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Sela Y, Levi-Belz Y. Nurses' Attitudes and Perceptions Regarding Suicidal Patients: A Quasi-Experimental Study of Depression Management Training. Healthcare (Basel) 2024; 12:284. [PMID: 38338169 PMCID: PMC10855615 DOI: 10.3390/healthcare12030284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
Suicide prevention is a priority globally. Community nurses are on the frontline of healthcare, and thus well placed to identify those at risk of suicide and act to prevent it. However, they are often ill-equipped to do so. This study examines whether depression management training for nurses may also help them manage suicide-risk patients. METHOD This quasi-experimental study used a questionnaire that included a randomly assigned textual case vignette, measures related to patient descriptions portrayed in the vignette, and demographic and clinical/training information. The participants were 139 Israeli nurses who were mostly Jewish, Israeli-born, and married women working as community nurses. Almost half had completed depression management training (DMT) in their routine work. RESULTS Nurses who completed depression management training were more likely than non-trainees to query the patient regarding mental status and suicide plans and were more likely to refer them to appropriate further treatment. The graduate nurses also reported higher self-competence and more positive attitudes regarding their ability to assess depression and suicide risk than nurses who had not received depression management training. DISCUSSION The results highlight the importance of depression management training, as suicide assessment and referral are among the major steps to suicide prevention.
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Affiliation(s)
- Yael Sela
- Ruppin Academic Center, Emek Hefer 4025000, Israel;
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Incidence and Severity of Depression Among Recovered African Americans with COVID-19-Associated Respiratory Failure. J Racial Ethn Health Disparities 2021; 9:954-959. [PMID: 33825114 PMCID: PMC8023522 DOI: 10.1007/s40615-021-01034-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 01/30/2023]
Abstract
Background Coronavirus disease (COVID-19) disproportionately affects African Americans, and they tend to experience more severe course and adverse outcomes. Using a simple and validated instrument of depression screening, we evaluated the incidence and severity of major depression among African American patients within 90 days of recovery from severe COVID-19-associated respiratory failure. Methods African American patients hospitalized and treated with invasive mechanical ventilation for COVID-19-associated respiratory failure in the intensive care unit (ICU) of Grady Memorial Hospital, Atlanta, between April 1, 2020, and June 30, 2020, were screened for depression within 90 days of hospital discharge using the validated patient health questionnaires (PHQ-2) and PHQ-9. Results A total of 73 patients completed the questionnaire. The median age was 52.5 years [IQR 44–65] and 65% were males. The most common comorbidities were hypertension (66%) and diabetes mellitus (51%). Forty-four percent of the patients had a diagnosis of major depressive disorder (MDD) based on their PHQ-9 questionnaire responses. The incidence of MDD was higher among females (69%, n=18/26) compared to males (29%, n=14/47), in patients > 75 years (66%) and those with multiple comorbidities (45%). Eighteen percent of the patients had moderate depression, while 15% and 22% had moderately severe and severe depression, respectively. Only 26% (n=7/27) of eligible patients were receiving treatment for depression at the time of this survey. Conclusion The incidence of depression in a cohort of African American patients without prior psychiatric conditions who recovered from severe COVID-19 infection was 44%. More than 70% of these patients were not receiving treatment for depression. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01034-3.
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Chu CH, McGilton KS, Spilsbury K, Le KN, Boscart V, Backman A, Fagertun A, Devi R, Zúñiga F. Strengthening International Research in Long-Term Care: Recommended Common Data Elements to Support Clinical Staff Training. Gerontol Geriatr Med 2021; 7:2333721421999312. [PMID: 33718524 PMCID: PMC7923973 DOI: 10.1177/2333721421999312] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 12/19/2022] Open
Abstract
The purpose of this study is to develop candidate common data element (CDE) items related to clinical staff training in long-term care (LTC) homes that can be used to enable international comparative research. This paper is part of the WE-THRIVE (Worldwide Elements to Harmonize Research in Long-Term Care Living Environments) group's initiative which aims to improve international academic collaboration. We followed best practices to develop CDEs by conducting a literature review of clinical staff (i.e., Regulated Nurses, Health Care Aides) training measures, and convening a subgroup of WE-THRIVE experts to review the literature review results to develop suitable CDEs. The international expert panel discussed and critically reflected on the current knowledge gaps from the literature review results. The panel proposed three candidate CDEs which focused on the presence of and the measurement of training. These three proposed CDEs seek to facilitate international research as well as assist in policy and decision-making regarding LTC homes worldwide. This study is a critical first step to develop candidate CDE items to measure staff training internationally. Further work is required to get feedback from other researchers about the proposed CDEs, and assess the feasibility of these CDEs in high and low resourced settings.
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Affiliation(s)
- Charlene H Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Katherine S McGilton
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | | | - Kim N Le
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Veronique Boscart
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | | | - Anette Fagertun
- Western Norway University of Applied Sciences, Bergen, Vastland, Norway
| | | | - Franziska Zúñiga
- Nursing Science, Department Public Health, University of Basel, Basel, Switzerland
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Elshatarat RA, Yacoub MI, Saleh ZT, Ebeid IA, Abu Raddaha AH, Al-Za'areer MS, Maabreh RS. Perinatal Nurses' and Midwives' Knowledge About Assessment and Management of Postpartum Depression. J Psychosoc Nurs Ment Health Serv 2018; 56:36-46. [DOI: 10.3928/02793695-20180612-02] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 04/26/2018] [Indexed: 11/20/2022]
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Lai CKY, Ho LYW, Chin KCW, Kwong EWY. Survival prediction among nursing home residents: A longitudinal study. Geriatr Gerontol Int 2017; 18:428-433. [PMID: 29139197 DOI: 10.1111/ggi.13197] [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] [Revised: 08/11/2017] [Accepted: 09/12/2017] [Indexed: 11/29/2022]
Abstract
AIM To determine the survival time and predictors of survival of residents in a nursing home. METHODS Nursing home residents admitted from June 2008 (when the nursing home started operating) to December 2012 (n = 230) to a new nursing home in Hong Kong were prospectively followed. The predictors of survival in the residents were assessed annually, with the exception of those who did not want to continue with the study, or were hospitalized, discharged from the nursing home or died, to compare changes occurring from 2008 to 2012. Cox's regression analysis was used to examine the predictors of survival. RESULTS A total of 66 of the nursing home residents (28.7%) died during the study period. The median length of survival was 20.46 months. Sex, the number of diseases, depressive symptoms, cognitive status and nutritional status were found to be significant predictors of survival. CONCLUSIONS It is crucial for healthcare providers to offer quality care to residents in long-term care to enhance their well-being in the final sojourn of their lives. Although there are no consistent reports of predictors in the international literature, it is important to address the modifiable predictors, as this might lead to improvements in the quality of life of the residents. Geriatr Gerontol Int 2018; 18: 428-433.
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Affiliation(s)
- Claudia Kam Yuk Lai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Lily Yuen Wah Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Kenny Chi Wing Chin
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Enid Wai Yung Kwong
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
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Sun Q, Cui C, Fu Y, Ma S, Li H. Nursing interventions in depressed children with low serum levels of BDNF. Exp Ther Med 2017; 14:2947-2952. [PMID: 29042908 PMCID: PMC5639410 DOI: 10.3892/etm.2017.4921] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 08/07/2017] [Indexed: 11/06/2022] Open
Abstract
The purpose of this study was to investigate the correlation between brain-derived neurotrophic factor (BDNF) in serum and depression in children, and explore the effects of different nursing protocols on patients with low levels of BDNF. We recruited 128 children with depression and 50 healthy subjects. Compared with healthy controls, the mRNA and protein levels of BDNF in serum were lower in children with depression (p<0.01). We selected 60 depressed children with low BDNF and randomly divided them in two groups: comprehensive nursing (n=30) and regular nursing (n=30). Compared to healthy children, there was a significant increase in Hamilton depression (HAMD) scores in patients with depression in childhood (p<0.01). After treatment, BDNF protein expression was higher in the comprehensive nursing group than that in the regular nursing group (p<0.05). Also, the HAMD score in the comprehensive nursing group was significantly lower than that in the regular nursing group (p<0.05). Compliance to treatment and quality of life after treatment improved in the comprehensive nursing group compared with the regular nursing group (p<0.05). Overall, a decrease in BDNF expression is closely correlated with depression, and comprehensive nursing care can significantly ameliorate the depression symptoms in pediatric patients, increase the BDNF expression, and improve compliance and quality of life. These results provide theoretical and practical significance for clinical nursing care of patients with depression in childhood.
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Affiliation(s)
- Qingrong Sun
- Department of Pediatrics, Binzhou City Center Hospital, Binzhou, Shandong 251700, P.R. China
| | - Chuanying Cui
- Department of Pediatrics, Binzhou City Center Hospital, Binzhou, Shandong 251700, P.R. China
| | - Yanxia Fu
- Department of Pediatrics, Binzhou City Center Hospital, Binzhou, Shandong 251700, P.R. China
| | - Shumei Ma
- Department of Cardiovascular Medicine, Binzhou City Center Hospital, Binzhou, Shandong 251700, P.R. China
| | - Hongxia Li
- Department of Obstetrics, Binzhou City Center Hospital, Binzhou, Shandong 251700, P.R. China
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Chun A, Reinhardt JP, Ramirez M, Ellis JM, Silver S, Burack O, Eimicke JP, Cimarolli V, Teresi JA. Depression recognition and capacity for self-report among ethnically diverse nursing homes residents: Evidence of disparities in screening. J Clin Nurs 2017; 26:4915-4926. [PMID: 28722775 DOI: 10.1111/jocn.13974] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To examine agreement between Minimum Data Set clinician ratings and researcher assessments of depression among ethnically diverse nursing home residents using the 9-item Patient Health Questionnaire. BACKGROUND Although depression is common among nursing homes residents, its recognition remains a challenge. DESIGN Observational baseline data from a longitudinal intervention study. METHODS Sample of 155 residents from 12 long-term care units in one US facility; 50 were interviewed in Spanish. Convergence between clinician and researcher ratings was examined for (i) self-report capacity, (ii) suicidal ideation, (iii) at least moderate depression, (iv) Patient Health Questionnaire severity scores. Experiences by clinical raters using the depression assessment were analysed. The intraclass correlation coefficient was used to examine concordance and Cohen's kappa to examine agreement between clinicians and researchers. RESULTS Moderate agreement (κ = 0.52) was observed in determination of capacity and poor to fair agreement in reporting suicidal ideation (κ = 0.10-0.37) across time intervals. Poor agreement was observed in classification of at least moderate depression (κ = -0.02 to 0.24), lower than the maximum kappa obtainable (0.58-0.85). Eight assessors indicated problems assessing Spanish-speaking residents. Among Spanish speakers, researchers identified 16% with Patient Health Questionnaire scores of 10 or greater, and 14% with thoughts of self-harm whilst clinicians identified 6% and 0%, respectively. CONCLUSION This study advances the field of depression recognition in long-term care by identification of possible challenges in assessing Spanish speakers. RELEVANCE TO CLINICAL PRACTICE Use of the Patient Health Questionnaire requires further investigation, particularly among non-English speakers. Depression screening for ethnically diverse nursing home residents is required, as underreporting of depression and suicidal ideation among Spanish speakers may result in lack of depression recognition and referral for evaluation and treatment. Training in depression recognition is imperative to improve the recognition, evaluation and treatment of depression in older people living in nursing homes.
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Affiliation(s)
- Audrey Chun
- Research Institute in Aging, The New Jewish Home, New York, NY, USA.,Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joann P Reinhardt
- Research Institute in Aging, The New Jewish Home, New York, NY, USA.,Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mildred Ramirez
- Research Division, Hebrew Home at Riverdale, RiverSpring Health, Riverdale, NY, USA.,Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Julie M Ellis
- School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
| | - Stephanie Silver
- Research Division, Hebrew Home at Riverdale, RiverSpring Health, Riverdale, NY, USA.,Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Orah Burack
- Research Institute in Aging, The New Jewish Home, New York, NY, USA
| | - Joseph P Eimicke
- Research Division, Hebrew Home at Riverdale, RiverSpring Health, Riverdale, NY, USA.,Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Verena Cimarolli
- Research Institute in Aging, The New Jewish Home, New York, NY, USA
| | - Jeanne A Teresi
- Research Division, Hebrew Home at Riverdale, RiverSpring Health, Riverdale, NY, USA.,Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA.,Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
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Abrams RC, Nathanson M, Silver S, Ramirez M, Toner JA, Teresi JA. A training program to enhance recognition of depression in nursing homes, assisted living, and other long-term care settings: Description and evaluation. GERONTOLOGY & GERIATRICS EDUCATION 2017; 38:325-345. [PMID: 26885893 DOI: 10.1080/02701960.2015.1115980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Low levels of symptom recognition by staff have been "gateway" barriers to the management of depression in long-term care. The study aims were to refine a depression training program for front-line staff in long-term care and provide evaluative knowledge outcome data. Three primary training modules provide an overview of depression symptoms; a review of causes and situational and environmental contributing factors; and communication strategies, medications, and clinical treatment strategies. McNemar's chi-square tests and paired t-tests were used to examine change in knowledge. Data were analyzed for up to 143 staff members, the majority from nursing. Significant changes (p < .001) in knowledge were observed for all modules, with an average change of between 2 and 3 points. Evidence was provided that participants acquired desired information in the recognition, detection, and differential diagnosis and treatment strategies for those persons at significant risk for a depressive disorder.
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Affiliation(s)
- Robert C Abrams
- a Departments of Psychiatry, and Geriatrics and Palliative Medicine, Weill Cornell Medical College , New York Presbyterian Hospital , New York , New York , USA
| | - Mark Nathanson
- b Department of Psychiatry , Columbia University and New York Presbyterian Hospital , New York , New York , USA
| | - Stephanie Silver
- c Research Division , Hebrew Home at Riverdale at RiverSpring Health , Bronx , New York , USA
- d Division of Geriatrics and Palliative Medicine , Weill Cornell Medical College , New York , New York , USA
| | - Mildred Ramirez
- c Research Division , Hebrew Home at Riverdale at RiverSpring Health , Bronx , New York , USA
- d Division of Geriatrics and Palliative Medicine , Weill Cornell Medical College , New York , New York , USA
| | - John A Toner
- e Department of Geriatrics , New York State Psychiatric Institute , New York , New York , USA
- f Stroud Center at New York State Psychiatric Institute , Columbia University , New York , New York , USA
| | - Jeanne A Teresi
- c Research Division , Hebrew Home at Riverdale at RiverSpring Health , Bronx , New York , USA
- d Division of Geriatrics and Palliative Medicine , Weill Cornell Medical College , New York , New York , USA
- f Stroud Center at New York State Psychiatric Institute , Columbia University , New York , New York , USA
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Stanyon MR, Goldberg SE, Astle A, Griffiths A, Gordon AL. The competencies of Registered Nurses working in care homes: a modified Delphi study. Age Ageing 2017; 46:582-588. [PMID: 28064168 PMCID: PMC5859996 DOI: 10.1093/ageing/afw244] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/21/2016] [Indexed: 11/12/2022] Open
Abstract
Background registered Nurses (RNs) working in UK care homes receive most of their training in acute hospitals. At present the role of care home nursing is underdeveloped and it is seen as a low status career. We describe here research to define core competencies for RNs working in UK care homes. Methods a two-stage process was adopted. A systematic literature review and focus groups with stakeholders provided an initial list of competencies. The competency list was modified over three rounds of a Delphi process with a multi-disciplinary expert panel of 28 members. Results twenty-two competencies entered the consensus process, all competencies were amended and six split. Thirty-one competencies were scored in round two, eight were agreed as essential, one competency was split into two. Twenty-four competencies were submitted for scoring in round three. In total, 22 competencies were agreed as essential for RNs working in care homes. A further 10 competencies did not reach consensus. Conclusion the output of this study is an expert-consensus list of competencies for RNs working in care homes. This would be a firm basis on which to build a curriculum for this staff group.
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Affiliation(s)
- Miriam Ruth Stanyon
- University of Nottingham, Division of Psychiatry & Applied Psychology, Institute of Mental Health, School of Medicine, Nottingham
, United Kingdom
| | - Sarah Elizabeth Goldberg
- University of Nottingham, Division of Rehabilitation and Ageing, Queens Medical Centre Medical School Nottingham, Nottingham NG7 2UH
, United Kingdom
| | - Anita Astle
- Wren Hall Nursing Home, Nottingham, United Kingdom
| | - Amanda Griffiths
- University of Nottingham, Division of Psychiatry and Applied Psychology, School of Medicine, Yang Fujia Building Jubilee Campus Wollaton Road, Nottingham NG81BB, United Kingdom
| | - Adam Lee Gordon
- University of Nottingham, Division of Medical Sciences and Graduate Entry Medicine, Medical School, Royal Derby Hospital Uttoxeter Road, Derby DE22 3DT, United Kingdom
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A Systematic Review of Interventions to Change Staff Care Practices in Order to Improve Resident Outcomes in Nursing Homes. PLoS One 2015; 10:e0140711. [PMID: 26559675 PMCID: PMC4641718 DOI: 10.1371/journal.pone.0140711] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 09/28/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We systematically reviewed interventions that attempted to change staff practice to improve long-term care resident outcomes. METHODS Studies met criteria if they used a control group, included 6 or more nursing home units and quantitatively assessed staff behavior or resident outcomes. Intervention components were coded as including education material, training, audit and feedback, monitoring, champions, team meetings, policy or procedures and organizational restructure. RESULTS Sixty-three unique studies were broadly grouped according to clinical domain-oral health (3 studies), hygiene and infection control (3 studies), nutrition (2 studies), nursing home acquired pneumonia (2 studies), depression (2 studies) appropriate prescribing (7 studies), reduction of physical restraints (3 studies), management of behavioral and psychological symptoms of dementia (6 studies), falls reduction and prevention (11 studies), quality improvement (9 studies), philosophy of care (10 studies) and other (5 studies). No single intervention component, combination of, or increased number of components was associated with greater likelihood of positive outcomes. Studies with positive outcomes for residents also tended to change staff behavior, however changing staff behavior did not necessarily improve resident outcomes. Studies targeting specific care tasks (e.g. oral care, physical restraints) were more likely to produce positive outcomes than those requiring global practice changes (e.g. care philosophy). Studies using intervention theories were more likely to be successful. Program logic was rarely articulated, so it was often unclear whether there was a coherent connection between the intervention components and measured outcomes. Many studies reported barriers relating to staff (e.g. turnover, high workload, attitudes) or organizational factors (e.g. funding, resources, logistics). CONCLUSION Changing staff practice in nursing homes is possible but complex. Interventionists should consider barriers and feasibility of program components to impact on each intended outcome.
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