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Centmayer R, Leiske M, Lahmann NA. Pain Prevalence and Pain Management in Nursing Home Residents With Cognitive Impairment. Results From Five Multicenter Cross-Sectional Surveys in Germany Between 2014 and 2018. Pain Manag Nurs 2024; 25:487-493. [PMID: 38853041 DOI: 10.1016/j.pmn.2024.05.005] [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: 08/03/2023] [Revised: 04/16/2024] [Accepted: 05/07/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Pain management depends on continuous pain assessment and a pain concept. In particular, pain assessment and treatment are major challenges for nursing home residents (NHR) with cognitive impairment (CI). Many caregivers often lack the knowledge to recognize and appropriately treat pain in this vulnerable group. Little is known about the proportion of NHR who are fundamentally dependent on external assessment for pain due to CI. OBJECTIVE The aim of the study was to determine pain prevalence and management among NHR with and without CI. A second objective was to determine the proportion of NHR who are dependent on external assessment for pain. METHODS Information on pain was collected from 3,437 NHR in multicenter cross-sectional surveys in 51 German nursing homes between 2014 and 2018. The presence of current pain in one-to-one interviews was determined as well as dependencies on third-party information, number of daily pain recordings, and administration of medication for pain. The analysis included a contingency table and log regression analyses. RESULTS Pain prevalence was 24.9% among NHR with severe CI and 40.4% among NHR without CI. Overall, 19.8% of all NHRs relied on a third-party assessment of pain. Significantly, NHR with severe CI were less likely to be classified as having pain (OR 0.51), to be assessed for pain several times a day (OR 0.53) or to receive pain medication (OR 0.55) compared with NHR without CI. No influence on pain management was shown for the type of pain assessment. CONCLUSIONS The study provides evidence of significant deficits in pain management among NHR with moderate and severe CI in nursing homes in Germany. NHR with moderate and severe CI are significantly less likely to be observed for pain or classified as pain sufferers and receive significantly less pain medication than NHR without CI. Intensive training of staff on pain management of NHR with severe CI is recommended.
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Affiliation(s)
- Rainer Centmayer
- Department of Geriatrics, Nursing Research Group in Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Manfred Leiske
- Department of Geriatrics, Nursing Research Group in Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Nils Axel Lahmann
- Department of Geriatrics, Nursing Research Group in Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Shackleton DA, Castillo LIR, Hampton AJD, Volodin A, Hadjistavropoulos T. Age Differences in Thermal Pain Responses: A Direct Laboratory Comparison. J Gerontol B Psychol Sci Soc Sci 2023; 78:1521-1525. [PMID: 37104120 DOI: 10.1093/geronb/gbad065] [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: 08/29/2022] [Indexed: 04/28/2023] Open
Abstract
OBJECTIVES According to a widely cited assertion, older adults are less likely than younger individuals to express pain complaints. Age-related differences in pain responses have been discussed in the literature despite a paucity of research involving direct comparisons of younger and older adults' pain reactions (i.e., verbal, nonverbal) in the context of a single experimental investigation. Our goal was to test the hypothesis that older adults are more stoic than younger adults in their expression of pain. METHODS We measured trait stoicism as well as multiple responses to thermal pain. RESULTS In contrast to suggestions in the literature, equivalence testing indicated that older and younger adults displayed similar verbal and nonverbal pain responses. Our results suggest that older adults are no more stoic about their pain than are younger persons. DISCUSSION This is the first attempt to explore a wide array of age differences in pain expression within the context of a single experimental study.
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Affiliation(s)
| | - Louise I R Castillo
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Amy J D Hampton
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Andrei Volodin
- Department of Mathematics and Statistics, University of Regina, Regina, Saskatchewan, Canada
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3
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Thirsk LM, Panchuk JT, Stahlke S, Hagtvedt R. Cognitive and implicit biases in nurses' judgment and decision-making: A scoping review. Int J Nurs Stud 2022; 133:104284. [PMID: 35696809 DOI: 10.1016/j.ijnurstu.2022.104284] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cognitive and implicit biases of healthcare providers can lead to adverse events in healthcare and have been identified as a patient safety concern. Most research on the impact of these systematic errors in judgment has been focused on diagnostic decision-making, primarily by physicians. As the largest component of the workforce, nurses make numerous decisions that affect patient outcomes; however, literature on nurses' clinical judgment often overlooks the potential impact of bias on these decisions. The aim of this study was to map the evidence and key concepts related to bias in nurses' judgment and decision-making, including interventions to correct or overcome these biases. METHODS We conducted a scoping review using Joanna Briggs methodology. In November 2020 we searched CINAHL, PsychInfo, and PubMed databases to identify relevant literature. Inclusion criteria were primary research about nurses' bias; evidence of a nursing decision or action; and English language. No date or geographic limitations were set. RESULTS We found 77 items that met the inclusion criteria. Over half of these items were published in the last 12 years. Most research focused on implicit biases related to racial/ethnic identity, obesity, and gender; other articles examined confirmation, attribution, anchoring, and hindsight biases. Some articles examined heuristics and were included if they described the process of, and the problems with, nurse decision-making. Only 5 studies tested interventions to overcome or correct biases. 61 of the studies relied on vignettes, surveys, or recall methods, rather than examining real-world nursing practice. This could be a serious oversight because contextual factors such as cognitive load, which have a significant impact on judgment and decision-making, are not necessarily captured with vignette or survey studies. Furthermore, survey and vignette studies make it difficult to quantify the impact of these biases in the healthcare system. CONCLUSIONS Given the serious effects that bias has on nurses' clinical judgment, and thereby patient outcomes, a concerted, systematic effort to identify and test debiasing strategies in real-world nursing settings is needed. TWEETABLE ABSTRACT Bias affects nurses' clinical judgment - we need to know how to fix it.
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Affiliation(s)
- Lorraine M Thirsk
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada.
| | - Julia T Panchuk
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Sarah Stahlke
- Department of Sociology, Faculty of Arts, University of Alberta, Edmonton, Alberta, Canada
| | - Reidar Hagtvedt
- Alberta School of Business, University of Alberta, Edmonton, Alberta, Canada
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Melile Mengesha B, Moga Lencha F, Ena Digesa L. Pain assessment practice and associated factors among nurses working at adult care units in public hospitals in Wolaita Zone, Southern Ethiopia, 2021. BMC Nurs 2022; 21:115. [PMID: 35562827 PMCID: PMC9102635 DOI: 10.1186/s12912-022-00892-4] [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: 02/04/2022] [Accepted: 05/05/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Using standard pain assessment techniques is a cornerstone for effective pain management. Pain is not assessed in a standardized manner in numerous practice settings. The problem of applying pain assessment principles was found to be higher in low-income countries. Very limited evidence indicates the standard of pain assessment practice among nurses in Ethiopia. Therefore, the purpose of this study was to identify pain assessment practice and associated factors among nurses working at adult care units in public hospitals in the Wolaita Zone, Southern Ethiopia. METHODS A cross-sectional study was conducted among 290 nurses working at adult care units in public hospitals in Wolaita zone. Data were collected from February to March 2021. A structured self-administered questionnaire was used for data collection. Epi Data 4.6 was used to enter the data, and SPSS version 26 was used to analyze the data. A logistic regression model was used, and statistical significance was declared at P ≤ 0.05. An adjusted odds ratio with 95%CI was used to measure the degree of association. RESULTS A total of 267 nurses participated in the study, giving a response rate of 97.8%. Almost three-fourths (73.8%) of the study nurses reported that they assessed pain for their patients. Only 23.6% of the study nurses discussed pain assessment scores during a nurse-to-nurse report. Below, half (47.2%) of the study participants documented pain assessment scores. The proportion of nurses with good pain assessment practice was found to be 38.2%. The odds of having good pain assessment practice among nurses who received training on pain management was two times higher than its counterpart. The nurses who perceived organizational support were twice more likely to have good pain assessment practice than their counterparts. CONCLUSION Nurses' pain assessment practice was found to be low. Moreover, a substantial proportion of the study nurses did not discuss pain assessment scores during a nurse-to-nurse report with low documentation practice. Continuous professional development through in-service training and education is crucial to the improvement of nurses' pain assessment practice. Furthermore, ameliorating organizational support by means of a supportive working environment is suggested to the betterment of nurses' assessment practice.
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Affiliation(s)
| | - Fikre Moga Lencha
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Lankamo Ena Digesa
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Gallant N, Hadjistavropoulos T, Winters EM, Feere EK, Wickson-Griffiths A. Development, evaluation, and implementation of an online pain assessment training program for staff in rural long-term care facilities: a case series approach. BMC Geriatr 2022; 22:336. [PMID: 35436906 PMCID: PMC9016985 DOI: 10.1186/s12877-022-03020-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pain among long-term care (LTC) residents, and especially residents with dementia, is often underassessed and this underassessment has been attributed, in part, to gaps in front-line staff education. Furthermore, although evidence-based clinical guidelines for pain assessment in LTC are available, pain assessment protocols are often inconsistently implemented and, when they are implemented, it is usually within urban LTC facilities located in large metropolitan centers. Implementation science methodologies are needed so that changes in pain assessment practices can be integrated in rural facilities. Thus, our purpose was to evaluate an online pain assessment training program and implement a standardized pain assessment protocol in rural LTC environments. Methods During the baseline and implementation periods, we obtained facility-wide pain-related quality indicators from seven rural LTC homes. Prior to implementing the protocol, front-line staff completed the online training program. Front-line staff also completed a set of self-report questionnaires and semi-structured interviews prior to and following completion of the online training program. Results Results indicated that knowledge about pain assessment significantly increased following completion of the online training program. Implementation of the standardized protocol resulted in more frequent pain assessments on admission and on a weekly basis, although improvements in the timeliness of follow-up assessments for those identified as having moderate to severe pain were not as consistent. Directed content analysis of semi-structured interviews revealed that the online training program and standardized protocol were well-received despite a few barriers to effective implementation. Conclusions In conclusion, we demonstrated the feasibility of the remote delivery of an online training program and implementation of a standardized protocol to address the underassessment of pain in rural LTC facilities. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03020-8.
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Affiliation(s)
- Natasha Gallant
- Centre on Aging and Health, University of Regina, Regina, SK, S4S 0A2, Canada. .,Department of Psychology, University of Regina, Regina, SK, S4S 0A2, Canada.
| | - Thomas Hadjistavropoulos
- Centre on Aging and Health, University of Regina, Regina, SK, S4S 0A2, Canada.,Department of Psychology, University of Regina, Regina, SK, S4S 0A2, Canada
| | - Emily M Winters
- Centre on Aging and Health, University of Regina, Regina, SK, S4S 0A2, Canada.,Department of Psychology, University of Regina, Regina, SK, S4S 0A2, Canada
| | - Emma K Feere
- Department of Psychology, University of Regina, Regina, SK, S4S 0A2, Canada
| | - Abigail Wickson-Griffiths
- Centre on Aging and Health, University of Regina, Regina, SK, S4S 0A2, Canada.,Faculty of Nursing, University of Regina, Regina, SK, S4S 0A2, Canada
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Pringle J, Mellado ASAV, Haraldsdottir E, Kelly F, Hockley J. Pain assessment and management in care homes: understanding the context through a scoping review. BMC Geriatr 2021; 21:431. [PMID: 34275442 PMCID: PMC8286436 DOI: 10.1186/s12877-021-02333-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Internationally, 2–5% of people live in residential or nursing homes, many with multi-morbidities, including severe cognitive impairment. Pain is frequently considered an expected part of old age and morbidity, and may often be either under-reported by care home residents, or go unrecognized by care staff. We conducted a systematic scoping review to explore the complexity of pain recognition, assessment and treatment for residents living in care homes, and to understand the contexts that might influence its management. Methods Scoping review using the methodological framework of Levac and colleagues. Articles were included if they examined pain assessment and/or management, for care or nursing home residents. We searched Medline, CINAHL, ASSIA, PsycINFO, EMBASE, Cochrane Library, and Google Scholar; reference lists were also screened, and website searches carried out of key organisations. Conversations with 16 local care home managers were included to gain an understanding of their perspective. Results Inclusion criteria were met by 109 studies. Three overarching themes were identified: Staff factors and beliefs - in relation to pain assessment and management (e.g. experience, qualifications) and beliefs and perceptions relating to pain. Pain assessment – including use of pain assessment tools and assessment/management for residents with cognitive impairment. Interventions - including efficacy/effects (pharmaceutical/non pharmaceutical), and pain training interventions and their outcomes. Overall findings from the review indicated a lack of training and staff confidence in relation to pain assessment and management. This was particularly the case for residents with dementia. Conclusions Further training and detailed guidelines for the appropriate assessment and treatment of pain are required by care home staff. Professionals external to the care home environment need to be aware of the issues facing care homes staff and residents in order to target their input in the most appropriate way. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02333-4.
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Affiliation(s)
- Jan Pringle
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK.
| | | | | | - Fiona Kelly
- School of Health Sciences, Queen Margaret University, Edinburgh, East Lothian, UK
| | - Jo Hockley
- Usher Institute, University of Edinburgh, Edinburgh, UK
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Rababa M, Hammouri AM, Hweidi IM, Ellis JL. Association of nurses' level of knowledge and attitudes to ageism toward older adults: Cross‐sectional study. Nurs Health Sci 2020; 22:593-601. [DOI: 10.1111/nhs.12701] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/04/2020] [Accepted: 02/24/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Mohammad Rababa
- Department of Adult Health Nursing Faculty of Nursing/Jordan University of Science and Technology Irbid Jordan
| | - Ammar M. Hammouri
- Jordan University of Science and Technology King Abdullah University Hospital Irbid Jordan
| | - Issa M. Hweidi
- Department of Adult Health Nursing Faculty of Nursing/Jordan University of Science and Technology Irbid Jordan
| | - Julie L. Ellis
- University of Wisconsin‐Milwaukee College of Nursing Milwaukee Wisconsin USA
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Dirk K, Rachor GS, Knopp-Sihota JA. Pain Assessment for Nursing Home Residents: A Systematic Review Protocol. Nurs Res 2019; 68:324-328. [PMID: 31261236 DOI: 10.1097/nnr.0000000000000348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The burden of pain in nursing homes is substantial; however, pain assessment for both acute and chronic conditions remains inadequate, resulting in inappropriate or inadequate treatment. Complexities in assessing resident pain have been attributed to factors (barriers and facilitators) arising at the resident, healthcare provider, and healthcare system levels. OBJECTIVES In this systematic review protocol, we identify our research approach that will be used to critically appraise and synthesize data in order to assess barriers and facilitators to pain assessment in nursing home residents aged ≥65 years. METHODS This is a Cochrane style systematic review protocol adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocols reporting standards. This review will include primary (original) qualitative literature concerning either barriers or facilitators to pain assessment in older adult nursing home residents. A thematic analysis approach will be employed in collating and summarizing included data and will be categorized into resident, healthcare provider, and system-level factors. Database searches will include Abstracts in Social Gerontology, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, and Web of Science. DISCUSSION The identification of barriers and facilitators to pain assessment in older adult nursing home residents may assist healthcare providers across all platforms and levels of education to improve pain assessment among nursing home residents. Improving the assessment of pain has the potential to improve quality of care and ultimately quality of life for older adult nursing home residents.
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Affiliation(s)
- Kennedy Dirk
- Kennedy Dirk, is Research Assistant, Translating Research in Elder Care (TREC) Program, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada. Geoffrey S. Rachor, BA, is Research Assistant, Translating Research in Elder Care (TREC) Program, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada. Jennifer A. Knopp-Sihota, PhD, NP, is Associate Professor, Faculty of Health Disciplines, Athabasca University; Associate Adjunct Professor, University of Alberta; and Co-Investigator, Translating Research in Elder Care (TREC) Program, University of Alberta, Edmonton, AB, Canada
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Knopp-Sihota JA, Dirk KL, Rachor GS. Factors Associated With Pain Assessment for Nursing Home Residents: A Systematic Review and Meta-Synthesis. J Am Med Dir Assoc 2019; 20:884-892.e3. [DOI: 10.1016/j.jamda.2019.01.156] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 11/15/2022]
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Where are we now in relation to determining the prevalence of ageism in this era of escalating population ageing? Ageing Res Rev 2019; 51:78-84. [PMID: 30858070 DOI: 10.1016/j.arr.2019.03.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 12/28/2022]
Abstract
Population ageing is escalating rapidly now worldwide. This is an important time to determine if ageism or discrimination against older people is of concern, such as it being prevalent and/or increasing in prevalence. Over the years, many ageism measurement tools have been developed, with research findings from their use of prime consideration then for determining the prevalence of ageism and any prevalence trends. All print and open access English-language research articles published in 1953+ that used one or more ageism measurement tools in a study were sought using the Directory of Open Access Journals and EBSCO Discovery Service. A total of 25 ageism measurement tools were identified. However, only six had been used one or more times to measure the prevalence of ageism. The identified prevalence levels varied considerably, but most investigations using small convenience samples, with limited generalizability of findings. This paper highlights the need to continue developing ageism measurement tools to estimate ageism or use other measures, such as census and population-representative polling, to assess the extent and impact of ageism. This foundational measurement is needed, as ageism could be prevalent and growing in effect.
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11
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Carpentier E, Moreau F, Soriot-Thomas S, Tourneux P. Training program for pain assessment in the newborn. Arch Pediatr 2018; 25:35-38. [DOI: 10.1016/j.arcped.2017.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 10/11/2017] [Accepted: 11/06/2017] [Indexed: 01/06/2023]
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12
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Buttigieg SC, Ilinca S, de Sao Jose JMS, Larsson AT. Researching Ageism in Health-Care and Long Term Care. INTERNATIONAL PERSPECTIVES ON AGING 2018. [DOI: 10.1007/978-3-319-73820-8_29] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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13
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Healy D, Smyth S. Poetry as an engagement strategy: A novice teacher experience of its use within lectures. Nurse Educ Pract 2017; 24:43-48. [PMID: 28359028 DOI: 10.1016/j.nepr.2017.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 09/19/2016] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
It has been acknowledged the traditional lecture format is a familiar teaching methodology and that there is still much to be learnt from using this in class room based lectures. Whilst the first author was a postgraduate student undertaking a programme in Nurse Education at a University in the Republic of Ireland, poetry was used to challenge undergraduate nursing students' attitudes towards older persons in a large group format. The students were in Year 3 of a Bachelor of Nursing Science General and Intellectual Disability Programmes. Feedback was obtained from the students that comprised of three main themes; Aids Recall of Information; Enriched Learning Experiences, Challenges Attitudes to Person Centred Care. Thus, the paper aims to evaluate using poetry as an engaging teaching strategy within a lecture format for the first time as a novice teacher when drawing out nursing students' attitudes towards older persons with a focus on supporting them in embracing key care skills in the clinical setting. This paper should provide other student educationalists the opportunity to see the value of poetry as a teaching strategy and provide practical tips on its use within the classroom.
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Affiliation(s)
- Denise Healy
- Department of Nursing, Health Sciences and Disability Studies, St Angela's College, A College of the National University of Ireland, Galway, Lough Gill, Sligo, Ireland.
| | - Siobhan Smyth
- School of Nursing and Midwifery, National University Ireland, Galway Aras Moyola, Upper Newcastle Road, Galway, Ireland.
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14
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Abstract
BACKGROUND Ageism in long-term care is pervasive, but it is not easy to define, to identify and to fight it in practice. These difficulties could be overcome if we develop research capable to conceptualize, detect, measure, and understand the multidimensionality and complexity of ageism. Nevertheless, to achieve this, it is fundamental to know how ageism in long-term care has been previously studied. METHODS This paper systematically reviews studies on ageism in long-term care services published before October 2015 and indexed in Web of Science, PubMed, and Social Care Online electronic databases. Electronic searches were complemented with visual scanning of reference lists and hand searching of leading journals in the field of gerontology. Four specific review questions were addressed: Which analytical angles (aetiology, prevalence, manifestations, consequences, and interventions) have been explored? Which theories and concepts have been used? Which methods have been employed? Which variants of ageism have been covered? RESULTS Studies have focused mainly on the manifestations, etiology, and prevalence of ageism, neglecting its consequences and the interventions to tackle it; a significant number of studies used scales of ageism which, despite being appropriate considering the aims of the research, present important limitations; most studies have focused on residential services, neglecting non-residential services; some of the variants of ageism have been well covered, while implicit and self-ageism have been under-explored. CONCLUSIONS Research on ageism in long-term care services is scarce but important. Much has been done but much remains to be done. An agenda for future research is presented.
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Howard EP, Schreiber R, Morris JN, Russotto A, Flashner-Fineman S. COLLAGE 360: A Model of Person-Centered Care To Promote Health Among Older Adults. ACTA ACUST UNITED AC 2016; 1:21-30. [PMID: 28989995 DOI: 10.14302/issn.2474-7785.jarh-16-1123] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Health care leaders and providers have introduced the assumption the typical elder, even in the presence of complex, chronic disease and prevailing illness, is capable of assuming greater personal responsibility for their health care, with a shift from provider-centered to a person-centered model of care. For older adults who often and repeatedly face challenges managing and maintaining their health status, guidance and support is needed. In this study, COLLAGE 360, a comprehensive assessment system and wellness coaching program that focuses on prevention and wellness, care coordination and self-management of health care was implemented in one continuing care retirement community. Following completion of two assessment tools via directed conversation with a wellness coach, older adults developed an individualized vitality plan that outlined life goals, supporting goals and action plans for goal achievement. Results from this program suggest engagement in the assessment and wellness coaching process via the COLLAGE 360 program translated into sample older adults sensing that they live in a more supportive environment when compared with elders not receiving any wellness coaching. In addition, the older adults had positive effects in the areas of mood, loneliness, social interaction, health status, and life satisfaction. Strategies to improve health and well being need an extended focus beyond the older adult's medical conditions and consider psychological, spiritual and social needs with personal preferences being paramount. These issues are foundational to a person-centered, health promotion approach needed among this population.
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Affiliation(s)
- Elizabeth P Howard
- Northeastern University School of Nursing, 360 Huntington Avenue, Boston, MA 02115
| | - Robert Schreiber
- Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131
| | - John N Morris
- Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131
| | - Aline Russotto
- Orchard Cove, Hebrew SeniorLife, One Del Pond Drive, Canton, MA 02021
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