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Li J, Okoye S, Dwivedi P, Sciarratta L, Li M, Taylor J, Szanton SL. Promoting sleep in low-income older adults with disabilities: Comparing CAPABLE with a social engagement control. Geriatr Nurs 2022; 47:220-225. [PMID: 35944382 PMCID: PMC10167677 DOI: 10.1016/j.gerinurse.2022.07.016] [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: 05/31/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022]
Abstract
Sleep plays a vital role in older adults' health. The Community Aging in Place-Advancing Better Living for Elders (CAPABLE) trial, conducted in Maryland between 2012 and 2016, is a 5-month biobehavioral environmental intervention study to reduce functional disabilities in 300 low-income older adults. Individual and environmental factors impacting sleep were addressed in CAPABLE. This secondary data analysis was to test the preliminary effect of CAPABLE on actigraph-measured sleep, compared with a social engagement control in 73 CAPABLE participants with pretest-posttest actigraph data. Participants in this analysis were aged 75.8±7.5 years; 86.3% of them were females and 84.9% were Black/African Americans. Both CAPABLE intervention and social engagement control improved sleep efficiency and reduced sleep onset latency. The effect of CAPABLE on sleep was comparable to social engagement. These findings underline the importance of promoting physical function and maintaining social activity for sleep in low-income older adults with disabilities.
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Affiliation(s)
- Junxin Li
- Johns Hopkins University School of Nursing, Baltimore, United States.
| | - Safiyyah Okoye
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Pallavi Dwivedi
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Lena Sciarratta
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Mengchi Li
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Janiece Taylor
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, United States
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Sirsch E, Lukas A, Drebenstedt C, Gnass I, Laekeman M, Kopke K, Fischer T. Pain Assessment for Older Persons in Nursing Home Care: An Evidence-Based Practice Guideline. J Am Med Dir Assoc 2020; 21:149-163. [DOI: 10.1016/j.jamda.2019.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/29/2019] [Accepted: 08/05/2019] [Indexed: 10/25/2022]
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Avian A, Messerer B, Meissner W, Sandner-Kiesling A, Kammel J, Labugger M, Weinberg A, Berghold A. Using a worst pain intensity measure in children and adolescents. J Adv Nurs 2017; 73:1873-1883. [DOI: 10.1111/jan.13271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Alexander Avian
- Institute for Medical Informatics Statistics and Documentation; Medical University of Graz; Graz Austria
| | - Brigitte Messerer
- Division of Anesthesiology for Cardiovascular Surgery and Intensive Care Medicine; Medical University of Graz; Graz Austria
| | - Winfried Meissner
- Department of Anesthesiology and Intensive Care; Jena University Hospital; Germany
| | - Andreas Sandner-Kiesling
- Division of Anesthesiology for Cardiovascular Surgery and Intensive Care Medicine; Medical University of Graz; Graz Austria
| | - Julian Kammel
- Institute for Medical Informatics Statistics and Documentation; Medical University of Graz; Graz Austria
| | - Marlies Labugger
- Division of Anesthesiology for Cardiovascular Surgery and Intensive Care Medicine; Medical University of Graz; Graz Austria
| | - Annelie Weinberg
- Department of Orthopedics and Orthopedic Surgery; Medical University of Graz; Austria
| | - Andrea Berghold
- Institute for Medical Informatics Statistics and Documentation; Medical University of Graz; Graz Austria
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Menezes CNB, Silva JAD, Medeiros PD, Freitas RLD, Aparecido DSJ. Adaptation of a Brazilian Version of the North/Northeast Region for the Brief Pain Inventory. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/pst.2017.53003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Medeiros PAD, Fortunato AR, Viscardi AADF, Sperandio FF, Mazo GZ. [Instruments developed for the management and care of the elderly in long-stay care institutions: a systematic review]. CIENCIA & SAUDE COLETIVA 2016; 21:3597-3610. [PMID: 27828592 DOI: 10.1590/1413-812320152111.09912015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 09/17/2015] [Indexed: 11/21/2022] Open
Abstract
The demand for long-stay care institutions for the elderly (ILPIs) is increasing and it is relevant for public health systems to discuss the process of assessing the health status of its residents. The study aimed to identify measurement tools built specifically for the management and care of elderly residents in long-stay care facilities. A systematic review was conducted following PRISMA recommendations in Medline and CINAHL databases since their creation to May 2013 using the Medical Subject Headings terms suitable for the search. A total of 1858 articles were located, of which 30 were selected and 28 instruments were identified in the studies. The United States was the country that created most instruments geared to this population and the Minimum Data Set/Resident Assessment Instrument (MDS/RAI) was the one most used in the studies of this review. The variables most frequently evaluated by the instruments were depression, cognition and functional capacity. The reformulation of public policies that ensure a standardized assessment system for residents in ILPIs in Brazil is urgently needed and the challenge is to ensure that the instruments developed are disseminated and effectively implemented in the daily tasks of the professionals working in these institutions.
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Affiliation(s)
- Paulo Adão de Medeiros
- Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. R. Pascoal Simone 358, Coqueiros. 88080-350 Florianópolis SC Brasil.
| | - Artur Rodrigues Fortunato
- Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. R. Pascoal Simone 358, Coqueiros. 88080-350 Florianópolis SC Brasil.
| | - Adriana Aparecida da Fonseca Viscardi
- Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. R. Pascoal Simone 358, Coqueiros. 88080-350 Florianópolis SC Brasil.
| | - Fabiana Flores Sperandio
- Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. R. Pascoal Simone 358, Coqueiros. 88080-350 Florianópolis SC Brasil.
| | - Giovana Zarpellon Mazo
- Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. R. Pascoal Simone 358, Coqueiros. 88080-350 Florianópolis SC Brasil.
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Budnick A, Kuhnert R, Könner F, Kalinowski S, Kreutz R, Dräger D. Validation of a Modified German Version of the Brief Pain Inventory for Use in Nursing Home Residents with Chronic Pain. THE JOURNAL OF PAIN 2016; 17:248-56. [DOI: 10.1016/j.jpain.2015.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 10/15/2015] [Accepted: 10/22/2015] [Indexed: 11/15/2022]
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Takai Y, Yamamoto-Mitani N, Kawakami S, Abe Y, Kamiyama M, Saito S. Differences between Nurses' and Care Workers' Estimations of Pain Prevalence among Older Residents. Pain Manag Nurs 2015; 16:20-32. [DOI: 10.1016/j.pmn.2014.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/09/2014] [Accepted: 03/17/2014] [Indexed: 10/25/2022]
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Savvas SM, Toye CM, Beattie ERA, Gibson SJ. An evidence-based program to improve analgesic practice and pain outcomes in residential aged care facilities. J Am Geriatr Soc 2014; 62:1583-9. [PMID: 25040607 DOI: 10.1111/jgs.12935] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pain is common in individuals living in residential aged care facilities (RACFs), and a number of obstacles have been identified as recurring barriers to adequate pain management. To address this, the Australian Pain Society developed 27 recommendations for comprehensive good practice in the identification, assessment, and management of pain. This study reviewed preexisting pain management practice at five Australian RACFs and identified changes needed to implement the recommendations and then implemented an evidence-based program that aimed to facilitate better pain management. The program involved staff training and education and revised in-house pain-management procedures. Reviews occurred before and after the program and included the assessment of 282 residents for analgesic use and pain status. Analgesic use improved after the program (P<.001), with a decrease in residents receiving no analgesics (from 15% to 6%) and an increase in residents receiving around-the-clock plus as-needed analgesics (from 24% to 43%). There were improvements in pain relief for residents with scores indicative of pain, with Abbey pain scale (P=.005), Pain Assessment in Advanced Dementia Scale (P=.001), and Non-communicative Patient's Pain Assessment Instrument scale (P<.001) scores all improving. Although physical function declined as expected, Medical Outcomes Study 36-item Short-Form Survey bodily pain scores also showed improvement (P=.001). Better evidence-based practice and outcomes in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce using this program improved analgesic practice and pain relief in participating sites. Further attention to the continued targeted pain management training of aged care staff is likely to improve pain-focused care for residents.
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Affiliation(s)
- Steven M Savvas
- National Ageing Research Institute, University of Melbourne, Melbourne, Victoria, Australia
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Savvas S, Toye C, Beattie E, Gibson SJ. Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities. Pain Manag Nurs 2014; 15:819-25. [PMID: 24675280 DOI: 10.1016/j.pmn.2013.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 09/02/2013] [Accepted: 09/05/2013] [Indexed: 10/25/2022]
Abstract
Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice.
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Affiliation(s)
- Steven Savvas
- National Ageing Research Institute, Victoria, Australia.
| | - Christine Toye
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Formerly (now adjunct) School of Nursing, Midwifery and Postgraduate Medicine, Edith Cowan University, Western Australia, Australia
| | - Elizabeth Beattie
- Dementia Collaborative Research Centre: Carers and Consumers, School of Nursing, Faculty of Health, Queensland University of Technology, Queensland, Australia
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Cimarolli VR, Morse AR, Horowitz A, Reinhardt JP. Impact of Vision Impairment on Intensity of Occupational Therapy Utilization and Outcomes in Subacute Rehabilitation. Am J Occup Ther 2012; 66:215-23. [DOI: 10.5014/ajot.2012.003244] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. To examine whether vision impairment is a predictor of intensity of occupational therapy utilization and outcomes in a sample of older adults ages ≥55 receiving subacute rehabilitation in a long-term care setting.
METHOD. Data for this cohort study were collected by means of structured, in-person interviews with 100 older adult rehabilitation patients at admission to a subacute unit in a long-term care facility and by medical chart review after discharge.
RESULTS. Regression analyses indicated that after controlling for sociodemographic, health, and social support variables, worse contrast sensitivity was a significant predictor of decreased time in occupational therapy, and worse visual acuity was a significant predictor of higher functional dependency at discharge.
CONCLUSION. Vision impairment may prevent full use of occupational therapy and hinder occupational therapy efficacy in subacute care settings. Study findings underscore the importance of developing low vision rehabilitation interventions that can be delivered in conjunction with more traditional subacute rehabilitation.
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Affiliation(s)
- Verena R. Cimarolli
- Verena R. Cimarolli, PhD, is Senior Research Scientist, Jewish Home Life Care, Research Institute on Aging, The Guild Center for Research in Vision and Aging, 120 West 106th Street, PH, New York, NY 10025;
| | - Alan R. Morse
- Alan R. Morse, JD, PhD, is President and Chief Executive Officer, The Jewish Guild for the Blind, New York, and is Adjunct Professor, Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York
| | - Amy Horowitz
- Amy Horowitz, DSW, is Professor, Graduate School of Social Service, Fordham University, New York
| | - Joann P. Reinhardt
- Joann P. Reinhardt, PhD, is Director of Research, Jewish Home Life Care, Research Institute on Aging, New York
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Shega JW, Ersek M, Herr K, Paice JA, Rockwood K, Weiner DK, Dale W. The Multidimensional Experience of Noncancer Pain: Does Cognitive Status Matter? PAIN MEDICINE 2010; 11:1680-7. [DOI: 10.1111/j.1526-4637.2010.00987.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pesonen A, Kauppila T, Tarkkila P, Sutela A, Niinistö L, Rosenberg PH. Evaluation of easily applicable pain measurement tools for the assessment of pain in demented patients. Acta Anaesthesiol Scand 2009; 53:657-64. [PMID: 19419361 DOI: 10.1111/j.1399-6576.2009.01942.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Difficulties in communication and lack of suitable pain scales may lead to undertreatment of pain in cognitively impaired patients. We performed a study in this type of patients and evaluated the usefulness of four simple pain scales. PATIENTS AND METHODS We studied 41 hospitalized elderly (76-95 years) who suffered from pain with an acute component. Cognitive function was assessed with the mini-mental state examination (MMSE) and the degree of depression was assessed on the geriatric depression scale (GDS). Pain intensity was assessed at rest and after a pain-provoking movement three times at 2-week intervals by repeating the test at a 10-min interval at each test session. The pain scales were the 50 cm red wedge scale (RWS), the seven-point faces pain scale (FPS), the 10 cm visual analogue scale (VAS) and the five-point verbal rating scale (VRS). RESULTS In group MMSE> or =24, patients were able to use all four scales rather successfully. In the other groups (MMSE 17-23, 11-16 and < or =10), only the use of VRS was successful to a reasonable degree (64-85% on average). GDS scores did not correlate with the pain scores, with the exception of pain scores on FPS during movement (P<0.01). The estimations of intensity and frequency of pain performed by nurses failed to correlate with the patient's own pain intensity estimations. CONCLUSION Scoring of pain with RWS, FPS and VAS seems to be feasible in elderly patients with a normal cognitive dysfunction. In our study VRS appeared to be applicable in the elderly with a clear cognitive dysfunction, i.e., with MMSE<17.
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Affiliation(s)
- A Pesonen
- Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland.
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