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Mueller KE, Van Puymbroeck M, Brown C, Crowe BM, Davis N. Measuring older adults' wellbeing when transitioning into assisted living facilities: a confirmatory factor analysis of the Mueller assessment of transition (MAT). Aging Ment Health 2024; 28:936-942. [PMID: 38117221 DOI: 10.1080/13607863.2023.2293054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Older adults' wellbeing during the transition into an assisted living facility (ALF) is not well understood and may influence their wellbeing. The Mueller Assessment of Transition (MAT) was created to measure the impact of transition on older adults' wellbeing. Early developmental testing of the MAT revealed a hypothesized model with two constructs (adjustment strategies and constraints to wellbeing). Therefore, the purpose of this study was to confirm the factor structure of the MAT with a representative sample of older adults transitioning into ALFs. METHODS In a nationwide sample, 108 older adult participants completed the MAT to measure wellbeing when relocating into ALFs. Confirmatory factor analysis (CFA) assessed the structural validity of the MAT. Internal consistency was evaluated, and chi-square tests of association for regional differences in MAT scores were also conducted. RESULTS The CFA produced strong fit indices to confirm the hypothesized 2-factor (constraints to wellbeing and adjustment strategies) model of the MAT. Cronbach's alpha for the internal consistency was 0.784 and chi-square test indicated no significant regional differences. CONCLUSION The MAT was established as a valid and reliable standardized assessment. Implications for using the MAT as a tool to measure older adults' wellbeing and future research are discussed.
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Affiliation(s)
- Kaitlin E Mueller
- School of Health Science and Human Performance, Catawba College, Salisbury, NC, USA
| | | | - Christy Brown
- Department of Education and Human Development, Clemson University, Clemson, SC, USA
| | - Brandi M Crowe
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, USA
| | - Nicole Davis
- School of Nursing, Clemson University, Clemson, SC, USA
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Windle A, Marshall A, de la Perrelle L, Champion S, Ross PD, Harvey G, Davy C. Factors that influence the implementation of innovation in aged care: a scoping review. JBI Evid Implement 2023; 22:02205615-990000000-00072. [PMID: 38153118 PMCID: PMC11163893 DOI: 10.1097/xeb.0000000000000407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVE The objective of this scoping review is to identify factors that influence the implementation of innovation in aged care. INTRODUCTION Aged care is a dynamic sector experiencing rapid change. Implementation of innovations in aged care has received relatively little research attention compared to health care. INCLUSION CRITERIA This review included studies of any design, that examined the implementation of innovations in aged care settings. METHODS Searches were conducted in MEDLINE, CINAHL, AgeLine, and ProQuest Social Sciences Premium Collection for studies published between January 1, 2012 and December 31, 2022. The titles and abstracts of retrieved citations were screened by two independent reviewers. Full-text articles were screened by one reviewer to determine inclusion. Data were extracted in NVivo using a tool developed by the research team. Factors that influenced implementation were inductively coded, interpreted, and grouped into categories in a series of workshops. RESULTS Of the 2530 studies that were screened, 193 were included. Of the included papers, the majority (74%) related to residential aged care, 28% used an implementation theory or framework, and 15% involved consumers. Five key categories of factors influencing implementation were identified: organizational context including resourcing and culture; people's attitudes and capabilities; relationships between people; the intervention and its appropriateness; and implementation actions such as stakeholder engagement and implementation strategies. CONCLUSIONS Our findings can be used to develop practical resources to support implementation efforts, and highlight the importance of resourcing for successful implementation. Attention to community-based aged care, and greater engagement with theory and community is needed to promote research rigor, relevance and applicability.
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Affiliation(s)
- Alice Windle
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Amy Marshall
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Lenore de la Perrelle
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Stephanie Champion
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Paul D.S. Ross
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Gillian Harvey
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Carol Davy
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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Mueller KE, Van Puymbroeck M, Crowe BM, Davis NJ. Exploring Constraints to Well-Being for Older Adults in Transition Into an Assisted Living Home: A Qualitative Study. Can J Aging 2023; 42:688-695. [PMID: 37439106 DOI: 10.1017/s0714980823000284] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
Transitions into an assisted living home (ALH) are difficult and may impact the well-being of older adults. A thematic analysis guided by grounded theory was employed to better understand how a transition into an ALH influenced older adults' overall well-being. Individual, face-to-face interviews were conducted with a convenience sample of 14 participants at an ALH in the rural, southeastern U.S. Two central findings that influenced well-being during the transition process were revealed: loss of independence (sub-themes include loss of physical and mental health and loss of driving) and downsizing in space and possessions. The themes support and broaden the Hierarchical Leisure Constraints Theory, a Modified Constraints to Wellbeing model is proposed, and implications for older adult health care practitioners in ALHs are recommended. Further research is needed on the Modified Constraints to Wellbeing model and how to better describe these constraints to older adults' well-being when relocating into ALHs.
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Affiliation(s)
- Kaitlin E Mueller
- School of Health Science and Human Performance, Catawba College, Salisbury, NC, USA
| | | | - Brandi M Crowe
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, USA
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Lekan D, Yasin R. Using the ModSPICES Geriatric Assessment Tool in Undergraduate Nursing Education. J Nurs Educ 2022; 61:338-344. [PMID: 35667113 DOI: 10.3928/01484834-20220404-07] [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: 11/20/2022]
Abstract
BACKGROUND Trends in aging demographics for a growing older adult population highlights the need for Gerontologic nursing competencies to prepare future nurses to provide safe and effective person-centered care. METHOD A geriatric assessment learning module incorporated the ModSPICES assessment tool based on geriatric syndromes in a didactic and clinical course in a prelicensure baccalaureate nursing program to facilitate nursing students' critical thinking and clinical judgment in the care of hospitalized older adults. RESULTS The ModSPICES tool fostered nursing students' critical thinking for data collection with attention to geriatric syndromes, which are highly prevalent and associated with numerous adverse outcomes but are also preventable and treatable. The tool helped to aggregate diverse clinical information and establish priorities in care. CONCLUSION The learning module strengthened the linkage between the classroom and clinical setting, enhanced the student's capacity and confidence in the promotion of function-focused care, and facilitated refinement of their evolving assessment skills. [J Nurs Educ. 2022;61(6):338-344.].
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Vluggen S, Metzelthin S, Lima Passos V, Zwakhalen S, Huisman-de Waal G, de Man-van Ginkel J. Effect, economic and process-evaluation of a generic function focused care program for long-term care; study protocol of a multicenter cluster-randomized trial. BMC Nurs 2022; 21:121. [PMID: 35590409 PMCID: PMC9118723 DOI: 10.1186/s12912-022-00902-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nurses are in a key position to stimulate older people to maximize their functional activity and independence. However, nurses still often work in a task-oriented manner and tend to take over tasks unnecessarily. It is evident to support nurses to focus on the capabilities of older people and provide care assistance only when required. Function-Focused Care (FFC) is a holistic care-philosophy aiming to support nurses to deliver care in which functioning and independence of older people is optimized. Dutch and internationally developed FFC-based interventions often lack effectiveness in changing nurses' and client's behavior. Process-evaluations have yielded lessons and implications resulting in the development of an advanced generic FFC-program: the 'SELF-program'. The SELF-program aims to improve activity stimulation behavior of nurses in long-term care services, and with that optimize levels of self-reliance in activities of daily living (ADL) in geriatric clients. The innovative character of the SELF-program lies for example in the application of extended behavior change theory, its interactive nature, and tailoring its components to setting-specific elements and needs of its participants. This paper describes the outline, content and theoretical background of the SELF-program. Subsequently, this paper describes a protocol for the assessment of the program's effect, economic and process-evaluation in a two-arm (SELF-program vs care as usual) multicenter cluster-randomized trial (CRT). METHOD The proposed CRT has three objectives, including getting insight into the program's: (1) effectiveness regarding activity stimulation behavior of nurses and self-reliance in ADL of geriatric clients, and (2) cost-effectiveness from a societal perspective including assessments of quality of life and health-care use. Measurements will take place prior to program implementation (baseline), directly after (T1), and in long-term (T2). Parallel to the CRT, a process evaluation will be conducted to provide insight into the program's: (3) feasibility regarding implementation, mechanisms of impact and contextual factors. DISCUSSION The SELF-program was developed following the Medical Research Council framework, which addresses the systematic development, feasibility testing, evaluation and implementation of complex interventions. The program has been subjected to a feasibility study before and results of studies described in this protocol are expected to be available from end 2022 onwards. TRIAL-REGISTRATION The study is registered in the Dutch Trial Register ( NL9189 ), as of December 22 2020.
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Affiliation(s)
- Stan Vluggen
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Duboisdomein 30, Maastricht, 6229 GT, The Netherlands.
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.
| | - Silke Metzelthin
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Duboisdomein 30, Maastricht, 6229 GT, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Valeria Lima Passos
- Department of Methodology and Statistics, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Sandra Zwakhalen
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Duboisdomein 30, Maastricht, 6229 GT, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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Jawad BN, Petersen J, Andersen O, Pedersen MM. Variations in physical activity and sedentary behavior during and after hospitalization in acutely admitted older medical patients: a longitudinal study. BMC Geriatr 2022; 22:209. [PMID: 35291952 PMCID: PMC8925078 DOI: 10.1186/s12877-022-02917-8] [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: 09/01/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inactivity is frequent among older patients during hospitalization. It is unknown how patients' daily activity pattern (diurnal profile) vary between hospitalization and after discharge. This study aims to describe and compare the distribution of physical activity and sedentary behavior in acutely hospitalized older patients during hospitalization and after discharge. METHODS We included data on 80 patients (+65 years) admitted with acute medical illness from the STAND-Cph trial. Physical activity and sedentary behavior were measured as daily number of steps, uptime (walking/standing) and sedentary behavior (lying/sitting) with an activity monitor (activPAL3, PAL Technologies Ltd). The patients wore the monitor for three periods of one week: during hospitalization, after discharge, and four weeks after discharge. RESULTS The patients' median age was 80 years [IQR: 75;88], 68% were female and the median De Morton Mobility Index (DEMMI) was 57 [IQR: 48;67]. The daily median uptime was 1.7 h [IQR: 1;2.8] during hospitalization, 4.0 h [IQR: 2.7;5.4] after discharge and 4.0 h [IQR: 2.8;5.8] four weeks after discharge. The daily median number of steps was 728 [IQR: 176;2089], 2207 [IQR: 1433;3148], and 2622 [IQR: 1714;3865], respectively, and median daily sedentary behavior was 21.4 h (IQR: 20.7;22.4), 19.5 h (IQR: 18.1;21.0) and 19.6 h (IQR: 18.0;20.8), respectively. During hospitalization, a small activity peak was observed between 9-11 AM without any notable variation after. At discharge and four weeks after discharge, a peak in physical activity was seen between 9-12 AM and at 5 PM. CONCLUSION Older hospitalized patients spend most of their time being sedentary with their highest activity between 9-11 AM. Daily activity doubles after discharge with one extra peak in the afternoon. Daily routines might be disrupted, and older patients have the potential to be more physically active during hospitalization. Interventions that encourage physical activity during hospitalization are warranted.
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Affiliation(s)
- Baker Nawfal Jawad
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark. .,The Emergency Department, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark. .,Department of Clinical Medicine, University of Copenhagen, Nørre Allé 20, DK-2200, Copenhagen-N, Denmark.
| | - Janne Petersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark.,Center for Clinical Research and Prevention, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark.,The Emergency Department, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Nørre Allé 20, DK-2200, Copenhagen-N, Denmark
| | - Mette Merete Pedersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Nørre Allé 20, DK-2200, Copenhagen-N, Denmark
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Woods D, Navarro AE, LaBorde P, Dawson M, Shipway S. Social Isolation and Nursing Leadership in Long-term Care: Moving Forward after COVID-19. Nurs Clin North Am 2022; 57:273-286. [PMID: 35659988 PMCID: PMC8860631 DOI: 10.1016/j.cnur.2022.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Barras L, Neuhaus M, Cyarto EV, Reid N. Effectiveness of Peer-Led Wellbeing Interventions in Retirement Living: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11557. [PMID: 34770069 PMCID: PMC8583038 DOI: 10.3390/ijerph182111557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/29/2022]
Abstract
Retirement living (RL) communities may be an ideal setting in which to utilize peer-leaders to implement or support health and wellbeing interventions. To date, this literature has not been systematically summarized. The purpose of this study was to fill this gap with a particular focus on describing the extent to which interventions addressed each level of the social ecological model of behavior change. This review utilized established frameworks for assessing methodological quality of studies, including the CONSORT guidelines and RoB2 bias assessment for cluster randomized controlled trials. A total of 153 records were identified from database searches, and seven studies met inclusion criteria. Overall, there is emerging evidence that peer-led health and wellbeing programs in RL communities can positively impact both health behavior, such as increased physical activity or nutrition, and health status, such as lower blood pressure. The study quality was modest to very good, but only one study was deemed not to have a high risk of bias. Peers are generally cost-effective, more accessible, and relatable leaders for health interventions that can still produce impactful changes. Future studies are needed to better understand how to sustain promising interventions.
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Affiliation(s)
- Lilian Barras
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD 4102, Australia
| | - Maike Neuhaus
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, QLD 4102, Australia; (M.N.); (N.R.)
| | - Elizabeth V. Cyarto
- Bolton Clarke, Brisbane, QLD 4059, Australia;
- Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Natasha Reid
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, QLD 4102, Australia; (M.N.); (N.R.)
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Giebel C, Zwakhalen S, Louise Sutcliffe C, Verbeek H. Exploring the abilities of performing complex daily activities in dementia: the effects of supervision on remaining independent. Aging Ment Health 2020; 24:1288-1294. [PMID: 30990082 DOI: 10.1080/13607863.2019.1603283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: The aim of this study was to explore the remaining abilities of people with dementia (PwD) in performing daily activities.Method: Informal carers of community-residing PwD were recruited across England via mail out and carer support groups. Carers completed the revised Interview for Deteriorations in Daily Living Activities in Dementia 2 to rate the PwD's initiative and performance of daily activities. Six complex instrumental activities of daily living (IADLs) were selected: shopping, preparing a hot drink, using the telephone, preparing a cold meal, house work, and engaging in social activities, all of which were broken down into three sub-tasks. Data were analysed using Chi-square tests and linear regression analysis, assessing the contributions of hours of IADL care, hours of supervision, and dementia stage for each activity.Results: 581 carers of people with mild, moderate, and severe dementia completed the questionnaire. The ability to perform individual activities deteriorated from mild to moderate to severe dementia, with PwD remaining the most able to perform subtasks of preparing a hot drink and a cold meal. Subtask performance varied across activities, with some better maintained than others across severity stages. Linear regression models showed that hours of supervising PwD explained a greater proportion of the variance of each IADL than IADL care hours.Conclusion: PwD should be supervised to continue engaging in activities, thereby avoiding performing everything for the PwD. Findings can have implications for PwD living in nursing homes, and future research should explore the remaining IADL abilities of nursing home residents.
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Affiliation(s)
- Clarissa Giebel
- Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom of Great Britain and Northern Ireland.,NIHR CLAHRC NWC, Liverpool, United Kingdom of Great Britain and, Northern Ireland
| | - Sandra Zwakhalen
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Caroline Louise Sutcliffe
- Personal Social Services Research Unit, University of Manchester, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Hilde Verbeek
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
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Wang YH, Liu LF, Chang LH, Yeh CH. The Implementation of Restorative Care and Factors Associated with Resident Outcomes in Long-Term Care Facilities in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3860. [PMID: 31614746 PMCID: PMC6843543 DOI: 10.3390/ijerph16203860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/19/2019] [Accepted: 10/08/2019] [Indexed: 11/16/2022]
Abstract
This study aimed to analyze how restorative care is implemented in long-term care facilities and factors associated with resident outcomes in Taiwan. A one-group pre-test and post-test design was adopted in 24 long-term care facilities by collecting a sample of 310 participants at the baseline and 210 at six months. Participants were residents aged 65 or over, and were being constrained, used diapers, or were bedridden, or a combination of these. Their physical and mental functions were measured using Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), Mini-Mental State Examination (MMSE), Geriatric Depression Scale-15 (GDS-15), and EuroQol-5D (EQ-5D). Mean differences in the outcomes were analyzed, and mixed effect models were used to examine influencing factors. The results showed that most of the participants had good family support. However, participants with better family support were more likely to drop out. Improvements were found in the residents' outcomes on physical function, depression and quality of life. Social support was a significant influencing factor on most of the outcomes. In conclusion, restorative care was found to have positive effects on residents' physical function and helped maintain mental function. Sufficient support and communication between participants, families, and staff in facilities are key factors leading to positive outcomes.
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Affiliation(s)
- Yu-Hua Wang
- Institute of Gerontology, National Cheng Kung University, Tainan 701, Taiwan.
| | - Li-Fan Liu
- Institute of Gerontology, National Cheng Kung University, Tainan 701, Taiwan.
| | - Ling-Hui Chang
- Department of Occupational Therapy, National Cheng Kung University, Tainan 701, Taiwan.
| | - Chien-Hsin Yeh
- Yung Shin Social Welfare Foundation, Taichung 437, Taiwan.
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Jung D, Lee H, Lee M. Function-focused care programme for older people in Korean long-term care facilities. Int J Older People Nurs 2019; 15:e12277. [PMID: 31589382 DOI: 10.1111/opn.12277] [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: 09/16/2018] [Revised: 07/31/2019] [Accepted: 08/29/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to develop and test the effect of the Korean Function-Focused Care Programme (K-FFCP) on cognition and physical and psychological status in long-term care facilities' (LTCs) residents. DESIGN A quasi-experimental repeated-measures design was used. METHODS The K-FFCP was developed to maintain and maximise functions of older people in LTCs. After implementing the K-FFCP for six weeks, differences in the cognitive status, activities of daily living (ADL) performance, physical capability, grip strength, fear of falling, depression and anxiety status of the two groups were examined using repeated-measures analysis of variance. Patient outcomes were evaluated at baseline and at 6 and 12 weeks after the intervention. RESULTS In the experimental group, a significant group-time interaction effect was reported for ADL performance and depression. CONCLUSION The current findings provided evidence of its feasibility and indicated significant improvement in older people's functions using the K-FFCP. Although this study is a pilot test, these results may confirm the importance of the K-FFCP for the maintenance of ADL performance in older people in LTCs.
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Affiliation(s)
- Dukyoo Jung
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Hyesoon Lee
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Minkyung Lee
- Hunter-Bellevue School of Nursing, Hunter College, CUNY, New York, NY, USA
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12
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From clinical work to dissemination of interventions. J Am Assoc Nurse Pract 2018; 30:308-310. [DOI: 10.1097/jxx.0000000000000044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Resnick B, Kolanowski A, Van Haitsma K, Galik E, Boltz M, Ellis J, Behrens L, Flanagan NM, Eshraghi KJ, Zhu S. Testing the evidence integration triangle for implementation of interventions to manage behavioral and psychological symptoms associated with dementia: Protocol for a pragmatic trial. Res Nurs Health 2018; 41:228-242. [PMID: 29485197 DOI: 10.1002/nur.21866] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 12/27/2017] [Indexed: 01/30/2023]
Abstract
Behavioral and psychological symptoms of dementia (BPSD) include aggression, agitation, resistiveness to care, depression, anxiety, apathy, and hallucinations. BPSD are common in nursing home residents and can be ameliorated using person-centered approaches. Despite regulatory requirements, less than 2% of nursing homes consistently implement person-centered behavioral approaches. In a National Institute of Nursing Research-funded research protocol, we are implementing a pragmatic cluster randomized clinical trial designed to enable staff in nursing homes to reduce BPSD using behavioral approaches while optimizing function, preventing adverse events, and improving quality of life of residents. The implementation is based on use of the Evidence Integration Triangle (EIT), a parsimonious, community-engaged participatory framework that is well suited to the complexity and variability in the nursing home environment. A total of 50 nursing home communities will be randomized to EIT-4-BPSD or education only. Primary Aim 1 is to determine if communities exposed to EIT-4-BPSD demonstrate evidence of implementation evaluated by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) criteria. Primary Aim 2 is to evaluate the feasibility, utility, and cost of the EIT approach in EIT-4-BPSD communities.
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Affiliation(s)
- Barbara Resnick
- School of Nursing, University of Maryland, Baltimore, Maryland
| | - Ann Kolanowski
- Pennsylvania State University, University Park, Pennsylvania
| | | | - Elizabeth Galik
- School of Nursing, University of Maryland, Baltimore, Maryland
| | - Marie Boltz
- Pennsylvania State University, University Park, Pennsylvania
| | - Jeanette Ellis
- School of Nursing, University of Maryland, Baltimore, Maryland
| | - Liza Behrens
- Pennsylvania State University, University Park, Pennsylvania
| | - Nina M Flanagan
- Decker School of Nursing, Binghamton University, Binghamton, New York
| | | | - Shijun Zhu
- School of Nursing, University of Maryland, Baltimore, Maryland
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Phillips LJ, Leary E, Blankenship J, Zimmerman S. Physical Function, Relocation, and Mortality Outcomes in Residential Care and Assisted Living Residents. J Aging Health 2017; 31:903-924. [PMID: 29254437 PMCID: PMC10081568 DOI: 10.1177/0898264317740047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study aimed to identify predictors of 6-month physical function and 12-month relocation or death in 272 residents of 34 residential care/assisted communities. Method: Measures collected at baseline, 6, and 12 months included health and demographic characteristics; self-reported pain, fatigue, and depressive symptoms; exercise self-efficacy, barriers, and expectations; attitudes on aging; performance-based physical function and physical activity; and community demographics, programs, and policies. GLIMMIX procedures for regression analyses with community as a random effect were run. Results: Better baseline physical function and grip strength, female sex, and residential care community predicted better 6-month physical function. At 12 months, 25.6% had relocated or died. The odds of 12-month relocation or death for 1-point increase in physical function score was 0.84 and for 1-point increase in depression score was 1.16. Discussion: Targets to promote longer tenure in residential care/assisted living include programs to ameliorate functional decline and depression screening and treatment.
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Zimmerman S, Greene A, Sloane PD, Mitchell M, Giuliani C, Nyrop K, Walsh E. Preventing falls in assisted living: Results of a quality improvement pilot study. Geriatr Nurs 2016; 38:185-191. [PMID: 27776786 DOI: 10.1016/j.gerinurse.2016.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2016] [Accepted: 09/19/2016] [Indexed: 10/20/2022]
Abstract
Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength.
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Affiliation(s)
- Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, USA; School of Social Work, University of North Carolina at Chapel Hill, USA.
| | | | - Philip D Sloane
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, USA; Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, USA
| | - Madeline Mitchell
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, USA
| | - Carol Giuliani
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, USA; Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, USA
| | - Kirsten Nyrop
- School of Medicine, University of North Carolina at Chapel Hill, USA
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Zisberg A, Gur-Yaish N. Older adults' personal routine at time of hospitalization. Geriatr Nurs 2016; 38:27-32. [PMID: 27473879 DOI: 10.1016/j.gerinurse.2016.07.002] [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] [Received: 04/01/2016] [Revised: 06/29/2016] [Accepted: 07/04/2016] [Indexed: 01/04/2023]
Abstract
This study is the first to explore whether hospitalization disrupts the daily routines of dependent and independent older adults. Data were collected as part of a prospectively designed study from 330 hospitalized older adults age 70+. Patients reported prehospitalization frequency, duration, and timing of basic activities of daily living and leisure activities at hospital admission. Hospital routine was assessed on day of discharge. Results indicated that frequency and duration of most basic activities decreased during hospitalization; the sharpest decrease was in frequency of getting dressed. Showering occurred 2 h earlier in the hospital setting, and getting dressed occurred an hour and a half later. For dependent respondents, the greatest change was in duration; for independent respondents, the greatest change was in frequency. Given the importance of routine maintenance to health and well-being, understanding the dynamics of its disruption in the hospital setting is imperative.
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Affiliation(s)
- Anna Zisberg
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare & Health Sciences, University of Haifa, 1199 Aba Khoushy Ave. 99, Mount Carmel, Haifa 3498838, Israel.
| | - Nurit Gur-Yaish
- Center for Research and Study of Aging, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel
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