be an easy applicable strategy to prevent or alleviate depression in residents. Although more research is needed, these findings may guide daily practice and the development of interventions that include informal strategies. UNLABELLED Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2022.2057427 .
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Affiliation(s)
- Inge A H Knippenberg
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands.,Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Ruslan Leontjevas
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands.,Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Slavi Stoyanov
- Faculty of Educational Sciences, Department of Technology Enhanced Learning and Innovation, Open University of the Netherlands, Heerlen, The Netherlands
| | - Anke Persoon
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | - Peter Verboon
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Hester Vermeulen
- IQ healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | | | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
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12
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Bower M, Kent J, Patulny R, Green O, McGrath L, Teesson L, Jamalishahni T, Sandison H, Rugel E. The impact of the built environment on loneliness: A systematic review and narrative synthesis. Health Place 2023; 79:102962. [PMID: 36623467 DOI: 10.1016/j.healthplace.2022.102962] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023]
Abstract
Loneliness is a pressing public health issue. Although quintessentially individual, it is shaped by wider environmental, cultural, socio-economic, and political circumstances. Using a systematic review methodology, this paper draws on interdisciplinary research to conceptualise the relationship between the built environment and loneliness. We present a narrative synthesis of 57 relevant studies to characterise the body of evidence and highlight specific built-environment elements. Our findings demonstrate the need for further conceptual and empirical explorations of the multifaceted ways in which built environments can prevent loneliness, supporting calls for investment into this public-health approach.
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Affiliation(s)
- Marlee Bower
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Jennifer Kent
- The University of Sydney School of Architecture, Design, and Planning, The University of Sydney, Australia.
| | - Roger Patulny
- Faculty of the Arts, Social Sciences, and Humanities, University of Wollongong, Australia
| | - Olivia Green
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Laura McGrath
- Faculty of Arts and Social Sciences, The Open University, Milton Keynes, England; UK
| | - Lily Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | | | - Hannah Sandison
- The University of Sydney School of Architecture, Design, and Planning, The University of Sydney, Australia
| | - Emily Rugel
- Westmead Applied Research Centre, The University of Sydney, Australia
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13
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Adolfo CS, Albougami ASB, Roque MY, Aruta JJBR, Almazan JU. An integrative review of negative emotions of older adults in later life. Nurs Forum 2022; 57:1452-1464. [PMID: 35962773 DOI: 10.1111/nuf.12785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 07/08/2022] [Accepted: 07/21/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Older adults are one of the most vulnerable populations requiring scientific, psychological, and clinical attention. Although several studies have explored psychoemotional needs in later life, one critical gap in the literature is a shortage of studies comprehensively reviewing negative emotional experiences and their antecedents associated with later life. AIM This integrative review aims to identify negative emotional experiences during older adult years. METHODS This review of articles from Medline, CINAHL, Science Direct, Web of Science, ProQuest, and Taylor and Francis synthesized negative emotional experiences during older adult years. Across these six electronic databases, we searched and identified 17 relevant articles from 2005 to 2020 containing quantitative, qualitative, and mixed-method studies. RESULTS Based on the review, we identified five negative emotions (sadness, anxiety, frustration, anger, and loneliness). These negative emotions were rooted in marital problems, separation from families, medical problems, physical functioning and disability, and financial limitations. Additionally, we identified common antecedents of negative emotions. CONCLUSION At the center of numerous interventions, older adults are reinvigorated to understand the antecedents of negative emotions. The complex array of emotions, specifically regrets and frustration in later life, is depicted by more negativity than positivity. Such array of emotions could help develop strategies to prevent the causes of regret and frustration that nurses see when working with older adults in a clinical practice setting.
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Affiliation(s)
- Cris S Adolfo
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | | | - Mark Y Roque
- College of Nursing, Taibah University, Taibah, Saudi Arabia
| | - John Jamir Benzon R Aruta
- Counseling and Educational Psychology Department, Br. Andrew Gonzalez, FSC College of Education, De La Salle University, Manila, Philippines.,Department of Psychology, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia
| | - Joseph U Almazan
- Nazarbayev University School of Medicine, Nazarbayev University, Nursultan, Kazakhstan
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14
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Health effects of loneliness and social isolation in older adults living in congregate long term care settings: A systematic review of quantitative and qualitative evidence. Arch Gerontol Geriatr 2022; 102:104728. [DOI: 10.1016/j.archger.2022.104728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 11/18/2022]
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15
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Srifuengfung M, Thana-udom K, Ratta-apha W, Chulakadabba S, Sanguanpanich N, Viravan N. Impact of the COVID-19 pandemic on older adults living in long-term care centers in Thailand, and risk factors for post-traumatic stress, depression, and anxiety. J Affect Disord 2021; 295:353-365. [PMID: 34488089 PMCID: PMC8397501 DOI: 10.1016/j.jad.2021.08.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/28/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is a lack of data concerning impact of COVID-19 among older adults (OA) living at long-term care (LTC) centers. This study investigated how COVID-19 has affected this population. The prevalence of and risk factors for post-traumatic stress, depression, and anxiety were investigated. METHODS A semi-structured interview to determine the effect of COVID-19 was conducted to 200 OA at two government LTC centers. The 17-item Post-traumatic Stress Disorder Checklist, the 9-item Patient Health Questionnaire, and the 7-item Generalized Anxiety Disorder Scale were used to evaluate post-traumatic stress, depression, and anxiety, respectively. RESULTS Most OA reported moderate or severe impact of COVID-19. The most impacted area was financial due to decreased support from outside the center. Seventy percent of OA reported no or mild psychological stress from COVID-19; however, 5.5% had post-traumatic stress, 7.0% had depression, and 12.0% had anxiety. Higher psychological stress from COVID-19 and having respiratory tract infection symptoms were independently associated with post-traumatic stress, depression, and anxiety. Receiving COVID-19 news via social media was independently associated with post-traumatic stress and depression. Having psychiatric comorbidity was independently associated with depression. CONCLUSIONS OA living in LTC centers reported moderate or severe impact from COVID-19, especially financial, but relatively low psychological stress. Psychological stress from COVID-19, having respiratory tract infection symptoms, and receiving COVID-19 news via social media were risk factors for psychological disorders. LIMITATIONS The data reflected the post-outbreak period. There is limitation in the generalizability of the results for other countries with different health care systems.
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Affiliation(s)
| | | | | | | | | | - Natee Viravan
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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16
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Wheeler M, Abbey KL, Capra SM. Meal choice for residential aged care is not yet defined: A scoping review of policies, standards, reports and guidelines. Nutr Diet 2021; 79:169-180. [PMID: 34448340 DOI: 10.1111/1747-0080.12700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/08/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022]
Abstract
AIM For residents in residential aged care, making choices in relation to food and mealtimes are opportunities to maintain a sense of self and autonomy. It is unknown, however, whether the concept of choice is adequately addressed in texts relating to residential aged care. The purpose of this review is to examine whether residents' right to make choices regarding the meals they eat, is discussed in grey literature including, policies, standards, reports and guidelines, which all impact practice in residential aged care. METHODS Grey literature was located utilising; Google, Google Scholar and hand searching. Texts had to be in reference to residential aged care and were assessed using the Appraisal of Guidelines for Research and Evaluation II and Joanna Briggs Institute tools. RESULTS Twenty-nine texts were included in the final review, consisting of, 12 policies and standards, 12 guidelines and 5 reports. Choice was discussed broadly in the majority of texts, with no definition included for the level of choice that should be provided by residential aged care. The use of alternative meals to provide choice was discussed; however, texts varied in their requirements and recommendations as to what constituted an adequate alternative. CONCLUSIONS The ambiguity surrounding choice affects the practices within residential aged care and ultimately the service provided to residents. With most recommendations being only general in nature, residential aged care homes are not provided with sufficient guidance for meal planning. To ensure residents' right to make choices in their meals is guaranteed, more definitive requirements and recommendations are needed.
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Affiliation(s)
- Mikaela Wheeler
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Karen L Abbey
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Sandra M Capra
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
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17
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Osborn TL, Kleinman A, Weisz JR. Complementing standard western measures of depression with locally co-developed instruments: A cross-cultural study on the experience of depression among the Luo in Kenya. Transcult Psychiatry 2021; 58:499-515. [PMID: 33818199 DOI: 10.1177/13634615211000555] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Our present understanding of depression relies on a Western nosology that might not be generalizable across diverse cultures around the world. As a consequence, current clinical research and practice may not capture culturally salient features of depression. Expanded cross-cultural research that uses ethnographic methods and local instruments may yield information of clinical utility to enhance culturally sensitive research and practice. In this mixed methods study, we used ethno-semantic interview procedures based on the DSM-5's cultural formulation process to elicit a broad range of depression features reported by the Luo people of western Kenya. We identified how the Luo conceptualize depression, including idioms of depressive distress, moods associated with persistent negative affect, and other features including context, stressors and support systems. This information informed the co-development of a Luo Depression Questionnaire (LDQ-17). We used the LDQ-17 in a cross-sectional community survey (N = 116) to investigate its association with a standard Western instrument (Patient Health Questionnaire-9; PHQ-9). Factor analysis revealed a one-factor model for the PHQ-9 but not the LDQ-17 for which exploratory factor analysis suggested a three-factor model including cognitive, affective, and physical symptoms. Psychological, environmental/social, and even supernatural causes (i.e., ancestors, God and devil) of these symptoms were identified, as were support systems. Finally, visualizations through multidimensional scaling approaches showed some overlap between the LDQ-17 and the PHQ-9, but the local LDQ-17 identified salient features the Luo associated with depression that the PHQ-9 missed. Our findings illustrate how simple ethnographic procedures may guide the development of local instruments to complement current standardized instruments, potentially enhancing cultural relevance.
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Affiliation(s)
- Tom L Osborn
- Shamiri Institute, Nairobi, Kenya.,Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Arthur Kleinman
- Department of Anthropology, Harvard University, Cambridge, MA, USA.,Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - John R Weisz
- Department of Psychology, Harvard University, Cambridge, MA, USA
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18
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Liu Y, Gellatly J. Barriers and facilitators of engagement in psychological therapies among older adults with depression: A systematic review and thematic synthesis. J Psychiatr Ment Health Nurs 2021; 28:509-520. [PMID: 33043526 DOI: 10.1111/jpm.12697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/20/2020] [Accepted: 09/27/2020] [Indexed: 12/26/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: The utilization rate of psychological therapies is low in older adults with depression. The barriers and facilitators to engaging in psychological therapies experienced by older adults with depression are unclear. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Personal suitability for therapy engagement, practical abilities, personal therapy preferences, and familiarity with psychological therapies are associated with psychological therapy engagement. Psychological therapists can also impact psychological therapy engagement among older adults with depression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Proving the effectiveness and suitability of chosen psychological therapies is important for improving therapy engagement. Strategies for handling functional impairments among older adults with depression are necessary for engaging this population in psychological therapies. Although in-home psychological therapies are accessible, barriers to handling the technologies used for delivering the therapies should be addressed. More methods of accessing information about psychological therapies should be available to older adults in order for them to increase their knowledge on the topic. Psychological therapists should have positive attitudes and the competence to treat depression in older adults. ABSTRACT INTRODUCTION: Although psychological therapies are preferred by older adults, the utilization rate of these therapies is significantly low in older adults with depression. Understanding the barriers and facilitators to engaging in psychological therapies experienced by older adults is important for improving utilization rates. AIM This review aimed to explore the barriers and facilitators to engaging in psychological therapies experienced by older adults with depression. METHODS A systematic review of qualitative studies on psychological therapy engagement among older adults with depression. Relevant published studies and grey literature were searched. The Critical Appraisal Skills Programme tool was used to assess the quality of the included studies. The results of the included studies were synthesized using thematic synthesis. RESULTS Personal suitability for therapy engagement, practical abilities, personal therapy preferences and familiarity with psychological therapies was associated with therapy engagement. Therapists' competencies also affected therapy engagement. DISCUSSION Older adult's personal health status and requirements for psychological therapy should be considered. IMPLICATIONS FOR PRACTICE Mental health practitioners should consider whether specific psychological therapies are beneficial and acceptable for older adults. Improvements are needed in older adult's familiarity with psychological therapies and the ability of therapists to address the mental problems of older adults.
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Affiliation(s)
- Yuan Liu
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Judith Gellatly
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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19
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Nair P, Gill JS, Sulaiman AH, Koh OH, Francis B. Mental Health Correlates Among Older Persons Residing in Malaysian Nursing Homes During the COVID-19 Pandemic. Asia Pac J Public Health 2021; 33:940-944. [PMID: 34243684 DOI: 10.1177/10105395211032094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Pritiss Nair
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Jesjeet Singh Gill
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ong Hui Koh
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Benedict Francis
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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20
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Zhai K, Dilawar A, Yousef MS, Holroyd S, El-Hammali H, Abdelmonem M. Virtual Reality Therapy for Depression and Mood in Long-Term Care Facilities. Geriatrics (Basel) 2021; 6:58. [PMID: 34199801 PMCID: PMC8293126 DOI: 10.3390/geriatrics6020058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022] Open
Abstract
Virtual reality (VR) describes a family of technologies which immerse users in sensorily-stimulating virtual environments. Such technologies have increasingly found applications in the treatment of neurological and mental health disorders. Depression, anxiety, and other mood abnormalities are of concern in the growing older population-especially those who reside in long-term care facilities (LTCFs). The transition from the familiar home environment to the foreign LTCF introduces a number of stressors that can precipitate depression. However, recent studies reveal that VR therapy (VRT) can promote positive emotionality and improve cognitive abilities in older people, both at home and in LTCFs. VR thus holds potential in allowing older individuals to gradually adapt to their new environments-thereby mitigating the detrimental effects of place attachment and social exclusion. Nevertheless, while the current psychological literature is promising, the implementation of VR in LTCFs faces many challenges. LTCF residents must gain trust in VR technologies, care providers require training to maximize the positive effects of VRT, and decision makers must evaluate both the opportunities and obstacles in adopting VR. In this review article, we concisely discuss the implications of depression related to place attachment in LTCFs, and explore the potential therapeutic applications of VR.
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Affiliation(s)
- Kevin Zhai
- Premedical Unit, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar; (K.Z.); (A.D.); (M.S.Y.)
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar;
| | - Azwa Dilawar
- Premedical Unit, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar; (K.Z.); (A.D.); (M.S.Y.)
| | - Mohammad S. Yousef
- Premedical Unit, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar; (K.Z.); (A.D.); (M.S.Y.)
| | - Sean Holroyd
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar;
| | - Haithem El-Hammali
- VCU School of the Arts in Qatar, Virginia Commonwealth University, Doha P.O. Box 8095, Qatar
| | - Marwa Abdelmonem
- VCU School of the Arts in Qatar, Virginia Commonwealth University, Doha P.O. Box 8095, Qatar
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21
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Kelly J, Davison TE, McCabe MP. A psychological needs-based intervention to facilitate adjustment and improve wellbeing in newly admitted aged care residents: three illustrative case studies. CLIN PSYCHOL-UK 2021. [DOI: 10.1080/13284207.2021.1909419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Julie Kelly
- Health & Ageing Research Group, Swinburne University of Technology, Melbourne, Australia
| | - Tanya E. Davison
- Health & Ageing Research Group, Swinburne University of Technology, Melbourne, Australia
| | - Marita P. McCabe
- Health & Ageing Research Group, Swinburne University of Technology, Melbourne, Australia
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22
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Garms-Homolová V, Declercq A, Finne-Soveri H, Notthoff N, van der Roest HG, van Hout HPJ. Adverse Life Events: Do Home Care Clients Have Resources for Mastering Them? Front Med (Lausanne) 2021; 8:522410. [PMID: 33748153 PMCID: PMC7973033 DOI: 10.3389/fmed.2021.522410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 02/08/2021] [Indexed: 12/30/2022] Open
Abstract
Objectives: Research on life stressors and adverse life events has a long tradition. Few studies have addressed this topic in connection to very old people. Life stressors, especially major life stressors (MLSs) experienced by clients of home care services in the community have rarely been the subject of studies. Considering this gap, we investigated the prevalence of MLSs in home care clients. We examined the effects that MLSs have on their mood and health status as well as the impact of clients' social resources on MLSs and their outcomes. Method: We used assessment data from 2,884 home care clients in six European countries. The methodological basis was the comprehensive and standardized interRAI Home Care Assessment (interRAI HC). Results: Fifteen point four percent of the sample—that consisted of women and men with an average age of 82.89 years–experienced an MLS in the last 6 months before the assessment. They were more depressed than persons without these experiences, and their health status indicated a higher level of instability and deterioration. At reassessment after 6 months, the situation changed. Despite the fact that both outcomes of the MLSs, depression and health status became worse in the reassessment-sample, home care clients without MLS were more affected by the worsening, especially that of depression. The expected buffering impact of social resources was low. Discussion: Although this study worked with limited information on MLSs, it could contribute to closing various knowledge gaps. The study shows that the MLSs represent a prevalent problem in a population of home care clients and that this problem has negative consequences for their mood and the stability of their health status. Furthermore, this research took up the situation of very old and vulnerable adults, who have previously rarely been considered in studies on major critical life events and stressors. Conclusion and Research Perspective: Future research on MLSs has to take up the issue of the time passage between the MLS and the impact on health and well-being of individuals dependent on care. It has to determine immediate as well as later consequences and identify those factors that are appropriate to reduce the MLS-effects on very old people dependent on care.
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Affiliation(s)
- Vjenka Garms-Homolová
- Hochschule für Technik und Wirtschaft Berlin, University of Applied Sciences, Berlin, Germany
| | | | | | - Nanna Notthoff
- Faculty of Sport Science, Leipzig University, Leipzig, Germany
| | | | - Hein P J van Hout
- Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, Netherlands
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23
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Fields N, Xu L, Greer J, Murphy E. Shall I compare thee…to a robot? An exploratory pilot study using participatory arts and social robotics to improve psychological well-being in later life. Aging Ment Health 2021; 25:575-584. [PMID: 31851830 DOI: 10.1080/13607863.2019.1699016] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Research suggests that the use of creative, artistic activities in later life may positively impact the psychological well-being of older adults. Social robots have been utilized in research with older adults, however, few studies have integrated participatory arts (e.g. theatre) into social robotic platforms for the purpose of implementing a psychosocial intervention with this population. An interdisciplinary team designed and delivered an intervention integrating theatre and social robotics with the aim of improving the psychological well-being of study participants both with and without cognitive impairment who live in a residential care setting. A purposive sample of older adults age 65 and older (N = 15) participated in this 3-session pilot study that involved a Shakespeare participatory art activity using the robot, NAO. Pre and post tests were conducted before and after each session with measures of depression, loneliness, and a simplified face scale for mood were asked. Results from Repeated Measurement Analysis of Variance (ANOVA) showed that depression, loneliness and face scores had significantly decrease across six time periods and these declines differed between people with dementia and those without dementia. In addition, only significant changes of depression before and after the intervention were found between persons with and without dementia. We discuss the promising aspects of using social robotics as a platform for participatory arts interventions with older adults and offer lessons learned from the use of innovative technology in residential care settings.
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Affiliation(s)
- Noelle Fields
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Ling Xu
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Julienne Greer
- College of Liberal Arts, University of Texas at Arlington, Arlington, TX, USA
| | - Erin Murphy
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
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24
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Haugan G, Deliktaş Demirci A, Kabukcuoglu K, Aune I. Self-transcendence among adults 65 years and older: A meta-analysis. Scand J Caring Sci 2021; 36:3-15. [PMID: 33522632 DOI: 10.1111/scs.12959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/10/2020] [Accepted: 01/04/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Self-transcendence is a human capacity for wellbeing by expanding one's personal boundaries and may act as a health-promoting resource among adults ≥65 years. Therefore, the objectives of this meta-analysis were to determine the mean score of self-transcendence based on place of residence and gender, and to evaluate the correlations of self-transcendence with meaning, sense of coherence, resilience and depression. METHODS Based on inclusion criteria, 13 studies were included. Orwin Safe N and Egger's test assessed publication bias. The mean score of self-transcendence and the correlation coefficients of the selected variables were estimated by random effects models. RESULTS The self-transcendence mean score (n = 1634) was low (M = 43.6) and a bit lower among those staying in care facilities (M = 42.8), but did not vary significantly across gender. The correlation coefficients were self-transcendence_depression (r = -0.40), self-transcendence_meaning-in-life (r = 0.53), self-transcendence_resilience (r = 0.50) and self-transcendence_sense of coherence (r = 0.28). The correlation coefficients, except for meaning-in-life, were homogeneous. CONCLUSION In a health-promoting perspective, the concept of self-transcendence can help to better understand wellbeing among older individuals and provide guidance for health professionals in facilitating wellbeing and health. The concept and theory of self-transcendence can inspire health professionals in realising new health-promoting approaches to support older individuals in maintaining health, wellbeing and independency.
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Affiliation(s)
- Gørill Haugan
- Department of Public Health and Nursing, NTNU Norwegian University of Technology and Science, Trondheim, Norway.,Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | | | | | - Ingvild Aune
- NTNU Department of Clinical and Molecular Medicine, Trondheim, Norway
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25
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Drageset J, Eide GE. Loneliness Among Cognitively Intact Residents of Nursing Homes With and Without Cancer: A 6-Year Longitudinal Study. SAGE Open Nurs 2021; 6:2377960820907778. [PMID: 33415270 PMCID: PMC7774416 DOI: 10.1177/2377960820907778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 11/06/2019] [Accepted: 01/26/2020] [Indexed: 11/17/2022] Open
Abstract
Limited information exists regarding the natural development of loneliness and
its determinants among cognitively intact nursing home residents. We aimed to
examine loneliness among nursing home residents by following up for 6 years and
to determine whether sociodemographic factors, diagnosis of cancer, sense of
coherence, social support, and depression symptoms influence loneliness. The
study was longitudinal and prospective and included baseline assessment and
6-year follow-up. After baseline assessment of 227 cognitively intact nursing
home residents (Clinical Dementia Rating score ≤0.5), 52 respondents were
interviewed a second time at the 5-year follow-up and 18 respondents a third
time at the 6-year follow-up. Data from the interviews were recorded using a
global question of loneliness, the Social Provisions Scale, Sense of Coherence
Scale, and Geriatric Depression Scale. Scores on Groll’s index
(p = .02) and the Sense of Coherence Scale
(p = .04) were positively correlated with loneliness and
negatively correlated with geriatric depression (p = .001).
Having a diagnosis of cancer, social support, and age were not correlated with
loneliness 6 years from baseline. Loneliness did not change during the 6 years
of follow-up, and symptoms of depression and the sense of coherence appeared to
be important components of loneliness. Finally, having a diagnosis of cancer and
social support were not associated with loneliness.
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Affiliation(s)
- Jorunn Drageset
- Department of Nursing, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Geir Egil Eide
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
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26
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Abbate S. Reframing Holistic Patient Care in Nursing Homes Through the Lens of Relational Autonomy. Holist Nurs Pract 2021; 35:3-9. [PMID: 33492875 DOI: 10.1097/hnp.0000000000000419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In nursing facilities, patient autonomy is more effective when it is reframed under the rubric of relational autonomy. Through this lens, patients, family, and staff, especially nurses, can share conversations that lead to effective decision-making that acknowledges the needs of the whole person within the nexus of the institutional setting.
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Affiliation(s)
- Skya Abbate
- Southwest Acupuncture College, Santa Fe, New Mexico
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Nasrallah E, Pati D. Can Physical Design Help Reduce Loneliness in the Elderly? A Theoretical Exploration. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2020; 14:374-385. [PMID: 33272059 DOI: 10.1177/1937586720975208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Over the past several years, a new problem affecting the elderly population has been increasingly reported in popular press-the elderly population is dying as a result of loneliness and related factors at a rate greater than that of lack of medical care. The problem is so pervasive that loneliness is being described as an epidemic. OBJECTIVE The objective of this inquiry was to examine whether the physical design of the lived environments could contribute to reducing loneliness in the elderly population. METHOD A combination of scoping and conceptual review of published literature was adopted for the study. The process involved multiple phases of searching, and a review was conducted at each stage. Databases targeted include PsycINFO, Academic Search Complete, PsycArticles, Psychology and Behavioral Sciences Collection, and SocINDEX. In all, 44 articles and books were subjected to in-depth analyses of underlying concepts, constructs, relationships, and empirical findings. RESULTS Several theories including meaning in life theory, lifespan ego-development theory, symbolic interaction theory, proxemics, and affordance theory suggest that the design of the physical environment may have a role in addressing loneliness in the elderly. A potential explanatory model articulating the causal pathway is presented in this article. CONCLUSIONS Between theoretical propositions and empirical literature, there exist grounds to assert that a plausible causal pathway exists between the physical environment and loneliness in the elderly population. The explanatory pathway suggests that the physical design could play both a direct and moderating role in influencing loneliness.
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Affiliation(s)
- Eman Nasrallah
- Department of Design, College of Human Sciences, 6177Texas Tech University, Lubbock, TX, USA
| | - Debajyoti Pati
- Department of Design, College of Human Sciences, 6177Texas Tech University, Lubbock, TX, USA
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Roswiyani R, Hiew CH, Witteman CLM, Satiadarma MP, Spijker J. Art activities and qigong exercise for the well-being of older adults in nursing homes in Indonesia: a randomized controlled trial. Aging Ment Health 2020; 24:1569-1578. [PMID: 31146543 DOI: 10.1080/13607863.2019.1617239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: This study aims to investigate the effect of an integrated intervention of art activities and Qigong exercise on the well-being of older adults in nursing homes in Indonesia.Method: We employed a randomized controlled trial with 4 specific groups, i.e. art, Qigong, integration of art and Qigong, and control group. A total of 267 participants aged 50 years or older were recruited from 9 nursing homes in Jakarta, Indonesia. The participants were randomly allocated to one of the four groups, attending two intervention sessions per week for eight weeks (16 sessions), lasting 90 minutes each. Measurements were administered at baseline (T0) and post-intervention (T1). The primary outcome was well-being (WHOQOL-Bref) and secondary outcomes were satisfaction with life (SWLS), depression (BDI-II), and health status (SF-36).Results: The art intervention had a significant positive effect on well-being, in particular in the domain of social relations. It also led to a decrease in depressive symptoms, as did the integration intervention. No significant effects were visible in the Qigong group nor in the integrated intervention compared to either art or Qigong alone.Conclusion: Interventions such as art programs and an integration of art and Qigong may give psychological benefits to older adults. Yet, results of the study need to be interpreted with caution and need to be replicated. A qualitative approach would be welcome to get an in-depth understanding of why art intervention is especially beneficial. (Trial registration: Clinicaltrials.gov NCT02957773, registered 28 September 2016).
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Affiliation(s)
- R Roswiyani
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Department of Psychology, Universitas Tarumanagara, Jakarta, Indonesia
| | - Chok H Hiew
- Fredericton, New Brunswick University, New Brunswick, Canada
| | - Cilia L M Witteman
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Jan Spijker
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Pro Persona Mental Health Care, Depression Expertise Centre, Nijmegen, the Netherlands
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The Impact of COVID-19 Measures on Well-Being of Older Long-Term Care Facility Residents in the Netherlands. J Am Med Dir Assoc 2020; 21:1569-1570. [PMID: 33036911 PMCID: PMC7833500 DOI: 10.1016/j.jamda.2020.09.007] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/24/2020] [Accepted: 09/06/2020] [Indexed: 12/20/2022]
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Miller VJ. The experience of transportation to visit a nursing home resident: A case study. SOCIAL WORK IN HEALTH CARE 2020; 59:300-321. [PMID: 32369432 DOI: 10.1080/00981389.2020.1756556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 06/11/2023]
Abstract
Maintaining social connections in the community can be accomplished through transportation access and opportunities. This includes relationships between family and residents in nursing homes. Previous research supports the relationship between transportation, social support, and visitation of residents in nursing homes (NHs), however no empirical research to date explores this relationship of family member transportation as a means to visit their loved one in this setting. Guided by a case study approach, a sample of 11 (N = 11) family members of residents in nursing homes across North Central Texas were selected to develop an in-depth understanding of transportation access and mobility, as it relates to visitation of residents in nursing facilities. Analyses revealed the following seven themes: Car access, Alternative modes, Flexibility, Travel time, Actual cost, Collateral cost, and Health and Mobility. Findings from this study uncover how cost, both actual cost and collateral cost, are greatly linked to car access, transportation access, and opportunities to visit, as well as the impact each of these features, and emergent themes, related to transportation have on maintained or fractured relationships of family and residents in nursing homes. This article concludes with implications for future research and social work practice.
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Affiliation(s)
- Vivian J Miller
- Department of Human Services, Bowling Green State University , Bowling Green, OH, US
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Haugan G, Eide WM, André B, Wu VX, Rinnan E, Taasen SE, Kuven BM, Drageset J. Joy-of-life in cognitively intact nursing home residents: the impact of the nurse-patient interaction. Scand J Caring Sci 2020; 35:208-219. [PMID: 32200564 DOI: 10.1111/scs.12836] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 01/12/2020] [Accepted: 02/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The nursing-home population is at a high risk of declined well-being and quality of life. Finding approaches to increase well-being among older adults in nursing-homes is highly warranted. Responding to this need, the approach framed 'Joy-of-Life-Nursing-Homes' (JoLNH) was developed in Norway. AIM To investigate the association between nurse-patient interaction and joy-of-life in the nursing-home population. METHODS Cross-sectional data were collected in 2017 and 2018 using the Nurse-Patient Interaction Scale and the Joy-of-Life Scale. A total of 204 cognitively intact nursing-home residents met the inclusion criteria and 188 (92%) participated. A structural equation model (SEM) of the relationship between nurse-patient interaction and joy-of-life was tested by means of STATA/MP 15.1. Ethical approval was given and each participant provided voluntarily written informed consent. RESULTS The SEM-model yielded a good fit with the data (χ2 = 162.418, p = 0.004, df = 118, χ2 /df = 1.38, RMSEA = 0.046, p-close 0.652, CFI = 0.97, TLI = 0.96, and SRMR = 0.054). As hypothesised, nurse-patient interaction related significantly with joy-of-life (γ1,1 = 0.61, t = 7.07**). LIMITATIONS The cross-sectional design does not allow for conclusions on causality. The fact that the researchers visited the participants to help fill in the questionnaire might have introduced some bias into the respondents' reporting. CONCLUSION Relational qualities of the nurse-patient interaction should be essential integral aspects of nursing-home care. Consequently, such qualities should be emphasised in clinical practice, and research and education should pay more attention to nurse-patient interaction as an important, integral part of the caring process promoting joy-of-life and thereby well-being.
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Affiliation(s)
- Gørill Haugan
- NTNU Center for Health Promotion Research, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Wenche Mjanger Eide
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway
| | - Beate André
- NTNU Center for Health Promotion Research, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Eva Rinnan
- Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Siv Eriksen Taasen
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway
| | - Britt Moene Kuven
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway
| | - Jorunn Drageset
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway.,University of Bergen, Department of Global Public Health and Primary Care, Bergen, Norway
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Haugan G, Drageset J, André B, Kukulu K, Mugisha J, Utvær BKS. Assessing quality of life in older adults: psychometric properties of the OPQoL-brief questionnaire in a nursing home population. Health Qual Life Outcomes 2020; 18:1. [PMID: 31898546 PMCID: PMC6941243 DOI: 10.1186/s12955-019-1245-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background Well-adapted and validated quality-of-life measurement models for the nursing home population are scarce. Therefore, the aim of this study was to test the psychometrical properties of the OPQoL-brief questionnaire among cognitively intact nursing home residents. The research question addressed evidence related to the dimensionality, reliability and construct validity, all of which considered interrelated measurement properties. Methods Cross-sectional data were collected during 2017–2018, in 27 nursing homes representing four different Norwegian municipalities, located in Western and Mid-Norway. The total sample comprised 188 of 204 (92% response rate) long-term nursing home residents who met the inclusion criteria: (1) municipality authority’s decision of long-term nursing home care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. Results Principal component analysis and confirmative factor analyses indicated a unidimensional solution. Five of the original 13 items showed low reliability and validity; excluding these items revealed a good model fit for the one-dimensional 8-items measurement model, showing good internal consistency and validity for these 8 items. Conclusion Five out of the 13 original items were not high-quality indicators of quality-of-life showing low reliability and validity in this nursing home population. Significant factor loadings, goodness-of-fit indices and significant correlations in the expected directions with the selected constructs (anxiety, depression, self-transcendence, meaning-in-life, nurse-patient interaction, and joy-of-life) supported the psychometric properties of the OPQoL-brief questionnaire. Exploring the essence of quality-of-life when residing in a nursing home is highly warranted, followed by development and validation of new tools assessing quality-of-life in this population. Such knowledge and well-adapted scales for the nursing home population are beneficial and important for the further development of care quality in nursing homes, and consequently for quality-of-life and wellbeing in this population.
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Affiliation(s)
- Gørill Haugan
- NTNU Center for health promotion research, Norwegian University of Science and Technology, Trondheim, Norway. .,Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
| | - Jorunn Drageset
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway.,University of Bergen, Bergen, Norway
| | - Beate André
- NTNU Center for health promotion research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kamile Kukulu
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - James Mugisha
- Social Worker, Kyambogo University and Butabika National Referral and Teaching Hospital, Kampala, Uganda
| | - Britt Karin S Utvær
- Department of Teacher Education, Norwegian University of Science and Technology, Trondheim, Norway
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Carver A, Lorenzon A, Veitch J, Macleod A, Sugiyama T. Is greenery associated with mental health among residents of aged care facilities? A systematic search and narrative review. Aging Ment Health 2020; 24:1-7. [PMID: 30430849 DOI: 10.1080/13607863.2018.1516193] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/08/2018] [Accepted: 08/22/2018] [Indexed: 10/27/2022]
Abstract
Objectives: Older adults living in residential aged care facilities (RACFs) may be vulnerable to mental health issues. Evidence suggests greenery is beneficial for adults' mental health in community settings. This review aims to summarise evidence of associations between greenery in RACFs and residents' mental health.Method: Six databases were searched with three sets of terms related to: (1) exposure (e.g. garden, green); (2) outcome (e.g. mental health, well-being); and (3) setting (e.g. aged care, nursing home). The inclusion criteria were peer-reviewed journal articles published in English up to 2017, reporting quantitative/qualitative associations between greenery and mental health in RACFs.Results: Of the nine articles identified, seven reported positive associations between greenery (in particular, garden use) at RACFs and some aspect of residents' mental well-being (e.g. quality of life); however, four out of seven studies used observations and perceptions of staff and relatives. One study examined depression and reported reduction in depression following garden use, while one examined physiological indicators of stress (blood pressure, heart rate) and found no association with garden use. Seven studies examined garden use and four examined the presence of greenery (two examined both exposures).Conclusion: Exposure to greenery and use of greenspace in RACFs show promise for promoting mental health. However, the findings relied mainly on non-validated measures of mental health. More robust evidence based on valid and reliable mental health measures is needed. Future studies also need to examine the effect of visual exposure to greenery and the effect of greenery on stress reduction.
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Affiliation(s)
- Alison Carver
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Alanna Lorenzon
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Ashley Macleod
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Takemi Sugiyama
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Fornaro M, Solmi M, Stubbs B, Veronese N, Monaco F, Novello S, Fusco A, Anastasia A, De Berardis D, Carvalho AF, de Bartolomeis A, Vieta E. Prevalence and correlates of major depressive disorder, bipolar disorder and schizophrenia among nursing home residents without dementia: systematic review and meta-analysis. Br J Psychiatry 2020; 216:6-15. [PMID: 30864533 DOI: 10.1192/bjp.2019.5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The elderly population and numbers of nursing homes residents are growing at a rapid pace globally. Uncertainty exists regarding the actual rates of major depressive disorder (MDD), bipolar disorder and schizophrenia as previous evidence documenting high rates relies on suboptimal methodology. AIMS To carry out a systematic review and meta-analysis on the prevalence and correlates of MDD, bipolar disorder and schizophrenia spectrum disorder among nursing homes residents without dementia. METHOD Major electronic databases were systematically searched from 1980 to July 2017 for original studies reporting on the prevalence and correlates of MDD among nursing homes residents without dementia. The prevalence of MDD in this population was meta-analysed through random-effects modelling and potential sources of heterogeneity were examined through subgroup/meta-regression analyses. RESULTS Across 32 observational studies encompassing 13 394 nursing homes residents, 2110 people were diagnosed with MDD, resulting in a pooled prevalence rate of 18.9% (95% CI 14.8-23.8). Heterogeneity was high (I2 = 97%, P≤0.001); no evidence of publication bias was observed. Sensitivity analysis indicated the highest rates of MDD among North American residents (25.4%, 95% CI 18-34.5, P≤0.001). Prevalence of either bipolar disorder or schizophrenia spectrum disorder could not be reliably pooled because of the paucity of data. CONCLUSIONS MDD is highly prevalent among nursing homes residents without dementia. Efforts towards prevention, early recognition and management of MDD in this population are warranted.
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Affiliation(s)
- Michele Fornaro
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | - Marco Solmi
- Neuroscience Department, Psychiatry Unit, University of Padua; Psychiatry Unit, Azienda Ospedaliera di Padova, Padua Hospital, Italy; and Psychiatry and Psychology Department of the Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust; and Health Service and Population Research Department and the Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - Francesco Monaco
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neuroscience, University of Salerno, Italy
| | - Stefano Novello
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | - Andrea Fusco
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | | | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Italy
| | - André F Carvalho
- Department of Psychiatry, University of Toronto; and Centre for Addiction & Mental Health (CAMH), Canada
| | - Andrea de Bartolomeis
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | - Eduard Vieta
- Psychiatry and Psychology Department of the Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Spain
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Estabrooks CA, Straus SE, Flood CM, Keefe J, Armstrong P, Donner GJ, Boscart V, Ducharme F, Silvius JL, Wolfson MC. Restoring trust: COVID-19 and the future of long-term care in Canada. Facets (Ott) 2020. [DOI: 10.1139/facets-2020-0056] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The Royal Society of Canada Task Force on COVID-19 was formed in April 2020 to provide evidence-informed perspectives on major societal challenges in response to and recovery from COVID-19. The Task Force established a series of working groups to rapidly develop policy briefings, with the objective of supporting policy makers with evidence to inform their decisions. This paper reports the findings of the COVID-19 Long-Term Care (LTC) working group addressing a preferred future for LTC in Canada, with a specific focus on COVID-19 and the LTC workforce. First, the report addresses the research context and policy environment in Canada’s LTC sector before COVID-19 and then summarizes the existing knowledge base for integrated solutions to challenges that exist in the LTC sector. Second, the report outlines vulnerabilities exposed because of COVID-19, including deficiencies in the LTC sector that contributed to the magnitude of the COVID-19 crisis. This section focuses especially on the characteristics of older adults living in nursing homes, their caregivers, and the physical environment of nursing homes as important contributors to the COVID-19 crisis. Finally, the report articulates principles for action and nine recommendations for action to help solve the workforce crisis in nursing homes.
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Affiliation(s)
| | - Sharon E. Straus
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Janice Keefe
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Pat Armstrong
- Department of Sociology, York University, Toronto, ON, Canada
| | - Gail J. Donner
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Véronique Boscart
- CIHR/Schlegel Industrial Research Chair for Colleges in Seniors Care, Conestoga College, Kitchener, ON, Canada
| | | | - James L. Silvius
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michael C. Wolfson
- School of Epidemiology and Public Health and Faculty of Law, University of Ottawa, Ottawa, ON, Canada
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Chao SF, Chen YC. Environment patterns and mental health of older adults in long-term care facilities: the role of activity profiles. Aging Ment Health 2019; 23:1307-1316. [PMID: 30450945 DOI: 10.1080/13607863.2018.1484889] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objectives: This study adopts the International Classification of Functioning, Disability and Health (ICF) model to determine extent to which the clustered patterns of long-term care (LTC) environment and activity participation are associated with older residents' mental health. Method: This study enrolled a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis and latent class analysis were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the hypothesized relationships. Results: Three environment profiles (Low-, Moderate-, and High-Support Environment) based on physical, social, and attitudinal environment domains and two activity profiles (Low- and High-Activity Participation) across seven activity domains were identified. Compared to the Low-Support class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in those two classes were more likely to be in the "High Activity Participation" class, which in turn, exhibited better mental health. Conclusion: Environment and activity participation directly relate to older residents' mental health. Activity participation also mediates the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents' mental health.
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Affiliation(s)
- Shiau-Fang Chao
- a Department of Social Work, National Taiwan University , Taipei , Taiwan
| | - Yu-Chih Chen
- b Brown School of Social Work, Washington University in St. Louis , St Louis , MO , USA
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Wang F, Meng LR, Zhang QE, Li L, Lam Nogueira BOC, Ng CH, Ungvari GS, Liu L, Zhao W, Jia FJ, Xiang YT. Sleep disturbance and its relationship with quality of life in older Chinese adults living in nursing homes. Perspect Psychiatr Care 2019; 55:527-532. [PMID: 30779143 DOI: 10.1111/ppc.12363] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 01/15/2019] [Accepted: 01/27/2019] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To examine sleep disturbances in older adults in Macau and Guangzhou, China and their associated factors. DESIGN AND METHODS Four-hundred and thirty seven subjects in Guangzhou and 244 subjects in Macau were interviewed. FINDINGS In total, 681 older adults participated in the study, and 27.8% reported sleep disturbance, with 43.9% in Macau and 18.8% in Guangzhou. Physical quality of life was negatively associated with sleep disturbances. Severe depressive symptoms were positively related but living in Guangzhou was negatively related to sleep disturbances. Sleep disturbances are more common in Macau compared to Guangzhou. PRACTICE IMPLICATIONS Appropriate screening and treatment strategies are needed to address sleep disturbance in this population.
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Affiliation(s)
- Fei Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong, China.,Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Li-Rong Meng
- School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China
| | - Qing E Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
| | - Lu Li
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Bernice O C Lam Nogueira
- School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China.,Macao Sino-Portuguese Nurses Association, Macao SAR, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Lianqi Liu
- Home for the Aged GuangZhou, Guangdong, China
| | - Wei Zhao
- Home for the Aged GuangZhou, Guangdong, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
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Kuo CL, Wang SY, Tsai CH, Pan YF, Chuang YH. Nurses' perceptions regarding providing psychological care for older residents in long-term care facilities: A qualitative study. Int J Older People Nurs 2019; 14:e12242. [PMID: 31070867 DOI: 10.1111/opn.12242] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/25/2019] [Accepted: 04/15/2019] [Indexed: 12/20/2022]
Abstract
AIMS AND OBJECTIVES To explore nurses' perceptions regarding providing psychological health care for older residents in long-term care facilities (LTCFs). BACKGROUND Loneliness and depressive symptoms are commonly observed among older residents living in LTCFs. Nurses are expected to provide holistic care including physical, psychological and social care for older residents in LTCFs to fulfil their needs. Therefore, understanding nurses' feelings and thoughts regarding providing care for older residents who feel lonely, sad, unhappy or depressed is important for delivering better care. DESIGN A qualitative research design was employed. The Standards for Reporting Qualitative Research (SRQR) was used to enhance for reporting quality. METHODS Purposive sampling and snowball sampling were applied in Northern Taiwan. One-to-one in-depth interviews were conducted using a semi-structured interview guide. Twenty-one nurses with a mean age of 38.4 years were interviewed. Content analysis was performed for data analysis. FINDINGS Four themes were generated from the data: "insufficient psychological healthcare competency," "having a willing heart but not adequate support," "families playing an essential role in residents' mood" and "physical-oriented care model." CONCLUSIONS Long-term care facilitie nurses felt that they were not adequately prepared for taking care of older adults' psychological problems before their nursing career or during their practice. Unreasonable nurse-to-resident ratios and an absence of care consensus among healthcare providers can make nurses feel that they have a willing heart but not adequate support. Family members are essential in older residents' emotional status within the Taiwanese cultural context. Physical care evaluation indicators emphasised by LTCF accreditation resulted in the current care practice model. IMPLICATIONS FOR PRACTICE This study provides valuable information for LTCF nurses, managers and directors to develop appropriate strategies to assist nurses in providing better psychological health care for older residents. Evaluation indicators required by LTCF accreditation in Taiwan must be re-examined at the earliest stage.
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Affiliation(s)
- Chien-Lin Kuo
- Department of Allied Health Education & Digital Learning, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shou-Yu Wang
- Discipline of Nursing, School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | | | - Yu-Fan Pan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Meaning in life matters for older adults with Alzheimer's disease in residential care: associations with life satisfaction and depressive symptoms. Int Psychogeriatr 2019; 31:607-615. [PMID: 30722804 DOI: 10.1017/s1041610218002338] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
UNLABELLED ABSTRACTObjectives:To examine whether previously established associations between experiences of meaning in life on the one hand and life satisfaction and depressive symptoms on the other hand are transferable to a population of older residential care residents with Alzheimer's disease (AD). DESIGN Cross-sectional study using questionnaires administered in a structured interview format. SETTING Nine residential care settings in Flanders, Belgium. PARTICIPANTS Convenience sample of 138 older adults (+65) living in residential care with a diagnosis of AD. MEASUREMENTS Meaning in life was measured using the Presence of Meaning (PoM) subscale of the Meaning in Life Questionnaire-Short Form, life satisfaction was measured using the Satisfaction With Life Scale (SWLS), depressive symptoms were measured using a five-item short form of the Geriatric Depression Scale (GDS), and general cognitive status was measured using the Mini-Mental State Examination (MMSE). RESULTS Controlling for demographic variables (age, sex, and marital status) and cognitive status, meaning in life scores were positively predictive of life satisfaction scores and negatively predictive of depressive symptoms. Post-hoc analyses suggested a possible interaction between meaning in life and cognitive status in predicting both outcomes of psychological functioning (GDS and SWLS). CONCLUSION The presence of meaning in life is related to important well-being outcomes for older adults with AD living in residential care. More awareness for the importance of existential themes and interventions fostering meaning might be warranted for this population.
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Miller VJ. Investigating Barriers to Family Visitation of Nursing Home Residents: A Systematic Review. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2019; 62:261-278. [PMID: 30412036 DOI: 10.1080/01634372.2018.1544957] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 11/02/2018] [Indexed: 06/08/2023]
Abstract
Families are integral in helping nursing home residents maintain feelings of social inclusion and an overall sense of belonging, thus reducing consequences of social exclusion. Preliminary research, particularly of the culture change movement in long-term care, shows there are barriers to family engagement and visitation of residents. The objective of this study is to: (1) identify and summarize the barriers most reported to family visitation and (2) synthesize the findings to determine which barriers are most often reported in literature, and which may pose the greatest challenges to family involvement. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a final sample of 15 articles across 11 databases report seven barriers to visitation: psychological, health, staff to family member relationship, employment/finances, travel time, access to transportation, and other. Findings suggest barriers to family visitation and point toward a need for further research as relationships between resident and family member is complex and warrants attention across professions. Interprofessional efforts between social work, allied professionals, and transportation planners are necessary to address this pressing concern experienced by residents in nursing homes, with the ultimate goal of lessening such barriers.
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Affiliation(s)
- Vivian J Miller
- a School of Social Work , University of Texas at Arlington , Arlington , TX , US
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41
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Warner CB, Roberts AR, Jeanblanc AB, Adams KB. Coping Resources, Loneliness, and Depressive Symptoms of Older Women With Chronic Illness. J Appl Gerontol 2019; 38:295-322. [PMID: 28380713 DOI: 10.1177/0733464816687218] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Chronic illness with its accompanying physical stressors poses a risk factor for loneliness and depression in later life. Testing a model of stress and coping, we examined the effects of three types of coping resources (religious coping; Selection, Optimization, and Compensation [SOC] adaptive strategies; and perceived social support) on the deleterious effects of chronic illness among older women. Community-dwelling older women (N = 138) with at least one chronic illness (M = 3.9, SD = 2.1) completed mailed questionnaires. Respondents reported multiple morbidities and 90% reported interference with daily life. Social support was associated with less loneliness and depression and mediated the relationship between physical health and loneliness. Our study demonstrates two distinct pathways to depressive symptoms: one through physical symptoms, pain, and disability, and another through the experience of loneliness. Findings support intervention approaches that address disability-related issues and loneliness, and assist older women with chronic illness in identifying and marshaling social support.
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Caspari S, Råholm MB, Saeteren B, Rehnsfeldt A, Lillestø B, Lohne V, Slettebø Å, Heggestad AKT, Høy B, Lindwall L, Nåden D. Tension between freedom and dependence-A challenge for residents who live in nursing homes. J Clin Nurs 2018; 27:4119-4127. [DOI: 10.1111/jocn.14561] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 05/23/2018] [Accepted: 06/03/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Bente Høy
- VIA University College; Aarhus Denmark
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Haesen S, Wangmo T, Elger BS. Identity as an older prisoner: findings from a qualitative study in Switzerland. Eur J Ageing 2018; 15:199-210. [PMID: 29867304 PMCID: PMC5971027 DOI: 10.1007/s10433-017-0443-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The increasing numbers of aging prisoners raise the issue of how they maintain their personal identity and self-esteem in light of long-standing detention. This study sought to answer this question since identity and self-esteem could influence mental and physical health. We conducted a secondary analysis of 35 qualitative interviews that were carried out with older inmates aged 51-75 years (mean age: 61 years) living in 12 Swiss prisons. We identified three main themes that characterized their identity: personal characterization of identity, occupational identity, and social identity. These main themes were divided into sub-themes such as familial network, retirement rights or subjective social position. Personal characterization of identity mostly happened through being part of a network of family and/or friends that supported them during imprisonment and where the prisoner could return to after release. Individual activities and behavior also played an important role for prisoners in defining themselves. Occupational identity was drawn from work that had been carried out either before or during imprisonment although in some cases the obligation to work in prison even after reaching retirement age was seen as a constraint. Social identity came from a role of mentor or counselor for younger inmates, and in a few cases older prisoners compared themselves to other inmates and perceived themselves as being in a higher social position. Identity was often expressed as a mix between positive and negative traits. Building on those elements during incarceration can contribute to better mental health of the individual prisoner which in turn influences the chances for successful rehabilitation.
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Chang LC. Is Social Support Always Related to Stress Reduction in Nursing Home Residents? A Study in Leisure Contexts. Res Gerontol Nurs 2018; 11:174-180. [PMID: 29767805 DOI: 10.3928/19404921-20180502-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/02/2018] [Indexed: 11/20/2022]
Abstract
The current study examined the main and interaction effects of leisure self-determination and two leisure social support types (emotional and instrumental) on stress in nursing home residents. A total of 139 nursing home residents (mean age = 79.4 years) in Taichung City, Taiwan, were recruited. Data were collected using face-to-face surveys, which included measures of leisure self-determination, leisure emotional support, leisure instrumental support, and stress. Data were analyzed using a hierarchical regression analysis. Results indicated that leisure self-determination and leisure emotional support were significantly and negatively correlated with stress, whereas leisure instrumental support was not. Moreover, higher levels of leisure instrumental support decreased the relationship between leisure self-determination and stress reduction. Therefore, enhancing levels of leisure self-determination and leisure emotional support appears to be an effective means of reducing stress in nursing home residents. However, providing excessive leisure instrumental support to nursing home residents should be avoided. [Res Gerontol Nurs. 2018; 11(4):174-180.].
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45
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Sullivan L, Willis DG. Towards Changing the Long Term Care (LTC) Paradigm: Explicating the Concept of Thriving in Older Adults Living in LTC. Issues Ment Health Nurs 2018; 39:388-397. [PMID: 29319403 DOI: 10.1080/01612840.2017.1390021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A phenomenon of interest for nursing is the facilitation of humanistic health care experiences and quality of life (Willis, Grace, & Roy, 2008 ). Inquiry into the concept of thriving as it manifests in the older adult residing in long-term care aligns with this interest. Thriving has been described by scholars in various disciplines but no context-specific definition for the LTC resident currently exists. Contrary to the generally held negative view of LTC, there is emerging evidence that older adult LTC residents "do well" or thrive in this environment.
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Affiliation(s)
- Louise Sullivan
- a Department of Nursing , Salve Regina University , Newport , United States
| | - Danny G Willis
- b School of Nursing, University of Wisconsin Madison , Madison , United States
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Hu SH, Chuang YH, Ting YF, Lin KY, Hsieh CJ. Prevalence of depressive symptoms in older nursing home residents with intact cognitive function in Taiwan. Res Nurs Health 2018; 41:292-300. [PMID: 29574780 DOI: 10.1002/nur.21873] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 02/24/2018] [Indexed: 12/21/2022]
Abstract
The investigators aimed to explore the prevalence of depressive symptoms and associated factors among older residents with intact cognitive function in nursing homes in Taiwan. A cross-sectional descriptive and correlational research design was used. A convenience sample of 178 older residents without cognitive impairment was recruited from 36 nursing homes in Southern Taiwan. The questionnaires included demographic data; the Barthel Index, which assesses the ability to perform activities of daily living; and the Geriatric Depression Scale Short Form. Among older residents in nursing homes with intact cognitive function, 39.3% had depressive symptoms. Age, religion, previous living status, previous working status, being totally dependent in physical function, and being severely dependent in physical function were significant predictors of depressive symptoms among cognitively intact older residents. The findings highlight the critical mental healthcare issues among older residents with intact cognitive function in nursing homes. Practical strategies for preventing the occurrence of depressive symptoms and caring for those who have depressive symptoms should be developed, especially for younger or dependent older residents or residents who have never been employed, have no religious beliefs, or have lived alone before they moved into an institution.
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Affiliation(s)
- Sophia H Hu
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yeh-Feng Ting
- School of Nursing, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Yu Lin
- Furoto Medical and Welfare Co. Kaohsiung, Kaohsiung, Taiwan
| | - Chia-Jung Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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47
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Wang D, Zhang H, Ren H, Luo Y. Qualitative analyses of lived experience for residents in the Elderly Care Departments at the community health service centres in Southwestern China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e164-e172. [PMID: 28857339 DOI: 10.1111/hsc.12490] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/15/2017] [Indexed: 06/07/2023]
Abstract
With its huge ageing population, China faces an enormous challenge for its elderly support and care. One of the proposed solutions was to diversify the elderly support systems. Towards this goal, setting up the Elderly Care Departments in the community health service centres is one of such new Chinese endeavour. This qualitative study was conducted among the residents enrolled in existing Elderly Care Departments established at the community health service centres in Chongqing, a Southwestern Chinese city, to evaluate the lived experience of the residents and to find strategies for improvement. Eighteen participants were recruited from the residents of the Elderly Care Departments of three community health service centres in the city. Data were collected through semi-structured in-depth individual interviews and were analysed utilising the Colaizzi's phenomenological method. Five main themes were identified: Safety and trust; Satisfaction and relief; Gratitude and mutual understanding; Complaints and helplessness; and Worries and apprehension. We found that set-up of the Elderly Care Departments at the community health service centres appeared to be consistent with the idea of integrated care and in general, the current running mode was able to provide the elderly with effective medical, nursing and other cares. The psychological and cultural services at these departments, however, need to be further enhanced.
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Affiliation(s)
- Dan Wang
- School of Nursing, Third Military Medical University, Chongqing, China
| | - Huilan Zhang
- School of Nursing, Third Military Medical University, Chongqing, China
| | - Hui Ren
- School of Nursing, Third Military Medical University, Chongqing, China
| | - Yu Luo
- School of Nursing, Third Military Medical University, Chongqing, China
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48
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Graham ME, Fabricius A. Beyond "Home-Like" Design: Visitor Responses to an Immersive Creative Space in a Canadian Long-Term Care Facility. J Appl Gerontol 2017; 38:1045-1057. [PMID: 29165001 DOI: 10.1177/0733464817743333] [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: 11/16/2022] Open
Abstract
This study examined the benefits of expanding upon the "home-like" design by introducing an immersive creative space for residents, staff, and visitors to explore in a long-term care facility in Eastern Ontario, Canada. Data were collected through guestbook comments ( N = 93) and coded for themes according to guidelines for thematic analysis. Selected themes included visitors' enjoyment of the winter aesthetic, expressions of gratitude to the artists, time spent socializing with family and visitors in a creative milieu, and the experience of remembering in an evocative space. The results indicate that residents and visitors benefited from the experience of a creative space that was neither institutional, nor "home-like." Implications for future research are discussed.
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Affiliation(s)
| | - Andréa Fabricius
- 2 The Perley and Rideau Veterans' Health Centre, Ottawa, Ontario, Canada
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49
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Morris JN, Declercq A, Hirdes JP, Finne-Soveri H, Fries BE, James ML, Geffen L, Kehyayan V, Saks K, Szczerbińska K, Topinkova E. Hearing the Voice of the Resident in Long-Term Care Facilities-An Internationally Based Approach to Assessing Quality of Life. J Am Med Dir Assoc 2017; 19:207-215. [PMID: 29030309 DOI: 10.1016/j.jamda.2017.08.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 08/10/2017] [Accepted: 08/14/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES interRAI launched this study to introduce a set of standardized self-report measures through which residents of long-term care facilities (LTCFs) could describe their quality of life and services. This article reports on the international development effort, describing measures relative to privacy, food, security, comfort, autonomy, respect, staff responsiveness, relationships with staff, friendships, and activities. First, we evaluated these items individually and then combined them in summary scales. Second, we examined how the summary scales related to whether the residents did or did not say that the LTCFs in which they lived felt like home. DESIGN Cross-sectional self-report surveys by residents of LTCFs regarding their quality of life and services. SETTING/PARTICIPANTS Resident self-report data came from 16,017 individuals who resided in 355 LTCFs. Of this total, 7113 were from the Flanders region of Belgium, 5143 residents were from Canada, and 3358 residents were from the eastern and mid-western United States. Smaller data sets were collected from facilities in Australia (20), the Czech Republic (72), Estonia (103), Poland (118), and South Africa (87). MEASUREMENTS The interRAI Self-Report Quality of Life Survey for LTCFs was used to assess residents' quality of life and services. It includes 49 items. Each area of inquiry (eg, autonomy) is represented by multiple items; the item sets have been designed to elicit resident responses that could range from highly positive to highly negative. Each item has a 5-item response set that ranges from "never" to "always." RESULTS Typically, we scored individual items scored based on the 2 most positive categories: "sometimes" and "always." When these 2 categories were aggregated, among the more positive items were: being alone when wished (83%); decide what clothes to wear (85%); get needed services (87%); and treated with dignity by staff (88%). Areas with a less positive response included: staff knows resident's life story (30%); resident has enjoyable things to do on weekends (32%); resident has people to do things with (33%); and resident has friendly conversation with staff (45%). We identified 5 reliable scales; these scales were positively associated with the resident statement that the LTCF felt like home. Finally, international score standards were established for the items and scales. CONCLUSIONS This study establishes a set of standardized, self-report items and scales with which to assess the quality of life and services for residents in LTCFs. The study also demonstrates that these scales are significantly related to resident perception of the home-like quality of the facilities.
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Affiliation(s)
| | - Anja Declercq
- LUCAS and Faculty of Social Sciences the Katholieke Universiteit Leuven, Belgium
| | - John P Hirdes
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Harriet Finne-Soveri
- Hospital, Rehabilitation, and Care Department, City of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Brant E Fries
- Division of Geriatrics and Palliative Care, University of Michigan, Ann Arbor, MI; Ann Arbor VA Healthcare Center, Ann Arbor, MI
| | - Mary L James
- Division of Geriatrics and Palliative Care, University of Michigan, Ann Arbor, MI
| | - Leon Geffen
- Sampson Institute for Ageing Research, Cape Town, South Africa; Institute of Ageing in Africa, Faculty of Health Sciences at University of Cape Town, Cape Town, South Africa
| | | | - Kai Saks
- Department of Internal Medicine, University of Tartu, Estonia
| | - Katarzyna Szczerbińska
- Unit for Research on Aging Society, Department of Sociology of Medicine, Chair of Epidemiology and Preventive Medicine, Medical Faculty, Jagiellonian University Medical College, Krakow, Poland
| | - Eva Topinkova
- Department of Geriatric Medicine, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; Faculty of Health and Social Sciences, South Bohemian University, Ceske Budejovice, Czech Republic
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50
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Watkins R, Goodwin VA, Abbott RA, Hall A, Tarrant M. Exploring residents' experiences of mealtimes in care homes: A qualitative interview study. BMC Geriatr 2017; 17:141. [PMID: 28697747 PMCID: PMC5506571 DOI: 10.1186/s12877-017-0540-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/06/2017] [Indexed: 11/10/2022] Open
Abstract
Background Many interventions aim to alleviate well-documented problems of malnutrition in residential care homes and improve residents’ health and wellbeing. Despite some positive findings, little is known about how and why mealtime interventions might be effective, and in particular, what effects residents’ experiences of mealtimes have on health outcomes. The aim of this study was to gain an insight into these experiences and explore some of the issues that may impact on residents’ enjoyment of meals, and resulting health and wellbeing. Methods Semi-structured interviews were conducted with eleven residents from four care homes in the South West UK. Thematic analysis was used to derive content and meaning from transcribed interviews. Interviews were supplemented by researcher observations of mealtimes. Results The dining experience was a focal point for participants’ broader experiences of residing in a care home. Three themes pertaining to residents’ experiences were identified: (1) Emotional and psychological connections with other residents; (2) managing competing interests with limited resources; and (3) familiarity and routine. Conclusion Mealtimes are a mainstay of life in a care home through which residents’ experiences are characterised, exemplified and magnified. Understanding how residents interact with one another, accommodating their preferences and encouraging autonomy may enhance their mealtime experiences. It may also help to ease the transition from independent-living to life in care, which can be particularly stressful for some residents, and improve health and wellbeing over the long-term.
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Affiliation(s)
- Ross Watkins
- University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK. .,National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South West Peninsula, UK.
| | - Victoria A Goodwin
- University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.,National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South West Peninsula, UK
| | - Rebecca A Abbott
- University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.,National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South West Peninsula, UK
| | - Abi Hall
- University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.,National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South West Peninsula, UK
| | - Mark Tarrant
- University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.,National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South West Peninsula, UK
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