1
|
Quasdorf T, Manietta C, Rommerskirch-Manietta M, Braunwarth JI, Roßmann C, Roes M. Implementation of interventions to maintain and promote the functional mobility of nursing home residents - a scoping review. BMC Geriatr 2023; 23:600. [PMID: 37752436 PMCID: PMC10523713 DOI: 10.1186/s12877-023-04213-5] [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: 02/07/2023] [Accepted: 08/02/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND To provide an overview of the available evidence on the implementation of direct and capacity-building interventions to promote and maintain the functional mobility of nursing home residents. METHODS We conducted a scoping review following the methodological guidance for the conduct of scoping reviews as described by the Joanna Briggs Institute. We searched for studies in MEDLINE (via PubMed) and CINAHL (via EBSCO). We conducted a qualitative content analysis of the included studies with deductive categories based on the Consolidated Framework for Implementation Research (CFIR). RESULTS Ultimately, we included 8 studies on direct interventions, 6 studies on capacity-building interventions, and 2 studies on both types of interventions in our review. Seven studies provided evidence on implementation strategies comprising discrete as well as multifaceted, multilevel strategies. Most of the studies did not systematically evaluate the strategies but remained at a descriptive level. All 16 studies provided evidence of influencing factors. We identified 32 of the 37 influencing factors of the CFIR. The five most frequent influencing factors were available resources (n = 14), access to knowledge and information (n = 12), patient needs and resources (n = 10), knowledge and beliefs about the intervention (n = 10) and compatibility (n = 9). CONCLUSIONS The available evidence on the implementation of functional mobility interventions in nursing homes is rather limited. This emphasizes the need for further research. Regarding implementation strategies, the systematic evaluation and further development of the reported promising approaches might be a starting point.
Collapse
Affiliation(s)
- Tina Quasdorf
- School of Health Science, Institute of Nursing, ZHAW Zürich University of Applied Science, Winterthur, Switzerland.
| | - Christina Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Standort Witten, Witten, Germany
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
| | - Mike Rommerskirch-Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Standort Witten, Witten, Germany
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
| | - Jana Isabelle Braunwarth
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Standort Witten, Witten, Germany
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
| | - Christin Roßmann
- Bundeszentrale für gesundheitliche Aufklärung (BZgA), Köln, Germany
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Standort Witten, Witten, Germany
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
| |
Collapse
|
2
|
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.
Collapse
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
| | | | | |
Collapse
|
3
|
Vogel RGM, Bours GJJW, Metzelthin SF, Erkens PMG, van Breukelen GJP, Zwakhalen SMG, van Rossum E. The perceived behavior and barriers of community care professionals in encouraging functional activities of older adults: the development and validation of the MAINtAIN-C questionnaire. BMC Health Serv Res 2020; 20:907. [PMID: 32993737 PMCID: PMC7526165 DOI: 10.1186/s12913-020-05762-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community care professionals need to encourage older adults in performing functional activities to maintain independence. However, professionals often perform functional activities on behalf of older adults. To change this, insights into the behavior and barriers of professionals in encouraging activities are required. In the current study, the MAINtAIN questionnaire, which was developed for nursing homes, was adopted. The objective was to create a modified version that is suitable for measuring behavior and barriers of community care professionals in encouraging functional activities of clients in the community care setting. The overall aims were to assess the content validity, construct validity, and internal consistency of the modified version. METHODS Data was collected by qualitative and quantitative methods in two phases. During phase one, the MAINtAIN was assessed on appropriateness and feasibility by community nurses (N = 7), and the adapted questionnaire was assessed on content validity by research experts (N = 9) and community care professionals (N = 18). During phase two, the psychometric properties of the adapted MAINtAIN-C were assessed in community care professionals (N = 80). Construct validity was evaluated by an Exploratory Factor Analysis (EFA), and internal consistency was determined by calculating Cronbach's alpha coefficients. RESULTS The formulation, verbs, and wording of the MAINtAIN were adapted; some items were excluded and relevant items were added, resulting in the MAINtAIN-C with two scales, showing good content validity. The Behaviors scale (20 items) measures perceived behavior in encouraging functional activities, expressing good internal consistency (Cronbach's alpha: .92). The Barriers scale measures barriers in encouraging functional activities related to two dimensions: 1) the clients' context (7 items), with good internal consistency (.78); and 2) the professional, social, and organizational contexts (21 items), showing good internal consistency (.83). CONCLUSIONS The MAINtAIN-C seems promising to assess the behavior and barriers of community care professionals in encouraging functional activities. It can be used to display a possible difference between perceived and actual behavior, to develop strategies for removing barriers in encouraging activities to foster behavioral change. The results also provide guidance for further research in a larger sample to obtain more insight into the psychometric properties.
Collapse
Affiliation(s)
- Ruth G M Vogel
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands. .,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.
| | - Gerrie J J W Bours
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.,Research Centre for Community Care, Academy of Nursing, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Silke F Metzelthin
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Petra M G Erkens
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Gerard J P van Breukelen
- Care and Public Health Research Institute, Department of Methodology and Statistics, and Graduate School of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sandra M G Zwakhalen
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.,Research Centre for Community Care, Academy of Nursing, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Erik van Rossum
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.,Research Centre for Community Care, Academy of Nursing, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| |
Collapse
|
4
|
Bäckström J, Fogelberg J, Gabrielsson G, Lindberg M, Arving C, Hellström K. Reliability and internal consistency of the Swedish version of the MAastrIcht Nurses Activities INventory (MAINtAIN(S)) - A pilot testing of the tool. Geriatr Nurs 2020; 41:790-803. [PMID: 32522423 DOI: 10.1016/j.gerinurse.2020.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the test-retest reliability and internal consistency of the Swedish version of the MAastrIcht Nurses Activities INventory (MAINtAIN(S)) developed to measure nursing staff perceived behaviours and barriers for promotion of everyday activities in nursing home residents. METHOD Nursing staff completed the MAINtAIN(S) questionnaire on two occasions at 3-week intervals. Relative reliability, absolute reliability and internal consistency with Cronbach's alpha were calculated. RESULTS The test--retest reliability of MAINtAIN(S)-behaviours subscales ranged from ICC2. = 0.78--0.91 and MAINtAIN(S)-barriers subscales from ICC2.1 = 0.60--0.84. Cronbach's alpha varied between 0.60 and 0.91 for the different subscales. The MAINtAIN(S) inventory shows acceptable reliability and internal consistency. MAINtAIN(S) seems to be a promising tool for identifying behaviours and barriers in promoting everyday activities in nursing home residents and can be used to develop ward specific interventions for promotion of daily physical activity level in the care of older adults.
Collapse
Affiliation(s)
- Josefin Bäckström
- Department of Neuroscience, Psychiatry, Uppsala University, Sweden; Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Jonathan Fogelberg
- Department of Neuroscience, Physiotherapy, Uppsala University, SE-751 24 Uppsala, Sweden
| | - G Gabrielsson
- Department of Neuroscience, Physiotherapy, Uppsala University, SE-751 24 Uppsala, Sweden
| | - M Lindberg
- Department of Neuroscience, Physiotherapy, Uppsala University, SE-751 24 Uppsala, Sweden
| | - Cecilia Arving
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Karin Hellström
- Department of Neuroscience, Physiotherapy, Uppsala University, SE-751 24 Uppsala, Sweden.
| |
Collapse
|
5
|
den Ouden M, Zwakhalen SMG, Meijers JMM, Bleijlevens MHC, Hamers JPH. Feasibility of DAIly NURSE: A nursing intervention to change nursing staff behaviour towards encouraging residents' daily activities and independence in the nursing home. J Clin Nurs 2018; 28:801-813. [PMID: 30230069 PMCID: PMC7380124 DOI: 10.1111/jocn.14677] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 09/02/2018] [Accepted: 09/13/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To examine the feasibility of DAIly NURSE and a nursing intervention to encourage nursing home residents' daily activities and independence. BACKGROUND Nursing home residents are mainly inactive during the day. DAIly NURSE was developed to change nursing behaviour towards encouraging nursing home residents' activities and independence by creating awareness. It consists of three components: education, coaching-on-the-job and policy. DESIGN A mixed-method study. METHODS The feasibility of DAIly NURSE in practice was tested in six psychogeriatric nursing home wards, using attendance lists (reach), evaluation questionnaires (fidelity, dose received and barriers), notes made by the researcher (dose delivered and fidelity) and a focus group interview (dose received and barriers) with nursing home staff (n = 8) at the end of the study. RESULTS The feasibility study showed that all three components (education, coaching-on-the-job and policy) were implemented in practice. The attendance rate in the workshops was high (average: 82%). Nursing home staff were satisfied with the workshops (mean score 9 out of 10 points) and agreed that DAIly NURSE was feasible in daily nursing care practice. Recommendations to optimise the feasibility of DAIly NURSE included the following: Add video observations of a specific moment of the day to create awareness of nursing behaviour; educate all nursing staff of the ward during the workshops; and organise information meetings for family members before the start of the intervention. Nursing staff were satisfied with the intervention and provided recommendations for adjustments to the content of the three components. The most important adjustment is the use of video observations to create awareness of nursing staff behaviour. CONCLUSIONS DAIly NURSE, consisting of education, coaching-on-the-job and policy, is feasible in nursing home practice. RELEVANCE TO CLINICAL PRACTICE DAIly NURSE might help to change nursing behaviour towards encouraging residents' daily activities and independence.
Collapse
Affiliation(s)
- Mirre den Ouden
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Sandra M G Zwakhalen
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Judith M M Meijers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Michel H C Bleijlevens
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Jan P H Hamers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
6
|
Kuk NO, Bours GJ, Hamers JP, Kempen GI, Zijlstra GR. Feasibility of the Translating Innovations into Practice-toolbox (TIP-toolbox): A mixed-methods study for implementing activity innovations in nursing homes. Geriatr Nurs 2017; 38:498-504. [DOI: 10.1016/j.gerinurse.2017.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/02/2017] [Accepted: 03/06/2017] [Indexed: 11/26/2022]
|
7
|
Myers DR, Rogers RK, LeCrone HH, Kelley K. The Behavioral Health Role in Nursing Facility Social Work. J Appl Gerontol 2017; 38:1063-1095. [DOI: 10.1177/0733464817733103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Types of compromised resident behaviors licensed nursing facility social workers encounter, the behavioral health role they enact, and effective practices they apply have not been the subject of systematic investigation. Analyses of 20 in-depth interviews with Bachelor of Social Work (BSW)/Master of Social Work (MSW) social workers averaging 8.8 years of experience identified frequently occurring resident behaviors: physical and verbal aggression/disruption, passive disruption, socially and sexually inappropriateness. Six functions of the behavioral health role were care management, educating, investigating, preventing, mediating, and advocating. Skills most frequently applied were attention/affirmation/active listening, assessment, behavior management, building relationship, teamwork, and redirection. Narratives revealed role rewards as well as knowledge deficits, organizational barriers, personal maltreatment, and frustrations. Respondents offered perspectives and prescriptions for behavioral health practice in this setting. The findings expand understanding of the behavioral health role and provide an empirical basis for more research in this area. Recommendations, including educational competencies, are offered.
Collapse
|
8
|
Kuk NO, Zijlstra GAR, Bours GJJW, Hamers JPH, Tan FES, Kempen GIJM. Promoting Functional Activity Among Nursing Home Residents: A Cross-Sectional Study on Barriers Experienced by Nursing Staff. J Aging Health 2017; 30:605-623. [PMID: 28553799 DOI: 10.1177/0898264316687407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To obtain insight into (a) the prevalence of nursing staff-experienced barriers regarding the promotion of functional activity among nursing home residents, and (b) the association between these barriers and nursing staff-perceived promotion of functional activity. METHOD Barriers experienced by 368 nurses from 41 nursing homes in the Netherlands were measured with the MAastrIcht Nurses Activity INventory (MAINtAIN)-barriers; perceived promotion of functional activities was measured with the MAINtAIN-behaviors. Descriptive statistics and hierarchical linear regression analyses were performed. RESULTS Most often experienced barriers were staffing levels, capabilities of residents, and availability of resources. Barriers that were most strongly associated with the promotion of functional activity were communication within the team, (a lack of) referral to responsibilities, and care routines. DISCUSSION Barriers that are most often experienced among nursing staff are not necessarily the barriers that are most strongly associated with nursing staff-perceived promotion of functional activity.
Collapse
Affiliation(s)
- Nienke O Kuk
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
| | - G A Rixt Zijlstra
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
| | - Gerrie J J W Bours
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands.,2 Research Centre for Autonomy and Participation for Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Jan P H Hamers
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
| | - Frans E S Tan
- 3 Department of Methodology and Statistics, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
| | - Gertrudis I J M Kempen
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
| |
Collapse
|
9
|
Kuk NO, den Ouden M, Zijlstra GAR, Hamers JPH, Kempen GIJM, Bours GJJW. Do nursing staff encourage functional activity among nursing home residents? A cross-sectional study of nursing staff perceived behaviors and associated factors. BMC Geriatr 2017; 17:18. [PMID: 28088168 PMCID: PMC5237509 DOI: 10.1186/s12877-017-0412-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 01/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors. METHODS In this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors. RESULTS Nursing staff perceived that household activities (mean 4.1 (scale range 1-9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or information-seeking behaviors, but no consistent pattern in associations emerged. CONCLUSIONS According to nursing staff, household activities are not as often encouraged as ADL or miscellaneous activities. Professional characteristics, contextual factors, and information-seeking behaviors are not consistently associated with the encouragement of functional activity. Nursing staff should also focus on improving the encouragement of household activities. Future research could examine the role of other factors in encouraging functional activity, such as experienced barriers, and assess to what extent the perception of nursing staff corresponds with their actual behavior.
Collapse
Affiliation(s)
- Nienke O Kuk
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, MD, 6200, The Netherlands.
| | - Mirre den Ouden
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, MD, 6200, The Netherlands
| | - G A Rixt Zijlstra
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, MD, 6200, The Netherlands
| | - Jan P H Hamers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, MD, 6200, The Netherlands
| | - Gertrudis I J M Kempen
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, MD, 6200, The Netherlands
| | - Gerrie J J W Bours
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, MD, 6200, The Netherlands.,Research Centre for Autonomy and Participation of People with a Chronic Illness, Zuyd University of Applied Sciences, Faculty of Health, Heerlen, The Netherlands
| |
Collapse
|
10
|
Palese A, Del Favero C, Antonio Zuttion R, Ferrario B, Ponta S, Grassetti L, Ambrosi E. Inactive Residents Living in Nursing Homes and Associated Predictors: Findings From a Regional-Based, Italian Retrospective Study. J Am Med Dir Assoc 2016; 17:1099-1105. [PMID: 27575983 DOI: 10.1016/j.jamda.2016.07.010] [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: 03/21/2016] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES It has been amply reported that nursing home (NH) residents are largely inactive, a condition that may further increase functional decline, behavioral disorders, and risk of death. To date, studies have mainly focused on individual characteristics that may decrease residents' involvement in activities. Therefore, the aim of this study is to describe the prevalence of inactive NH residents in an Italian context, identifying predictors of inactivity at the individual and NH levels. DESIGN Retrospective regional-based study performed in 2014. SETTING All NHs (n = 105) located in the Friuli Venezia Giulia Region, northeastern region of Italy. PARTICIPANTS A total of 8875 residents with at least 1 nursing assessment and living in an NH for at least 1 year. MEASUREMENTS The dependent variable was inactivity in the last week, defined as the resident not being involved in any socially or individually based, or meaningful recreational (eg, gardening) activities. The independent variables were set at individual and NH levels. Aiming at identifying predictors of inactivity, a hierarchical generalized linear (mixed-effects) model incorporating both fixed-effect parameters and random effects, was performed. RESULTS A total of 4042 (45.6%) residents were inactive during the week before the evaluation. At the resident level, those with severe cognitive impairment [odds (OR) 4.462, 95% confidence interval (CI) 3.880-5.132], unsociable behavior (OR 2.961, 95% CI 2.522-3.473), night restlessness (OR 1.605, 95% CI 1.395-1.853), lack of cooperation in daily care (OR 1.408, 95% CI 1.199-1.643), pressure sores (OR 1.314, 95% CI 1.065-1.622), depressive disorders (OR 1.242, 95% CI 1.089-1.416), and clinical instability (OR 1.110, 95% CI 1.037-1.188) reported an increased risk of being inactive. At the NH level, for each additional hour of care offered by professional educators, there was 1% less likelihood of inactive residents (OR .964, 95% .933-.996). CONCLUSIONS Approximately one-half of the residents in this study living in Italian NHs are inactive. Inactivity is significantly associated with the presence of severe cognitive impairment, behavioral disorders (eg, unsociability, night restlessness, and lack of cooperation in daily care), pressure sores, depressive symptoms, and clinical instability. Moreover, receiving care from professional educators whose aim in their training program and professional mission is to improve individual and social engagement, decreased the likelihood of resident inactivity.
Collapse
Affiliation(s)
- Alvisa Palese
- Department of Medical Biological Sciences, University of Udine, Udine, Italy.
| | - Carolina Del Favero
- Department of Medical Biological Sciences, University of Udine, Udine, Italy
| | | | | | - Sandra Ponta
- Welfare Unit, Friuli Venezia Giulia Region, Italy
| | - Luca Grassetti
- Department of Economics and Statistics, University of Udine, Udine, Italy
| | - Elisa Ambrosi
- School of Nursing, University of Verona, Verona, Italy
| |
Collapse
|